Operating Instructions Race Car Tympanometer
Contents
1. When a proper seal is detected the test status will change to testing The graphic of 16 Operating Instructions Race Car Tympanometer When the test is finished the following screen will appear I To test the other ear with RC animation first switch the ears with the L R button then press ENTER to start the animation Perform the test in the same way as stated above If a leak is detected during the test the following graphic will be displayed Leaking will be displayed at the top of the screen ASS as KaD Zire Stree ATT MAICO ey RETEST If the probe tip is blocked either by wax or up against the ear canal wall the same graphic will display But Blocked will be displayed at the top of the screen In either case remove the probe and re insert into the ear to re start the test 17 4 8 4 9 Operating Instructions Race Car Tympanometer How to print the test result button The quiet thermal printer prints out the example used in the previous After 10 of a test you can print the results for your records by pressing the Print paragraph in only six seconds While the printer is working no key MAICO Race Car Tymponamater ema action is possible and the probe is Te inactive figure Id No Patient sId number a Date Actual test date Name Name of the patient Examiner Name of the examiner Remarks Additional information abou2. ENTER Select item Put the probe tip s without ear tip into the hole of the test cavity labeled 0 5 ml Figure 6 The text on the display will request that the The RC main menu probe tip be inserted for the 2 ml calibration Put the probe tip in the 2 ml cavity Do this again for the 5 ml volume The RC will automatically change into the Calibration tympanometry mode The basic menu for Place the probe in the 5 ml cavity the impedance measurement appears again and you are ready for measurements If the error information Cavity Calibration Out of Range appears during the calibration please check if the opening of the probe tip is clean and try to recalibrate the probe If the error information appears again the probe or the instrument is Figure 7 probably in need of service Inform your The calibration screen Maico Special Instrument Distributor to get immediate help Operating Instructions Race Car Tympanometer 3 6 Getting familiar with the probe angles 0 60 and 80 It is adjusted by turning the locking screw at the bottom of the probe using a coin or a screw driver Adjust the probe head C by pulling it into the required position until it rests After it is set to the oO position tighten the fixation screw again The probe button can be used to select the required par i ii a test ear oe aes The color of the Orr light changes accordingly to red right ear or blue left ear
3. If leakage occurs the control light of the probe turns yellow and Leaking will appear under Status If the probe is blocked the control light of the probe turns yellow and Blocked will appear under Status Please proceed as described in chapter 3 6 Getting familiar with the probe To measure the other ear change the side by pressing the L R key or the probe buttonzand repeat the measuring procedure described above with the other ear 14 Operating Instructions Race Car Tympanometer 4 5 How to evaluate the tympanogram display After having completed a measurement you can see the results on the LCD On the left side of the display you see a graph of the tympanogram The area surrounded by the box is valid for normal tympanograms You can change the area or turn it off For details see chapter 10 Individual Setup of the RC Figure 14 In the top middle of the LCD Display of a normal tympanogram the words Right or Left indicate the ear chosen at the moment L Mi Tympanometer at the top right indicates that the reflex measurement has been switched off In the boxes to the right the following test measurements are displayed Ear Volume indicates the volume of the section of the auditory canal between the ear tip and the eardrum in ml in the example 0 94 ml Compliance indicates the maximum value of the compliance from the tympanogram in ml in the example 0 81 ml Pressure indicates t
4. Optional cccccsssccceeeeeeeessssssaeees 23 6 6 How to interpret the reflex GiSplay cccccccccseeeeecceeececeessstsseeeeeeeeeeeseeeesseaaees 23 6 7 How to print the test results s 1ncaccesciuadaniscdconmnbnninsaioisdeaaeei nuances 24 7 interpreting Test RESUItS cccccccccccceceeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeens 25 7A Understanding the printout ou caracvererrwsneenorusstevrasimea sistauuesainienrcnasdaenonumaunseutieurads 25 7 2 Interpreting the tympanometric test result cece ceeeeeeeeeeeeeeneeeeeeeeenteeeeees 26 T3 ADNOM MIG it ct ot TEE EER 26 S HOW to test CHIRON sivcsecisssvsniasssederanawertvaccdeverensdversvesscdenenieiunns 28 9 Additonal Reading snose 29 10 Individual Setup of the RC eect 30 Operating Instructions Race Car Tympanometer 10 1 WWE s tup MENU sinistros aae Eak a ERa Rat 30 10 2 The tympanometer setup wiicesicaicsdn viunicaiorsscbedevsavesiennauabcusnaudedenvedsbeamndcdeasdnndakedsvecs 31 10 3 The Setup menu for Reflex Test 00 00 0cccccsseeseeasecsccssseneesssseessneneersdenstecsaeesenees 32 10 4 The Common Setup MOI vis eaczaicecancis neesdeicinaiennemientetniiaindareiantelubsoueenntanmnicsdens 33 10 5 Insert your personal printout data s i issssssseiiiiiiisssserriiirrrrrssrrrrrrrrrrrrn 34 11 Care and maintenance of the instrument seseseseesseeeeeees 35 12 How to change the printer paper ccccceceeessesseseeseeneeneeeeees 36 13 Warranty maintenance and
5. Toes dou The color of the control light on the probe indicates your current operation A red control light indicates that the right ear is selected The system is ready for Figure 8 measurements As soon as The probe of the RC you have put the probe into the auditory canal the control light turns green Now the test is in progress Do not change the position of the probe until the green control light goes out indicating the end of the measurement A blue control light indicates that the left ear is selected The system is ready for measurements As soon as you have put the probe into the auditory canal the control light turns green Now the test is in progress Do not change the position of the probe until the green control light goes out indicating the end of the measurement A yellow control light indicates an error The kind of error is indicated on the LCD under status LEAKING The ear tip is not sealed in the auditory canal Change the position of the probe until the control light turns green If you are not successful use a bigger ear tip BLOCKED Indicates blockage in the probe opening Change the position of the probe so that it points straight into the auditory canal until the control light turns green If you are not successful check that the probe is not blocked with ear wax The complete probe insert can be changed by pressing the release button Q If the probe tip is clogged you can remove it by opening the fixat
