Practical Flashcards
1
Q
what happens if you increase soft gain
A
increases CR
2
Q
increasing SG & CR
A
makes soft sounds audible
3
Q
what happens when you decrease soft gain
A
decreases CR
4
Q
what does decreasing SG & CR do
A
makes soft sounds audible
5
Q
what happens if you increase loud gain
A
CR decreases
6
Q
increasing LG & decrease CR
A
makes signal more crisper and clearer
7
Q
decreasing LG
A
increases CR
8
Q
decreasing LG & increasing CR
A
improves the comfort of loud sounds
9
Q
noiseblock
A
DNR in phonak
10
Q
machine noise
A
DNR in starkey
11
Q
normal hearing
A
0-20
12
Q
mild hearing
A
20-40
13
Q
moderate hearing
A
40-55
14
Q
moderately severe
A
55-70
15
Q
severe
A
70-90
16
Q
profound
A
90+
17
Q
what vent for 50-60 loss
A
.5 to none
18
Q
vent size for 40-49 loss
A
1-2mm
19
Q
vent size for 30-39
A
2-3mm or power
20
Q
20-29 loss vent size
A
3-3.5 or closed dome
21
Q
</ 20dB up to 1.5
A
open dome
22
Q
what is the occlusion effect
A
Increased perception of ones own voice when there is something blocking the ear canal
23
Q
what hearing loss does BTE fit
A
all
24
Q
what hearing loss does slim tube fit
A
mild to mod HL
-10 in lows up to 55
25
RIC fitting
min to severe
-10 to 90
26
ITE fitting
normal LF to mod severe
-10 to 70
27
ITC fitting
slight LF to mod severe
20-70
28
cic
mild to mod severe
25 to 70
29
IIC
mild to mod severe
25 to 70
30
what HA's can be used for a patient with mild to moderate hL
BTE
Slim
RIC
ITE
ITC
CIC
IIC
31
What HA's can be used for normal LF to moderately severe
BTE
RIC
ITE
ITC (needs 20 LF)
32
what HA's can be used for near normal LF to moderately severe
BTE
RIC
ITC
CIC
33
what ha's can be used for mild to moderately severe HL
BTE
RIC
CIC
IIC
34
what HA's can be used for severe HL
BTE
RIC
35
what HA's can be used for profound HL
BTE
36
what is a cros
Contralateral routing of sound
Single sided deafness - one ear is normal and poorer ear is unaidable
One good ear and one bad
37
full shell fitting
higher output for sev to profound
38
what is a bicros
Bilateral contralateral routing of sound
Bilateral asymmetric HL - one ear has threshold loss & poorer ear is unaidable
Both ears are bad, asymmetry HL
39
skeleton moldfitting
mild to severe (25-90)
40
canal mold fitting
mild to severe (25-90)
41
canal lock fitting
mild to severe (25-90)
42
half shell fitting
mild to severe (25-90)
43
open dome
44
closed dome or tulip
20-29
can be accompanied with custom with vent 3-3.5
45
power dome
30-39
can be accompanied with custom with vent size 2-3
46
when should you use vinyl
infants, firm ear texture, high gain, older adults w/ dexterity issues, facial flex concerns
47
adv/dis of vinyl
adv: easily modified, softens at body temperature, snug fit
dis: shrinks, discolors, hardens, has to replace very 6-12 mos
48
when to use silicone molds
peds
high gain
allergies
facial flexa
49
adv/dis of silicone
adv: doesn't shrink, durable, hypoallergenic, snug fit
dis: can cause blisters, disocomfort, hard to modify, costs more
50
when to use lucite/acrylic molds
adults
mild to sev losses
soft floppy pinnas
51
adv/dis lucite/acrylic
adv: durable, doesn't srhink, smooth for easy insertion
dis: incrased risk of feedback, injury if hit, doesn't compress to move beyond narrow/tortuous areas
52
tubing for mild to moderate losses (30-50)
13 standard
53
tubing for moderate to severe (50-70)
13 heavy wall
54
tubing for severe to profound (70-100)
13 double wall
55
describe expansion
needed when someone complains about soft sounds they do not need to hear
really low CR (lower than linear), adds large amounts of gain to increase TK
56
describe WDRC
AGCI
input compression
needed to add more to soft sounds, less to moderate sounds and even less to intense sounds
restores loudness perception
CR is low - almost linear
TK is low
SLOW AT & RT
57
describe output limiting compression
protects the ear from loud sound
AGCo
high TK
high CR
fast AT
variable RT
58
what is SII
Calculates % of speech info that is audible and usable to the listener
59
what is an SII of 50%
SII of 50% of speech cues supporting intelligibility are audible in a quiet setting
60
Increase in # of dots
requency region with higher contribution to intelligibility (HF)
61
Decrease in # of dots
frequency region with reduced contribution to intelligibility (LF)
62
what is the purpose of LDL
needed to ensure amplified output doesn’t exceed the individual’s loudness tolerance
63
how to explain LDL results to a patient
This test determines how much loudness you will be able to tolerate out of a hearing aid or in everyday environments. The average is 100-105.
