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Interacoustics Eclipse Additional Information

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Additional Information

Eclipse
D-0105222 - E - 2017/09
Valid from software version:
EPx5 4.5
ASSR 1.2.7
ABRIS 1.06.2
DPOAE 1.03.2
TEOAE 3.04.3

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Summary of Contents for Interacoustics Eclipse

  • Page 1: Additional Information

    Additional Information Eclipse D-0105222 - E - 2017/09 Valid from software version: EPx5 4.5 ASSR 1.2.7 ABRIS 1.06.2 DPOAE 1.03.2 TEOAE 3.04.3...

  • Page 3: Table Of Contents

    Module Setup in OtoAccess™ .................. 1 Starting up from NOAH (ASSR only)..................2 Change & view License ......................3 Ensuring the Eclipse is working properly ..................5 Calibration of Eclipse ......................5 2.1.1 peSPL to nHL correction values ................6 Limiting noise in the test environment ...................
  • Page 4 3.15 eABR – Trigger Enabled (if included in your license) ............73 3.15.1 Protocol Settings for eABR ..................73 3.15.2 Using the Eclipse Trigger ..................74 3.16 ECochG (Electrochochleargraphy) (if included in your license) .......... 76 3.16.1 Protocol Settings for ECochG ................. 76 3.17 Cochlear Microphonic (CM) (if included in your license) .............
  • Page 5 Exporting the whole session ....................86 Exporting waveform when offline ..................87 Exporting data from another laptop ..................87 Exporting other data ......................87 Technical details of the research module ................88 Import of XML-file in external program ................89 4.8.1 Import in Excel ......................
  • Page 6 6.4.3.1 Correction factors in Estimated Audiogram .......... 137 System setup ........................139 6.5.1 Auto Tests Setup ....................139 6.5.2 General Setup ....................... 141 6.5.3 Report Templates ....................142 6.5.4 Correction Factors ....................143 6.5.4.1 Correction factor values ................ 143 Preparing for an ASSR measurement ................145 6.6.1 Visual inspection of the ear canal .................
  • Page 7 DPOAE PC shortcuts ......................182 TEOAE ............................183 About the TEOAE25 module ..................... 183 Brief Introduction to TEOAE ....................183 The TEOAE25 Menu Items ....................184 General Operation of TEOAE25 ..................185 TEOAE25 System Setup ....................187 9.5.1 Auto Test ......................187 9.5.2 General Setup .......................
  • Page 9 Throughout this manual the following meaning of warnings, cautions and notices are used: WARNING indicates a hazardous situation which, if not avoided, could re- sult in death or serious injury. CAUTION, used with the safety alert symbol, indicates a hazardous situa- tion which, if not avoided, could result in minor or moderate injury.

  • Page 11: Launching The Software

    1 Launching the software Starting up from OtoAccess Ensure that the Eclipse is on, before performing recordings and then open the software module. If the hard- ware is not detected the selected Eclipse module can still be opened in reader mode.

  • Page 12: Starting Up From Noah (Assr Only)

    Eclipse Additional Information Page 2 For further instructions about working with the database, please see the operation manual for OtoAccess™. Starting up from NOAH (ASSR only) Open NOAH Select the patient you want to work with by highlighting it orange If the patient is not yet listed: ...

  • Page 13: Change & View License

    01.003.230 can be used. This license key is stored in Eclipse, as well as in the Interacoustics manufacturing database, so that we can find the license key already stored in the box, even if the customer gives us only the serial no of the DSP board mentioned above.
  • Page 14 Eclipse Additional Information Page 4 When pressing OK the program asks to store the new license key. Press Yes to overwrite the old License key. The application has to be restarted in order to activate the new features.

  • Page 15: Ensuring The Eclipse Is Working Properly

    (IEC 60318-4 / 60711) not a 2cc / HA-2 coupler, for which different values apply. Unofficial figures for the HA-2 coupler are available at: http://hearing.screening.nhs.uk/calibration. Remember to check Eclipse stimuli levels. An easy sound check with the transducer left on the table is often a good manual weekly procedure.

  • Page 16: Pespl To Nhl Correction Values

    Maximum stimulus intensity is limited to 100dBnHL by the air conduction transducers. The ABR unit leaves the factory with nHL calibration, but it can easily be changed to peSPL values. Please refer to the FAQ or contact your local Interacoustics distributor if you are interested in changing the calibra- tion unit.

  • Page 17: Limiting Noise In The Test Environment

    Do not connect the Eclipse to a safety transformer, as a safety transformer is built in to the Eclipse already. When ensuring grounding be aware of the following: 1.

  • Page 18: Limiting Noise - Equipment Setup

    Eclipse Additional Information Page 8 Always disconnect any powering of the patient bed during ABR test. It will cause more noise. We have several cases where the noise was more than halved after the patient bed was disconnected to power. A bed with a battery can cause noise even when the bed is not plugged into the wall, and should be replaced with a bed without a battery.

  • Page 19: Limiting Noise - During Testing

    Eclipse Additional Information Page 9 2.2.4 Limiting noise - During testing Run electrode cable from one direction to the patient and earphone tubes or cables from the other direction to the patient – do not let them cross. Run electrode leads close together or better braid the electrodes leads.

  • Page 20: Service Check Using The Loop Back Box (Lbk15)

    Repeat the test on the other channel if both must be tested. Note If the EEG curve is red it can indicate no/poor ground is connected to the Eclipse or you have to search for noise sources (see the section “Limiting noise in the test environment” to help you locate the noise source).
  • Page 21 Eclipse Additional Information Page 11 6. You have now tested the system with the stimulus Tone Burst of 2kHz, to verify that the hardware func- tions properly. 7. To change the test frequency, select the wanted frequency from the drop down menu on the toolbar.

  • Page 22: Testing Noise Level On The Artificial Patient Lbk15

    4. Optimally test with the LBK and Eclipse on same position as you would place the test subjects. 5. Check that electrode fall off is working as expected, full rejection is expected when one lead is discon- nected (example of check of left electrode is shown below).

  • Page 23: Check The Amplitudes Of The Eeg With Lbk15

    Eclipse Additional Information Page 13 2.4.1 Check the amplitudes of the EEG with LBK15 Double click on the EEG to get picture below. Use and move the horizontal curtains in the EEG box to read the peak to peak amplitude of the EEG. Typi- cally an amplitude of 2uV peak to peak is expected for electrical quit surroundings.
  • Page 24 Eclipse Additional Information Page 14...

  • Page 25: Ep15/25

    ABR recordings are converted into a digital signal in the ADC (Analog to Digital Con- verter) inside the Eclipse. The digital ABR recordings undergo data processing handled by the PC to improve the ABR recordings. The ABR-recordings are displayed on the monitor for the operator for further examina- tion and diagnosis.

  • Page 26: Brief Introduction To Abr

    Eclipse Additional Information Page 16 Brief Introduction to ABR When a well-functioning ear is stimulated with sound electrical activities are generated within the cochlea as well as in the combined nerve system connecting the cochlea to the brain. The cortex itself also generates electrical activities when a sound is processed at these high levels of brain activity.

  • Page 27: The Ep15/25 Menu Items

    Eclipse Additional Information Page 17 The EP15/25 Menu Items From the main menu, the following options are available - Setup, Print, Edit or Help. The menu has the fol- lowing structure: File | Setup System allows you to enter the EP15/25 setup where the settings of all protocols can be viewed and changed.

  • Page 28: General Operation Of Ep 15/25

    Eclipse Additional Information Page 18 General Operation of EP 15/25 The Toolbar is always available during testing. In the left side of the screen, there are the tabs Record, Edit, and Latency. The Record tab shows the recording screen, the Edit tab will allow you to edit and mark your current and measured data and the Latency tab lets you examine the latency differences between the measured peaks.
  • Page 29 Eclipse Additional Information Page 19 The suggest waveform markers are only intended as guidelines and the function cannot determine if the selected peak stems from a patient response or is just noise. Always use this function with care and ensure that each of plotted waveform markers are correct.

  • Page 30: Record Tab

    Eclipse Additional Information Page 20 Note The display gain may be presented at display gains different from the default 100µV per division, if Auto Single Curve Display Gain is selected in the General Setup. 13. Split Screen Split Screen function will display Right and Left waveforms on separate sides of the screen.

  • Page 31: Rejection Level

    Eclipse Additional Information Page 21 4. Manual Stimulation: The Man. Stim window allows you at any time, also before the test starts, to over- rule the automatic test protocol you have selected: Select ear and click on one or more intensities. If an auto- matic test sequence is in progress, the manually entered intensities will be tested as soon as the automatic intensity sequence has finished.

