unity 2 / v4.7.1 probe mic. (real-ear, coupler and … · end program session list connexx module...
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Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
Unity 2 / v4.7.1
Vera Spitzlei, Corporate Audiology
Probe Mic. (Real-ear, Coupler and RECD Measurements) and Hearing Instrument Analyzer
Page 2 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
UNITY™ 2
2
Page 3 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
� Objective evaluation
� InSitu-/or Coupler measurements to verify target gains� InSitu-/or Coupler measurements for fine tuning
� Semi-objective evaluation
� Aided Audiometry compared to unaided measurements� Speech Audiometry according to speech development
� Subjective evaluation / Validation
� Close monitoring of the patient‘s listening behavior� Questionnaires
Hearing Instrument Fitting: Verification Methods
Page 4 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
� Objective evaluation
� InSitu-/or Coupler measurements to verify target gains� InSitu-/or Coupler measurements for fine tuning
� Semi-objective evaluation
� Aided Audiometry compared to unaided measurements� Speech Audiometry according to speech development
� Subjective evaluation / Validation
� Close monitoring of the Patient‘s listening behavior� Questionnaires
Hearing Instrument Fitting: Verification Methods
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Page 5 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
During the fitting of hearing instruments, real-ear measurements and coupler measurements are used for the electro-acoustic verification of “aided“ situations (coupler measurements following calibration standards, e.g. ANSI S3.22 and DIN IEC 118-7).
During a hearing instrument fitting, they are used to
� Verify First Fit or fine tuning of hearing instruments
� Conduct fine tuning with uncooperative patients and children
� Document and compare the response curves of different hearing instruments (gain / output) according to specific input signals and signal levels
Why conduct Verification Measurements?
Page 6 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Anatomical terms
� Every ear canal has an individual shape and size!
� Coupler or ear simulator can only provide an estimate / approximation of the residual ear canal volume and resulting acoustics at the eardrum
� Esp. in children, auricle and ear canal are smaller, more straight and more narrow than in adults
� Resonance peaks are shifted towards higher frequencies
Why conduct Real-Ear Measurements?
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Page 7 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
RECD according to age
-5
0
5
10
15
20
25
30
100 1000 10000
f[Hz]
L[dB
]
RECDd0t12(CXX) RECDd13t24(CXX) RECDd25t48(CXX)RECDd49t60(CXX) RECDd60andup(CXX)
REUG according to age
-5
0
5
10
15
20
25
30
100 1000 10000
f[Hz]
L[dB
]
REUG 0t4m REUG 9t14m REUG 14t24m REUG 24andup
With a smaller ear canal volume (e.g. children), resonance peaks are shifted to higher frequencies !
Why conduct Real-Ear Measurements?
Page 8 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
This might contribute to a
higher sound level at the
eardrum of probably
more than 20 dB!
Danger of over-amplification!
REIG gap@FOG50dB, related to adult values (>60 months)
-10
-5
0
5
10
15
20
25
100 1000 10000
f[Hz]
L[dB
]
3 months 12 months 24 months 36 months 48 months
Why conduct Real-Ear Measurements?
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Page 9 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Start fromUnity
environment
Start fromNOAH module
Probe Microphone Measurements in Unity:Starting/Accessing the Module
Page 10 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity:Starting/Accessing the Module
In Noah, Unity 2 PC Probe in „On top mode“ can be left opened while using
any fitting software
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Page 11 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Start Screen (Unaided Measurement, OEG)
Page 12 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity:Toolbar
Client list
Save fitting
session
Change ear sides
SPL / Gain view
Unaided measurement
(Open ear gain)
Aided Measurement
(InSitu and coupler)
Insertion Gain
Input/Output
diagram
RECD
Sound Mapping
Probe tubecalibration
End program
Session list
Connexx module
Open Ear Spectrum
Print fitting
sessionOccluded
measurementOcclusion
effects
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Page 13 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements:General „Guidelines“
Preparation of the Measurement
In-Situ measurement
Recommended Stimuli for NAL-NL1 and DSL:ILTASS (non-modulated), Icra1 (non-modulated), Icra7 (modulated), ISTS
OEG measurement
REIG measurement
RECD measurement
Adaptation of Formula Configurations
Coupler measurement
Page 14 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Placement of the Client in front of the Loudspeaker :
� Patient facing loudspeaker or with 45°azimuth
� Fitted ear close to loudspeaker
� Patient should keep head in position during measurements
� Recommended distance between loudspeaker and ear:
� ~ ½-1 m (2 - 4 ft.)
