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otometrics Hortmann Vestlab 100 User Manual

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Hortmann Vestlab 100
User Manual
Doc no. 7-50-0940_02
Part no. 7-50-09400
0 4 5 9

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Summary of Contents for otometrics Hortmann Vestlab 100

  • Page 1 Hortmann Vestlab 100 User Manual Doc no. 7-50-0940_02 Part no. 7-50-09400 0 4 5 9...
  • Page 2 Printed in Denmark by GN Otometrics A/S, Denmark All information, illustrations, and specifications in this manual are based on the latest product information available at the time of publication. GN Otometrics A/S reserves the right to make changes at any time with- out notice.

  • Page 3: Table Of Contents

    Table of Contents Hortmann Vestlab 100 User Manual Introduction ............5 1.1 Intended use .
  • Page 4 Table of Contents Hortmann Vestlab 100 • User Manual 3.6.1 VNG measurement window ........32 3.6.2...
  • Page 5 8.1 Hortmann Vestlab 100 ........
  • Page 6 Table of Contents Hortmann Vestlab 100 • User Manual Otometrics...

  • Page 7: Intended Use

    Introduction Intended use The Hortmann Vestlab 100 is a nystagmograph that is intended to measure, record, and display involuntary movement (nystagmus) of the eyeball. Description The Vestlab software is intended for performing vestibular examinations during the examination of dizziness or imbalance in a vestibular laboratory or a research facility.

  • Page 8: Hardware Part

    Device setup and software installation 1.4.1 Equipment setup The Hortmann Vestlab 100 and accessories should only be used in combination with a battery charged laptop computer or a PC designed especially for use in medical environments that features an isolation transformer.
  • Page 9 Video goggle cable to video goggle Footswitch to Hortmann Vestlab 100 hardware USB cable to Hortmann Vestlab 100 hardware Hortmann Vestlab 100 hardware power cord to DC power supply (AC/DC converter) to isolation transformer Isolation transformer cable to medical grade outlet...
  • Page 10 Introduction Device setup and software installation Vestlab 100 Back Panel Connections Video goggles Footswitch or Irrigator cable PC (laptop) Light bar (not available) Power input fuse DC power input Otometrics...

  • Page 11: Software Installation

    If it does not, select and type the drive name for your CD-ROM Start > Run drive, as in , where denotes your CD-ROM drive, and d:\setup.exe setup.exe is the command for starting the Setup Wizard. 3. Click Start 4. Click Otometrics...
  • Page 12 It is recommended that the installation software be installed in this default folder in case technical support is needed. (The digits that you see in the folder name in place of the “xx” shown here identify the software version. The digits are automatically inserted as part of the folder name.) Otometrics...
  • Page 13 Introduction Device setup and software installation 6. After clicking , double-click the Vestlab icon on the desktop to start the Close Vestlab software. When prompted click to invoke the licensing dialog. Otometrics...

  • Page 14: Uninstalling Software

    Start Control Panel 4. Double-click on Add or Remove Programs 5. Scroll through the list to find the current version of Vestlab. 6. Click on the program name and click the button. Remove 7. Click to uninstall software. Otometrics...

  • Page 15: Configure Network For Single Work Folder

    About this manual This is your guide to using the Hortmann Vestlab 100 System. We strongly recommend that you read through the screen descriptions in this manual before you use the Hortmann Vestlab 100 System for the first time. 1.5.1 Safety This manual contains information and warnings which must be followed to ensure the safe performance of the Hortmann Vestlab 100 System.
  • Page 16 Introduction Typographical conventions Otometrics...

  • Page 17: Vestlab Software

    Vestlab software System startup 1. Switch on the computer. 2. Initialize the software by double-clicking on the Vestlab icon. Main window 1. Menu bar 2. Icon bar 3. Available tests (depending on the configuration of your system) Otometrics...

  • Page 18: Icons And Menus

    New... (Ctrl + N) Enter new patient data. Open... (Ctrl + O) Open existing patient data. Close Close patient data. Save (Ctrl + S) Save patient data under current patient name. Save As... Save patient data under current patient name. Otometrics...

  • Page 19: Test Icons

    Exit Exit the software program. Info Info - Click to view Vestlab Software license infor- mation here. 2.2.2 Test icons Test icons History Create a patient History. Clinics Perform a Clinics information and test (ear sketch, Romberg, Unterberger, StarGait). Otometrics...