64
what is ANL
determines how much willingness a listener can listen to speech in presence of background noise
Predictive of hearing aid satisfaction with 85% accuracy
Identifies those who will have more difficulty adapting to amplification
65
what is a low ANL score
<7
Indicates the patient ACCEPTS a lot of noise background noise w/o issues
This patient is likely to wear hearing aids on a regular basis
66
what is a high ANL score
>13
Indicates the patient LACKS TOLERANCE for background noise
This patient is less likely to wear hearing aids regularly
67
Indicates the patient LACKS TOLERANCE for background noise
This patient is less likely to wear hearing aids regularly
May require extra post-fitting counselling or adjustment period
68
how to explain anl to a patient
This test where I had you face the speaker and noise and a story was coming out at the same time allowed me to test your tolerance level of background noise. Do you find that you are bothered by this easily or it takes a lot before it does?
Yes bothered easy - this test and the results confirmed this and showed me that you do (high anl score)
No - this test and the results confirmed this and showed me that it takes a lot of background noise before it bothers you. (low anl score)
69
what is SNR
Speech intelligibility in noise remains the #1 improvement patients seek with hearing aids
70
SNR loss of 0-2
normal
might benefit with omni or directional mic
71
snr loss of 2-7
mild
recommend standard directional mic
72
snr loss of 7-15
moderate
requires beamforming mics in additon to directional mics
73
>15 snr
severe
need remote mic in addition to the rest for the other losses
74
what is the point of rem external loudspeaker
generating variety of input signals
75
what is the ear level probe module
connects to the REM systema
has ref mic
retention cord
probe tube
probe mic
76
what is the ref mic on probe module
monitor and calibrate the soundfield speaker output, maintaining the desired signal intensity at the measurement point
77
what is the probe tube on teh probe module
measure the intensity of the signal arriving to the TM
78
what is the prob mic on the probe module
collects and measures sound from the probe tube attached to it
Stem
79
Aided output of 15dB in needed to achieve binaural benefit
true
80
describe type i test signal
Brief puretone signal swept over a variety of frequencies
dribes higher output than speech and accurately shows MPO
DFScan attenuate it & doesn't show how compression or channel interaction affect output
81
describe type II signals
complex “speech-like” signals
Broadband signal consisting of random frequencies occurring at different intensities
mimics speech
might not see all spectral issues or device's true response to different spectral shapes
82
types of type II signals
Type II Signal Standardized Speech Signals (Calibrated)
Non-standardized signals
83
Standardized Speech Signals
Calibrated
repeatable, consistent signals to verify a device’s ability to meet prescriptive targets for output & frequency response
ex: Speechmap- speech signals filtered to provide the long-term average speech spectrum (LTASS)
ISTS- International Speech Test Signal: 6 female talkers reading the same passage in American English, Arabic, Chinese, French, German and Spanish
ICRA- International Collegium for Rehabilitative Audiology: distorted speech signal is a recording of an English-speaking talker that has been digitally modified to make the speech largely unintelligible
84
Non-standardized signals
not used for amplification programming
Measures output of different signals, good for counceling, intensities and frequencies are less repeatable
85
Visual representation of modulated speech sounds
LTASS “SPEECH ENVELOPE”
86
Measured by averaging a measured signal for 10 seconds
ltass
87
Speech envelope has a crest factor of ______ dB (louder speech signals) & valleys of _____ dB (soft speech signals)
+12
- 18
88
The difference between the valleys (softest signal) and peaks (loudest signal) of speech is ______dB SPL
~30
89
The Speech Intelligibility Index (SII) is maximized when the entire speech is above threshold.