The further the distance between the loudspeaker and the reference microphone, the louder the signal
Probe Microphone Measurements in Unity: Real-Ear Measurements
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Page 15 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
Page 16 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
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Page 17 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Unaided measurement / response (Open ear gain, OEG) :
Measured with the probe tube placed in the open ear canal (i.e. no earmold or hearing instrument inserted)
The Unaided Response
� reflects the natural amplification of the signal by the outer ear, particularly within the frequency range for speech discrimination
� is required to calculate the Insertion Gain during Insertion Response measurements
� is required for transferring AC, MCL or UCL values from dB HL to dB SPL (SPLogram view: Particularly for comparing Aided Responses)
� can be used for calculating the Real Ear to Coupler Difference
Page 18 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Unaided measurement (Open ear gain, OEG)
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Page 19 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
Page 20 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Occluded measurement (Occluded response):
Measured with the probe tube placed in the ear canal and a mold or hearing instrument inserted, but with the hearing instrument turned off .
The Occluded measurement� shows the damping effect of the inserted earmold and can be used to
determine an appropriate vent size� shows the influence of occlusion on the natural amplification of the test
signal� indicates the principle of insertion gain measurements:
A hearing instrument (HI) must first provide a sufficient gain to overcome the loss of natural amplification before it can start accounting for the actual hearing loss
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Page 21 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Occluded response
Page 22 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
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Page 23 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Aided Measurement:
(Aided response, InSitu and/or coupler)
Measured with the probe tube placed in the open ear canal, together with a earmold or hearing instrument inserted in the ear canal and with the hearing instrument turned on.
The Aided Measurement
� reflects the sound pressure level measured at the ear drum of the client (if the input is a broadband signal, the RMS Value of the signal is also display)
� can be used to transfer AC, MCL or UCL values from dB HL to dB SPL (for SPLogram view) to compare different AR results
Page 24 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Aided Coupler Measurement
Stimulus:Depending on the fitting formula and the hearing instrument.
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
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Page 25 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Aided Coupler Measurement
(according to DSL v5)
with ILTASS@6565 / 8080 dB
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Page 26 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Aided In-Situ Measurement
Stimulus:Depending on the fitting formula and the hearing instrument.
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Page 27 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
Page 28 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Insertion Gain (IG):
If an audiogram is available for one patient, the Target Gain will be shown in the Insertion Gain display (only “Gain” view available)
The Insertion Gain measurement:
� Is conducted with the probe tube placed in the ear canal, together with an earmold or hearing instrument inserted, and with the hearing instrument turned on
� Is calculated during measurements in Unity (REIG = REAR – REUR )� measured Unaided Response is subtracted from the measured
output at the ear drum of the client = Aided Response� Reflects the insertion gain for each presented frequency (if the input is
a broadband signal, the RMS value of the signal is also displayed)
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Page 29 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Insertion Gain (IG): Real Ear Insertion Gain (REIG)
Open measurement dialog:
� The measurement can be opened from the toolbar:
Prerequisite:
� Measured OEG
� The REIG will automatically be calculated of the REAG and the OEG:
REIG = REAG – REUG (OEG) (= REAR – REUR)
Stimulus type and level are always depending on the fitting formula and the hearing instrument.
