Fitting Guide - Med-El
Contents
1. to eee a When selecting Start Measure ment the hearing implant gene rates an impulse sound across the whole frequency range for Ron popin bri EF lia mi ee ee et fee ee eee ooo v h se 1 tes a A O cee a eee At gt nm A de STAR the programs that have been selected This impulse sound is ka m ikke pi e mn li ps Bi H emm her y illes u mi its Er el mi ee a dao mi ee ee ciphered and analyzed by the microphones Select Optimise to apply the recommended settings Import and export of client data With the help of this tool client data can be imported and exported Start the tool by selecting Client DB Import Export from the file menu Exporting client data The saved client data can be exported by choosing between one several or all entries Figure x With the Show all button all the clients saved on the current workstation are displayed Entries can be selected from this list To define the location as to where the exported data should be saved insert the correspon ding file path and file name in the field Export client data to file After you have selected at least one entry the export process can be started by clicking on the Export button In a subsequent step the type of export has to be defined APPENDIXES DELEA 4 Sahit at iani Chert dotshass ct ee Dari dest dela to C Deo RW TEST abe Export data for standalone use SHS compatible data will be expor2. APPENDIXES Appendix III miniTek The SAMBA is equipped with a wireless connection which enables the user to connect to the Siemens miniTek M Due to the wireless connection of this remote control it is able to bypass ambient noise by picking up the clean target signal e g from a Bluetooth enabled source like a Phone TV or Music player Tele coil or a FM signal and transmitting it directly into the SAMBA audio processor without audible delay PRIOR TO FITTING THE CONNECTED AUDIO PROCESSOR TOGETHER WITH THE MINITEK REMOTE CONTROL IN CONNEXX PLEASE ATTACH THE REMOTE TO THE PC VIA USB USB TYPE A gt USB TYPE MINI B You can register the Siemens miniTekM remote instead of the MED EL Remote Control at the stage of first fit as de scribed in chapter IV By doing so please choose at least 4 hearing programs in the First Fit Navigator which should then be stored in the SAMBA as with the Siemens mini Tek remote there will be two of these programs especially assigned with the features in the Siemens remote P2 will be automatically set to Bluetooth Phone and P4 will be set as the Tek miniTek Audio TV program Tr zu Tek ad Remote Come Mirolmea Ei ping P LATI the min Tak iacta ES Lana am APPENDIXES If you want to add a Siemens miniTekM remote at a follow up fitting appointment this can be done bv clicking the Wireless Settings and Accessories button in Connexx and the Wireless
3. toolbar Save a complete fitting session To save a completed hearing instrument fitting and all associated data select Save Session in the File menu or click the highlighted icon in the toolbar Figure x The dialog box for saving a session will appear Figure x Session Comment Enter a comment for this fitting This comment will appear later in the session list Remark Please note that everything stored here is not stored in the user database It is only stored on your local Con nexx installation and these settings cannot be exported Dista 435 Sarg pei vut Dee to ona fii Hi ee cece ml eget Hees Prien Masidscisor VERSOS T MEDEL Mes hubiera Hi reir mi Seal rr Des T rie urieti Uni mi Filing Porman a AR MMA VO PP APPENDIXES Completion of this field is optional Fitting Select the data to be stored for this fitting by checking Audio gram right hearing instrument and or left hearing instrument The input fields Manufacturer and Hearing Instrument are automatically filled in and cannot be changed Enter the serial numbers of the hearing instruments in the input field Serial Number if desired By clicking Ok the selected fitting data is stored and Is available for later use The Ok button cannot be cho sen if no data has been selected By clicking Cancel the dialog box is closed and data is not saved Mute button Click on the loudspeaker symbol Figure x in the lower tool
4. ae musti a in lis as d BWAR ra window will sia l es A t Se pmm ge m f ka Tr appear Select D the Remote rl M safi Las en Ta Control tab activate the MED EL remote control via the checkbox and click on Ok The remote control allows the user to switch between the different fitting programs as well as to change the overall volume in each of these programs refer to volume control range on page xxx At this stage it is also possible to register an al ternative remote control e g the miniTekTM if avallable The miniTekTM remote control is property of Siemens Audiologische Technik GmbH 91058 Erlangen Germa ny and issold separately For further information and avallability please contact For technical details about the remote control please refer to the corresponding section in the SAMBA Inst ructions for Use IFU IF NO REMOTE CONTROL IS SELECTED ONLY ONE PRO GRAM IS AVAILABLE IN THE SAMBA AUDIO PROCESSOR Step 4 The First FIT Navigator After registering the remote control the The First FIT Navigator is started Click on Next to reach the Fitting Method screen The Fitting Method screen Acclimatization level and Fitting formula For the Bonebridge the fitting formulas DSL I O or NAL NLI can be used In addition for the Vibrant Soundbridge NAL NL2 is also available When using DSL I O or NAL NLI the setting of the Acclimatizati on Level refl