yes
90
Difference bw threshold & LDL represents
dynamic range
91
Probe Mic calibration
Place tip of probe directly over reference mic
The modified pressure concurrent equalization calibration signal arrives simultaneously to the probe tip and reference mic during. Therefore, the “distance” b/w the reference mic and probe tube tip becomes acoustically invisible
Ref mic must face speakers during calibration
Hold probe module 6” to 36” away from the speaker
Keep your fingers and body out of the way!
Present calibration signal
92
test box calibration
Position reference test mic on reference point with reference test mic grid w/ in 1mm from reference mic
Close chamber
Press Tests, Test box measures, calibrate, start test
93
Measurement mic that is sealed into the coupler and collects output data from the HA
Coupler mic
94
Calibration Method Protocols
Substitution method of soundfield equalization
Modified pressure methods
95
Substitution method of soundfield equalization
Done before the PT arrives, placed at where subject’s head would be, stored as a reference point, used to calibrate the reference mic and probe
Impacts results if the subject changes location or moves
96
Modified pressure “concurrent equalization”
reference mic monitors test signal throughout test to equalize and adjust, calibration signal replays every 10 seconds (pink noise segment)
97
Modified pressure “stored equalization”
probe is calibrated one time on PT’s ear & stored for fitting process
Used to avoid ref mic contamination (stops it) - happens when amp output escapes ear canal through open dome
98
Probe tube Calibration & Acoustic Transparency
probe microphone module cannot be physically located in the ear canal; the probe tube serves as an extension to the probe microphone
Probe tube tip is placed directly over the reference microphone during calibration. This protocol accounts for the different intensities arriving to the probe microphone module’s reference mic and through the probe tube.
The unit mathematically adjusts the intensity differences removing the tube’s resonance effects.
This procedure makes the probe tube “acoustically invisible”
99
HA1 coupler
simulates custom products
small
100
ha2 coupler
bte
longer
101
what is working distance
Distance allowed bw PT and speaker (18”-36”)
Reflective surfaces & tester: 2 x WD (about 34-36 in away)
102
Ambient noise in the room must be 10dB lower than REM signal
true
103
Horizontal plane: 0º azimuth: greatest reliability
true
104
Vertical plane: speakr should be level to the PT’s ear in order to accurately measure HF output
true
105
what is reur
natural response resulting from the pinna and ear canal that the PT walked in the door with
Changes due to: size, shape, abnormal anatomy, age, and ear to ear
106
Otoscopy
Watch direction/angle of EAC
Helps w/ probe tube insertion
Check for cerumen/debris
Can interfere/plug tube and interfere with placement
Insert at an angle to avoid cerume or remove it before
107
probe tube placement protocol
Place patient at appropriate distance/azimuth from loudspeaker (e.g., 0.5 m/0 degree).
The reference mic must face the room (away from the patient’s neck)
Use the blue cord to stabilize the probe module under the earlobe
Clip the probe module cable to the opposite side to stabilize the location of the reference mic
Slip the probe behind the blue cord so the black marker lays in the inter-tragal notch
On audioscan navigate to On-ear measurements, speechmap, Present 65 dB SPL pink noise signal and insert probe
Go until HF output confirms tip is w/in 5mm of ™
move black marker to intertragal notch
108
how can you confirm tube is w/in 5mm of tm
Look at HF notches
It is w/in 5mm when notch no longer dragging gain curve down in HFs (not >5dB at 6kHz)
More than 5mm away results in acoustic nulls from standing waves
109
what is REOR
measurement of insertion loss caused by placing an earmold/dome in the ear canal
110
what is RECD
A sound generating transducer produces a signal in the ear canal and in a 2cc coupler to measure the resonance of each.