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Page 30 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Insertion Gain (IG): Real Ear Insertion Gain (REIG)
REIG measurements should be performed as follows:
1. Turn the hearing instrument OFF
2. Play back the calibration noise (use the “start” for this step)
3. Turn the hearing instrument ON
4. The measurement shall should run until the result is stable
5. Record the measurement by using the „Record“ button
Probe Microphone Measurements in Unity: Real-Ear Measurements
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Page 31 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
Page 32 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Input / Output Diagram
Can be performed as In-Situ (Real-ear) or coupler measurement.
The LI / LO measurement:
� addresses the output sound pressure level at the ear drum as a function of the input level for a certain frequency
� is mostly used to determine the compression properties of the hearing instrument
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Page 33 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Input / Output (LI/LO)
Page 34 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
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Page 35 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Open Ear Spectrum
The Open Ear Spectrum of the client is measured with the probe tube placed in the open ear canal, that is, when no earmold or hearing instrument is inserted. The main difference to OEG measurements is that the test signal is produced by the client (long vowels like “A” or “E”are recommended; a volume meter is displayed and the client should be instructed to keep the sound level inside the green area. Unity automatically accepts and records the curve during a measurement as soon as a valid measurement result is available.
The Open Ear Spectrum� cannot be measured in a 2 cc coupler� is required as basis for Occlusion Effect measurements, comparing the
resonance of internally generated sounds such as speech or chewing in an open and an occluded ear canal. An increase of resonances usually occurs in low frequencies.
Page 36 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Open Ear Spectrum
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Page 37 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
Page 38 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Occlusion EffectsOcclusion effects are the second part of Open Ear Response/Occlusion Effects � conducted with the probe tube placed in the ear canal and sealed with an earmold or hearing instrument. The client again is asked to produce e.g. “A” and “E” at the same level as during the OEG measurement; the volume meter supports adjusting the sound level
The Occlusion Effects measurement� Cannot be conducted in an 2 cc coupler � Shows the occurrence of resonances of internally generated sounds
(speech, chewing) in the occluded ear canal, mainly in low frequencies� Is calculated by subtracting the Open Ear Spectrum from the gain of
the output signal at the ear drum of the client� Reflects the occlusion effect for each presented Frequency when the
RMS value of the signal is accepted by Unity
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
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Page 39 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Occlusion Effects
Page 40 November 2009
Confidential / Copyright © Siemens AG 2009. All righ ts reserved.
H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
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Page 41 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
RECD
(Real-Ear-to-Coupler Difference / Moodie, Seewald et. al. 1994)
RECD describes the difference of an acoustic response, measured in a 2cc-coupler and in an individual’s ear canal, using the same sound source, as a function of frequency in dB SPL
� The individual residual ear canal volume can be taken into account without the need of a complete In-Situ measurement for each fitting
� Calculated parameters can be stored
� Least possible strain for the patient
� RECD Measurement Procedure
Page 42 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
RECD
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H WS AU MB AVera Spitzlei, Corporate Audiology
1. Insertion of Probe Tube not deep enough
2. Acoustical Leak / Venting
3. Grommet or Perforation
4. Eardrum Problems and / orOtitis Media with Effusion
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
RECD:
Possible sources of error /insecure measurement results
1. Capping at 2 - 3 kHz
2. Negative values at lower frequencies (-1 to -9 dB)
3. Negative values at lower frequencies (-10 to -15 dB)
4. Positive values at lower and mid frequencies
Page 44 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
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Page 45 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Sound Mapping
SPLogram view for verification:
� Optimum fit to residual dynamic range (using REAG / REAR)
� Behavior of HI for different input levels (LTASS = long term average speech spectrum)
� Compression characteristics of HI
� Complex hearing aid systems can be adjusted more accurately
� Reduced danger of over- and under-amplification
� Counseling of patients / relatives
Page 46 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements / Sound Mapping
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Page 47 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Sound Mapping
� Targets: Target gain curve display for the selected fitting formula
� Pictograms: (Optional) Demonstrate common noise sources and their relationship to the hearing loss
� Hearing Threshold: Patient’s hearing threshold converted to dB SPL
� Speech Field: Displaying the dynamic range of unamplified speech
� VU Meter: Current signal level [dB SPL] at the reference microphone
� Normal Threshold: A normal hearing threshold of 0 dB HL can be displayed in a SPL view as a reference
Page 48 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Sound Mapping
� Speech Field:
The Speech Field for unamplified speech with an average level of 60 dB SPL can be displayed as a reference; the spectrum corresponds to the long-term average of speech (LTASS) and is extended 12 dB above the average and 18 dB below the average for the dynamic range of speech.