  • Page 32: Advanced Rejection

    Eclipse Additional Information Page 22 3.4.3.1 Advanced Rejection Advanced EEG settings can be entered by double clicking on the EEG curve. It can be useful to change the advanced rejection during the recording e.g. to avoid rejection taking place due to bone conductor stimuli ar- tefacts.

  • Page 33: Fmp And Residual Noise

    Eclipse Additional Information Page 23 Checking the rejection level with the stimuli enabled You may also wish to set the rejection level with the stimuli enabled. Please note that the activation of the stimulus is only available from the main screen and not in the Protocol Setup.
  • Page 34 Eclipse Additional Information Page 24 The residual noise bar will be grey until the residual noise criterion is reached (e.g. 40nV). If enabled the bar will turn green with a checkmark when the criterion is reached. Show response confidence & residual noise bars are enabled/disabled in the General Setup.

  • Page 35: Graph Area

    Eclipse Additional Information Page 25 3.4.5 Graph area 3.4.5.1 Changing the Gain and Time scale Changing the gain or time scale with the arrows affect only the viewing range on the screen and does not influence the actual characteristics of the recording. The preference of time and gain display can be set indi- vidually for each test protocol from Auto Protocol Setup.

  • Page 36: Right Click On The Curve Handle

    Eclipse Additional Information Page 26 Depending on the settings in the Auto Protocol Setup the display of X, Y and Z or I’, III’ or V’ can be selected instead of CR, RA and INC. 3. Rearrange curves arrange curves with equal distance between them.
  • Page 37 Eclipse Additional Information Page 27 Creating Sum Curve (merge) and Add this curve: Create sum curve will generate a single curve based on the total average of the individual sweeps of the two selected curves. � ��������. �������� ������������������������. The Sum curve will contain the two merged curves recording sweeps and in this way an improved SNR reached.
  • Page 38 Eclipse Additional Information Page 28 In order to remove the added curve – use the “Delete” – to delete the curve.  In this way repeated curves can be merged together in order to maximize the reduction of residual noise if needed.

  • Page 39: Edit Tab

    Eclipse Additional Information Page 29 Edit tab Select the Edit tab to enter Edit mode. You may edit a test while an automatic protocol is in progress or after the test has been finished. For the Edit tab you can then monitor the rejection situation by observing the little light at the bottom of the screen during a recording.
  • Page 40 Eclipse Additional Information Page 30 The corresponding ms and μV values will be displayed in the boxes next to the Waveform Markers. Interlatency values will also be calculated after the relevant markers have been placed. Manual Marking of Trough To use the SN10 / trough markers, it must be selected in the General Setup. Tr buttons will appear for man- ual positioning of the various troughs including trough V.

  • Page 41: Latency Times

    Eclipse Additional Information Page 31 The above markers CR, RA & INC are shown on the Printout together with other relevant parameters such as the area ratio. Further, note the Ratio in the table indicating 2.9. That is the ratio of interest when compar- ing peak V and trough V (SN10).

  • Page 42: Double Cursor / Measuring Individual Differences

    Eclipse Additional Information Page 32 3.5.2 Double Cursor / measuring individual differences This feature gives you the ability to use two cursors in the Edit Screen. Pointing at the highlighted waveform (not its handle) and then clicking the right button on your mouse activates the double cursor. Alternatively, you may select the cursor by hitting the icon View in the upper menu bar.

  • Page 43: Show Condition / Show Fmp Graph

    Eclipse Additional Information Page 33 3.5.4 Show Condition / show Fmp Graph It is possible to toggle between Show Fmp graph and Show Conditions in the Edit tab. By clicking Show Conditions the summary of the test settings shown below appear. At the right of the table is the comments box.

  • Page 44: Latency Tab

    Eclipse Additional Information Page 34 Latency tab Click the tab Latency to enter the Latency window. Left panel The two boxes on the left part of the screen provide the latencies of all Waveform Markers assigned to the curves in this session for right and left ear (see below, left). When selecting InterLatency the information at the right in the picture below will appear.
  • Page 45 Eclipse Additional Information Page 35 An example of a comparison of peak V, III and I. Here the grey area indicates the norm range for entered in the System Setup. You can add more norms and changes the default ABR normative latency data.

  • Page 46: System Setup

    Eclipse Additional Information Page 36 System Setup 3.7.1 Auto Protocols From the File menu it is possible to enter the System Setup. From here it is possible to modify existing proto- cols and create new protocols. NOTICE Features not included by your license will be dimmed or not visible.

  • Page 47: Type Of Measurement

    Eclipse Additional Information Page 37 If you want to edit an existing test sequence, select it from Selected protocol, instead of selecting New. You have the option to save an edited test with a new protocol name, thus preserving the original protocol.
  • Page 48 Page 38 CE-Chirp® (Broadband CE-Chirp®) In Interacoustics ABR system an additional broad band stimulus (a Chirp), can be chosen if license allows for it. A chirp stimulus counteracts the temporal dispersion in the normal cochlea and thus presents its low- frequency energy before its high-frequency energy.
  • Page 49 Eclipse Additional Information Page 39 Polarity Stimulus polarity may be set to Rarefaction, Condensation or Alternating. Rarefaction and Condensation will each provide slightly different waveforms and either is recommended for normal ABR. Alternating polarity provides a waveform which is actually a combination of these two wave- forms.
  • Page 50 Eclipse Additional Information Page 40 Rise/Fall and Plateau (applicable to Burst only) Here you can design your stimulus manually (if you have selected “Manual” in the “Window” mentioned above. Rise/Fall sets the number of sine waves it takes before the maximum intensity is reached. The same number of sine waves will eventually be used in terminating the stimulation.

  • Page 51: Filter Properties

    (and the metal bed) is usually more beneficial than adapting filter settings. If filtering is applied to smooth the curves, the goal is to make interpretation easier. The Eclipse offers two different filtering methods 1) Input Amplifier filtering, modified from the System Setup, and 2) Preliminary Visual display filtering, applied from either the System Setup or the Edit tab.
  • Page 52 The frequency you choose for the low pass filter is the maximum frequency to record. The picture below shows the different low pass filters frequency response and steepness for the Eclipse at a DSP sampling rate of 30kHz.
  • Page 53 Eclipse Additional Information Page 43 The effect of the High Pass Filter of the Amplifier The high pass frequency you choose is the frequency above which frequencies are recorded. The number next to the frequency indicates the filter slope in dB per octave. At the chosen frequency you will have 3dB attenuation/filtering at the chosen frequency.
  • Page 54 Eclipse Additional Information Page 44 Under the Edit tab you can choose display digital filtering of the measurement (which can be done be- fore/during and after the recording). A default display filter can be set in the System Setup for the individual Auto Protocols. This can if needed be changed temporary anytime under the Edit tab later.

  • Page 55: Display Properties

    Eclipse Additional Information Page 45 Overview of Filtering and Recording In general the advice is to follow the default parameter of the factory protocols. On some occasions there might be an electrical noise source within the testing environment which 'forces' you to apply some stricter filtering to get rid of the problems.

  • Page 56: Recording Properties

    Eclipse Additional Information Page 46 The Gain info on raw EEG allows you to change the display of the EEG window; off, in dB, and as a factor are the options. 3.7.1.7 Recording properties Stop criteria Allows you to select the maximum number of accepted stimuli you need for each test.

  • Page 57: Recording Begin And End

    Eclipse Additional Information Page 47 The scale for the residual noise goes from 0nV to 200nV in the combined Fmp & residual noise view. Typi- cally a residual noise level of 40nV is considered by some as a practical noise target for no-response situa- tions.

  • Page 58: Optimized Recording

    Eclipse Additional Information Page 48 Fine tuning the rejection level Simply grab one of the horizontal lines with the mouse and move the rejection level to match an exact value. The current rejection level is shown to the left on the curve and updated while moving the horizontal lines.
  • Page 59 Eclipse Additional Information Page 49 This method was originally formulated and tested by Elberling and Walhlgreen (1985). By comparing this method of weighted averaging to traditional averaging and to different strategies for artifact rejection the su- periority of weighted averaging was demonstrated by Don and Elberling (1994).

  • Page 60: Wave Reproducibility (Wave Repro)

    Eclipse Additional Information Page 50 If a very tough rejection level is set: In this case, all noisy sweeps are simply rejected for both Bayesian and non-Bayesian recordings. Only the most quite sweeps are accepted, and you have a situation almost similar to above.