6. The Setup menu for Reflex Test Select the menu option Reflex Test Setup Menu from the main setup menu as described before for the Tympanometry Setup Menu The reflex setup menu will appear on the LCD The reflex setup menu offers the following options Auto start dB With this option you can choose the starting acoustic pressure level if the automatic Reflex Test Setup Menu PAU COMES lame 80 Auto Maximum dB 105 identification of the reflex threshold is switched Reflex sensitivity Normal on You can choose the acoustic pressure levels Print graphic On from 70 dBHL to 100 dBHL in steps of 5 dB S00 tiz son 1000 Hz On Auto maximum dB 2000 Hz On 4000 Hz On With this option you can choose the maximum acoustic pressure level the RC uses if the automatic identification of the reflex threshold is T cnangeiem switched on You can choose maximum levels aan a a aA ME from 80 dBu to 110 dBHL in steps of 5 dB Figure 28 RC Reflex Setup Menu Reflex sensitivity auto start dB setup selected With this option select the sensitivity of the Stapedius reflex detection The Sensitive setting will achieve a Pass test result with a very small compliance change i e 0 03ml The Normal setting is the default setting i e 0 05ml With the Robust setting a larger compliance change is needed to detect a Pass i e 0 08ml Print graphic With this option the printout of the graphic reflex display ca
7. You are now ready to print 36 Operating Instructions Race Car Tympanometer 13 Warranty maintenance and after sales service 13 1 Warranty This warranty is extended to the original purchaser of the RC by Maico through the authorized Special Instrument Distributor from whom it was purchased and covers defects in material and workmanship for a period of one year from date of delivery of the RC Should the Maico RC require service due to a defect in material or workmanship Maico at its option will repair or replace the instrument at no charge except for transportation to and from the point of service It is the purchaser s responsibility to return the RC to the Maico Special Instrument Distributor from whom it was purchased or directly to Maico after receiving a return authorization This warranty does not cover breakage or failure caused by tampering misuse carelessness accident or modification The warranty is void if the instrument is serviced by other than an authorized Maico Special Instrument Service Center NOTE Specifications in this manual are in effect at the time of printing Maico reserves the right to modify or change specifications or design at any time without notice or incurring obligation WARNING The Maico RC is designed to be used with a hospital grade outlet Injury to personnel or damage to equipment can result when a three prong to two prong adapter is connected between the power plug and an AC o
8. after sales service 37 13A Wairahity a ee ree eee a E ee eee eee 37 132 Maintenance orse a E T ESE E EE EEEE 38 14 Safety regulations aanssnnnssnnnnnnnnnnnnnnnnnnnnnnnnnnnnn nnmnnn nnmnnn nne 40 14 1 Electrical safety ireren a E E EE 40 14 2 Measuring accuracy inicannaniarwainarcarnaariaayplainiarcaindo tian ilainiarca inion tian ladniarcaintatianyslainiirainds 40 14 3 Device control vncsinaintncbnruracimenreinsniasslstinenintatinastnanunditoielanutotageatsbiadualiansntabaandasd 40 15 Checklist for subjective device control nsnsnnnnnnnnnnnnnnnnnns 41 16 Technical Data and Accessories seeeseeeeeeeeeeeeeeeeeees 42 Operating Instructions Race Car Tympanometer Introduction Thank you very much for purchasing a quality product from MAICO This automatic Race Car RC Tympanometer is manufactured to meet all quality and safety requirements This user manual should make it as easy as possible for you to become familiar with the functions of the RC The description of the position e g of controls displays and connections found again in the text will make it easier for you to learn how to operate the RC If you have problems or have ideas for further improvements please get in touch with us Simply call Your MAICO team 2 2 1 Operating Instructions Race Car Tympanometer Description The RC is an automatic instrument that is designed for tympanometric screenin
9. an extremely small compliance change any movement of the probe during the test may produce an artifact false response The test result is recorded as Pass No Response and in graphical form If the tympanometric results display any abnormal findings the results of the acoustic reflex testing may be inconclusive and should be interpreted with care Theoretically a compliance peak is necessary to observe a reflex at peak pressure 3 3 1 Operating Instructions Race Car Tympanometer Getting started Your RC was carefully inspected and packed for shipping However it is good practice to thoroughly inspect the outside of the shipping container for signs of damage If any damage is noted please notify the carrier immediately Unpacking Remove the accessories Carefully remove the instrument from the shipping carton Remove the instrument from the plastic bag and inspect the case for any damage Notify the carrier immediately if any mechanical damage is noted This will assure that a proper claim is made Save all packing material so the claim adjuster can inspect it as well When the adjuster has completed the inspection notify the MAICO Special Instrument Distributor you purchased this unit from Save all the original packing material and the shipping container so the instrument can be properly packaged if it needs to be returned for service or calibration 3 1 1 Accessories Supplied Please check that all accessories listed bel
10. and should not be exposed to loud noise for at least 12 hours before the test The instrument must be calibrated according to chapter 3 5 of the operating intstuctions Instrument type Serial No Test person Connectors and cables OK Instrument and probe Is the green light of the probe blinking Probe tip and ear tip clean Are all controls easy to use Are the test signals clear and non distorted left ear 90 dBHL If significant differences or damages are found please send in for service repair Tested by Date 41 Operating Instructions Race Car Tympanometer Type Tympanometer Test frequency Test level Pressure range Volume range Accuracy Test time Compliance range Reflex measurement Test frequencies Test method Test level ipsilateral High freq option Test level contralat High freq option Attack release time ON OFF Ratio Pressure at test General Memory LCD display Printer Printing time Voltage Power consumption 16 Technical Data and Accessories Impedance measurement Clas 2 acc to ANSI 3 39 226 Hz 1 85 dBspL in 2 cm 200 to 400 daPa 0 1 to 6 0 ml 5 or 10 daPa Less then 3 seconds typical 0 2 to 3 0 ml 500 Hz 1 kHz 2 kHz 4 kHz 2 ipsilateral contralateral optional 70 GBH to 105 dBHL for 4 kHz to 105 dBu1 70 dBHL to 110 dBHL for 4 kHz to 105 dBu1 Typical 10 ms Greater than 70 dB
11. can produce both positive and negative pressure are connected with tube C Less sound is reflected to the microphone when the eardrum is stiff and the eardrum transmits the majority of the sound via the middle ear to the inner ear The highest compliance is normally reached with an air pressure corresponding to the outside pressure During a Tympanometry measurement a ac gt 9 4H continuous change of positive and Be negative pressure is produced by the pump of the instrument in the outer 2 6 auditory canal The compliance is measured simultaneously and shown in a 0 8 diagram the tympanogram which illustrates the compliance in ml over the pressure in daPa In Figure 12 the area 0 for normal tympanogram curves is hatched Here you can see that the highest compliance is reached with normal pressure When you create ice ml 08 1 6 3 Complian positive and negative pressure the Figure 12 eardrum stiffens the compliance Tympanogram decreases normal curve area is hatched So you can draw conclusions on the condition of the middle ear from the shape and the values of the tympanogram 13 4 2 4 3 4 4 Operating Instructions Race Car Tympanometer Preparing the patient Explain to the patient that the measurement is painless and that nothing enters the auditory canal The patient does not have to respond when there are loud test sounds or when the pressure in the auditory canal changes In no case s