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Page 49 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
The Percentile Analysis can be used to display the dynamic range of the aided input signal using short-term, third-octave levels.
After 60s, the measurement result is displayed using percentiles, according to the probability of occurrence for loud = 99%, soft =30% and average = LTASS levels
Saturation Level (OSPL90):
Should be measured separately (using PT Sweep to make sure that narrow-band AGC-O is activated)
Percentile Analysis in Sound Mapping
Page 50 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Fitting recommendation for percentile analysis
How to use compression parameters (gain, CK, CR, AGC-o, time constants) appropriately?
First Fit
1. Fitting to medium Target (65dB) : LTASS for 65 dB ISTS� adjust via master gain
2. Fitting to highest Target (80dB) : LTASS for 80 dB ISTS� adjust via gain for loud input levels and compression ration
LTASS = long term average speech spectrum
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
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Page 51 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Page 52 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Fitting recommendation for percentile analysis
How to use compression parameters (gain, CK, CR, AGC-o, time constants) appropriately?
Fine Tuning
1. UCL: 99% - percentile for 80 dB ISTS / Output Level� adjust via MPO� little residual dynamic range: syllabic compression
2. Optimize Audibility (esp. 1-3 kHz, considering hearing threshold):30% - percentile for 65 dB ISTS / Output Level
� adjust via gain for soft input levels
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Page 54 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Beside the existing percentile analysis, the new SW version provides a graphic equalizer display in Sound Mapping to support counseling of patients.
It displays the live spectra of the incoming signal, picked up by the probe microphone. Maximum levels and average level (LTASS) are displayed and can be stored.
Graphic Equalizer in Sound Mapping
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
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Page 55 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Verification of Simulated HI Gain / Output
Connexx simulation Unity measurement
Page 56 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
Patient Voice / External Signals
In Sound Mapping , any External Signal can be used for Real-ear measurements.
With the help of Patient Voice , the effect of live speech amplified by the HI can be demonstrated (required for measuring the Open Ear Spectrum and Occlusion Effects).
For better orientation, THR, MCL, UCL and targets can be displayed.
VU monitoring of external signals
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Types of Real-Ear Measurements
� Unaided measurement (Open ear gain)
� Occluded measurement
� Aided Measurement (InSitu and coupler)
� Insertion Gain
� Input / Output diagram
� Open Ear Spectrum
� Occlusion Effects
� RECD
� Sound Mapping
� Probe Tube Calibration
� Overview
� Guidelines
Page 58 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
A calibration of the probe tube
must be carried out prior to a
real-ear measurement.
It should be repeated every time
the probe tube is replaced.