  • Page 20: Menu Bar

    Save Save patient data under user-defined name Save as Email patient records to another party Email it Print report Print Display patient information window Patient data List of most recently Select file from the list to reopen. opened files... Otometrics...
  • Page 21 Settings Program Access the program settings. (See Program settings  23.) Tests Access the test settings for each test (see each test for explanation of the settings) Nystagmus analysis Access the nystagmus analysis settings (See Nystagmus analysis settings  Otometrics...
  • Page 22 Display all windows side-by-side each other vertically. Close All Close all windows. List List of all open windows. Help Hortmann Vestlab 100 Display the electronic version of the manual. ICS Balance Platform Display the electronic version of the manual. Info Display the software version.

  • Page 23: General Test Information

    • Instruct the patient in how to act during the test and make sure the patient understands. • Re-instruct the patient if necessary. Entering new patient data 1. Click icon, or select File > New 2. Enter the patient data. Fields with bold captions are required. 3. Click Otometrics...
  • Page 24 Enter patient’s height in feet and inches or centimeters (for- Height mat determined in program settings selection). Enter patient’s weight in pounds or kilograms (format deter- Weight mined by program settings selection). Enter patient’s address. Address Enter any notes important to the patient’s care. Notes Otometrics...

  • Page 25: Accessing Existing Patient Data

    Open patient folder 1. Click the icon or select Open File > Open 2. Highlight the desired patient to be selected. 3. Click Program settings 3.4.1 General The settings can be accessed from the menu bar: Settings > Program > General Otometrics...
  • Page 26 Delete Layout Select layout options. Start switch Choose whether the system should emit a short auditory sig- nal at the beginning of each test. Otometrics...

  • Page 27: File Administration

    Choose how to display the patient data list and if the patient data is saved automatically. If is selected, a mini- PatientID mum of four digits for the Patient ID is required. Configure the software to access the GDT interface. EDP connection Otometrics...

  • Page 28: Input Devices

    Note · This feature is for demonstration and training purposes only. None If you select this item, the software will disable all tests using video goggle. You can still use the software to view previously collected data and to test with the ICS Bal- ance Platform. Otometrics...
  • Page 29 3.4.3.1 Video Image Controls For the Hortmann Vestlab 100 VNG to work properly, the mirrors and video camera lenses in the goggles must be properly aligned with the patient’s eyes, and the images must be focused. In the Auto Adjustments box, the patient’s eyes are properly aligned in VNG when the pupil is in the square region of interest and focused as the patient looks straight ahead.

  • Page 30: Stimulus Devices

    Settings > Program > Stimulus devices section contains the device settings for the different stimulus devices. Device The drop-down list contains all the devices available, depending on your configura- tion. Note · Tracking device, Optokinetic device, Rotary Chair are not available. Otometrics...

  • Page 31: Printout

    Regarding the default profiles, Profile A is optimal for caloric tests. Profile B is setup to be less sensitive. In the settings of every test, the user can select the profile to be used. This is valuable due to the different kinds of nystagmus beats provoked by dif- ferent stimuli. Otometrics...
  • Page 32 Eye movements that resemble nystagmus, but the Ignore Artifacts system determines are artifacts (indicated by high- lighting in pink), will not be counted as valid beats. If changes are made after data collection, the data must be reanalyzed to reflect the new settings. Otometrics...

  • Page 33: Culmination

    Starts counting the nystagmus beats 30 seconds after the start of the measurement and counts the beats for 30 seconds (as during an examination with Frenzel lenses). Average Counts all nystagmus beats during the measure- ment and then computes the 30 second average. Otometrics...

  • Page 34: Measurement Windows

    General test information Measurement windows Measurement windows The Hortmann Vestlab 100 VNG system uses video goggles, instead of electrodes, to obtain eye movement information. The patient’s eyes can also be monitored in real time by selecting “Always on top” under Settings >...

  • Page 35: Video Goggles

    Adjustments are done through the control knobs located on the video goggles and through the software. The operator views the adjustment proc- ess by looking at each eye on the video image that displays in the Auto Adjust box. Otometrics...
  • Page 36 Caution · Tightening the knobs to the maximum position may cause damage to the adjustment pieces holding the mirror. If the pupils are out of the Auto Adjust box, physi- cally move the goggles on the patient's head and then fine tune with the knobs if needed. Otometrics...
  • Page 37 1. Clean and disinfect using a pre-moistened, non-alcohol based pad (i.e., Audio- Wipe) or apply the solution to a soft cloth or pad before placing the goggles on the next patient. 2. Use a pre-moistened non-alcohol based pad (e.g., Audiowipes) or apply the solu- tion to a soft cloth. Otometrics...

  • Page 38: Editors

    To influence the analysis, you can use the Cal- ibration Editor to edit the calibration. Select the Calibration Editor from the Measurement menu, or double-click in one of the diagrams or right-click on the calibration window. Otometrics...