5. dialogue will open The two miniTek remote related programs mentioned above must then be set manually after registering the Siemens remote whereas the Bluetooth Phone program can only be chosen in program slot 2 For the Tek miniTek Audio TV program you can choose Slot 3 4 or 5 Input mode Bluetooth Phone Bluetooth Phone only Bluetooth Phone and microphone Bluetooth Level Microphone Level II an a II k non 2 1 y dE EdE Accessible manually Bluetooth Phone P2 If you want to add a Siemens miniTek M remote at a follow up fitting appointment this can be done by clicking the Wireless Settings and Accessories button in Connexx and the Wireless dialogue will open The two miniTek M remote related programs mentioned above must then be set manually after registering the Siemens remote whereas the Bluetooth Phone program can only be chosen in program slot 2 For the Tek miniTek Audio TV program you can choose Slot 3 4 or 5 Only if a Siemens miniTek M remote has been selected will the additional Input modes become available in the Microphone Bluetooth tab under Fine Tuning for the following Programs Input mode Tek miniT ek Microphone Telecol Tek 7 minil ek Bluetooth Phone mini ek FM mini ek Telecol Direct Audio Input FR Tek miniTek Audio TV Only if a Siemens miniTek M remote has been selected will the additional Input modes become availab
6. only is selected the speech and noise management is activated only if speech in noise is detected Sound Smoothing If activated the SAMBA detects loud and sudden sounds such as clattering dishes rustling paper or slamming doors which can be disturbing for hearing impaired people Sound Smoothing eliminates these sounds but does not affect speech intelligibility or soft impulsive sounds The recommended and default setting is Med Wind noise Reduction This feature is useful for outdoor use where wind generates unwanted noise in the audio processor s mi crophones This noise will be detected and selectively reduced whilst increasing the user s listening comfort Besides certain programs such as Music Wind noise Reduction is activated in most programs by default FeedbackStopper This technology achieves effective feedback suppression Please set one of the following options if feedback occurs Slow setting Feedback is only mildly reduced by keeping the sound quality constant This is ideal for users who are less bothered by occasional feedback 26 Frequency Shaping Compression Sound Management Speech and Noise Management Broadband Multichannel min max _ Speech in noise only Sound Smoothing Wind noise Reduction FeedbackStopper Slow Med Fast Microphone Bluetooth Instrument Settings Medium setting More effective feedback suppressi on with minor changes in sound qua
7. pt medel com MED EL UK Ltd MED EL UK Head Office office medel co uk MED EL UK London Office office medel co uk MED EL Corporation USA implants medelus com MED EL Latino America S R L medel ar medel com MED EL Colombia S A S Office ColombiaQmedel com MED EL Mexico Office Mexico medel com MED EL Middle East FZE office ae medel com MED EL India Private Ltd implants medel in MED EL Hong Kong Asia Pacific Headquarters office hk medel com MED EL Philippines HQ office ph medel com MED EL China Office office medel net cn MED EL Thailand office th medel com MED EL Malaysia office my medel com MED EL Singapore office sg medel com MED EL Indonesia office id medel com MED EL Korea office kr medel com MED EL Vietnam office vn medel com MED EL Japan Co Ltd office japanemedel com MED EL Australasia office medel com au i y a NI 00 N
8. red in the Audiogram tab Vibrogram First FIT Frequency Shaping Compression Sound Management Microphone Bluetooth Instrument Settings 5 E E E MN E MAM ales i lo alin li lis hi lie s E lo J li Ba ali i ales ali ao o a n als ali li d lio lis lis lio l engen Pr eg ae li maidahi pensa hing minga dog This jiprova AN ty e ppp kiaia a cree elie Arden eid Gr oge PE coral a eo rd aa Mas g Te fel PRC Ja 13 First FIT Entering the Vibrogram thresholds in the Audiogram Tab Open the Audiogram tab which is the first of five tabs in the Connexx software and insert the Vibrogram thresholds obtained This data will be used by Connexx to calculate the target gains for the audio processors THE VIBROGRAM THRESHOLDS MUST BE ENTERED USING THE AIR CONDUCTION AC SYMBOLS SEE ARROW PLEASE EXTRAPOLATE THE VALUES AT 125 Hz AND 250 Hz AS MARKED IN THE AUDIOGRAM ABOVE Step 3 Begin with the actual First Fit of the SAMBA audio processor After entering the Vibrogram thresholds click on de tect connected instruments in the Audiogram tab The Detect hearing instruments window will open FI a E ae KI OW gt Select New fitting go to FirstFit configurator and click on Ok You will be prompted in the Save session window to store changes from the previous session The audio pro cessor will be detected and the Remo te control configuration a