  • Page 61: General Setup

    3.7.2 General Setup From the General Setup the user can setup and change basic test parameters. The functions not included by your license will not be visible when connected to Eclipse hardware. 3.7.2.1 External Trigger Output The unit has an electrical output socket carrying a synchronization signal, by which external stimulation de- vices may be synchronized to enable ABR recordings.

  • Page 62: Language

    Eclipse Additional Information Page 52 3.7.2.3 Language There are several languages available for the EP15/25 module. Please ask for and install the separate lan- guage CD-ROM. When installed they language settings can be changed from the dropdown. 3.7.2.4 ECochG Area Function In the setup it can be specified whether the ratio calculation must be based on the Amplitude or the Area.

  • Page 63: Special Waveform Markers

    Eclipse Additional Information Page 53 3.7.2.6 Special Waveform Markers In the edit screen, you have additional labels to use for marking points of interest on the waveforms. In con- trast to the normal Waveform Markers, these marks may be applied to many waveforms all of the same in- tensity, as their ms and µV values are not used for the latency/intensity graph.
  • Page 64 Eclipse Additional Information Page 54 This option carries the potential for the operator to misinterpret the curve. It is important for the operator to note the dis- play scale being used and to estimate the size of any response. Responses that are, in voltage terms, uncharacteristi- cally small or large should be correctly identified as such and not mistaken for genuine responses.

  • Page 65: Level Measure Method

    Eclipse Additional Information Page 55 Show Standard deviation on EMG graph when testing VEMP, the standard deviation is displayed on the grap Leave intensity checkmark on When enabled the intensity checkmark is left on when the intensity is started. This is beneficial, as the intensity will restart when the running intensity has met the stop criteria de- fined in the Auto Protocol or when pressing Next intensity from the recording screen.

  • Page 66: Latency Template

    Eclipse Additional Information Page 56 3.7.3 Latency Template Below this tab you are able to enter you own latency template values, relative to patient age and gender. This Latency Setup permits you to enter latency values which will then be displayed as grey shaded areas when you assign Waveform Markers on curves.
  • Page 67 Eclipse Additional Information Page 57 ABR Latency Norms With the release of EP4.4 the latency norms for Click, CE-Chirp® LS and NB CE-Chirp® LS have been aligned to make it more straight forward locating the wave V response. The figures below show how re- sponse latencies for all three types of stimuli are aligned for the different stimuli levels.

  • Page 68: Report Templates

    Eclipse Additional Information Page 58 Latency norms for the click stimulus for the 3-4 months, 5-8 months and 9-16 month age ranges were pro- vided by Gabriela Ribeiro Ivo Rodrigues & Doris Ruthy Lewis, based on data collected in a published study (Rodrigues &...

  • Page 69: Printing

    Eclipse Additional Information Page 59 Printing To print the session, select the print icon in the upper menu bar. The printout will appear according to the way you have set up your curves with scaling, position etc. The test results will be printed based on the print template set for the protocol.
  • Page 70 Eclipse Additional Information Page 60 Print anonymous allows you the print a file without patient information, which is beneficial when you want to share data with others, e.g. colleges or students. The anonymous file still contains the date for test so it is possible to locate the original file in your database, if you want to do so at a later stage.

  • Page 71: Printer Setup

    Eclipse Additional Information Page 61 3.8.2 Printer Setup 1. Print view lets you modify the view of the curves (aspect ratio) and latencies on the printout. 2. Native filename formatter By clicking on the Setup native print it is possible to change the destination of the saved PDF-files.
  • Page 72 Eclipse Additional Information Page 62 Elements | Add Quality curves will display the quality curves containing the Fmp and residual noise infor- mation. Elements | Add report to add a report field that contains the information you have added in your report.
  • Page 73 Eclipse Additional Information Page 63 Elements | Add Latency Curve shows the latency curve information, similar to what is shown in the latency tab. Elements | Add Latency Tables provides information about the latencies and inter-latencies. Elements | Add Condition Tables shows the conditions of the measurement.

  • Page 74: Preparation Prior To Testing

    Eclipse Additional Information Page 64 Preparation Prior to Testing This description explains how to prepare for testing when performing measurements that requires the tradi- tional electrode montage used for threshold examination, neuro latency examination, and etc. For a descrip- tion of electrode placement that differs from the traditional ABR electrode montage please refer to the Quick Guide provided with the software installation for the particular test.

  • Page 75: Placement Of Electrodes

    Eclipse Additional Information Page 65 Neonates generally do not require excessive abrasion. Neonates Alcohol prep pads may be used to prepare the electrode site. Observe and comply with any local protocol that may limit the agents and techniques used in preparing electrode sites in neonates.

  • Page 76: Impedance Check

    Eclipse Additional Information Page 66 If a socket is left open or a cable not connected to the patient via an electrode, rejection will occur and test- ing will not be possible. Both the ipsilateral and contralateral EEG is evaluated to determine rejection.

  • Page 77: Placement Of Bone Conductor

    Eclipse Additional Information Page 67 3.10.2 Placement of bone conductor When testing with the bone-conductor, stimulus artifacts will be present at intensities near maximum output. Reduce the artifact by placing the electrode on the front of the earlobe instead of mastoid position. Placing the bone conductor too close to the electrode causes artifact and more noise in the recording.

  • Page 78: Abr Threshold Determination

    Eclipse Additional Information Page 68 3.12 ABR Threshold Determination For a child not able to co-operate in traditional audiometric tests, ABR is a popular and effective way to eval- uate hearing threshold. This is done by testing at different stimulation levels and evaluating the resulting waveforms for responses related to the sound stimulation.

  • Page 79: Abr Threshold Results

    Eclipse Additional Information Page 69 Type of measurement: ABR-30 Stimulus Ear: Insert phone Filter properties: LP: 1.5 kHz/12dB/oct HP: 33 Hz/6dB/oct Residual noise ≤ 40nV Stop criteria: Recording: Optimize recording Bayesian weighting Rejection level ± 40µV Display: Split Screen enabled...

  • Page 80: Protocol Settings For Bone Conduction Abr

    Eclipse Additional Information Page 70 3.12.3 Protocol Settings for Bone Conduction ABR The EP15/25 contains the default bone conduction protocols: Bone Conduction CE-Chirp LS, Bone Conduc- tion 2 kHz TB, Bone Conduction 2 kHz NB CE-Chirp LS, and Bone Conduction Click.

  • Page 81: Neuro Latency Examination

    Eclipse Additional Information Page 71 3.13 Neuro Latency Examination If there is a tumour affecting the hearing nerve, the transmission time is prolonged. Since the transmission time is fairly stable between individuals of the same age group, it is common to compare the latency of the response against a set of ABR normative data.

  • Page 82: Neuro Rate Study Examination

    Changes in response latency between fast stimulation rates and slow stimulation rates are recorded and compared. The Eclipse offers both slow and fast markers and performs the calculation between the inter-peak Wave V latencies (be- tween Left and Right) as well as the intra-peak latency shift change from slow to fast rate.

  • Page 83: Eabr - Trigger Enabled (If Included In Your License)

    Eclipse Additional Information Page 73 3.15 eABR – Trigger Enabled (if included in your license) The Electrical Auditory Brainstem Response (eABR) is a measurement of the ABR using an electrical stimu- lus. The purpose of the test is to determine if the auditory nerve responds as expected to electrical stimula- tion.

  • Page 84: Using The Eclipse Trigger

    To describe the Eclipse trigger an example of the Eclipse connected to a cochlear implant stimulator is used. The cochlear implant stimulator is provided by the manufacturer of the cochlear implant. Left: The trigger socket on the back of the Eclipse. Center and left: The PPS box from Cochlear Nucleus and it setting.
  • Page 85 Page 75 Trigger Cable Connection to the Eclipse is via a standard 6.3mm stereo Jack. The “Trigger In” signal is on the tip of the jack. The “Trigger Out” signal is a stereo jack with the signal present on the “middle ring”. Ensure that the trigger cable used is a stereo jack.

  • Page 86: Ecochg (Electrochochleargraphy) (If Included In Your License)

    Eclipse Additional Information Page 76 3.16 ECochG (Electrochochleargraphy) (if included in your license) Electrocochleography (ECochG) is a measure of the electrical potentials of the cochlea, which appear within the first few milliseconds of the response. Typically, the measurement is characterized by the stimulus onset (baseline), the response of the cochlea to the stimulus (summating potential - SP) and response to the syn- chronous firing of nerve fibers (action potential - AP).

