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40 Cards in this Set

  • Front
  • Back
CI Candidacy
1) Severe - Profound bilateral sensorineural loss
2) Greater success if adventitiously deafened
3) Little or no benefit from a hearing aid
4) No radiological contraindications
5) Psychologically & motivationally suitable (parents & child)
Medical exam should show
no deafness due to VIII nerve lesion or central aud pathway

no active middle ear infection

no absence of cochlear developemnt
Surgery
2 hour procedure
1 day hospital stay
4 weeks prior to stimulation
Components of CI
Ear level microphone
Processor
External coil
Internal receiver
Electrodes

Speech Processor
-feature extraction
-filter band
Risks
Meningitis
Injury to facial nerve
Cerebrospinal fluid leakage
Reaction to anesthesia
Perilymph fluid leak
Infection of the skin wound
Blood or fluid collection at the site of surgery
Attacks of dizziness or vertigo
Tinnitus
Taste disturbance
Other risks
May not be able to have MRI
Electrical surgery
Electroocnvulsive therapy
Ionic radiation therapy
Zinc air batteries last
1-3 weeks
FM
Frequency Modulated
What is the most fragile part of an FM system?
the audioshoe
CI Troubleshooting
-Remove the FM system from CI speech processor
-Visual check for broken parts
-Check battery- Replace if dead
-Listening check of the speech processor
-If speech processor still has no sound, intermittent, static, or distorted sound, contact the audiologist for further check
FM Troubleshooting
Static
-Unwind or unknot antenna on transmitter
-Change the channel
-FM receiver may have exceeded its operating range. Move closer to transmitter.
FM Troubleshooting
Sound is intermittent
-Unwind or unknot antenna on transmitter
-Change the transmitter channel and synchronize the receiver to the new channel
-Check any cords for breaks
FM Troubleshooting
Receiver could not be synchronized
-Complete visual inspection of audioshoe. Make sure none of the gold contacts are missing from the audioshoe
-If FM receiver and hearing aid are working, replace audioshoe and synchronize transmitter to receiver again
FM Troubleshooting
No sound from transmitter
-Make sure hearing aid is switched on and functioning
-Does the receiver need to be “synchronized” to this channel?
-Turn hearing aid switch from “M” to “FM/M”
-Turn receiver switch to or
-Verify the transmitter is on the correct channel
-Make sure transmitter is not muted
FM Transmitters
WICC
Wireless Channel Changeability

1)Direct Fq Synchronization- DFS
Ex: MLxi with inspiro

2) Automatic Fq Synchronization AFS
Ex: MLxi with Wall Pilot
Channels
216-217 MHz
Phonak inspiro
Can program transmitter for selected channels
Oticon Amigo
can use transmitter to change settings on FM Receiver
FM Technology
Advantages
Less equipment on the body
No pouches/harnesses tomaintain
No cords to break
FM technology
Disadvantages
Smaller components
Non-rechargeable batteries
Possible more variety of units to accommodate personal hearing aid
FM Receiver Coupling Options
Basic System

Personal system
New term

FM Amplifies
Child comes to school and removes personal HA and uses Ear Level FM system
Basic system
FM Receiver Coupling
Button earphone
Headphone
Soundfield speaker
Personal system
FM receiver coupling
Neckloop
Direct audio input
Silhouette
Integrated FM Receiver
No Microphone
Programmable Gain
No earmold
3 Basic ways to use FM systems with CIs
Audio Coupling

Electrical Coupling

T-coil Coupling
Audio Coupling
Wall mounted soundfield FM systems
Desktop soundfield systems
Electrical Coupling
Patch cords connect FM receiver to CI
Cable-connect receiver
Direct plug-in of FM receiver
T-Coil Coupling
Processor has t-coil to receive electromagnetic signal from the body-worn FM system with neckloop
Disadvantages with T-coil Coupling
Signal may vary with orientation of t-coil
May reduce low-fq input to listener
T-coils add noise
BAHA
Bone anchored hearing aid
Steps in FM Fitting
FM Referral
Current audiogram
Make FM Recommendation
Order Equipment
Earmold Impressions
FM Fitting Appointment
Steps in FM Fitting cont
Evaluate the Personal Hearing Aid
-electroacoustically- is it working OK?
-Match to Target-Does it provide adequate gain/output?

Listening Check with FM System
-MA mic active
-FM mic active

HA+FM match MA alone?
more Steps in FM fitting
Evaluate FM Advantage
Evaluate Max Output
Label Equipment
Provide written instructions
Inservice for teachers
Follow up visits
Behavioral verification
Percent Correct Speech
Recognition with and without FM system
The average improvement when adding the FM system in noise was
29.75%
The difference between CI alone and Ci+FM in quiet was
minimal
Verification of CI/FM system arrangements
1. Check equipment arrangement
2. Informal assessment
a. listening check using headphones
b. informal behavioral assessment - follow simple directions via CI & FM mic
3. Formal Behavioral Assessment
-sph recognition test
-evaluate sph recognition in noise
Informal assessment without child
Ling Six Sound Test (a, i, u, s, sh, m) and spondee words via CI & FM mic with headphones

Audiologist should listen for distortion in the signal, and crackling or popping sound
Informal assessment with the child
1. verify that the CI mic is receiving the acoustic signal
-follow simple directions or repeat words/phrases

2. Verify that the CI is receiving the FM signal
-step out of the room and has child follow simple directions or repeat words/phrases