9. the suggestions made by the assistant Start the assistant by selecting Fitting Assistant from the Fitting menu Fitti ng Assistant Right Soung Feedback and Effects Environmental Sounds Bluetooth Froposal 1 Decrease gain for high freguencies Own voice is reverberant or hollow sounds like in a bucket 2 in general 2 at high frequency hearing loss Own voice is booming dull Own voice sounds occluded like in a tunnel like in a barrel feels plugged i Own Voice Is harsh sharp shrill metallic tinny Own voice is unnatural Own voice is nasal sounds like when you catch a cold Proposal e Decrease gain tor loud sounds at high frequencies Apply FOLLOW UP FITTING The Fine Tuning The Fine Tuning tab within the Connexx software allows the professional to further optimize the basic fitting according to the user s feedback In this tab the fine adjustments for the fitting of the SAMBA can be made Changes in specific Frequency Gain settings Maximum Power Output as well as Compression Sound management Microphone Bluetooth adjustments Instrument Settings and Vibrogram values can be made in this tab Proceed as shown in the steps below 1 Load client data either via CONNEXX or Noah 2 Select Fitting gt Detect to enable stored settings to be read out Or click on the detect connected instruments button Sa 3 Select t
10. the window during a conversation or conference making it much easier to listen in noise Omnidirectional The omnidirectional microphone should be used for music and outdoor programs FOLLOW UP FITTING Frequency Shaping Compression Sound Management Microphone Bluetooth Microphone System e Automatic Ambient Sound _ Speech in noise only Activation Threshold 54dB w Speech Tracking Directional Adaptive Lo Omnidirectional Input mode Microphone Instrument Settings Input Mode The Input Mode is automatically set to Microphone when using the MED EL remote control Other choices will only be available if a miniTek M is registered within Connexx FOLLOW UP FITTING Instrument settings In the Instrument Settings tab it is possible to enable or disable melody beeps which indicate the following situations Program change Plays a melody beep when swit ching through programs e Power on off To play a melody beep when the audio processor is switched on or off VC volume control change To indicate when the volume is changed e VC limit To indicate that the upper or lower limit of the volume control range is reached e VC Power on Position To indicate that the starting point power on position of the audio processor is reached while adjusting the volume Low battery Plays a melody beep when the battery power is low ENABLING THE CHECKBOX OF AN ALERT TONE IN ONE PROGRA
11. Business Unit Vibrant Fitting Guide SAMBA hearLlFE Table of Contents INTRODUCTION 3 I Introduction 7 II Setting up Hardware and Software 7 II Explain the device it s handling and functionality FIRST FIT 1 IV First FIT of the SAMBA audio processor BASIC TUNING 19 V The Basic Tuning FOLLOW UP FITTING 23 MI Follow up fitting 29 VII Listening programs in the SAMBA audio processor FURTHER INFORMATION 33 VIII Further Information APPENDIXES 37 Appendix The Curve Display 39 Appendix II Intelligent Sound Adapter 39 Appendix III miniTEK 41 Appendix IV Useful Connexx Tools 1 Introduction INTRODUCTION Introduction The new SAMBA with its key features Automatic Ambient Sound Intelligent Sound Adapter and Remote Con trol sees the beginning of a new era for VIBRANT MED EL s audio processors The Vibrogram function integrated within the SYMFIT software is now available for all SAMBA variants and for both the Vibrant Soundbridge and Bo nebridge implant systems Its sleek design allows for easier handling and gives users the option of personalizing their SAMBA by choosing from the wide selection of cover colours and designs The SAMBA Fitting Guide enables the professional to follow a straightforward fitting workflow which will lead to an efficient fitting session and successful outcome for each patient It provides step by step instructions and describes how the new fea
12. Erlangen Germany and are sold separately For further information and availability please contact Key functions in the SAMBA programs Universal The Universal program is stored under slot 1 It incor porates the Intelligent Sound Adapter with a specific evaluation of the user s listening behavior in the three sub sets Speech Noise and Music Noisy Environment Here the Directional Adaptive microphone is acti vated and the Speech and Noise Management is set towards the maximum Music The Music program is primarily intended for listening to music in situations without background noise It aims to provide a natural wideband sound for the SAMBA user All Sound Management features are deactivated and the microphones are set to Omnidirectional TV The TV program is primarily intended for listening to TV applications It aims to provide a natural wide band sound for the Samba user The microphone system is set to Omnidirectional mode Wind noise Reduction Is turned off whilst Speech and Noise Management as well as Sound Smoothing are both set to medium Phone Acoustically This program is intended for telephone applications It is aimed to provide speech intelligibility for the nar rowband telephone signal The microphone system is set to Omnidirectional mode Wind noise Reduction Is turned off whilst Speech and Noise Management as well as Sound Smoothing are both set to medium The FeedbackStopper is a