  • Page 87: Cochlear Microphonic (Cm) (If Included In Your License)

    Eclipse Additional Information Page 77 3.17 Cochlear Microphonic (CM) (if included in your license) The presence of CM and absence or abnormal ABR is used in the diagnosis of auditory neuropathy spec- trum disorder (ANSD). When a click ABR is not present or abnormal performing an CM test should be con- sidered as an important part of the ANSD diagnosing to examine if the response from the OHCs is present (normal or abnormal).

  • Page 88: Amlr (If Included In Your License)

    Eclipse Additional Information Page 78 3.18 AMLR (if included in your license) AMLR has the potential to offer a more complete picture of the status of the auditory system and can be used to help determine the degree of hearing loss. The most common neurological use of the AMLR is for the assessment of the functional integrity of the auditory pathway above the level of the brainstem in cases with suspected lesions and for the assessment of nonorganic hearing loss.

  • Page 89: Alr (If Included In Your License)

    Eclipse Additional Information Page 79 3.19 ALR (if included in your license) These tests are concerned with revealing responses at cortical levels, where well documented responses can be found in the 100-500ms range. A time window of up to 980ms provides possibilities here.

  • Page 90: P300 (If Included In Your License)

    Eclipse Additional Information Page 80 3.20 P300 (if included in your license) P300 and MMN are popular ALLR tests. Both of them rely on their electrical responses of the patient’s atten- tion to the stimuli. Two different stimuli like 1kHz and 2kHz are presented randomly but with different relative likelihood –...

  • Page 91: Mmn (If Included In Your License)

    Eclipse Additional Information Page 81 3.21 MMN (if included in your license) Mismatch Negativity Test (MMN) is designed to retrieve the MMN response phenomenon, which is present approximately 250ms after stimulus onset. The MMN is present on a calculated differential curve found by subtracting two waveforms where one is recorded with a frequently appearing sound stimulus and another recorded with a rare appearing different sound stimulus.

  • Page 92: Loop Back

    Eclipse Additional Information Page 82 3.22 Loop Back The loopback test is described in the chapter “Ensuring the Eclipse is working properly”. Please refer to the chapter for information about the test procedure.

  • Page 93: Ep 15/Ep25 Pc Shortcuts

    Eclipse Additional Information Page 83 3.23 EP 15/EP25 PC shortcuts Many of the functions carried out by dragging and clicking with the mouse can be accessed also from the keyboard. Once you get to know these functions, you may find them faster and easier than using the mouse.
  • Page 94 Eclipse Additional Information Page 84...

  • Page 95: Research Module

    Eclipse Additional Information Page 85 4 Research Module The research module license enables options to export averaged curves. It can also be used to log each sweep so the entire recording can be “replayed”. The exported data can be analyses further in e.g. Excel and Matlab programs.

  • Page 96: Exporting The Single Curve

    Eclipse Additional Information Page 86 Exporting the single curve To export one curve of interest, right click at the intensity handle to export this averaged waveform. The exported curve is an XML-file located in the specified Export Waveform folder. Exporting the whole session Click Menu-File and Export session to export the full session of the averaged data seen on screen.

  • Page 97: Exporting Waveform When Offline

    The six curves (3 right and 3 left) are listed in the spreadsheet when scrolling down the list. Exporting waveform when offline The recorded data is available for export when the Eclipse is not connected, but only if the recordings are made on an Eclipse with license for the research module function.

  • Page 98: Technical Details Of The Research Module

    Transducer “Transducer” The sampling rate of the Eclipse is 30 kHz with an Analog to Digital resolution of 16 bits. The numbers of dots per trace is specified by the variable “NumberOfSamples” in the xml file, which is typi- cally 467 dots displayed per trace.

  • Page 99: Import Of Xml-File In External Program

    Eclipse Additional Information Page 89 Import of XML-file in external program Use e.g. Excel, Matlab, Notepad ++ (freeware), Microsoft notepad or Internet explorer to open the XML-file. To open the file in Excel, select how you want to open the file in the dialog below.
  • Page 100 Eclipse Additional Information Page 90 If opening from Excel and choosing the format As a read-only table workbook, the data sheet is rear- ranged and renamed into IPSI & Contra. See picture below with the red square. Here an example of a single block of B-Buffer data displayed as a graph in Excel. The loopback 2kHz stimuli...
  • Page 101 Here the same recording, but as an average of all recorded data from both the A & B buffer. Showing basi- cally the same in Excel as on the Eclipse ABR software, the 2kHz loopback stimuli. The difference is that each epoch is saved and can be redisplayed and analysed.

  • Page 102: Import In Notepad ++ (Freeware), Microsoft Notepad Or Internet Explorer

    Eclipse Additional Information Page 92 4.8.2 Import in Notepad ++ (freeware), Microsoft notepad or Internet Explorer The top columns of the file indicate the test parameters used for the logged curve. Below, they are indicated by color, the parameter, and the number.
  • Page 103 The Analog to Digital converter can maximum handle a signal of ±1.6V from the preamplifier. The Eclipse gain in this exported waveform session is set to 74dB. This means that the data in the buffer has a resolution of (1.6V/74dB)/32768 = 9.7425nV.
  • Page 104 Eclipse Additional Information Page 94 This is the excel sheet template, holding examples of the loopback test of TB 2kHz and a CE-Chirp Besides this it also holds recorded data for click and for a NB Chirp LS 2kHz. Not plotted.

  • Page 105: Has The Insert Tubing Time Delay Been Compensated

    This means when one of the transducer is attached to the eclipse and stimulating the patient, there is NO difference in the response latency (as the below difference of 0.9ms goes with the insert tube time) and both headphones and insert phones then provides the acoustic stimuli at time 0ms.

  • Page 106: How To Import Wav Files For Stimuli

    4.11 Open the calibration software and add the WAV files for calibrate the stimuli to expected loudness. More detailed information about calibration of WAV files can be found in the Eclipse Service Manual. Please contact your distributor if required. Add the stimuli e.g. ABCDEF (you can create your own experimental stimuli).
  • Page 107 Eclipse Additional Information Page 97 a. Stimuli can also be saved and presented to use only SPL format 4. Make sure to do this operation for any transducer and both Right and Left side. 5. To use the new added stimuli, open the software and the ABCDEF stimuli appears on the dropdown list.
  • Page 108 Eclipse Additional Information Page 98 6. You can create your protocol using the new stimuli and run e.g. an LBK test to see the stimuli recorded.

  • Page 109: Da, Ba & Ga Wavefile Sounds

    Eclipse Additional Information Page 99 4.12 Da, Ba & Ga wavefile sounds For your convenience, there are three speech vowel files located under the installation folder. These can be used for any ABR test, including the MMN test. Find the Speech files for import placed in the folder “Wave Files” on the installed drive.
  • Page 110 Eclipse Additional Information Page 100 To investigate the extracted files use e.g. Notepad ++ (freeware), standard notepad can also be used. Double click EditERA.iad Search after “ABRS00” in the complete record, which will guide you to the start of the session. US (Unit sep- arator –...
  • Page 111 Eclipse Additional Information Page 101 EndPos: End position of the curve. CorrelationStartPos: Start of the correlation start pos. MeasureType: Type of the measure. (ABR15/30, MMN,ALB..) WhatCurveContains: Is curve standalone, or is it the rare or frequent curve to a MMN measure?
  • Page 112 Eclipse Additional Information Page 102 US StimuliSide US SoundLevel US Intensity US NowDate US Examiner US Stimuli Type US BurstFre- quency US BurstSinWaves US BurstRiseFall US BurstPlateu US BurstWindow US Stimuli Speed US Amp US NumberOfMeasured US NumberOfRejected US Transducer US J1 US J2 US J3 US J4 US J5 US J6 US...

  • Page 113: Vemp

    About the VEMP module The Eclipse with VEMP (Vestibular Evoked Myogenic Potential) is intended for vestibular evoked myogenic potential testing to assist in the assessment of vestibular function. The target population for Eclipse VEMP includes all ages. The VEMP (Vestibular Evoked Myogenic Potential) module includes two different tests in the EP module;...

  • Page 114: General Operation Of Vemp

    Eclipse Additional Information Page 104 General Operation of VEMP Muscle Contraction Muscle contraction/activation has a critical influence on the quality of the VEMP recording. An ongoing EEG display will clearly indicate when a suitable contraction of the muscle is obtained during data acquisition.
  • Page 115 Eclipse Additional Information Page 105 In order to change the amplitude target for allowable EMG contractions, simply drag the two vertical black bars to move them to the appropriate values. This feature is provided as the VEMP response amplitude is related to the level of EMG.