Probe Microphone Measurements in Unity: Calibration of the probe tube
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity:
Presets and Diagram settings
� Overview
� Guidelines
Page 60 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Presets and Diagram settings
General Settings for Devices and Measurement Defaults can be selected and changed in the “Settings” menu
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Presets for audiometry data General settingsand reference curves
The current status of the diagram is displayed in the status bar:
Probe Microphone Measurements in Unity: Presets and Diagram settings
Page 62 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity:
User Interface Display
Fitting Rationales
Signal Types
Measurement Procedures
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity:
User Interface Display
Fitting Rationales
Signal Types
Measurement Procedures� back
Page 64 November 2009
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H WS AU MB AVera Spitzlei, Corporate Audiology
Probe Microphone Measurements in Unity: Start Screen (Unaided Measurement, OEG)
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Probe Microphone Measurements in Unity: User Interface Display
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Probe Microphone Measurements in Unity: User Interface Display
Control Tabs for selecting the measurement type
Broadband Measurements
Narrow-band Measurements
(if available)
Single Tone Measurements
(if available)
Results List
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Probe Microphone Measurements in Unity: User Interface Display
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Sample Audiogram:� AC: 40 dB HL � BC: 35 dB HL� MCL: 75 dB HL� UCL: 100 dB HL
SPLogram: calculation of equivalent SPL values at the eardrum
LdB(SPL) = LdB(HL) + MAP*
For coupler measurements, individual or statistical RECD values are subtracted
* MAP: Minimum Audible Pressure
Probe Microphone Measurements in Unity: User Interface Display
Configuration of SPLogram Display
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Probe Microphone Measurements in Unity: User Interface Display
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Probe Microphone Measurements in Unity:
User Interface Display
Fitting Rationales
Signal Types
Measurement Procedures� back
36
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Probe Microphone Measurements in Unity:Fitting rationales and prescriptive formulas
� Unity offers several linear fitting rationales (NAL-RP, POGO II, etc.) and non-linear formulas such as DSL[i/o], DSL v5 and NAL-NL1
� Especially for fitting hearing instruments in patients with a sensori-neural hearing loss, non-linear target prescriptions are required
� Target gain is calculated and displayed automatically based on entered tone audiogram values
� Target gain is calculated and can be measured for real ear Probemeasurements as well as for 2 cc Coupler
� In Unity, the desired target prescription can be selected from the following list:
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Linear fitting formulas, e.g. Half-gain rule (HV ½):
Appropriate for
� Conductive hearing loss� Profound hearing loss
Non-linear prescription rules (DSL [i/o], DSL v5, NAL-NL1):
Appropriate for
� Sensorineural hearing loss, especially with recruitment
Probe Microphone Measurements in Unity:Fitting rationales and prescriptive formulas
37
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Probe Microphone Measurements in Unity:
User Interface Display
Fitting Rationales
Signal Types
Measurement Procedures� back
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Pure tone (PT): Sinusoidal pure tone
Warble (WT): Pure tone, modulated by a second tone (triangular signal), bandwidth spread over 1/3 octave
Narrow-band Noise (NN): Random noise, filtered to 1/3 octave
Pink noise (PN): Broad-band signal, pink weighted pseudo-random noise
Speech noise (SN): Broad-band signal, pseudo-random noise, shaped as the average of human speech
White random noise (WN): Broad-band signal, random noise
Probe Microphone Measurements in Unity: Signal Types
38
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ICRA: International Collegium of Rehabilitative Audiology by HACTES work group (Hearing Aid Clinical Test Environment Standardization)
ICRA signals contain individual level information to reflect the loudness of the signal. Level information is retained during signal presentation (e.g. 70 dB signal level with URGN-M-L results in 82.1 dB)
Resulting level = signal level selected + relative level of the track
Together with ICRA signals, signal levels at 50, 65 and 80 dB are recommended to collect information about the dynamic range of the hearing instrument. The selection of an ICRA signal will give the remaining level information.