13. M AFFECTS ALL ACTIVATED LISTENING PRO GRAMS WITHOUT AN ACTIVATED REMOTE CONTROL SOME OPTIONS MAY BE DISABLED THE DEFAULT SET TINGS ARE SHOWN IN FIGURE X The Alert profile can be selected between Basic and Advanced The loudness of the alert tones can be set in 10 dB steps from 55 dB to 85 dB When the alert profile Basic is selected the frequency of the alert tones can be set to 500 750 1250 or 1500 Hz When the alert profile Advanced is selected the frequency of the beep is set automatically Frequency Shaping Microphone Bluetooth Instrument Settings Melody Beeps Program change wi Power onjott vic ww VC limit WC Power on Position wi Low Battery Alert protile Advanced v Loudness loud bdbE v Frequency v hhh A A A FOLLOW UP FITTING VII Listening programs in the SAMBA In general up to five programs can be activated in the SSAMBA for different listening situations If the MED EL remote control is registered in Connexx three out of five programs are activated by default When a Siemens miniTek remote is registered five programs will be activated in the SAMBA automatically including two special programs P2 Bluetooth Phone and P4 Tek M miniTek Audio TV All the parameters within the SAMBA can be modified and individually adjusted in each listening program The miniTek M remote is property of Siemens Au diologische Technik GmbH 91058
14. PRIATE VIEW OF THE CURVE DISPLAY PLEASE REFER TO APPENDIX Master gain If the overall volume of ll nied iain f x the system is reported x by the user as being l rre too loud or too soft it Horus pound can be changed with a the Master gain pooch i Lo mounda E Loudness a To improve the fitting it TATI SETA r is also possible to adjust Esad pueda y Se only the volume of loud sounds speech soft sounds and the volume of the user s own voice Sound Quality According to the information given by the user the sound quality can be changed by clicking on too sharp or too muffled The button too sharp will reduce the gain in the high frequencies and simultane ously increase the gain in the low frequencies making the sound more muffled The opposite effect will be achieved by clicking on too muffled ALL FREQUENCY DEPENDENT CHANGES CAN BE IMME DIATELY SEEN IN THE GRAPHICAL DISPLAY Remark The VSB is able to provide high frequency amplification which the user might not be used to in the beginning It may be necessary to reduce the gain in the high fre quencies at the first fit However the user may benefit from more gain in the high frequencies at a later stage If the user is implanted with a Bonebridge and is suffering from single sided sensorineural deafness the SYMFIT software offers an additional feature in the basic tuning tab The target curves of the SAMBA BB will be autom
15. T database you have installed via Settings gt Info about Database Please refer to the Samba IFU to check which version of the SYMFIT database is required for the Samba to be programmed correctly 2 The Samba Battery Pill is not properly inserted into the processor Please refer to the Samba IFU to learn how to connect the Battery Pill correctly 3 The hardware is not installed correctly Please refer to the user manual of the HI PRO box or NOAHLink for further advice Make sure that the HI PRO box is set up on a Serial port of COM to COM4 33 6 Appendixes Appendix The Curve Display In order to have the most intuitive view of the applied fitting strategy it is recommended to set a suitable input output Gain Curve Display figure x in the Con nexx software before carrying out the next steps In the curve display the relation between the following axes can be seen e x axis the Frequencies from 125 Hz to 8 kHz e y axis Gain or Output depending on the curve display visualization Three black lines and three coloured lines cherry red or teal depending on side can be seen in the curve display The coloured lines represent the target gain output that Connexx calculated in the first fit according to the audiogram for inputs of 40 dB soft sounds 65 dB conversational level and 90 dB loud sounds The black lines represent the current settings that are stored in the SAMBA and therefore the actual ga