12. pressing the Menu key 2 you can return from every sub menu to the main menu tympanometry mode T Change item You can change the menu options with the ENTER Select item up down left right cursor keys The menu option selected is highlighted on the LCD Figure 25 Setup in Figure 25 Accept the chosen RC main menu menu option by pressing Enter 10 1 The setup menu Select the menu option Setup as illustrated in Figure 25 and the main setup menu will appear on the LCD You can make different settings for the measurement of the tympanogram and the Stapedius reflex as well as the instrument setup for example the contrast of the LCD All your settings are saved permanently until you change them again The settings also remain when the instrument is switched off 30 Operating Instructions Race Car Tympanometer 10 2 The tympanometer setup Select the menu option Tympanometry Setup Menu as illustrated in figure 26 and the Tympanometer Setup Menu will appear on the LCD Change the menu options with the up down cursor keys Change the displayed item with the left right cursor keys The following settings are possible Main Setup Menu Pump speed With this option you can set the Renex Test Setup Menu measurement speed With Automatic Common Setup MENU the pump speed adjusts automatically to the Clinic Setup Menu test conditions It is possible to choose Minimum Medium or Maximum as well A lower pump spee
13. the instrument will not have stable pressure in the outer auditory canal In addition speaking causes Stapedius muscle reflexes which lead to a change in the compliance of the eardrum The child should be made familiar with the surroundings and the ear being touched by the probe in order to carry out a successful impedance measurement This could be done by getting in touch with the child and by playfully touching the ear with the probe If you can touch the ear without problems the child will normally accept the probe being inserted 28 Operating Instructions Race Car Tympanometer 9 Additional Reading Auditory Disorders A Manual for Clinical Evaluation Jerger Susan and James Jerger Boston College Hill Press 1981 Handbook of Clinical Audiology Katz Jack Baltimore William amp Wilkins 1994 Roeser s Audiology Desk Reference Roeser Ross J New York Stuttgart Thieme 1996 Auditory Diagnosis Silam Shlomo and Carol A Silvermann San Diego London Singular Publishing Group 1997 29 Operating Instructions Race Car Tympanometer 10 Individual Setup of the RC The RC offers many options for the experienced user to adapt the instrument to individual demands Main Menu The settings shown in the figures are the TA standard settings If you have altered a Sa Calibration value by accident you just have to return to ZTE the standard setting shown here and the instrument will work as before By
14. to you contact the factory at Maico Diagnostics 10393 West 70th St Eden Prairie MN 55344 Toll free 888 941 4201 Phone 952 941 4200 Fax 952 903 4200 Customers outside of North America and South America may contact Maico Diagnostic GmbH Sickingenstr 70 71 10587 Berlin Germany Phone 030 70 71 46 50 Fax 030 70 71 46 99 38 Operating Instructions Race Car Tympanometer Care of eartips The eartips supplied with your instrument are latex free silicone rubber and can be cleaned with a mild soap and water chlorine bleach or with alcohol Dry the tips thoroughly before replacing them on the probe Shipping instructions for recalibration or repair In the event it becomes necessary to return the instrument for recalibration or repair please follow these instructions 1 Place the instrument in the original shipping carton using the packaging provided Be sure to include all accessories as they are required for proper calibration 2 Enclose an explanatory letter describing the service you require carefully detailing any operational problems Be sure to include your name phone number the serial number and your full return address for return shipping 3 Ship prepaid to your Maico Special Instrument service center NOTE Warranty service is provided by your authorized Maico Special Instruments Distributor DO NOT ATTEMPT TO REMOVE THE INSTRUMENT CASE YOURSELF THIS SHOULD ONLY BE DONE BY AN AUTHORIZED MAICO SER
15. Pressure max compliance Storage of two complete test result sets Graphical display of the tympanograms and the reflex curves Numeric display of max compliance pressure at max Compliance canal volume gradient and reflex thresholds Thermal printer paper roll width 110 mm Between 4 seconds one tympanogram and 12 seconds tympanogram and reflex for both ears 96 240 V 50 60 Hz approximately 65 VA 42 Operating Instructions Race Car Tympanometer a Figure 4 Connectors on the rear of the RC Connection plugs A Power socket B Pressure tube C Probe D USB PC interface E Contra lateral phone option Warm up time less than 10 minutes after power on Environment conditions 15 to 35 C 59 to 95 F operation 5to 50 C 41 to 122 F storage Maximum humidity 90 storage and operation Dimensions 15 Wx 11 1 2 Dx4 H 39 cm W x29 cm Dx 11 cm H Weight approximately 5 5 Lbs 2 6 kg 43 Operating Instructions Race Car Tympanometer Accessories Standard 1 hand held probe 1 power cable 1 set of ear tips 1 calibration cavities cavities 5ml 2ml 0 5ml 1 printer paper roll for app 350 printouts Consumable 1 roll printer paper A pc 4 pc A pc A pc 4 pc A pc ear tips yellow 7 mm ear tips green 9 mm ear tips white 11 mm ear tips yellow 13 mm ear tips green 15 mm ear tips blue 18 mm Specifications are subject
16. T MAICO Operating Instructions Race Car Tympanometer MAICO Diagnostics 10393 West 70 Street Eden Prairie MN 55344 USA Toll Free 888 941 4201 Operating Instructions Race Car Tympanometer Table of Contents Page TREO GU CHOI resosi Ei EES 1 2 WSC MON s a a 2 2 1 TyYMPANOMETY vas ccncch enecseen conse a E O EA a 2 De ACOUSIC RETOX saree serena E ETE REEE E EE ARE EE ARA 3 3 Getting started sississesiciiceiansisneitisiccannnicarcnsswrsioanedvnsetivintenansmectesndaocdeisds 4 3l UAPACKN e are ee ee eee ere E E ES 4 3 2 Environmental conditions for the RC ceccnnsaisiccisniorscarcainacaremerncstnninccnundavaaseaanociinedtd 5 3 3 Preparing the RC for Use eee ne eee reer erence er eee 5 3 4 Getting familiar with the RC vz terccarvess secssrzenninitacncaceidivsesitexaseiettepanuansacidieseieeabee 6 3 5 Calibrate the probe s cceceiutioncavabavaestdatebcaciinsesaasd a leadoneh iebessaadeadatehiuhe sand iacaabdeaasdeloees 9 3 6 Getting familiar with the probe ciacecsicesseeesdencduiicecadenionmendscantbesaneatancenatanienneedee 10 3 7 Choose an appropriate ear tip aise ccs cienccnineasaaeouninuignavunidsiesuveseiniaenediundeandnndeneaenads 11 4 How to create a tympanogram ccecececeeeeeeeeeeeeeeeeeeeeeeeeeeeeeees 12 4 1 The basics of the impedance measurement ccccsseccecceeccceestssteeeeeeeeeeeeeeenees 12 4 2 Preparing the PAIS sss catecte essere cadiesaalsstocbite chadlaviusestinvinichedinaunledanoi