Probe Microphone Measurements in Unity: Signal Types
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ICRA signals are best used for verification of HI with noise suppression
Client interview about listening environments to select ICRA type accordingly � hearing instruments can adapt to a realistic signal
URGN-M-N: Un-modulated speech-weighted noise, Male, Normal effort, Level: Lref
URGN-M-R: Un-modulated speech-weighted noise, Male, Raised effort, Level: Lref + 5.7 dB
URGN-M-L: Un-modulated speech-weighted noise, Male, Loud effort, Level: Lref + 12.1 dB
Probe Microphone Measurements in Unity: Signal Types (ICRA)
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Probe Microphone Measurements in Unity: Signal Types (ICRA)
3BSMN-F-N: 3 -band Speech-weighted Modulated Noise (3bSMN), Female, Normal effort, Level: Lref
2PB-1F1M-N: 2 Persons Babble, 1 Female 3bSMN + 1 Male 3bSMN Idealized speech spectrum. Normal effort, Level: Lref
6PB-N: 6 persons babble, 1f + 1m + 2f-6dB + 2m-6dB, all 3bSMN Idealized speech spectrum. Normal effort, Level: Lref+4.7 dB
6PB-R: 6 persons babble, 1f + 1m + 2f-6dB + 2m-6dB, all 3bSMNIdealized speech spectrum. Raised effort, Level: Lref+10.7 dB
6PB-L: 6 persons babble, 1f + 1m + 2f-6dB + 2m-6dB, all 3bSMNIdealized speech spectrum. Loud effort, Level: Lref+17.2 dB
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Probe Microphone Measurements in Unity:
User Interface Display
Fitting Rationales
Signal Types
Measurement Procedures� back
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Probe Microphone Measurements in Unity: Preparation / setup of real-ear measurements
� Calibration of the probe tube
� Adjustment / check of hearing instrument settings(program appropriate test settings)
� Adjustment / check of diagram settings
� Selection of fitting rationale and / or adjustment of configurations
� Selection of appropriate test signal type and input level
� Adjustment of the maximum output level (account for individual UCL)
� Determination of appropriate tube length and insertion of probe tube into the ear canal
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Determination of appropriate tube length:
For reliable high-frequency sound during a measurement (e.g. aided response), the probe tube should exceed the earmold by at least 5 mm ( � decrease the influence of standing waves in the ear canal), but not touch the eardrum.
A correct placement of the probe tip in the ear can al relative to the ear drum is crucial for correct real ear measuremen ts.
Probe Microphone Measurements in Unity: Real-ear Measurements
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Probe Microphone Measurements in Unity: Real-ear Measurements
Insert Probe Tube into ear canal
� measure sound pressure output of HI directly at the eardrum
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Probe Microphone Measurements in Unity: Real-ear Measurements
Insert Earmold
and attach hearing instrument
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RECD Measurements in Unity
� back
� Overview
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RECD Measurements in Unity
43
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RECD Measurements in Unity
Unity 2 supports two different methods for obtainin g RECD:
� With hearing instruments in free sound field (the reference signal is applied via loudspeaker and amplified by HI � Real-ear and Coupler measurement are compared)
� With insert phones (e.g. with Eartones 3A/5A or In-Situ Headset) � recommended option
The probe tube of the In-Situ Headset must be calibrated prior to the measurement.
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Presets for RECD measurements in Unity
RECD Measurements in Unity
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Option 1:
RECD measurement using Insert Earphones
(recommended)
RECD Measurements in Unity
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RECD Measurements in Unity
RECD measurementusing Insert Earphones
(Select under Measurement Defaults for RECD type /transducer in Unity )
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1A) Application of sound signal to 2cc BTE coupler (HA2)using insert earphones
RECD Measurements in Unity
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1B) Application of sound signal to 2cc BTE coupler (HA2)using insert earphonesadapter of In-Situ headset
RECD Measurements in Unity
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2) Stage 1:
Record the coupler portion of RECD
RECD Measurements in Unity
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2) Stage 1:
Coupler portion of RECD
RECD Measurements in Unity
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3a) Determine the appropriate tube length for the probemicrophone
RECD Measurements in Unity
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3b) Attach an ear tip to the end of the handle
The handle contains both, the receiver tube and the probe tube.
The probe outlet of the handle tube should always be elongated with the short, 5mm tube to get the opening closer to the eardrum.