Difference bw SPL resonance of a 2cc coupler and that of the real ear
111
what is the practical benefit to recd
personalizes conversion factors; adjusts for the absolute volume as well as impedance differences in the canal
112
what are the 2 purposes to recd
correct & convert individuals HL audiometric thresholds to SPL values (allows for precise adjustments for differences in ear canal volume and impedance variations) & predicts the real–ear output when the HA measurements are made in the test box
113
what are ansi standards of RECD
Can be made with a custom earmold or foam insert
requires use of HA1 Coupler
114
Meets ansi standard, #1 standard for RECD
ha 1
115
#2 standard for ansi
ha2
116
RECD protocol (with patient first)
Connect the coupler to the RECD transducer’s nozzle and place in the test box to calibrate
On audioscan, go to tests, on ear measurements, RECD
Prompt will be either foam tip or earmold
Calibrate
Go to tests, on ear, speechmap. Perform HAND WASHING & OTOSCOPY then REUR (see above protocol) to ensure probe is 5mm from ™
Insert foam tip into the ear making sure the probe tube doesn’t move & allowing it to fully expand
Go to tests, on ear, RECD, press (measure real ear)
Once it stabalizes click continue to save data. Print data
117
negative RECD in the LF
check foam seal
increase the size or add lubricant
118
RECD curve deviates more than 10dB from 4-6
check probe tube placement
may have blockage (foam tip or cerumen)
119
RECD pink lin
real ear measurement
real ear resonance
120
RECD green line
recd calibration
coupler resonance
121
recd dots
avg HA1 RECD
122
RECD blue line
HA-1 RECD (measured on PT)
actual RECD measured
123
negative LF value suggests
slit leak
(blue line dips below in LFs)
When pink goes below green in LF = slit leak = acting like a vent effect = poor seal
124
LF sound leaks out around it and causes negative RECD values below 1000 Hz
loose fitting mold or large vent
125
Negative LF results are expected when
perf or pe tubes are present
Below 1.5 kHz RECD will be up by 8dB lower than the adult avg indicating ECV is larger than normal
126
Negative RECD >10dB in the 4-6 kHz region
probe tube blockage
check probe tube placement or blockage and remeasure
127
RECD Below the average line
larger than avg
128
RECD Above the average line
smaller than average
129
what does open mastoid cavity look like
decreases RECD in mid to highs
130
what does MEE look like
increased REC in mid frequencies
131
protocol to programming in the test box
enter into noa & audio
Connect HA to software
Connect HA to coupler
On audioscan, go to tests, test box, speechmap
Change instrument to BTE HA-2
Click Audiometry and change
Rx method (dsl, nal, etc.)
Set UCL to measured
Set RECD to measured
Enter audio, UCL & RECD data
On software:
Set planned acoustic parameters for the device
Set fitting algorithm (NAL, DSL, manufacturers)
Set experience level to 100% & create “first fit” for PT
Do not run DFS
On audioscan, run speechmap verification in test box at 65dB
Adjust bands as needed to meet targets
Run 50-55 dB
Adjust gain in compression shaping channels as needed
Run 70-75
Adjust gain in channels as needed
Run MPO at 90
Adjust MPO to maximize or reduce output of device
Verify audibility of HFs /s/ sound
Adjust FL to MOAF as needed
132
Proprietary formula
developed by manufacturers
REM targets aren’t available
133
NAL-NL2
Loudness equalization formula - balances perception of loudness over a range of frequencies (LFs have more energy than HF so this increases mid and high intensity until energy equals the lows)
Uses REIG targets
If PT is desiring increased intelligibility
Adults only
134
If PT is desiring increased intelligibility
nal nl2f
135
DSL 5.0
Loudness normalization formula - maximizes audibility to assist language development
Uses REAR output targets (soft, moderate and loud are increasted)
Provides targets for MPO
PT is desiring increased comfort or their REUR is not average
Adults and kids
136
Milder thresholds
low TK (~30 dB SPL)
137
Severe thresholds
higher TK (~60 dB SPL) - too much gain of soft results in loss of intelligibility here
138
PT is desiring increased comfort or their REUR is not average
dsl 5.0
139
decrease intensity of loud inputs does what to compression
increase
140
Decrease intensity of loud input levels (increase CR) of what portion of LTASS
upper
141
soft signals