17. VICE TECHNICIAN 39 Operating Instructions Race Car Tympanometer 14 Safety regulations 14 1 Electrical safety The RC tympanometer is constructed to comply with protection class Il of the international standard IEC 601 1 EN 60601 1 The instruments are not intended for operation in areas with an explosion hazard 14 2 Measuring accuracy To guarantee that the tympanometer works properly the instrument has to be checked and calibrated at least once a year The service and calibration must be performed by an authorized service center The use of non calibrated tympanometers is not allowed 14 3 Device control The user of the instrument should perform a subjective instrument check once a week This check can be completed following the list for subjective instrument check see next page For your own security you should copy the enclosed list fill it in once a week and store it in your files 40 Operating Instructions Race Car Tympanometer 15 Checklist for subjective device control According to the manufacturer requirements the user should test the instrument once a week This is to find errors immediately and to avoid inaccurate test results This test should test tympanogram and reflex with an otologic normal person and compare the results with earlier measurements The printout should be filed together with the subjective test protocol to document the instrument test The test person should be healthy no otitis etc
18. d creates a higher precision of the measurement but needs more test time ENTER an oe MENU Exit Display limits Figure 26 On displays normative boundries in the BG Setup ment tympanogram test Screen Off turns it off Tympanometry Setup Menu Press Limit hi With this option you can set the right limit of the normative box display on the Display Limits Oh tympanogram test screen Values can be POSS ey 4109 dapa set between O daPa and 200 daPa in steps Press Limit Lo 1 200 dap of 25 da Pa Compl Limit Hi 1 5 ml n Limitlo 0 1 daP Press Limit lo Compl Limit lo ely Here With this option you can set the left limit of the normative box display on the Te changelon tympanogram test screen Values can be 4 gt Change item setting MENU Exit set between 400 daPa and 25 daPa in Figure 27 steps of 25 daPa RC Tympanometer Setup Menu Comp limit hi pump speed selected ei ed E Fi a og aeons With this option you can set the upper limit eSP aV An a SROS AECE of the normative box display on the tympanogram test screen Values can be set between 0 1 ml and 3 ml in steps of 0 1 ml Comp limit lo With this option you can set the lower limit of the normative box display on the tympanogram test screen Values can be set between 0 1 ml and 1 0 ml in steps of 0 1 ml To leave the Tympanometry Setup Menu press the Menu button 31 Operating Instructions Race Car Tympanometer 10 3
19. d other accessories use a soft damp cloth use warm soapy water no liquids containing alcohol or ammonia should be used to gently wipe the area clean During cleaning please ensure that no liquid runs into the switches level control or probe openings 35 Operating Instructions Race Car Tympanometer 12 How to change the printer paper At the right side of the housing pull the printer cover up using its finger recess in the front of the printer cover Remove the printer cover Remove the empty paper roll Place the new paper roll in the paper compartment in such a way that the paper unrolls from the bottom side of the roll Pull the blue lever which is located on the right front of the printer forward into position The paper must feed from the bottom because it is only coated on one side If it is inserted wrong no printout will be visible Gently insert the paper end in between the rubber roll and the black plastic part at the rear of the printer Feed the printer paper until it appears from the upper part of the rubber roll Feed about 4 5 inches of paper from the roll Push the blue lever back into its backward position Guide the paper end through the paper slot of the printer cover Close the printer cover by putting the two guide rails at the end of the printer cover into their appropriate slots in the paper compartment of the housing of the RC Press the front of the printer cover down until it fastens
20. dalvenmnauleaiideatabadeviat 14 4 3 Preparing the measurement x0 c0 sopeidcdinacetaranieddeadesteyidediondemerdaateadaanuus 14 4 4 Measuring the tympanogram sssssssssssiissesiiinntstiiintttirinnttttrrnrttrrnn memento 14 4 5 How to evaluate the tympanogram display ccccccceeeceeeceeeeeeeseeeeeeeeeeeees 15 4 6 Performing the tympanometry test W ANIMATION eee ceeeeeeeeeeeteeeeeeeeeteees 16 47 Graphicsand SPO SING sei anncoiacasnedmientnadionan cktniseateadsaaaiuannseiinadnaan EA EEE EANAN eE 16 4 8 TOW to print the test result sssssssniiiinssssessuniiiiiirsssessiiiirrrrnnssrrrrrrrrrrrnnneeen 18 4 9 How to delete the test results ssnnnnnnssninnnesnniinneniitnretitinnetirrrrrtrrnnrrrrrrnr een 18 5 How to create a tympanogram with high probe tone 19 5 1 To select high probe tone frequency cccccccsscccceeccccecesssseeeeeeeeeeeeeeeettssaaeeeeeeeees 19 6 How to measure the Stapedius reflex ccccccccceceeeeeeeeeeeeeees 20 6 1 The basics of the Stapedius reflex measurement ccc ccceeceeeeeeeeeeeceeeettssanaees 20 6 2 Preparing the PAUISINT i 20ns coucnstececuacnedemanemasetdcdudotungmaaneddanenmeniaesteataauadennesuntoise 20 6 3 Preparing the ipsilateral measurement cccccceeccecceeccceessssseeeeeeceeeeeeeettttaaaees 21 6 4 Taking the ipsilateral measurement ccceeeecceeeeeeeeeeeeeeeeeeeeeseeteeeeeeeeeeeeeees 22 6 5 Preparing the contralateral measurement
21. eported as the tympanogram width at half of peak compliance expressed in daPa A limits box is available on both the display and printout to aid in diagnosis Compliance is measured with respect to an equivalent volume of air with the scientific quantity milliliter ml Air pressure is measured in deca Pascals daPa NOTE 1 02 mm H20 1 0 daPa Operating Instructions Race Car Tympanometer 2 2 Acoustic Reflex An acoustic reflex or contraction of the Stapedius muscle occurs under normal conditions when a sufficiently intense sound is presented to the auditory pathway This contraction of the muscle causes a stiffening of the ossicular chain which changes the compliance of the middle ear system As in tympanometry a probe tone is used to measure this change in compliance When the stimulus presentation and measurement are made in the same ear by means of the probe this acoustical reflex is referred to as an ipsilateral acoustic reflex When the stimulus presentation and measurement are made in opposite ears the reflex is referred to as a contralateral acoustic reflex For best results this reflex measurement is automatically conducted at the air pressure value where the compliance peak occurred during the tympanometric test Stimulus tones of varying intensities at 500 1000 2000 or 4000 Hz are presented as short bursts If a change in compliance greater than 0 05 ml is detected a reflex is considered present Because this is
22. est Results Pass Fail and ipsi contra or tympano gram depending on the test you have performed This information provides the data you need to interpret the test results A graph of the tympanogram is provided Figure 24 to assist you in a visual interpretation of the test This graph is a representation of the relative mobility of the middle ear system The horizontal axis shows the changes in air pressure and the resulting mobility of the system The compliance is recorded on the vertical axis This mobility is expressed as a change in the volume of the ear canal in ml The reflex is shown in up to four graphs with time on the horizontal axis and the change of the compliance on the vertical axis 25 MAICO Race Car Tymponamater Figure 24 Printout of a normal tympanogram 7 2 7 3 Operating Instructions Race Car Tympanometer Interpreting the tympanometric test result As a general rule values for ear canal volume should be between 0 2 and 2 0 ml children and adults A variance will be seen within this range depending on the age and ear structure of the person For example a 2 0 ml or larger reading in a small child could indicate a perforation in the tympanic membrane while it may be a normal reading in an adult You will become more familiar with the normal ranges when you use the instrument The normal range for compliance is 0 2 ml to approximately 1 8 ml A compliance peak within the range i