  • Page 116: Edit Tab

    Eclipse Additional Information Page 106 5.3.1 Edit Tab Under the Edit tab, it is possible to view the EMG contractions for single curves or for the right and left ear VEMP partners (indicated by 95a on the curve handle). All EMG contractions over a waveform recording can be displayed here and printed out.
  • Page 117 Eclipse Additional Information Page 107 After the marker is selected, place it on the desired peak or trough. A second way of marking the peak from the Edit tab is to double click the waveform handle (to select it) you would like to mark.
  • Page 118 Eclipse Additional Information Page 108 3. VEMP Asymmetry Ratio The VEMP asymmetry ratio is calculated based on the difference of the largest and smallest amplitude in relation to the overall amplitude as shown below. Where: LA is the amplitude in µV (measured from the P1 marker to N1 marker) of the largest VEMP (left or right).
  • Page 119 Eclipse Additional Information Page 109 4. EMG scaling Many prefer to scale after recordings are completed. After the recording is complete, you can right click the waveform and choose EMG Scaling. Waveforms will then be scaled according to the average of the EMG values recorded throughout the collec- tion.
  • Page 120 Eclipse Additional Information Page 110 The EMG graphs above shows a larger Right RMS value compared to the Left RMS value. In the left-hand example, the two recordings (left and right) have been compared without scaling applied. Without scaling the asymmetry ratio is very high (0.56) –...

  • Page 121: System Setup

    Eclipse Additional Information Page 111 System setup There are two default test protocols for cVEMP (cVEMP 500Hz TB and cVEMP 1kHz TB) and two default test protocols for the oVEMP (oVEMP 500Hz TB and oVEMP 1kHz TB). The protocols can be viewed and modified from the System Setup.
  • Page 122 Eclipse Additional Information Page 112 EMG Controlled Stimulus/Recording Set the EMG contraction target amplitude range. EMG Controlled Stimulus/Recording ensures that the recording of the VEMP response will only take place when the patient has contracted their muscles within the target range. These values can be adjusted by slid- ing the vertical black bars with the mouse.
  • Page 123 Eclipse Additional Information Page 113 A second PC monitor is required to use the Visual EMG monitor. When se- lected, the screen below is displayed and guides the user during testing. The patient should be positioned so they can see the VEMP monitor during test- ing.

  • Page 124: General Setup - Vemp

    The Interacoustics Eclipse with VEMP protocol can control the waveform display for any electrode montage and comes by default with settings that will show the positive deflections of the VEMP waveform pointing upwards when electrode positioning as described in the next section is used.

  • Page 125: Protocol Settings Cvemp

    Eclipse Additional Information Page 115 Protocol settings cVEMP There is one default cVEMP protocols. The settings for the stimulus and recordings are: Stimulus parameters Type: 500Hz ToneBurst blackman (2:2:2) Rate: 5.1/s Intensity: AC: Typically ≥95 dBnHL is used, but is not preselected, and must be set by the user prior to star- ing the test.

  • Page 126: Preparing For The Cvemp

    Eclipse Additional Information Page 116 Preparing for the cVEMP 5.7.1 Visual inspection of the ear canal Check the external ear canal for wax with an otoscope and remove excessive wax to prevent the probe opening from clogging which will inhibit testing.

  • Page 127: Impedance Check Button

    Eclipse Additional Information Page 117 5.7.4 Impedance check button IMP button 1. After having attached the electrodes to the patient, it is crucial to check if the skin impedance is accepta- ble. For best results, impedance at each electrode site should be as low as possible; preferably 10kΩ or less and best if they are balanced.

  • Page 128: Performing A Cvemp Measurement

    Eclipse Additional Information Page 118 3. Hold the foam tip in the ear canal until the foam expands. This takes a few seconds. Use a new pair of ear tips for the next patient. Performing a cVEMP measurement 1. Choose one of the cVEMP Protocols 2.

  • Page 129: Cvemp Results

    Eclipse Additional Information Page 119 cVEMP Results Patient age, stimulus type, stimulus intensity, stimulus rate, filter settings, rise/fall times, plateau settings, electrode placement, muscle contraction/activation technique are all factors that influence the resulting cVEMP waveform. The cVEMP module does not include normative data, it is therefore important that a defined clinical protocol is used so that patient data can be compared to a normative data set either from peer reviewed published literature or collected by your individual institution.
  • Page 130 95 dBnHL was (abnormal) 0.80, as shown on the screen. cVEMP Click This is an example of a cVEMP measured with a click. The default protocols for Eclipse are with Tone bursts, but it is possible to create a protocol using a click in the Protocol Setup.

  • Page 131: Protocol Settings Ovemp

    Eclipse Additional Information Page 121 5.10 Protocol settings oVEMP There is one default oVEMP protocols. The settings for the stimulus and recordings are: Stimulus parameters Type: 500Hz ToneBurst, blackman (2:2:2) Rate: 5.1/s Intensity: AC: Typically ≥ 95 dBnHL is used, but is not preselected, and must be set by the user prior to star- ing the test.

  • Page 132: Preparing For The Ovemp

    Eclipse Additional Information Page 122 5.11 Preparing for the oVEMP 5.11.1 Visual inspection of the ear canal Check the external ear canal for wax with an otoscope and remove excessive wax to prevent the probe opening from clogging which will inhibit testing.

  • Page 133: Impedance Check Button

    Eclipse Additional Information Page 123 5.11.4 Impedance check button IMP button 1. After having attached the electrodes to the patient, it is crucial to check if the skin impedance is accepta- ble. For best results, impedance at each electrode site should be as low as possible; preferably 10kΩ or less and best if they are balanced.

  • Page 134: Performing An Ovemp Measurement

    Eclipse Additional Information Page 124 5.12 Performing an oVEMP measurement 1. Choose one of the oVEMP protocols from the dropdown menu: 2. Select test side (Right or Left) 3. Choose intensity – starting intensity is normally ≥95 dBnHL. 4. Instruct the patient to look/gaze upwards at the target on the wall and hold their gaze.

  • Page 135: Ovemp Results

    Eclipse Additional Information Page 125 5.13 oVEMP Results Patient age, stimulus type, stimulus intensity, stimulus rate, filter settings, rise/fall times, plateau settings, electrode placement, gaze positioning are all factors that influence the resulting oVEMP waveform. The oVEMP module does not include normative data, it is therefore important that a defined clinical protocol is used so that patient data can be compared to a normative data set either from peer reviewed published literature or collected by your individual institution.
  • Page 136 Eclipse Additional Information Page 126...

  • Page 137: Assr

    6 ASSR About the ASSR module The Eclipse ASSR (Auditory Steady-State Response) is intended for use in the recording and analysis of hu- man physiological data for the diagnosis of auditory and hearing-related functions. The target population for Eclipse ASSR includes all ages.

  • Page 138: Nb Ce-Chirp® For Assr

    Eclipse Additional Information Page 128 With the design in the frequency domain the spectral characteristics of the stimulus can be accurately de- signed (see below), however, the temporal characteristics may be less precise. Whereas design in the time domain is well known and has been preferred for the construction of traditional ABR-stimuli, the design in the frequency domain is not well known.

  • Page 139: Snr In Assr

    Eclipse Additional Information Page 129 6.2.3 SNR in ASSR In order to extract the evoked activity from the electrical background noise, which are picked up by the elec- trodes, averaging is applied. This can be carried out in the temporal domain as well as in the spectral do- main.

  • Page 140: The Assr Menu Items

    Eclipse Additional Information Page 130 The ASSR Menu Items From the main menu in the ASSR module the menu items File and Help are available. From the file menu the following functions can be accessed. File | Setup System to enter the ASSR setup where the settings of the protocols can be viewed and changed.

  • Page 141: General Operation Of Assr

    Eclipse Additional Information Page 131 General operation of ASSR The user interface consists of the Toolbar, the ASSR tab, and the Audiogram tab. 6.4.1 Toolbar For the toolbar you have the following options: Test protocol selection form where you can select the default test protocols...
  • Page 142 Eclipse Additional Information Page 132 9. Select the Rejection Level from the dropdown. Report By selecting the Report button in the upper menu bar, you may write a report for the session. If report tem- plates are entered in the System Setup, then you may choose one of these.

  • Page 143: The Assr Tab

    The Start/Stop button is used to start data acquisition. The button is dimmed if no test can be carried out (e.g. no ECLIPSE is connected, or no test stimuli are selected). The Pause button allows you to stop the data acquisition temporarily, e.g. if the patient...