16. TARTING POINT FOR THE FITTING PROCESS Starting the fitting session entering client data After starting up the Connexx software the Client List and Data window appears figure x Depending on whether the session is a first fit session or a follow up fitting a new client can be created Whereas the fields Last Name First Name and the Date of Birth must be filled in for a new client the data from an existing client can simply be retrieved l r w N i l First FIT Step Detecting that the SAMBA audio processor is connected The first step is the detection of the hearing instru ment via the detect connected instruments button on the toolbar figure x It is not necessary to select the audio processor vari ant at this point The detection function automatically recognizes which audio processor is connected Select Follow Up fitting go to Fine Tuning and click on Ok You will be forwarded to the Fine Tuning tab File Edit Fitting View settings Help s OA ar 2 oa PE Step 2 The Vibrogram The Vibrogram is a pure tone audiogram received by direct stimulation of the inner ear through the Vibrant Soundbridge VSB or the Bonebridge BB implant system By measuring the Vibrogram you are able to evaluate the appropriate levels of vibratory energy for each patient which can then be applied to the inner ear via the FMT VSB and BC FMT BB respectiv
17. atically adapted to the special needs of SSD users by clicking the SSD checkbox SSD y Master bain w Loudness loud sounds AFTER ADJUSTING THE FIRST FIT VIA THE BASIC TUNING SCREEN THE USER CAN BE DISCHARGED TO GAIN EXPERIENCE WITH THE DEVICE AND THE NEW HEARING SITUATION IT IS RECOMMENDED THAT THE USER MAKES A WRITTEN NOTE ABOUT HIS HER FIRST EXPERIENCES FOR USE IN THE FOLLOW UP FITTING SESSION 4 Follow up fitting Fine tuning for an ideal fitting is more relevant at a subsequent follow up visit after appropriate listening experi ences have been obtained by the VSB or Bonebridge user after their first fit session Fine tuning after 4 weeks of listening experience is an essential second stage of any fitting strategy and should include formal assessment As mentioned in the first fit chapter the user should be able to provide you with good information about the hearing experience for the follow up fitting AS WITH EVERY APPOINTMENT PLEASE CHECK THE MAGNET STRENGTH ASK ABOUT THE OVERALL In addition to the information found in this fitting FEELING WITH THE SAMBA AND THE AVERAGE DAILY guide the Fitting Assistant contained within the WEARING TIME SYMFIT software Figure x provides fitting and trou bleshooting suggestions for immediate adjustment during the actual fitting session Fitting adjustments in accordance to the user s feedback can be directly addressed with
18. bar to mute the SAMBA Click on the symbol a second time to unmute the SAMBA ahi Of y Wm 8 09 ii lt Program link When a change in one program is made it can be applied to all the programs by clicking on the marked symbols Figure x Binaural link For bilateral SAMBA users a setting for both audio processors can be changed simultaneously To apply a change to one program for the respective program on the contralateral side click on the marked symbols Figure x Critical Gain Measurement PP N PP N ase ED BOTEN o da If feedback occurs after activation the Feedback Can cellation svstem can be activated within the Speech Sound settings Furthermore programming adjust ments can be made to eliminate the feedback A suggested adjustment strategy is as follows start by increasing the compression kneepoint by a few incre ments in compression band no 8 If the feedback level Stays the same bring it back to the initial position and try the same strategy with the next compression band no 7 Continue until you have identified which band creates the feedback Note that this is the recommended manual procedure In addition an automated Anti Feedback analyzer is available by selecting Critical Gain Measurement in the Fitting menu Figure x Rabon komma fos free at ea ered Crew Gen Mesure rset 2 Laka et eet EP ATE A er ta Fan a iba Be eee Ps rw Fai eed ee ee ee or ar i sii
19. ects the user s experience with amplifi cation from conventional hearing aid systems Please set accordingly Volume Control Range The volume control range figure x defined by the Shaded area around the 65 dB gain curve allows you to select the amount of overall gain the user is able to set via the remote control from O dB up to 32 dB It is recommended to leave the pre defined 8 dB range as it stands Number of Programs The number of programs in the first fit can be chosen if the remote control has been previously selected see step 3 By default three programs are selected but you can choose up to five programs for the SAMBA audio processor Each program contains presets which are automatically optimized for different listening situ ations by the Connexx fitting software AT THE FIRST FIT IT IS RECOMMENDED TO ACTIVATE ONLY THE FIRST UNIVERSAL PROGRAM BY ACHIEVING A SATISFACTORY BASIC FITTING IN PROGRAM 1 YOU MAY ADD ADDITIONAL PROGRAMS ACCORDING TO THE USER S NEEDS AT A LATER STAGE HOWEVER IT IS ADVISABLE TO LET THE USER ACCLIMATIZE TO THE FIRST PROGRAM DURING THE FIRST WEEKS OF USING THE IMPLANT SYSTEM First FIT e Rice PALA Pe DL OA Le Li 40dB 50 30 125 250 500 tk 2k 4k amp k Hz Apply First FIT By clicking on Apply First Fit the first fit configurati on is completed and you will be automatically forwar ded to the Basic Tuning tab 3 Basic Tuning FOR AN APPRO