23. f instrument and software version for a moment Then the basic measuring figure appears The RC should be switched on about 10 minutes before the first measurement to guarantee precise measuring results If the device has been cooled down e g during transport please wait until it has warmed up to room temperature Operating Instructions Race Car Tympanometer 3 4 3 The display of the RC The test result is shown during the measurement on the LCD The measurements are saved automatically and can be primen out in a fast and quiet way with the integrated printer r a a In figure 5 the initial empty m measurement screen is shown Fea The measurement screen shows actual settings test results and the graphical display of the tympanogram and reflexes From left to right the top line shows the type of test impedance is shown in Figure 5 the selected test ear left or right and the selected reflex test 057 contra optional or tympanogram if no reflex test is selected Figure 5 At the left center the graph of The measurement screen of the RC the tympanogram is shown At the right five boxes show the status and test values The upper box shows the actual status of the instrument READY means that the instrument is ready for testing IN EAR shows that the probe is inserted in the ear TESTING means that the test is in progress BLOCKED means that probe is blocked in the ear LEAKING indicates
24. flex measurement It is very important that the patient does not move because a reflex can be registered with a change of compliance of 0 05 ml 20 Operating Instructions Race Car Tympanometer 6 3 Preparing the ipsilateral measurement The LCD shows the empty tympanogram for the right ear and the control light of the probe is red oo l To measure the left ear change the side by pressing the L R key or the probe button The selected test ear shown in the middle top of the LCD will change from Right to Left and the control light of the probe will turn blue H L f D Turn the reflex measurement on by pressing the Reflex key The word Ipsi must appear at the right top of the display The sound stimuli for the reflex measurement are reproduced by Figure 19 the receiver integrated in the Display Tympanogram and reflex probe ready for measurement Set the desired intensity level with the down up keys On the LCD below the reflex boxes at the bottom the selected level in dB Figure 19 80 dB appears The I indicates that an ipsilateral test is selected You can choose between the fixed levels 70 75 80 85 90 95 and 100 dBH and Auto If you choose Auto the RC starts with the preset level and increases the level automatically until a reflex is registered or the maximum value is reached You can choose your individual starting level and maximum level If you have chosen a fixed level the ins
25. g Tests done in the tympanometric screening mode measure middle ear mobility and ipsilateral acoustic reflex Contralateral acoustic reflex is available as an option Test results are displayed on the front panel LCD liquid crystal display screen and may be printed The design of the RC allows rapid and reliable measurements This equipment is designed for middle ear function screening PC Interface A USB interface for data transfer to a connected computer is built in Tympanometry Tympanometry is the objective measurement of middle ear mobility compliance and pressure within the middle ear system During the test a tone 226 Hz or 1000Hz is presented to the ear canal by means of the hand held probe This tone is used to measure the change in compliance in the middle ear system while the air pressure is varied automatically from a positive value 200 daPa to a negative value 400 daPa max Figure 1 The middle ear Maximum compliance of the middle ear system occurs when the pressure in the middle ear cavity is equal to the pressure in the external auditory canal This is the highest peak of the curve as it is recorded on the chart The position of the peak on the horizontal axis and on the vertical axis of the chart will provide diagnostic information regarding the function of the middle ear system Examples of normal and abnormal tympanograms can be found in a later section of this manual Gradient calculations are r
26. he pressure with the highest measured compliance in the example 37 daPa Gradient calculations are reported as the tympanogram width at half of peak compliance expressed in daPa in the example 32 daPa 15 Operating Instructions Race Car Tympanometer 4 6 Performing the tympanometry test w animation NOTE Animation must be turned on in set up menu see section 10 4 the commom set up menu e Press ENTER to activate the RC animation e INSERTING THE PROBE While the child is distracted by the graphics Place the hand held probe with proper ear tip inside the child s ear while gently pulling the earlobe down Check for excess wax or obstructions Because children have very small ear canals this allows the operator to maintain a seal easily NOTE The ear tip does not need to go into the ear canal It should only seal the canal opening Attempt to point the end of the ear tip into the canal toward the eardrum Depending on the child or larger size ear tip may be needed to secure a proper seal 4 7 Graphics and screens The Race Car Tympanometer or Race Car Tympanometer W Audiometer will show different graphics throughout the test In addition the status of the test will also be indicated at the top of the screen When the Insturment is ready to test the following screen will appear Ready Status will be indicated at the top of this screen When the probe is inserted into the ear the status changes to in ear
27. hould the patient swallow chew or move during the measurement Preparing the measurement The LCD shows the empty measurement screen for the right ear and the control light of the probe turns red TQ measure the left ear change the side by pressing the L R key or the probe puton M Then the selected test ear shown in the middle top of the LCD will change from Right to Left and the control light of the orobe will turn blue Switch off the reflex measurement by pressing the Reflex key The word Tympanometry must appear at the right top of the display Make sure the auditory canal is clear Choose an ear tip according to the size of the auditory canal and put it firmly onto the probe tip see Figure 9 in chapter 3 7 Measuring the tympanogram Take hold of the top of the outer ear and oe it back Insert the probe with the ear tip into the auditory canal until the control light of the probe is green indicating the start of the test Do not move the probe until the green light goes out the patient must not swallow or speak during the measurement During the test the LCD will display the tympanogram on the left side as the test is running and then the values will appear on the right side After about 4 5 seconds the test is completed Figure 13 and the green light turns off Measurement screen only tympanogram Now you can remove the probe from the ear Hii If an error occurs during the measurement the test will stop