  • Page 144: Eeg

    Eclipse Additional Information Page 134 6.4.2.2 EEG The EEG is shown in both the ASSR tab and the Audiogram tab for right and left ear respectively, as shown above. If the measurement is too noisy the curves turns red to indicate rejection.

  • Page 145: Right Clicking On A Handle

    Eclipse Additional Information Page 135 Right clicking during testing Right clicking with the mouse in this area will provide access to control of the stimulus for that specific au- diogram point (e.g. 4000Hz, Left ear). All 8 audiogram points can be controlled individually by right clicking in their specific areas.

  • Page 146: The Table

    Eclipse Additional Information Page 136 6.4.2.5 The Table These tables hold the numerical values of the response probability and noise reached for each of the stimuli presented. In the example shown below the lowest intensity that provided a response for 500Hz is 15dB, for 1000Hz is 25dB, for 2000Hz is 25dB, and for 4000Hz 15dB is the indicated in green.

  • Page 147: The Audiogram Tab

    Eclipse Additional Information Page 137 6.4.3 The Audiogram tab This screen shows the Estimated Audiogram (Right - Red & Left - Blue) based on the ASSR recordings. The grey lines with “A” marking are the ASSR recordings. The difference between the estimated audiogram and the ASSR recording is the applied correction.
  • Page 148 Eclipse Additional Information Page 138 Manual correction is also possible if needed, simply by using the mouse to drag the estimated audiogram point to a new position. Such an example is shown below. Even though both the ASSR result (the A) and the result stemming from the standard correction table is applied (the grey ring) are also stored in the database.

  • Page 149: System Setup

    Eclipse Additional Information Page 139 System setup 6.5.1 Auto Tests Setup The system setup allows you to change a default protocol. 1. Selected Test shows available pre-programmed test protocols and its parameters. 2. Name of Test is where you can enter the name of a new test protocol you have created yourself.
  • Page 150 Eclipse Additional Information Page 140 For optimum recordings, the EEG level should be low enough that a 20µV rejection threshold setting could be applied and ensure that brief periods of increased EEG level would be rejected. However, for non-optimum recording situations, a setting of 40µV may be needed. Such an action is not without conse- quences however, and it is unlikely that near-threshold responses will be recorded in such adverse re- cording conditions.

  • Page 151: General Setup

    Eclipse Additional Information Page 141 6.5.2 General Setup 1. From Language it is possible to change the language settings. The same characters as used in Windows are used. 2. Join audiogram symbols with lines. If selected the adjacent audiogram points will be connected with a solid line in the Estimated Audiogram Screen and on printouts.

  • Page 152: Report Templates

    Eclipse Additional Information Page 142 6.5.3 Report Templates Any number of default reports for different clinical findings can be created in this Report Template Generator. Once the reports are made, they can be addressed by the Report button in the ASSR screen or the Esti- mated Audiogram Screen and used for easy reporting of the session.

  • Page 153: Correction Factors

    Eclipse Additional Information Page 143 6.5.4 Correction Factors 1. Selected Correction allows you to select any available pre-programmed correction factor table can be selected and its parameters will be displayed. 2. From Name of Correction you can enter the name of a new correction factor table you create yourself.
  • Page 154 Eclipse Additional Information Page 144 Infants: Data collected by Gabriela R. Ivo Rodrigues (PhD) and Doris Ruthi Lewis (PhD) - Audiology and Speech Pa- thology Program, Catholic University of São Paulo (PUCSP), Hearing in Children Center, São Paulo, Brazil. Adults: Data collected by Deborah L.

  • Page 155: Preparing For An Assr Measurement

    Eclipse Additional Information Page 145 Preparing for an ASSR measurement For obtaining reliable and valid test results it is important that the patient is well prepared for the test. 6.6.1 Visual inspection of the ear canal Check the external ear canal for wax with an otoscope and remove excessive wax to prevent the probe opening from clogging which will inhibit testing.

  • Page 156: Electrode Placement

    Preamplifier in a way where they do not get close to any other electrical cables or equipment, including the cables from the Eclipse and the headphones. Note Do not press in the middle of the disposable electrodes when mounting, since this will cause gel to be pressed out and the adhesive below the white line will not stick.
  • Page 157 Eclipse Additional Information Page 147 After attaching the electrodes to the patient, it is crucial to check the skin impedance. For best results, im- pedance at each electrode should be as low as possible, preferably lower than 3kΩ. Press the Imp. button...

  • Page 158: Performing An Assr

    Eclipse Additional Information Page 148 Performing an ASSR Starting ASSR from OtoAccess™ or NOAH 1. Switch on your PC and wait for Windows® to start. 2. Double click on the OtoAccess™ or NOAH Icon 3. Choose an existing client or enter and save a new client.

  • Page 159: Assr Results

    Eclipse Additional Information Page 149 ASSR Results Example of ASSR results for a patient with a hearing loss...
  • Page 160 Eclipse Additional Information Page 150 Example of ASSR results for a patient with normal hearing This ASSR test has been started and recorded to NOAH database.

  • Page 161: Bc Assr

    Eclipse Additional Information Page 151 BC ASSR The ASSR threshold can be tested with the bone conductor to examine if a patient is having a conductive hearing loss. The transducer selection can be changed during the measurement from the temporary setup (see below).

  • Page 162: Placement Of Bone Conductor

    Eclipse Additional Information Page 152 Even though the ASSR response detector can disregard artifacts to a certain degree, a likelihood of in- creased number of false passes exists when large artifacts are present. For ASSR testing the following guidelines should be followed, to reduce the risk of false passes, caused by above mentioned stimulus artifact.

  • Page 163: Assr Masking

    Eclipse Additional Information Page 153 6.10 ASSR Masking An ASSR threshold can be masked to ensure that the threshold level is not overheard. The easiest way to apply masking during a measurement is to stop the measurement or wait until the running curves are com- plete.
  • Page 164 Eclipse Additional Information Page 154 During the measurement the applied masking level is indicated in top of the masked ear.

  • Page 165: Noah Compatibility

    NOAH. The Interacoustics ASSR system is prepared for the latest NOAH software – which enables the user to easily save the estimated Threshold Audiogram directly to NOAH so the data is available for Hearing Aid fitting software.
  • Page 166 Eclipse Additional Information Page 156...

  • Page 167: Abris

    7 ABRIS About the ABRIS module The Eclipse ABRIS is intended for use in the audiologic evaluation and documentation of ear and nerve dis- orders using auditory evoked potentials from the inner ear, the auditory nerve and the brainstem. The target population for Eclipse ABRIS is newborns.

  • Page 168: General Operation Of Abris

    Eclipse Additional Information Page 158 From the dialog box the license key can be viewed and a new license key can be entered (see below). General Operation of ABRIS 1. The toolbar Save and Exit. Saves Session results and returns to database.
  • Page 169 Eclipse Additional Information Page 159 2. Stimulus shows the stimulus chosen in the system setup. 3. Test status shows the status of the test during testing. 4. Ear shows which ear is being tested. 5. Start/Stop will Start or Stop the test. NOTE If there is too much EEG noise, the test will be in Pause mode, waiting for the noise to settle down before starting.

  • Page 170: System Setup

    Eclipse Additional Information Page 160 System setup 7.4.1 General Setup 1. Here the default settings for the test can be set. Choose to start out with the right or left ear and if both ears must be tested. 2. Choose whether the default display must be the EEG or the noise bar.

  • Page 171: Report Setup

    Eclipse Additional Information Page 161 7.4.2 Report Setup From the Report Setup you can setup the template for you report.

  • Page 172: Password

    Eclipse Additional Information Page 162 7.4.3 Password From Password you can set a password if you do not want anyone to change the settings in the system setup. If you want to remove a password, delete it in the field and press ok.

  • Page 173: Preparing For A Abris Measurement

    Eclipse Additional Information Page 163 Preparing for a ABRIS measurement 7.5.1 Visual inspection of the ear canal Check the external ear canal for wax with an otoscope and remove excessive wax to prevent the ear tip opening from clogging which will inhibit testing.

  • Page 174: Impedance Check

    Eclipse Additional Information Page 164 7.5.5 Impedance Check 1. After having attached the electrodes to the patient, it is crucial to check if the skin impedance is accepta- ble. For best results, impedance at each electrode site should be as low as possible; preferably 3 kΩ or less and best if they are balanced.

  • Page 175: Abris Results

    Eclipse Additional Information Page 165 ABRIS Results When the pass criteria have been reached, the result “PASS” will be shown on the screen. Note A “PASS” result will not necessarily mean that the full auditory system is normal. A full audiologic ex- amination should be performed if there are other indications that the patient has a hearing impairment.