  • Page 39: Nystagmus Editor

    Repeat the data collection for that test. The current test will be overridden. New Analysis Reanalyze the data. Settings Activate the Nystagmus Analysis Settings dia- log. Close Close the nystagmus analysis editor window. Edit Next Move mark to the next nystagmus beat Otometrics...
  • Page 40 Move to the beginning of the tracing Page Right Move to the end of the tracing Channel Up Move up one tracing, making it active Channel Down Move down one tracing, making it active Delete Delete the selected nystagmus beat Otometrics...
  • Page 41 Zoom in Zoom in Zoom out Zoom out Spread the channels Spread channels Overlay the channels Overlay channels Previous beat Select the previous nystagmus beat Delete Delete the currently selected nystagmus beat Next beat Select the next nystagmus beat Otometrics...
  • Page 42 The duration of the video in seconds is reported in the lower right corner of the screen. Duration of video Video settings Start Start the video Pause Pause the video. Stop Stop the video. Close Close the window. Replay Set to replay video continuously. Stretch Set to stretch the video to the maximum size. Otometrics...
  • Page 43 The following is an example of a Position test. The nystagmus editor window can be configured in size by moving the splitter bar between the two parts of the window. The nystagmus editor window can be enlarged for larger screens. Otometrics...
  • Page 44 By left-clicking and dragging these buttons upwards or downwards you can move the level of the traces. To exclude the beginning and the end of the trace from the calculation of parameters, drag the small sliders at the top of the trace. Otometrics...
  • Page 45 Right-clicking on a nystagmus beat will delete the beat to clean the trace. The blue line represents the baseline (average of SPV between the right and left nys- tagmus beats). Otometrics...

  • Page 46: Keyboard Commands

    Select the second lowest channel Ctrl + Arrow down Select the first nystagmus beat Ctrl + Home Select the last nystagmus beat Ctrl + End Hide the channel Ctrl + Ins Delete the marked nystagmus beat Ctrl + Del Otometrics...

  • Page 47: Test Battery

    Test Battery History window displays answers to questions defined by the tester. History Left-click in the empty box to display the question. Right-click in the empty box to display optional answers to the questions. Otometrics...

  • Page 48: History Test Settings

    Select the name of the tester from the drop-down list or type in manually. 4.1.1 History test settings These questions can be configured from the menu bar: Settings >Tests > History Insert user definable categories and matching questions that will appear in the His- tory questionnaire. Otometrics...

  • Page 49: Clinics

    Instruct the patient to stand with his/her arms in front and parallel to the ground (palms up or down) and eyes closed, and then turn his/her head to one side at a time. Positive Romberg is indicated when the patient sways backwards with head turned toward the affected side. Otometrics...
  • Page 50 • Once text has been saved, right-click to access the text and then click on the text to insert into the Findings box. Operator Select the name of the tester from the drop-down list or type in manually. Otometrics...

  • Page 51: Clinics Test Settings

    Step test Unterberger Select to view the Unterberger diagram. Star gait Select to view the Star gait diagram. Romberg Duration (s) Set the test duration of the measurement. Scale +/- (mm) Set the scaling of the X and Y axis. Otometrics...

  • Page 52: Calibration

    The patient should NOT move his/her head. 4.3.3 Performing the Calibration 1. Make sure the icon is selected. Goggles 2. Click the tab and select New Test Calibration 3. Select or double-click on one of the grids in the test Measurement > Calibration window. Otometrics...

  • Page 53: Calibration Results

    4. Make sure that the patient is instructed and click the button to start the Start recording. 4.3.4 Calibration results The result of a calibration is displayed in the diagrams of the test window. Below the tracings is a list of all tests performed including the calibrations. Otometrics...

  • Page 54: Calibration Editing

    Note · The software must know the calibration angle. See Stimulus devices 28. The software can figure out both plateaus by itself or it can be overruled by the using changing the sliders. Calibration Editor  4.3.6 Calibration test settings Otometrics...
  • Page 55 Deselecting this box will allow the user to calibrate the horizontal and vertical channel. Duration (s) Set the test duration of the calibration. Angle (°) Not available for the Hortmann Vestlab 100. Image Not available for the Hortmann Vestlab 100. File (*.blk) Otometrics...

  • Page 56: Gaze Test

    Note · Patient should only move the eyes. The head should not move. If the patient moves his/her head, it is appropriate to hold the patient’s head at a center position. Otometrics...

  • Page 57: Performing The Gaze Test

    (based on thickness of arrow) of the nystagmus. A circle indicates no nystagmus detected. Values A table below the grid displays measurement values for each gaze direction. The score displays the following measurements of gaze: Otometrics...