28. ion ring D After cleaning the probe tip or attaching a new one the tip must be fixed again The probe of the RC is shown in figure 8 The probe head is Catt to three 10 3 7 Operating Instructions Race Car Tympanometer fastening the fixation ring Choose an appropriate ear tip Choose an ear tip of the appropriate size from the ear tip set Put the ear tip tightly on the probe tip The probe tip should end near the end of the ear tip It should not be inserted more than about 1 mm inside the ear tip or just protrude out of the ear tip see Figure 9 By choosing an appropriate ear tip and placing it correctly on the probe you create the basic conditions for measurements without problems and mistakes Now all preparations are concluded and you can start the impedance and reflex measurement Please read the following chapters min 0 mm max 1 mm Figure 9 Proper placement of ear tip 11 Operating Instructions Race Car Tympanometer 4 How to create a tympanogram In the following paragraph we will briefly explain the principle and the background of the impedance measurement to create a better understanding If you want to begin the measurements immediately just skip this paragraph and continue reading section 4 1 4 3 Preparing the Measurements The basics of the impedance measurement The impedance measurement assists in diagnosing of the condition of the middle ear and can therefore not be compared di
29. n be turned on or off for documentation 500 Hz The Stapedius reflex test can be turned on and off with this option 1000 Hz The Stapedius reflex test can be turned on and off with this option 2000 Hz The Stapedius reflex test can be turned on and off with this option 4000 Hz The Stapedius reflex test can be turned on and off with this option To leave the Setup Menu for reflex press the Menu button 32 Operating Instructions Race Car Tympanometer 10 4 The Common Setup Menu Select the menu option Common Setup Menu from the main setup menu The common setup menu offers the following options Power up Choose the test mode of the RC after Common Setup Menu switching on With the Tymp setting only Acsi a OaE N Baud Rate 57600 tympanometry is tested after power up AT IR With Tymp and Reflex tympanometry and Subject Data Printout On Clinic Data Printout On reflex are tested after power up Print after Test Off Baud Rate Race Car On Language English Set the transmission speed of the serial data Display adjust interface Possible settings are 57600 Baud or 38400 Baud T Change item Remote Switch Figure 29 Change the function of the probe button RC Reflex Setup Menu You can choose between auto start dB setup selected L R the test ear can be selected with the probe button Pause the test can be paused and restarted with the probe button L R or Pause both the_test ear and
30. ndicates normal mobility of the middle ear system A peak found outside of these limits may indicate one of several pathologies Middle ear pressure should be equivalent to ambient air pressure 0 daPa on an air pressure scale Minor shifts of the peak compliance to the negative may occur with congestion and are rarely to the positive side Establish criteria for abnormal negative pressure when you become more familiar with using the equipment It is generally accepted that negative pressure of greater than 150 daPa indicates a referral for medical evaluation A normal tympanogram is shown on the previous page in figure 24 Abnormal Values It is the purpose of this section to provide samples of tympanograms which reflect abnormal states of the middle ear mechanism It is not the intention of this section to provide you with a complete guide to interpreting results Complete information regarding pathologies and abnormal impedance testing can be found in the literature referenced A perforation in the tympanic membrane will cause a high ear canal volume measurement because the instrument will measure the volume of the entire middle ear space The RC may refuse to run the test with the probe indicating a volume out of tolerance by illuminating the red light or a flat tympanogram will be recorded since no movement will occur with a change in air pressure An extremely flaccid tympanic membrane or an ossicular chain discontinuity will yield a ve
31. ow are received in good condition If any accessories are missing or damaged immediately notify your MAICO Special Instrument Distributor Description Part No Hand held probe 570G 14 24 count eartips kit 6613 4 yellow 7 mm 6643 4 green 9 mm 6644 4 white 11 mm 6645 4 yellow 13 mm 6646 4 green 15 mm 6647 4 blue 18 mm 6648 Thermal printer paper 5529 Calibration test cavity 5533 Operating Instructions 1162 0321 Optional Accessories Soft sided carrying case 1035 3002 Contra button phone and cable 4796 Contra TDH 39 phone and cable 4682 Operating Instructions Race Car Tympanometer 3 2 Environmental conditions for the RC The RC should be operated in a quiet room The test room must be at normal temperature usually 15 C 59 F to 35 C 95 F and the instrument should be switched on about 10 minutes before the first measurement to guarantee precise measuring results If the device has been cooled down e g during transport please wait until it has warmed up to room temperature 3 3 Preparing the RC for use 3 3 1 Connect probe and accessories Connect the probe cable to socket c on the rear of the instrument Insert the plug into the socket and secure the connection by fastening the two screws of the connector Insert the pressure tube into the socket and press it until it is secure on the socket connection socket and then plug it into a power Put the enclosed power cable in
32. rease in compliance and is caused by loud acoustic stimuli Regardless whether the acoustic stimulus is active on the left or on the right or on both sides Figure 16 the Stapedius reflex is always The middle ear binaural i e it occurs in both ears at the same time The Stapedius reflex is elicited by sound pressure levels between 70 and 105 dB in ears of adults with normal hearing In the probe ear the reflex method continuously measures the compliance at peak pressure as indicated by the tympanogram Simultaneously the stimulus ear is irritated by the sound which causes the contraction of the Stapedius muscle The ipsilateral reflex measurement uses the same ear for the p probe and the stimulus The contra lateral measurement uses different ears for the probe and the stimulus The acoustic stimulus is applied to the ear opposite the probe ear Figure 17 l l Ipsilateral If the applied stimulus causes a reflex the impedance Pa EU RR measuring instrument registers a decrease in compliance in the probe ear which indicates a Stapedius reflex at the actual test frequency and the test level The lowest _h b test level at which a reflex occurs is called a reflex threshold and is shown in dBut dB hearing level Preparing the patient Figure 18 soa i Contralateral test In addition to the general introduction described in chapter 4 2 explain to the patient that loud test sounds will occur during the re