  • Page 176: Abris Pc Shortcuts

    Eclipse Additional Information Page 166 ABRIS PC shortcuts Shortcut Function Help Start / Stop test Toggle ear Pause / Resume test Toggle view (advanced/simple) Report Print session Ctrl L Select left Ctrl R Select right Ctrl P Print session Shift F1...

  • Page 177: Dpoae

    Distortion Product Otoacoustic Emissions. The target population for Eclipse DPOAE in- cludes all ages. The Eclipse DPOAE module is designed to be used only by skilled personnel such as audiologists, ENT sur- geons, doctors, hearing healthcare professionals or personnel with a similar level of education. The device should not be used without the necessary knowledge and training to understand its use and how results should be interpreted.

  • Page 178: The Dpoae Menu Items

    Eclipse Additional Information Page 168 The DPOAE Menu Items From the main menu in the DPOAE module the menu items File, Edit, View, and Help are available. File | Setup System to enter the Setup where the settings of all protocols can be viewed and changed.

  • Page 179: General Operation Of Dpoae20

    Eclipse Additional Information Page 169 General Operation of DPOAE20 1. Protocol selection: From the dropdown you can select test protocol. 2. Temporary setup Create temporary changes to the selected session. The Temporary Setup is used to change/add different test parameters temporarily. The window is similar to the System Setup but has limited options, as shown below.
  • Page 180 Eclipse Additional Information Page 170 5. Save and exit saves and exits the session. Please note that once the session is saved and closed no further changes can be made to the session. 6. Save 7. Status  Measured data for the frequency or intensity.
  • Page 181 Eclipse Additional Information Page 171 12. Probe check window / Probe fit Run a probe check to ensure correct function of the OAE probe in the ear canal. The probe check curves are generated by a number of clicks stimulated separately by the two internal speakers within the OAE probe.
  • Page 182 Eclipse Additional Information Page 172 The checkmark will not be applied, even though appropriate S/N ratio has been met in the following situa- tions: If the S/N ratio has not been stable over a preset period of time. If the DP level is below -10dB SPL. Such low level DPs do not carry the same diagnostic strength as DPs of higher SPLs.

  • Page 183: Dpoae20 System Setup

    Eclipse Additional Information Page 173 DPOAE20 System Setup 8.4.1 Auto Test Setup Choose Predefined tests to create, change or delete a protocol. Change the sound stimuli Relations. Test parameters:  DP-gram is used to test for DPOAE at different frequencies F2.

  • Page 184: Template

    Eclipse Additional Information Page 174 8.4.2 Template From the template you can set your report template.

  • Page 185: Norm Data

    Eclipse Additional Information Page 175 8.4.3 Norm Data From the norm data tab you can set norm data for the DPOAE measurements. You can add a new data sheet for the norm data and add lines as shown below, and in that way setup your own norm values for each...

  • Page 186: Preparing For A Dpoae Measurement

     Coughing, talking and swallowing will disturb test results. 8.5.3 Probe selection Always use the short neck ear tips that are designated for Interacoustics OAE measurement. Use of the incorrect tip could invalidate the OAE measurement. In general, flanged or mushroom shaped ear tips will be used for most testing. The table below can be used...

  • Page 187: Performing A Dpoae Measurement

    Eclipse Additional Information Page 177 Performing a DPOAE measurement Two frequency specific sound stimuli are presented by two encapsulated speakers in the OAE probe and after a certain time a DPOAE may be recorded by the encapsulated microphone in the OAE probe.

  • Page 188: Results

    Eclipse Additional Information Page 178 Results Below are examples of results from the different DPOAE protocols. DP gram Screening (fast)
  • Page 189 Eclipse Additional Information Page 179 DP gram Diagnoistic & DP I/O combined (Screening) DP-Gram and I/O test used to test the outer hair cells response at the primary “hearing” frequencies for speech, afterwards the same frequencies are tested automatically for OAE threshold in the I/O test. DP-...
  • Page 190 Eclipse Additional Information Page 180 DP gram (extended) The Extended DP-Gram test used to test a greater variety of the outer hair cells response. The test can be used to detect slopes, but can also be used for screening. DP gram (Diagnostic) DP-Gram Detailed 65/55 dB SPL can set up to 31 Frequencies.
  • Page 191 Eclipse Additional Information Page 181 DP I/O range 1-8 kHz (diagnostic) I/O test used to test the outer hair cells response at a fixed frequency at different levels used to determine the OAE thresholds. DP I/O 4kHz. DP I/O 6kHz.

  • Page 192: Dpoae Pc Shortcuts

    Eclipse Additional Information Page 182 DPOAE PC shortcuts Shortcut Function Help Start / Stop test Toggle ear Pause / Resume test Toggle view (advanced/simple) Report Print session Ctrl L Select left Ctrl R Select right Ctrl P Print session Shift F1...

  • Page 193: Teoae

    Page 183 9 TEOAE About the TEOAE25 module The Eclipse TEOAE25 module is intended for use in the audiologic evaluation and documentation of ear dis- orders using Transient Evoked Otoacoustic Emissions. The target population for Eclipse TEOAE25 module includes all ages.

  • Page 194: The Teoae25 Menu Items

    Eclipse Additional Information Page 184 The TEOAE25 Menu Items From the main menu in the DPOAE module the menu items File, Edit, View, and Help are available. File | Setup System to enter the Setup where the settings of all protocols can be viewed and changed.

  • Page 195: General Operation Of Teoae25

    Eclipse Additional Information Page 185 General Operation of TEOAE25 1. Protocol selection: From the dropdown box to select desired test protocol. 2. Temporary setup takes you to the temporary protocol setup and allows you to make temporary changes your settings before you start the test.
  • Page 196 Eclipse Additional Information Page 186 11. Probe Check: Interpreting probe check information from a graph is not always easy. Therefore the qual- ity control that is required to perform a proper TEOAE measurement. 12. Start/Stop will start and stop the DPOAE test respectively.

  • Page 197: Teoae25 System Setup

    Eclipse Additional Information Page 187 TEOAE25 System Setup 9.5.1 Auto Test From the Auto Test tab you will be able to enter a name for your protocol which will then be stored. You can also find the stimulus and recording parameters (see figure 3.1) which can be manipulated according to the test protocol.
  • Page 198 Eclipse Additional Information Page 188 A pre-set Screening Algorithm can be selected from the drop box. Various Display Options of the Emission and noise floor can be selected. Selecting the Pass/Refer Band option divides the emission and noise floor into five frequency bands. In the dropdown either the OAE level or the Signal-to-noise-ratio can be selected to be displayed during recording.

  • Page 199: General Setup

    Eclipse Additional Information Page 189 9.5.2 General Setup From the General Setup tab it is possible to set the language, set the intensities displayed in the temporary setup and auto test tab, when creating a new protocol, and enable and disable the display of S/N figures and...

  • Page 200: Printer Layout

    Eclipse Additional Information Page 190 9.5.3 Printer Layout From the Print Layout tab it is possible to change what will be shown on the printout.

  • Page 201: Report Templates

    Eclipse Additional Information Page 191 9.5.4 Report Templates From the Report Templates tab a general report is created and a report can be generated.

  • Page 202: Auto Screening

    Eclipse Additional Information Page 192 9.5.5 Auto Screening An automatic screening protocol can be implemented in the TEOAE25 software, such that testing can be un- dertaken by one who has little or no experience in OAE testing. A physician, audiologist or other such pro- fessional can then control the testing parameters.

  • Page 203: Preparing For A Teaoe Measurement

     Coughing, talking and swallowing will disturb test results. 9.6.3 Probe selection Always use the short neck ear tips that are designated for Interacoustics OAE measurement. Use of the incorrect tip could invalidate the OAE measurement. In general, flanged or mushroom shaped ear tips will be used for most testing. The table below can be used...

  • Page 204: Performing A Teaoe Measurement

    Eclipse Additional Information Page 194 Performing a TEAOE measurement 9.7.1 Probe Check There are a number of factors that can affect the measurement of TEOAEs. These include the type of stimu- lus used, the noise floor or the amount of ambient and physiologic noise present during the testing (Rhoades et al, 1998), and;...

  • Page 205: Teoae Results

    Eclipse Additional Information Page 195 9.7.4 TEOAE Results Clinical Test - note an stimuli intensity of 83 dB is standard (TE bar view and TE graph view) Pass-Refer Test – A stimuli intensity of 83 dB is standard (Right & Left Pass)
  • Page 206 Eclipse Additional Information Page 196...