20. ely This innovative approach will give you a response of hearing thresholds at each measured frequency by directly driving the inner ear with the implant The levels obtained result in a spe cific individual dynamic range which allows you to create the most precise fitting to optimize the hearing benefit for each patient This method is applicable for both VSB and BB users independent from HL surgical technique and placement It can be performed with all versions of the SAMBA audio processor as well as for the Amad audio processors Loading the Vibrogram settings In order to obtain proper Vibrogram thresholds the necessary calibration settings are temporarily loaded into the audio processor Therefore in the Connexx main menu bar Fitting gt Test Settings should be selected and the corresponding Test settings window see Fig x will appear Now select Vibrogram Settings to load the calibrated test settings The audio processor is now placed over the implant coil on the patient s head DO NOT CLOSE THE TEST SETTINGS WINDOW UNTIL YOU HAVE PERFORMED THE VIBROGRAM 12 Testsetting for coupler and insitu measurements omnidirectional mode There is no testsetting active Please choose atestsetting by pressing the appropriate button The testsetting will be activated immediately Measuring the Vibrogram As you are already in the Fine Tuning section select the Vibrogram tab from the six
21. he option Follow Up fitting go to Fine Tuning and click OK 4 The Fine Tuning tab will open 5 Fine tune the audio processor in accordance to the user s needs Frequency Shaping In the first tab within the Fine Tuning screen the gain for each of the 16 individual frequency bands can be adjusted separately using a drag and drop method see figure x By marking several frequency bands with the mouse the gain in the user defined frequency areas can be changed quickly and easily The Maximum Power Output MPO The output limiter in the SAMBA can be modified in different frequency ranges Multichannel if the user experiences uncomfortably loud inputs in these frequencies 24 Frequency Shaping Gain ES a 14d6 za 01 05 14 35 8kHz Maximum Power Output G Broadband Multichannel 12db 15d6 21 dB 15d 01 05 14 als 8kHz Compression gain controls Frequencv dependent amplification for loud and soft input sounds It is possible to independently adjust the gain for soft sounds 40 dB the conversational level master gain and loud sounds 90 dB in up to 16 channels These settings will also result in automatically matched valu es of Compression Kneepoint and Compression Ratio as well as the gain in the respective equalizer bands Click the view options eyeglass button and select the number of channels you want to display for Frequency Shaping as well as for Compression settings Co
22. in output of the system for the same input levels JU 125 250 500 ik ak 4k OK Fiz Setting the desired curve display To display the correct values for the Vibrant Sound bridge and Bonebridge systems we recommend chan ging the default settings from the Connexx software in the curve display This can be achieved by selecting Settings gt Preferences in the menu bar The first tab shown is the Curve Display tab where the following settings have to be selected The change of curve display visualization only needs to be done once In following Connexx sessions these settings will be shown by default 1 Gain G or Output LO This defines whether the gain or the output of the system is displayed The output level for the Vibrant Soundbridge Is given in db SPL sound pressure level The output level for the Bonebridge is given in db FL force level ida Tia rias Type Tara Ger A ae Tega Gen bien ien pases bay w Target ers Oma SSF 3 ee Lire e dy oor lie rich le Co Ma Pen ada ini Pri biri Pla di cd TL AI 2 Coupler Type Set to Ear Simulator 3 Stimulus Set to Pure Tone APPENDIXES Appendix II Intelligent Sound Adapter With the Intelligent Sound Adapter the SAMBA can learn how the user likes to hear in different situations within just a few weeks When enabled this technology improves listening performance by automatically adjusting acou stic parameters to an individua
23. l s listening preference for different environments The result is an intuitive audio processor that automatically adjusts itself to suit user s listening preferences eliminating the need for manually changing the volume after the learning period Intelligent Sound Adapter is accessible under the DataLearning Logging dialog It is only available in Program 1 Universal Programs 2 and 3 It is only in Program 1 that the Intelligent Sound Adapter allows for a more specific evaluation of the user s listening behavior where it shows independent setting prefe rences for Speech Noise and Music Programs 2 and 3 support regular learning capabilities The Usage Analysis dialog shows logged informati on such as Wearing Time and Microphone Modes for each listening program Acoustical environment shows the percentage of times the user has been hearing speech noise and music This percentage is also reflected in the Usage Analysis pie chart By clicking the Gain Preferences tab you see learned gain settings for each of the three situations or clas ses under the Universal program When learning has occurred for one of the three situations an exclamati on mark will be displayed in the respective situation on the pie chart THE AUDIO PROCESSOR SHOULD BE WORN FOR AT LEAST ONE WEEK BEFORE ANALYSIS OF LOGGED DATA OPTIMAL LEARNED SETTINGS FOR ALL THREE CLASSES SHOULD BE OBTAINED AFTER APPROXIMATELY TWO WEEKS x