Adjusting CR in order to optimize detection of soft input signals or reduce loud input signals for increased comfort
142
Adjustments here adjusts the bottom portion of the speech envelope
soft signals
143
Adjustments here adjusts the top portion of the speech envelope
loud signals
144
what can raising MPO do
make it sound clearer, brighter & scrisper
145
what can lowering mpo too low do
sound muffled, dull, distorted or squashed
146
too high of an MPO pt complaints
PT experience is negative and they conclude HA’s are not useful
147
too low of an mpo pt complaints
distorted speech due to peak clipping
148
When you adjust a band, you adjust
entire speech envelope up and down
149
When you adjust a channel, you either adjust
bottom or the top of the speech envelope
150
move bands, raise soft sounds, then raise loud sounds - maintain balance bw
all the CR TKs
151
SII for frequency bands
60-70%
152
SII for compression shaping of soft input
35-40%
153
clinical reasoning for LTASS levels falling within +/- 5dB
Begin by following +/- 5dB match target rule as a good general guideline
However, make further adjustments based on PT complaints
The line must match the shape (contour) of the targets that are present
154
How do you adjust and verify HF /s/ sound
Use the /s/ stimulus on audioscan to assess HF audibility
Adjust frequency lowering in manufacturer software if needed
Too much audibility = poor sound quality
Goal is to add least amount of FL needed
155
Lower limit of MOAF
frequency where LTASS becomes inaudible
156
UPPER LIMIT OF MOAF
upper range frequency where speech envelope becomes inaudible
157
what is MOAF
Max audible output frequency range)
Region where audibility ends?
158
keys to adding manual programs
make sure programs are linked to the primary one so that changes are applied to all
159
DSP features
directional mic
DNR
music settings
phone seetings
at/rt
tk levels
etc.
160
Closer the lines are the higher the compression ratio is
true
161
Further lines go apart - more linear
true
162
If we shift tk up and down it impacts signal at kneepoint and the rest of the signal
no it doesnt effect the rest of the signal
163
ILD
HF above 3 kHz
164
ITD
LF below 850 Hz
165
Strategies for binaural advantage
Fit better ear first
Relies on this for communication
Fit poorer ear second after good ear is optimized
166
cros verification
PT sits with better ear toward speaker at 45 deg angle
present with no aids
turn same deg to poor ear
present with no aids
add aids
PT sits with poor ear & cros device at 45 deg to the speaker
the aided ltass equals unaided becuase CROSS elimaes head shadow
167
type I NIHL fitting
represents the configuration after a few years of exposure
Normal or near normal to 2k Hz then crops to a moderate notch at 4 kHz back up to a mild HL in the HFs
Special fitting strategies aren’t necessary
168
Type II NIHL fitting
represents many years of excessive exposure to noise
Threshold loss extends into the lower frequencies (i.e., below 2000 Hz).
Use of typical fitting strategies may help if output supplies HF audibility
169
type III NIHL
represents the extreme case in which hearing is near normal for the low frequencies only
Threshold loss shows a precipitous slope into the high frequencies.
Special fitting strategies are needed to support success
170
Full high frequency audibility is not a reasonable goal due to comfort and sound quality problems.
true
171
Protocol for NIHL (i and ii)
add 5-8 before the drop
region of residual add audibility
disable FL
add audibility in residual frequency ranges (avoid adding to those close to LDL)
add 5-8dB to normal range before precipitous drop
enable expansion to reduce mic noise when hearing is near normal below 2
verify audibility of s
adjust and add FL 4-6wks after first fit
172
protocol for type iii nihl
Add gain to thresholds below 85 dB HL
Strive to achieve a balance audibility from 500 Hz up to 3k Hz,for thresholds below 85 dB HL
Add 5-8 dB of gain to normal thresholds just before the precipitous drop
This bump of audibilityfor normal thresholds benefits sound quality and intelligibility
Enable expansion to reduce mic noise when hearing is near normal below 2k Hz
Internal noise will cause patients to lower overall volume
If a threshold is near LDL, apply no gain or 1/5 the threshold (2% of threshold vs.46%)
173
Full high frequency audibility is not a reasonable goal due to comfort and sound quality problems.