  • Page 207: Teoae Pc Shortcuts

    Eclipse Additional Information Page 197 TEOAE PC shortcuts Shortcut Function Help Start / Stop test Toggle ear Pause / Resume test Toggle view (advanced/simple) Report Print session Ctrl L Select left Ctrl R Select right Ctrl P Print session Shift F1...
  • Page 208 Eclipse Additional Information Page 198...

  • Page 209: Faq & Trouble Shooting

    The Eclipse is not connected and the program is operating as a Reader station only.  Please check that the Eclipse is turned on (the blue light in front of the Eclipse is on).  Please check the USB connection from the Eclipse to the Laptop.
  • Page 210 You can also use a 2cc. IEC126 and 6cc. IEC303 please follow the instructions from technote 0114. Interacoustics will supply correction data allowing a 0138 coupler from B&K to be used to obtain the same calibration results for servicing purposes. When entering calibration mode you will find info there on the two possible calibration systems peSPL and nHL.
  • Page 211 Eclipse Additional Information Page 201 5. Save 6. Import the patient back into OtoAccess , and say yes to overwrite In some circumstances, the attempt to import the file back in will error. If so, change the name of the exported file to another name.
  • Page 212 Eclipse Additional Information Page 202 Click Add a local printer Select LPT2 printer port Click next Find and select your printer, click next (remember to select the correct driver for your printer – Windows cannot automatically detect your printer model via the virtual port, and therefore you...
  • Page 213 Eclipse Additional Information Page 203 Follow the steps in the printer wizard (make sure that the name the newly added printer gets isn’t longer that 30 character). Next time from EP or ASSR use the new LPT2 printer and it should print.

  • Page 214: Faq - Abr

    Eclipse Additional Information Page 204 10.2 FAQ – ABR 10.2.1 ABR preparation Must all four/three electrodes be mounted? Yes. If you do not place the contra lateral electrode rejection will occur, as both ipsilateral and contra- lateral EEG is evaluated in determining rejection.
  • Page 215 Place the ground electrode closest to the noise source on the test subject. This will to drive the noise into the preamplifer improving the reduction of the noise artefact. Ensure a dedicated ground is connected to the Eclipse. Ensure that patient bed/chair is connected to ground.
  • Page 216 Eclipse Additional Information Page 206  Preamplifier not connected to main unit.  Preamplifier in IMP mode. All rejected despite raw EEG of normal size and within limits on raw EEG bar. Interference by a frequency which is so high that it does not show on the raw EEG curve.

  • Page 217: Abr User Interface

    Eclipse Additional Information Page 207 10.2.3 ABR user interface Can I change the displayed size of the curves? Yes. Use the Up/Down arrow keys on the keyboard and all curves will change size. For changing dis- play gain of single curves, just click on the right mouse button while pointing at the highlighted curves’...

  • Page 218: Abr Latency Data

    Eclipse Additional Information Page 208 Why can I not choose rise/fall and plateau for Blackman tone burst? Manual allows you to specify the rise/fall and the plateau yourself. The Blackman envelope (or win- dow) does exactly this - it specifies at what rate and speed to increase and decrease the stimulus level to obtain good frequency specificity.

  • Page 219: Abr Disposables & Accessories

    Can I reuse the supplied disposable electrodes? No, they are intended for single use only. Reusable electrodes are available from Interacoustics. When using reusable electrodes you must be sure that they are free of old gel – so cleaning of reusable electrode is important.

  • Page 220: Abr System

    Eclipse Additional Information Page 210 Is any accessory available for performing an easy check of system performance? Yes. The LBK15 box is an included accessory that allows an easy check of the impedance measuring system.Also, it easily allows the stimulus routed to the electrodes offering a combined check of stimu- lus quality and the entire data acquisition system.

  • Page 221: Faq - Vemp

    It is a 5 cycle 2-2-2 stimulus at 500Hz. This adheres well to the typical Tone Burst stimuli mentioned in the VEMP literature. Like all click and brief tone burst stimuli used in the Eclipse it is calibrated to ISO 389-6 when a dB nHL scale is used.

  • Page 222: Faq - Assr

    Please also see other documentation for the Interacoustics ASSR system dealing with this issue. I am testing without any acoustic stimulation. I have found passes in this situation.
  • Page 223 Eclipse Additional Information Page 213 I get a printout from a historical session that looks different – why? The printout of a historical session depends on the Auto Test Protocol selected when you press Print. This way you can get different print outs depending on your Auto Test Protocol. Some users actually make Auto Test Protocols specifically designed just to make different contents and lay outs of the print out available.
  • Page 224 Eclipse Additional Information Page 214 Why 90Hz and 40Hz stimuli rate? At repetition rates close to 40 stimuli/s, components of the middle latency response overlap and the recorded ASSR is named the 40-Hz response (Galambos et al., 1981). Although the ABR often can be identified in this response, it is dominated by evoked activity from the higher auditory pathways in the thalamus middle brain and the cortex.

  • Page 225: Faq - Dpoae

    Eclipse Additional Information Page 215 10.5 FAQ – DPOAE The default protocols have been changed or deleted. Remove the DPOAE20 using Windows® “Add or Remove Programs” within the Control panel. Delete the DPOAE20 folder from your hard drive using Windows® Explorer. The DPOAE20 folder is placed below the IaBaseII folder on the C drive if the standard installation has been used.
  • Page 226 Eclipse Additional Information Page 216...

  • Page 227: Dictionary

    Eclipse Additional Information Page 217 11 Dictionary As this dictionary may be used as a guide, some of the words give rise to more comments than just the basic definition. ABR: Auditory Brainstem Response. An AEP, ABR is a recording of the electrical signals generated by the nerves that are transmitting the sound-elicited signal from the Cochlea through the Brainstem.
  • Page 228 In this unit the raw EEG is displayed online. In common with other AEP systems, the term “EEG” is used by the Eclipse to encompass all unaveraged recorded electrical activity regardless of its origin. In fact most of what is typically seen when viewing the “EEG” is usually muscle activity. The term is therefore offi- cially a misnomer but is one that has entered the vocabulary in this subject and is understood to mean all electrical activity.
  • Page 229 Eclipse Additional Information Page 219 Epoch: The recording obtained after each stimulus. It is these Epochs that are averaged together to provide the resulting waveform. This term is also referred to as timebase or window. Filter: The electrical potentials picked up by the electrodes contain a range of frequencies. Depending on the type of measurement we are interested in, only a limited range of frequencies has our interest.
  • Page 230 Eclipse Additional Information Page 220 MMN Test: Mismatch Negativity Test. A test designed to retrieve the MMN response phenomenon, which is present approximately 250ms after stimulus onset. The MMN is present on a calculated differential curve found by subtracting two waveforms where one is recorded with a frequently appearing sound stimulus and another recorded with a rare appearing different sound stimulus.
  • Page 231 The most popular complex en- velope is the Blackman envelope. A linear envelope is obtained in the Eclipse by selecting the manual func- tion. Longer latency AEPs such as responses of cortical origin allow longer duration tone busts to be used, which offer near-ideal frequency specificity.
  • Page 232 Eclipse Additional Information Page 222 Window: This term has more than one possible meaning. In the context of a recording, the window is the same as Epoch or timebase. In the context of stimulation, window refers to the envelope used to shape a...

  • Page 233: References & Relevant Articles

    Eclipse Additional Information Page 223 12 References & Relevant articles Cebulla, M., Stürzebecher, E., Elbering, C., Muller, J. (2007). New click like stimuli for hearing testing. J Am Acad Audiol, 18, 725-738. Cebulla, M., & Elberling, C. (2010). Auditory brain stem responses evoked by different chirps based on differ- ent delay models.
  • Page 234 Eclipse Additional Information Page 224 Elberling, C., Don, M., & Kristensen, S.G.B. (2012 b). Auditory brainstem responses to chirps delivered by an insert earphone with equalized frequency response. J. Acoust. Soc. Am. 132, EL149-154. Elberling, C., Wahlgreen, O. (1985). Estimation of auditory brainstem response, ABR, by means of Bayesian inference, Scand.
  • Page 235 Eclipse Additional Information Page 225 Small, S.A., Hatton, J.L., & Stapells, D.R. (2007). Effects of bone oscillator coupling method, placement loca- tion,and occlusion on bone-conduction auditory steady-state responses in infants. Ear and Hearing, 28(1): 83-98. Selters WA, Brackmann DE. (1977) Acoustic tumor detection with brain stem electric response audiometry.

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