24. le in the Microphone Bluetooth tab under Fine Tuning for the following Programs For a detailed description of all Siemens miniTekM remote functions and capabilities please refer to the corresponding user manual The miniTekTM remote is property of Siemens Audiolo gische Technik GmbH 91058 Erlangen Germany and is sold separately For further information and availability please contact APPENDIXES Appendix IV Useful Connexx Tools Store and recall hearing instrument settings To store SAMBA settings for quick access and later use press the highlighted icon in the toolbar Figure x The following dialog box appears Figure x The hearing instrument type and date time are auto matically entered and cannot be altered Activate the checkboxes for the program settings which are to be stored for the SAMBA displayed A Comment can be added to the text field at the top of the menu which relates to this setting Click on the Store button to acknowledge the hearing instrument setting has been stored The hearing instru ment setting shown on the screen is stored perma nently in the client s data form If the setting is not to be stored click on the Cancel button to return to the main CONNEXX window For evaluation purposes it may prove useful to com pare the current settings with a previous fitting To recall previously stored SAMBA settings select Recall Settings in the Edit menu or click on the icon in the
25. lity Fast setting Fast feedback suppression should be used for individuals more prone to feedback interference Microphone Bluetooth Automatic Ambient Sound This mode is the default option in Program 1 Univer sal To take full advantage of this microphone setting and to fine tune its function it is possible to adjust the Activation Threshold at which the microphone switches from the omnidirectional to directional mode default is 54 dB This is the level that the environ mental noise has to reach before the directional microphone Is activated By selecting Speech in noise only the directional mi crophone will be activated only when speech in noise is detected When music or speech in quiet is detec ted the omnidirectional microphone is activated Speech Tracking Speech Tracking continuously scans sounds in the listening environment for speech patterns and sets the microphones maximum directivity towards speech regardless from which direction it originates With Speech Tracking the user can hear speech well in the presence of background noise even when it comes from behind or from the side This is ideal when driving a car or the user cannot look at the person he or she Is speaking to Directional Adaptive Directional adaptive microphones are focusing on sounds that originate in front of the user while they follow and reduce noises from other directions as they move for example if a truck drives by
26. mpression kneepoints ratio and time constant CK CR By clicking on show kneepoints individual adjust ments to the compression kneepoints compression ratio and time constant may be carried out by double clicking on the related box You can go back by clicking on show gain controls FOLLOW UP FITTING Frequency Shaping Compression show kneepoints gt gt ad mm a IbdE 1446 1346 16d6 d6 0 1 0 5 14 35 kHz Haster Gain ES 5dB 10dB 10dB 13dB 11dB 9dB 13dB 1dB 01 0 5 14 35 8kHz Gain for loud sounds LI 30dE 3dB SdB dB dB 8dB 6dB 946 2 E 0 1 0 5 1 4 3 5 kHz Sound Management Microphone Bluetooth Instrument Settings 25 FOLLOW UP FITTING Sound Management With the tools in this tab the Speech and Noise Management Sound Smoothing Wind Noise reduction and FeedbackStopper can be set These settings can support the user s hearing experience in different environmental situations figure x Speech and Noise Management This feature evaluates the noise currently detected by the SAMBA and maximizes both the hearing comfort and the speech intelligibility for each acoustical situation Multichannel allows noise attenuation in four frequency channels independently If the checkbox Speech in nol se