RECD Measurements in Unity
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4a) Insert the probe tube
���� measure sound pressure output of HI directly at the eardrum
RECD Measurements in Unity
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5a) Carefully insert earmoldand attach inserts
RECD Measurements in Unity
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5b) Carefully insert ear tip
RECD Measurements in Unity
Page 98 November 2009
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7) Stage 2: Real EarMeasurement
Apply reference signal and measure the individual RECD for each ear (Real-ear portion)
Stimulus: For the test signal, it is recommend to use white noise at a level of 70 dB
RECD Measurements in Unity
50
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Coupler response (usually blinded)
Real-ear-to-Coupler Difference (RECD)
7) Stage 2: Real-EarMeasurement
Measure the individual RECD for each ear (Real-ear portion)
RECD Measurements in Unity
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Resulting Real-ear-to-Coupler Difference (RECD)
RECD Measurements in Unity
51
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RECD in Unity:
Configurations for DSL v5 and NAL-NL1
� back
� Overview
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RECD in Unity:Configuration of RECD dialog
Insert measured RECD in Unity
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DSL v5 Configuration:
Insert
� (developmental) age� Transducer used for assessment� RECD type� number of HI channels
RECD in Unity:Configuration of RECD dialog
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DSL v5 Configuration:
Manually insert measured RECD
���� Advanced Settings
RECD in Unity:Configuration of RECD dialog
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Manual insertion of measured RECD in Unity (DSL v5 dialog)
���� RECD Left / Right
RECD in Unity:Configuration of RECD dialog
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Configuration dialog for NAL - NL1
RECD in Unity:Configuration of RECD dialog
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Verification in Connexx
� back
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Verification in Connexx
Programming of test settings: FOG, omnidirectional/directional for coupler and In-Situ measurements
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Verification in Connexx: Direct measurement using Unity
Direct measurements: Measuring Box (coupler measurement)
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Verification in Connexx: Direct measurement using Unity
Direct measurements: In-Situ (Real-ear measurement)
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Hearing InstrumentAnalyzer
Unity 2:
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Unity 2 Hearing Instrument Analyzer
Two test procedures are possible:
1. Auto Test
All measurements in one complete test sequence according to a particular standard :
� ANSI S3.22-1987� ANSI S3.22-1996� IEC 118-7/A1
2. Stand-alone measurements
All measurements are carried out separately. The single measurements do not need to conform with standards. Other signal types, signal levels, etc. can be used. It is possible to choose default settings according to the standards.
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Start fromUnity
environment
Start fromNOAH module
Unity 2 Hearing Instrument Analyzer:Starting / Accessing the Module
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Unity 2 Hearing Instrument Analyzer:User Interface
OSPL90Reference Test Gain
Full On Gain
Frequency Response
Curve
Equivalent Input Noise
Harmonic Distortion
Level Input / Level Output
Attack and
Release Time
Induction Coil
Auto-test Dialog
Battery Current
Single Test Toolbar
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Unity 2 Hearing Instrument Analyzer:User Interface
Control PanelControl Panel
Measurement View
Toolbar
Status Bar
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Unity 2 Hearing Instrument Analyzer:User Interface
Results Window
Open the result window via the right tab in the control panel
Selection of a context menu: Click on right mouse button
Delete Curve:
Deletes the selected measurement
Delete All Curves:Deletes all shown measurements
Freeze Curve: Deletion of measurement not possible
Unfreeze Curve:Deletion possible again
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Unity 2 Hearing Instrument Analyzer:Auto Test
Starting Auto Test
Via Menu:
Measurements � Auto Test
Or via in Toolbar Button:
Configure Test Parameters
To change HI parameters during Auto Test, select Start Connexx Mini
Start Auto Test with Start button
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Unity 2 Hearing Instrument Analyzer:Connexx Mini
Start CXX Mini to adjust Settings in Siemens Hearing Instruments:
Settings � Adjust Hearing Instrument
or
Open with Symbol in Toolbar
or
Start automatically with Auto Test
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Unity 2 Hearing Instrument Analyzer:Auto-Test Sequence
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Unity 2 Hearing Instrument Analyzer:Presets (Single Test Settings)