33. rectly with other audiometric tests such as sound or speech audiometry which assists in the measurement of hearing Furthermore the impedance measurement is an objective measuring method which does not depend on the cooperation of the test person and can therefore not be falsified by the patient The two most important impedance measuring methods possible with your RC are tympanometry and the measurement of the Stapedius reflex which is discussed in chapter 5 How to measure the Stapedius reflex Figure 10 The middle ear loudspeaker manometer Figure 11 Principle of the impedance measurement 12 Operating Instructions Race Car Tympanometer The impedance measurement examines the acoustic resistance of the middle ear If the eardrum is hit by a sound part of the sound is absorbed and sent via middle ear to the inner ear while the other part of the sound is reflected The stiffer the eardrum the more sound reflected and therefore less sound reaches the inner ear Inside the probe of the impedance measuring instrument a small loudspeaker is installed which emits a tone through a tube Figure 11 A into the auditory canal before the eardrum Another tube Figure 11 B is connected to the microphone inside the probe which receives the sound Together with a third tube Figure 11 C all three are inserted nearly to the eardrum and are made airtight against outside pressure by the ear tip A manometer and a pump which
34. ry high peak compliance in the presence of normal middle ear pressure Ear canal volume will be normal and the reflex will be absent A fixation of the ossicular chain as in otosclerosis will produce a tympanogram with very low compliance in the presence of normal middle ear air pressure Ear canal volume is normal and the reflex is absent 26 Operating Instructions Race Car Tympanometer Middle ear fluid such as in serous otitis media will yield a very flat tympanogram with no definite peak A resolving case or beginning case may produce a reduced peak in the presence of severe negative middle ear pressure The ear canal volume is normal and the reflex is either absent or at an elevated level Eustachian tube dysfunction in the absence of fluid will show a normal compliance curve but it will be displayed to the negative side of the tympanogram Ear canal volume will be normal and the reflex may be present depending on the degree of involvement 27 Operating Instructions Race Car Tympanometer How to test children When practicing impedance measurement with small children be aware of problems caused by the child being restless or afraid of the examination or reacting sensitively to the change of pressure and the loud test sound There are also different conditions of the eardrum and the middle ear which do not appear in ears of adults It may be difficult to create a probe seal with restless children If the child yawns or cries
35. ses and the curve rises The box which appears during the test symbolizes the threshold at which the RC accepts a change of compliance as a valid Stapedius reflex 22 Operating Instructions Race Car Tympanometer 6 5 Preparing the contralateral measurement optional Switch on the contralateral reflex measurement by pressing the Reflex key the word Contra must appear on the right top of the LCD Here the highest fixed level is 110 dBHL with TDH 39 contra phone only The contralateral measurement produces more reliable results because the receiver emitting the test signal and the probe measuring the compliance are separated If you are using an insert phone for contalateral measurement put an Figure 21 appropriate ear tip on the insert phone Example of a normal tympanogram and insert it in the contralateral ear with contralateral reflex results Continue now as described previously for the ipsilateral measurement 6 6 How to interpret the reflex display After having carried out a measurement you can read the recorded values on the LCD In addition to the tympanogram shown on the left side and the values shown on the right the results of the reflex measurement appear in the lower part of the display In the four boxes marked 1 to 4 the Stapedius response is shown graphically Below each box the test level the test frequency and the type of the test l ipsi C contralateral are shown The test re
36. standard tympanometry mode 226Hz In order to choose tympanometry with high probe tone 1000Hz hold down the Reflex key for two seconds The screen for high probe tone tympanometry looks very similar to the normal tympanometry mode however the following differences will appear on the screen e The scaling is now measured in mmho e The pre selected frequency 1000 Hz is displayed in the upper left hand side of the screen The tympanometry test with high probe tones is performed in the exact same way as a normal tympanometry test It is possible to perform normal tympanometry and high probe tone tympanometry in one test session and print the results for comparison Now the next curve will be drawn automatically Press Print and a printout presenting both curves will appear When the first tympanometry curve has been drawn press the Reflex key for two seconds to switch to high probe tone tympanometry Note It is not possible to perform reflexes on the basis of a high probe tone tympanogram 19 6 2 Operating Instructions Race Car Tympanometer How to measure the Stapedius reflex The basics of the Stapedius reflex measurement While tympanometry measures the change of the compliance caused by changing pressure in the outer auditory canal the Stapedius reflex measurement works with a changing compliance caused by contraction of the Stapedius muscle in the middle ear The contraction called Stapedius reflex causes a dec
37. sult is also shown as Pass or Fail In Figure 22 for 500 Hz a Stapedius reflex was registered at 100 dBHL and for 4 kHz at 95 dBHL If no reflex threshold is registered Fail ELI aM appears below the frequency Figure 22 Example of a normal tympanogram Correct interpretation of the reflex with ipsilateral ies Se results should be made in conjunction with the tympanogram the graphic reflex display and other audiometric data 23 Operating Instructions Race Car Tympanometer 6 7 How to print the test results After a test print the results for MAICO Race Car Tymponamater your documents by pressing the Print button The printer prints out the example used in the previous paragraph in only 12 seconds While the printer is working no key action is possible and the probe is inactive In addition to printing the text as seen in chapter 4 6 the result of the reflex test is printed out The level value dBHL at which a reflex had been measured appears below the graph If no reflex was registered Fail is printed on the top of the graph behind the test frequency Figure 23 Printout of a normal tympanogram with ipsilateral reflex measurement 24 Operating Instructions Race Car Tympanometer Interpreting Test Results Understanding the printout The printout contains the following information e Ear volume e Compliance e Pressure e Gradient e Reflex T
38. t the test or patient All other values and the tympano gram correspond to those you have seen on the LCD explained on the previous page under 4 5 The intelligent printer control helps you save paper It will only print out what was actually measured The printout in the example above does not show reflex frequencies because only the tympanogram was measured Figure 15 Printout of a normal tympanogram If you have saved two tympanograms for example both the left and the right ear they are printed side by side You can produce as many printouts as you want by pressing the Print button several times How to delete the test results By holding down the L R key the measurement memory will be deleted On the LCD the message Delete all Data appears Press Enter to delete all patient data Then the LCD shows an empty measurement screen If you press the Menu button you return to the measurement screen without deleting the measurement data 18 5 5 1 Operating Instructions Race Car Tympanometer How to create a tympanogram with high probe tone In addition to the standard 226 Hz probe tone tympanometry a higher frequency probe tone may be selected by the user A tympanogram recorded using the high probe tone may better suited for screening newborns and provides more accurate results for those subjects To select high probe tone frequency When the instrument is switched on it automatically powers up in the