27. tabs available The Vibrogram table will appear figure x THE SAMBA AUDIO PROCESSOR MICROPHONES WILL BE AUTOMATICALLY DEACTIVATED DURING THE MEASURE MENT AND ARE REACTIVATED WHEN CLOSING THE TEST SETTINGS WINDOW PLEASE NOTE NEVER MUTE THE MICROPHONES MANUALLY DURING THIS PROCEDURE The method of obtaining a Vibrogram Is the same as obtaining an audiogram Please advise the patient ac cordingly It is recommended to start the measurement at 1 kHz and 30 dB above the patient s bone conduc tion threshold conditioning them to the stimulus Click on the corresponding symbol to activate the tone and start the measurement The tone will remain active until either another test tone is activated or the stop button is used Please note down the individual Vibrogram thresholds obtained for the whole frequen cy range since they won t be stored automatically Remark In cases where the dynamic range of the user is limi ted it might also be useful to obtain uncomfortable loudness levels UCL values with the Vibrogram tab and then transfer them into the Connexx audiogram Completing the Vibrogram measurement When the measurement is finished you can close the Test Settings window The following message will appear figure x Always select Yes in order to reprogram the previous settings as it is not the intention to leave the calibra ted test settings in the SAMBA The Vibrogram thresholds obtained can now be ente
28. ted NOAH import is not possible with this format Export data for use in NOAH NOAH compa tible data will be exported Here your NOAH user ID has to be entered Importing client data Client data can be added to the database via the import function Figure x by clicking on Import client data from file navigating to the file s location and selecting the appropriate file The Client database location displays the database to which the new data will be added If an NHA file is selected the whole list of clients which will be added during the import pro cess Is shown in the list field Click the import button to start the import process Remark Please be aware that importing client data is only pos sible with the identical version of the Import Export tool that you used for exporting the client data The client database is not compatible with earlier versions of Connexx impar Alar pr Ingest Cea dots Tan A 1 ETT JULK TST rhe Chart dotebase Cant ee tye MED EL GmbH Niederlassung Wien office at medel com MED EL Deutschland GmbH office medel de MED EL Deutschland GmbH Buro Berlin office berlinomedel de MED EL Deutschland GmbH Office Helsinki office fi medel com MED EL Unita Locale Italiana ufficio italiaemedel com VIBRANT MED EL Hearing Technology France office fr medel com MED EL BE office be medel com MED EL GmbH Sucursal Espana office es medel com MED EL GmbH Sucursal em Portugal office
29. tures of the SAMBA function ll Setting up Hardware and Software For hardware and software requirements please refer to the SYMFIT 7 0 IFU and the SAMBA IFU In addition you can find videos which demonstrate how to use the SAMBA audio processor They can be found by clicking on the demo tab within the Hearing Instruments sec tion of the Connexx software II Explaining the SAMBA s features and functions Take your time to explain to the user how the SAMBA Samba Hi sudio processor and the Remote Control function For a more detailed F Lauri dee carl instruction please refer to the SAMBA IFU In addition AAA you can find videos which demonstrate how to use the i rejd SAMBA audio processor They can be found by clicking v A on the demo tab within the Hearing Instruments ty eres iment cars section of the Connexx software Hearing insumerts 2 First FIT IV First FIT of the SAMBA audio processor The aim of this chapter is to offer you a simple yet efficient workflow for the initial fitting of the SAMBA audio processor It will direct you through the necessary steps in order to achieve a good First Fit with the aim of retur ning audibility with comfort and to eventually restore normal loudness perception This chapter is based on the Vibrogram fitting method which helps you to acquire an ideal foundation for the initial fitting process THE VIBROGRAM THRESHOLDS ARE RECOMMENDED TO BE USED AS A S
30. utomatically set to Fast Outdoor Sports The program Outdoor Sports is predominately inten ded for outdoor activities such as cycling or jogging Wind noise Reduction is activated and the micropho ne system is set with Omnidirectional characteristics The amplification in the lower frequency range is reduced and both Speech and Noise Management and Sound Smoothing are set to a minimum Privacy This program is intended for all applications where the SAMBA user does not wish to be disturbed by environmental sounds Hence the amplification is decreased by 10 dB for the whole freguency range The microphone system is set to Omnidirectional Speech and Noise Management is on minimum and Wind Noise reduction is deactivated The Sound Smoothing algorithm is set to its maximum in this program If you need assistance regarding the Connexx Soft ware please refer to the Connexx Help via the Help Menu gt Connexx Help or simply by pressing Fl on your keyboard If you need any further information regarding the fit ting of the SAMBA audio processor please refer to the Bild IFU Instructions for Use IFU For further information on our products please visit the MED EL website or contact us via email vi NOTE Troubleshooting gt If the Samba is not recognized correctly it might be due to one of the following reasons 1 The wrong SYMFIT version is installed You can check which version of the VIBRANT MED EL SYMFI
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