Focus on supplying gain to heathier areas of the cochlea in the low and mid-frequencies
There’s no need to select a receiver offering wider frequency responses with extended high frequencies
nihl type III
174
do you need special fitting strategies for 1-2 cochlear dead regioins?
no might need for more
175
how to adjust for more than 2 dead regions
add HF gain only if 1-2 dead regions are bw 1-4kHz
2/3 of those with more than 3 dead regions preferred HF audibility
176
reverse slope fitting
focus on residual hearing regions audibility
leads to unsuccessful fitting: adding too much LF gain (upward masking)
add 15-20 to LF & mids
add 10-15 to increase audibility at 2kHz & above if WNL
allow PT to habituate before increasing
add MF gain in 5 dB steps after habituation
once LF & MF are adjusted comfortably modify HF based on their perceptions and adding 5-10
177
Additional gain is needed to overcome the attenuation caused by the mechanical loss
chl
178
A/B gaps with normal B/C thresholds: is compression needed
not needed because the dynamic range is normal.
very low cr or linear is good
179
A/B gaps with abnormal B/C thresholds (mixed loss): is compression needed
Compression is needed in addition extra gain due to the reduced dynamic range
180
which Rx method adjusts for ab gaps
na nls
181
CHL formula
add 25% of AB gap to AC threshold
calculate gain rec for ac threshold
add 25% of ab gap
increase MPO by same % used for ab gap calcuatio allowing extra gain headroom
*Subtract AC threshold from BC threshold
Take this value and multiply by .25
This is the 25% conductive component
182
small perf
1-2mm
minimal hl
183
large perf
25-35 chl
184
total perf
around 40 CHL
185
Posterior-superior w/ ossicular erosion
may result in a loss as great as 60 dB
186
options for perfs
BC/Bone ancored devices
Some dislike surgical recommendation or are not candidates
Ear level device (HA’s, etc.)
Will the pathology allow for an ear level device?
What pathophysiologic concerns must be considered?
Style considerations?
Prescriptive considerations?
Verification considerations?
187
severe to profound fitting
use nal-rp
establish their LDLs
reset their MPO to LDL in fitting software to max headroom
evaluate audibility of 65dB signal (its ok if signal below LTASS audibility is not possible)
use nal-rp, low CRs, & slow acting compressions
188
Raising or lowering TK modifies output for
soft input signals
189
Increasing or decreasing low frequency bands changes perception of
volume and sound quality
190
Increasing or decreasing high frequency bands improves
clarity or comfort
191
Increasing or decreasing intensity of soft input signals improves
clarity
192
Increasing or decreasing intensity of loud input signals improves
clarity or increase comfort
193
Increasing or decreasing MPO manages
very loud signals (90+)
194
“My voice is hollow I sound like I’m talking in a barrel; it’s annoying when I chew crunchy foods”
shell origin (OE)
or amp origin
195
describe shell origin
Prevalent when LF thresholds are <40 dB HL
Complaint continues when device is off
196
how to manage shell origina
Open the vent or increase the earmold canal length
If open dome doens’t allow enough HF gain due to feedback a custom hollow-shell earmold with a 2mm or larger vent can allow this LF energy to escape the ear canal
197
does their voice sound better with the device on
shell origin - modify the shell
198
if there is no change in their voice with it on or off
probably shell origin
modify shell
199
if there voice sounds better with the device off
amp origin.- modify HA gain/output
200
describe amp origin
can combine with OE to exacerbate the complaint
Complaint stops when HA is off because gain related issue isn’t present if it is off
201
how to manage amp origin
Lower LF band 4-6dB to improve
If this doesn’t help increase LF band 4-6 to overcome combo of mild OE & under amplification
Try manufacturer’s fitting assistant
Change the loud LF channel first
202
if you push the HA in to make it tighter or deeper and this improves voice complaint
increase canal length of device or improve aperture seal
203
if you pull the HA out and this improves voice complaint
increase vent size or shorten canal length
204
no difference when you push it in or out