39. that the ear tip does not have a proper seal The boxes below Status show the volume of the ear canal the compliance the pressure at maximum compliance and the gradient of the tympanogram when the test has been completed The four boxes at the bottom of the screen marked 1 to 4 show the graphical reflex curves after the test Below each box the test level Figure 5 80 dB and the test frequencies Figure 5 500 Hz 1000 Hz 2000 Hz and 4000 Hz are displayed After the frequency an I shows that ipsilateral testing is selected Finally at the very bottom in Figure 5 the word Auto and 80 dB scale is shown This means that the reflex test level will increase automatically until a reflex is found or the maximum level is reached With the arrow keys the test levels can be changed to a fixed level The dB values below the boxes change accordingly It is possible to have fixed levels from 70 dB to 100 dB or Auto Operating Instructions Race Car Tympanometer 3 5 Calibrate the probe Adjust the impedance measuring instrument Main Menu every day to the actual atmospheric Tympanometry pressure by means of the enclosed Calibration calibration volume The calibration is very Setup easy and takes only 20 seconds Press the menu key 4 and the main menu Figure 6 appears On the LCD Select the menu option Calibration with the arrow keys and press Enter Follow the instructions PEE i ange item on the LCD as shown in figure 7
40. the test can be selected paused and restarted with the probe button M or off Subject Data Printout Turn the printout of the headline data entry area at the top on or off Clinic Data Printout If you entered your clinic data the printout of the entered data can be switched on and off with this option Print after test With this option you enable an automatic printout after you have finished a test by setting it on With the setting off the printout will be processed after you press the Print button Race Car Turn on Race Car animation during tympanometry test by selecting ON If this feature is turned OFF only the traditional tympanogram will be shown during the test 33 Operating Instructions Race Car Tympanometer Language You can choose one of the following languages German French English or Spanish for the text on the LCD and the printout After selection all the texts appear in the chosen language Display adjust The contrast of the LCD can be changed with this option 10 5 Insert your personal printout data Select the menu option Clinic Setup Menu from the main setup menu see figure 28 to enter all required data for your clinic The data will be printed out with the test results and the patient data 34 Operating Instructions Race Car Tympanometer 11 Care and maintenance of the instrument Disconnect the power plug before cleaning To clean the instrument probe contralateral receiver an
41. to change T MAICO MAICO Diagnostics 10393 West 70 St Eden Prairie MN 55344 Tel 888 941 4201 Fax 952 278 4481 E mail info maico diagnostics com Internet www maico diagnostics com 44 Part No Part No Part No Part No Part No Part No Part No 5529 6643 6644 6645 6646 6647 6648 1162 0703 Rev A 08 07
42. to the power outlet The socket G is now Operational Figure 2 The probe of the RC Operating Instructions Race Car Tympanometer 3 4 Getting familiar with the RC D GOHO OGG 3 4 1 The RC Front Panel Controls 1 PRINT Prints the test results 2 L R Changes test ears from left to right or right to left for tympanogram or audiogram Press and hold for 2 seconds to erase stored tests 3 REFLEX Changes the reflex testing modes from IPSI to CONTRA or NO REFLEX Press and hold to change to 1000Hz probe tone for tymponametry MENU Enters the main menu screen 4 Decreases the frequency Hz for audiometric testing v Decreases the intensity level dB of reflex or audiometric testing Increases the frequency Hz for audiometric testing Increases the intensity level dB of reflex or audiometric testing ENTER Enters the highlighted menu or the highlighted option 10 POWER Power switch How to use the extended functions is described in chapter 9 Individual Setup of the RC Figure 3 The controls of the RC OW ON AWA Operating Instructions Race Car Tympanometer The RC Rear Panel Connections 240V 50 BOHZ i Figure 4 Connectors on the rear of the RC A Power connection socket B Probe tube connection C Probe connection socket D PC interface E Contra receiver socket 3 4 2 Switch the instrument on Turn the power switch 10 on The LCD will show the type o
43. trument measures only with this level Make sure the auditory canal is clear Choose the correct ear tip according to the size of the auditory canal and put it firmly onto the probe tip see chapter 3 7 Figure 9 21 Operating Instructions Race Car Tympanometer 6 4 Taking the ipsilateral measurement Carry out the measurement as described in chapter 4 4 Recording the Tympanogram The Stapedius reflex is measured after the measurement of the tympanogram During the measurement of the Stapedius reflex the change of the compliance is represented in real time on the LCD When the test is finished the curves for the changes of compliance at 500 Hz 1000 Hz 2000 Hz and 4000 Hz are shown in four separate graphs at the bottom of the measurement screen see Figure 20 Below each curve is the test level where a Stapedius reflex Figure 20 ar Example of a normal tympanogram was registered automatically This is with ipsilateral reflex results indicated by a Pass below the frequency If no reflex was detected a Fail is reported and the maximum level is shown You can judge this by watching the real time graph if you have a real Stapedius reflex or only disturbance and artifacts The lower dotted zero line of a graph indicates the measured compliance without a test sound All the positive or negative changes of compliance are shown as deviation from the zero line If a Stapedius reflex occurs the compliance increa
44. utlet or extension cord 37 Operating Instructions Race Car Tympanometer 13 2 Maintenance The RC is designed to require minimal maintenance and should provide you with years of trouble free use The following suggestions may assist you in avoiding and or solving problems Calibration The optimum length of time between recalibrations for impedance meters or audiometers varies depending upon the treatment given the instrument and the headphones probe It is recommended that the instrument have a laboratory calibration at least once every year Since rough handling such as dropping the probe can easily cause calibration errors it is advisable to establish a biological calibration check as soon as you receive the instrument Should you feel at a later date that the impedance or audiometer s calibration may be in error perform a biological check on a known ear If all retests show major changes calibration is probably in error All repair and recalibration should be done at an authorized Maico Special Instruments Distributor service center This assures the use of quality materials by trained and experienced technicians using the proper accurate equipment Maico Special Instruments Distributors are located in major cities throughout the world To minimize costs and time delays contact the Distributor that you purchased the instrument from If you don t know who that is or need to find the Distributor closest
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