  • Page 58: Gaze Test Editing

    The result of the Gaze test is displayed in the test window. 1. To edit the result double-click on one of the diagrams, or select Measurement > , or right-click and select in the diagram. Gaze Edit Nystagmus Editor  Otometrics...

  • Page 59: Gaze Test Settings

    Select the channels to be displayed on the screen. Horizontal, vertical Channel distance (°) Set the distance between the horizontal and vertical channel. Set the amplitudes displayed for each measurement; 40 Channel scaling (°) ° ° will be displayed as -20 to +20 on the y-axis. Otometrics...

  • Page 60: Position Test

    4.5.3 Performing the Position test To start the test: 1. To start the test select the position you want to record from the Measurement menu or double-click on the measurement window or diagram. Otometrics...

  • Page 61: Position Test Score

    Illustration of the occurring nystagmus beats showing the intensity and direction. The arrows in the diagram show the direction (points in direction based on patient looking at tester) and intensity (based on thickness of the arrow) of the nystagmus. A circle indicates no nystagmus detected. Otometrics...

  • Page 62: Position Test Editing

    The result of the Position test is displayed in the test window. 1. To edit the result double-click on one of the diagrams, or select Measurement > , or right-click and select in the diagram. Position Edit Nystagmus Editor  4.5.6 Position test settings Otometrics...

  • Page 63: Positioning Test

    This test can detect Benign Paroxysmal Positional Vertigo (BPPV). Nystagmus caused by BPPV typically occurs with a slight onset delay after the patient is re-posi- tioned, and it rapidly decreases in severity until absent. Otometrics...

  • Page 64: Patient Instructions

    During recording instruct the patient as described above. Note · The functionality of the measurement window is described in Measurement  windows 32. It is recommended to video record the eye in order to identify any rota- tional nystagmus. Otometrics...

  • Page 65: Positioning Test Score

    3. During the measurement observe potential rotational nystagmus by observing the eye on the computer screen and video recording. 4.6.4 Positioning test score The following is an example of the Hallpike-Stenger window. Otometrics...

  • Page 66: Positioning Test Editing

    The result of the Positioning test is displayed in the test window. To edit the result double-click on one of the diagrams, or select Measurement > , or right-click and select in the diagram. Positioning Edit Nystagmus Editor  4.6.6 Positioning test settings Otometrics...

  • Page 67: Calorics Test

    Caloric tests provide an objective evaluation of the function of the vestibular laby- rinths. Irrigation with either water or air induces nystagmus in patients with a functioning balance system. The nystagmus resulting from the irrigations in both ears are com- pared for evaluation. Otometrics...

  • Page 68: Patient Instructions And Preparations

    4. Begin irrigating the ear (right or left depending on test order). 5. The measurement window appears in standby mode. Click to start record- Start ing as soon as the irrigator begins. It is easiest to use the footswitch or irrigation Otometrics...

  • Page 69: Calorics Test Score

    Shows the presence of any spontaneous nystagmus before the irrigation is started SPV diagram The diagram shows the slow phase velocity of each registered nystagmus beat sym- bolized by a colored dot. The superimposed curve shows the calculated average (interpolation), while the colored vertical lines mark the culmination. Otometrics...
  • Page 70 • Once text has been saved, right-click to access the text and then click on the text to insert into the Findings box. Operator Select the name of the tester by selecting a name from the drop-down list or typing manually. Otometrics...

  • Page 71: Spv Analysis

    SPV before the fixation, the software calculates the average of the last three nys- tagmus beats before the fixation began. A fixation index of <25% is within normal limits. The fixation light should be turned on right after the culmination phase in order for the fixation index to be accurate. Otometrics...

  • Page 72: Jongkees-Formulas

         Directional Preponderance (DP)    irrigation irrigation nyst beats right nyst beats left    irrigation                 Otometrics...
  • Page 73                                        Otometrics...

  • Page 74: Calorics Test Editing

    The result of the Calorics test is displayed in the test window. To edit the result double-click on one of the diagrams, or select Measurement > , or right-click and select in the diagram. Calorics Edit Nystagmus Editor  Otometrics...

  • Page 75: Calorics Test Settings

    Set the order in which the different tests are per- formed. Pause (s) Set the duration of the pause between irrigations. After each caloric test a timer will count backwards to zero to keep track of how much time has elapsed between irrigations. Otometrics...
  • Page 76 (nystagmus to the same side) and contralateral nystagmus (nystagmus to the opposite side). Reduce printouts to cul- If checked, only the culmination phases are printed mination out. