Wk12-32-Troubleshooting and Practical Issues

Question 1

What are the first things to do when a patient reports a problem with their CI?

Answer 1

• visual inspection of the equipment
• use of testing services/listening checks
• Ling-6 sound test in paediatric population

Question 2

Generally, the step-by-step troubleshooting you should do (things to try changing) is:

Answer 2

• change cord
• change batteries
• change battery pack/controller
• change headpiece
• try loaner processor

Question 3

What additional troubleshooting can be done with Advanced Bionics?

Answer 3

• check LED codes (different colours indicate different issues)
• perform a listening check (slides onto speech processor so you can listen via headphones)
• check online troubleshooting guides
• app

Question 4

Does Cochlear N7 also offer listening check and LED light options to help troubleshooting?

Answer 4

Yes

also, an app

Question 5

What troubleshooting options does Med-EL offer?

Answer 5

Intellilink Check - couples to magnet on speech processor and shows flashing red light that flashes in time with your speech bursts

Listening Check - plugs into coil and headphones; requires remote to operate listening check

Troubleshooting videos online

Error Lights

App

Question 6

What troubleshooting options does Oticon use?

Answer 6

Error Lights

Microphone Check directly through device itself

Question 7

What connectivity options/accessories are available for Advanced Bionics?

Answer 7

• built in T-coil
• HiBan - ComPilot I, DECT phone, Phonak EasyCall
• Roger 17 receiver OR Roger Ready - connects to Roger Mic, Roger Pen, Roger Select
• Naida Connect - direct BT streaming, attaches to base of PowerCel 170 batteries

Question 8

What connectivity options/accessories are available for Cochlear?

Answer 8

• built in T-coil
• Roger MyLink or Roger20 receiver - connects to Roger Mic, roger Pen, Roger Select
• MiniMic 2+ (same as ReSound) - remote mic for individual or groups in noise; wireless headphones and T-coil connectivity
• Phone-CLip - BT connector for direct streaming of audio from our phone
• MFi - direct streaming from iPhone to N7

Question 9

What connectivity options/accessories are available for Med-EL?

Answer 9

• built in T-coil
• Roger MyLink, Roger 21 receiver or Roger X - connects to Roger Mic, Pen, Select
• AudioLink (for SONNET 2) - acts as TV streamer, remote mic, wireless headset, and BT connector for cellphone

Question 10

What connectivity options/accessories are available for Oticon Medical?

Answer 10

Oticon FM and application technologies

• ConnectLine
• Oticon ON app

Question 11

What factors do we consider when deciding which ear to implant?

Answer 11

• audiological criteria
• vestibular function (can be injured during implant -> poorer vestibular ear)
• anatomical factors (comorbidities, imaging needs, etc) -> can degrade performance after the fact
• pt preference (e.g. handedness)

-e.g. if frequent serial imaging is necessary - example would be aneurism monitoring - would implant the ear on opposite side if possible to avoid frequent magnet removal

Question 12

How might dental procedures impact CI users?

Answer 12

• may want to remove processor during procedure d/t aversive sounds, etc.
• avoidance of certain surgical tools (e.g. cautery -> charge can buildup on casing of internal device)

Question 13

What practical issues are there related to retention and magnet strength?

Answer 13

• magnet strength can cause the device to fall off if it’s too weak, or cause skin irritation and breakdown if it’s too strong

Question 14

What imaging issues are there?

Answer 14

• X-ray and CT safe with removal of speech processor AND removal of speech processor from the scanning area
• MRI - compatibility is different across manufacturers and the generation of the internal device (Advanced Bionics, Cochlear, and Med-El CURRENT generation internals are up to 3.0T safe with/without conditions; SWAMP = imaging artefact with MRI)

Question 15

What issues are there for CI users surrounding detection systems and swimming/bathing?

Answer 15

Theft detection
- can set off alarm or cause auditory percept for recipient as they pass through

Airport Security

• titanium may set off metal detectors
• carrying lithium ion batteries or other accessories may be an issue

Swimming/bathing

• external equipment needs to be removed or placed in waterproof housing
• having the device off makes communication difficult
• consider impact in paediatric cases when user may finally be acclimatized to having the device on

Question 16

What are the practical issues for CI users regarding sports, helmets, etc.?

Answer 16

• follow standard precautions for each sport
• careful of direct blows to implant site
• remote-mic technologies can be used by coaches
• sport head bands may be needed to improve retention
• care needs to be taken with placement of hard hats, helmets, etc.
• may need to be taken to vendor to have “inserts” cut out for coil

Question 17

What are practical issues for CI users regarding pressure?

Answer 17

Rollercoasters and Deep sea diving may put enough pressure on the internal device to cause it to break

Question 18

What are practical issues for CI users regarding cell phones?

Answer 18

• potential interference b/w phone and RF link
• not all users are able to use phone effectively
• need to be comfortable with connectivity options

Question 19

What are practical issues for CI users regarding static electricity?

Answer 19

• ground before touching implant/implant site

- avoid plastic play equipment and ball pits (paediatrics)

Question 20

What do you do for the other ear for bimodal/bilateral fitting?

Answer 20

Some CI devices allow connectivity to hearing aids in the other ear

• may be specific options for the device for the other ear so that devices can work together
• Cochlear connects to 2 ReSound devices
• Advanced Bionics only connects to one specific Phonak device (Naida Link)