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40 Cards in this Set
- Front
- Back
CI Candidacy
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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) |
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Medical exam should show
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no deafness due to VIII nerve lesion or central aud pathway
no active middle ear infection no absence of cochlear developemnt |
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Surgery
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2 hour procedure
1 day hospital stay 4 weeks prior to stimulation |
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Components of CI
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Ear level microphone
Processor External coil Internal receiver Electrodes Speech Processor -feature extraction -filter band |
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Risks
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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 |
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Other risks
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May not be able to have MRI
Electrical surgery Electroocnvulsive therapy Ionic radiation therapy |
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Zinc air batteries last
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1-3 weeks
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FM
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Frequency Modulated
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What is the most fragile part of an FM system?
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the audioshoe
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CI Troubleshooting
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-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 |
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FM Troubleshooting
Static |
-Unwind or unknot antenna on transmitter
-Change the channel -FM receiver may have exceeded its operating range. Move closer to transmitter. |
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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 |
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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 |
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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 |
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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 |
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Channels
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216-217 MHz
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Phonak inspiro
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Can program transmitter for selected channels
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Oticon Amigo
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can use transmitter to change settings on FM Receiver
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FM Technology
Advantages |
Less equipment on the body
No pouches/harnesses tomaintain No cords to break |
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FM technology
Disadvantages |
Smaller components
Non-rechargeable batteries Possible more variety of units to accommodate personal hearing aid |
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FM Receiver Coupling Options
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Basic System
Personal system |
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New term
FM Amplifies |
Child comes to school and removes personal HA and uses Ear Level FM system
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Basic system
FM Receiver Coupling |
Button earphone
Headphone Soundfield speaker |
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Personal system
FM receiver coupling |
Neckloop
Direct audio input Silhouette |
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Integrated FM Receiver
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No Microphone
Programmable Gain No earmold |
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3 Basic ways to use FM systems with CIs
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Audio Coupling
Electrical Coupling T-coil Coupling |
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Audio Coupling
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Wall mounted soundfield FM systems
Desktop soundfield systems |
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Electrical Coupling
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Patch cords connect FM receiver to CI
Cable-connect receiver Direct plug-in of FM receiver |
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T-Coil Coupling
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Processor has t-coil to receive electromagnetic signal from the body-worn FM system with neckloop
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Disadvantages with T-coil Coupling
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Signal may vary with orientation of t-coil
May reduce low-fq input to listener T-coils add noise |
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BAHA
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Bone anchored hearing aid
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Steps in FM Fitting
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FM Referral
Current audiogram Make FM Recommendation Order Equipment Earmold Impressions FM Fitting Appointment |
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Steps in FM Fitting cont
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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? |
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more Steps in FM fitting
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Evaluate FM Advantage
Evaluate Max Output Label Equipment Provide written instructions Inservice for teachers Follow up visits |
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Behavioral verification
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Percent Correct Speech
Recognition with and without FM system |
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The average improvement when adding the FM system in noise was
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29.75%
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The difference between CI alone and Ci+FM in quiet was
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minimal
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Verification of CI/FM system arrangements
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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 |
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Informal assessment without child
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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 |
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Informal assessment with the child
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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 |