probably amp origin and gain output needs changed
205
voice gets worse when they are loud
Indicates saturation or excessive gain
Adjust mpo or loud input
206
voice gets worse when they are softer
Insufficient gain
Increase LF band or soft inputs
207
no difference with speaking at differing intensities
OE
208
HF amp origin
Describes own voice as sounding like an echo, lispy, raspy or muffled
Report an unnatural perception of their voice coming from somewhere else
Increase gain in mids
Try manufacturers fitting assistant
209
processing delay origiin
PT complains voice echoes or their head is in a barrel
PT hears delayed signal resulting from DSP
Reduce vent size if you can - test by putting finger over vent while they talk
Change brand for faster processing
210
ex of low f soft signals
computer hum
purring kitten
vowels
211
ex of high f soft signals
leaves rustling
clock tick
consonants
212
ex of high f loud input signals
running water
paper crinling
dishes
213
ex of low f loud input signals
slamming doors
traffic
own voice
214
complaint: ha echoes
increase vent size
decrease LF gain bands
215
complaint: barrel sounding
incrase vent size
decrease LF gain bands
216
complaint: plugged feeling
incrase vent sie
decrease lf band gain
remake w/ longer canal
217
own voice echoes
increase vent size
cecrease lf gain bands
remake w/ longer canal
218
LF gain complaints
echoing, hollow sounding, barrel sounding
219
too much gain and output complaints
background is too loud
voices are too loud
HA booms
HA is too loud
220
complaint: loud background noise
decrease bands of LF gain
decrease loud LF gain to increase LF CR
decrease overall gain
221
common adjustments for lf gain complaints (sounding hollow, in a barrel, feeling plugged)
increase vent size, decrease bands of LF gain
222
common adjustments for too much gain and output complaints (background noise, voices are loud, ha boom, ha loud)
decrease overall gain
decrease bands of LF gain
223
too little gain and output complaints
not loud enough
too soft
cannot hear with it on
ha is weak
224
complaint: ha not loud enough
increase overall gain
increase mpo
increase lf gain bands
225
too little gain and output complaints (not loud enough, cannot hear, weak)
increase overall gain
increase mpo
increase lf gain bands
226
complaint: ha is too sfot
incrase overall gain
increase bands of LF gain
increase MPO
227
cannot hear with ha
increase overall gain
increase lf gain bands
incrase mPO
228
hearing aid is weak
increase overall gain
increase MPO
increase lf gain bands
229
too much HF gain complaint
ha whistles
sounds tinny
sounds shapr
sounds harsh
230
solution for ha whistles
sounds tinny
sounds shapr
sounds harsh
decrease HF gain bands
decrease loud hf gain to increase hf cr
231
ha whistles
decrease bands of hf gain
decrease vent
remake
cerumen blockage?
232
tinny ha
decrease bands of hf gain
increase bands of lf gain
233
sharp ha
decrease bands of hf gain
decrease loud hf gain to increase hf cr
234
harsh ha
decrease bands of HF gain
derease loud hf gain to increase hf cr
235
my voice sounds echo, hollow, plugged, barrerl
increase vent or extend canal
decrease LF band
decrease overall gain
236
my voice sounds muffled
increase loud HF and HF gain to reduce CR
increase overall MPO
increse HF band and decrease LF band
237
my voice sounds distorted or unnatural
decrease loud HF and LF gain to increase CR
238
voices are too loud
all sounds are too loud
voices are harsh
reduce overall gain
increase CR by reducing HF loud gain
239
cannot understand SIN
increase HF band
increase soft HF gain to increase CR
240
voices at a distance soun better than close
increase HF band
decrease soft HF gain to decrease CR then try soft LF gain
241
thresholds at 250 are 30, 45 at 500 and 50 at 1000. slopes from a mild to severe hearing loss what vent and hearing aid style?
custom mold with a 1-2mm vent (not power due to 500 being below 45)
RIC, BTE
242
thresholds at 250 are 55, 45 at 500 and 50 at 1000. slopes from a moderate to severe hearing loss what vent and hearing aid style?
no vent or .5 vent
RIC, BTE
243
voices are too soft
all sounds too soft
ha too soft
increase overall gain
increase mpo
increase soft gain overall to increase CR
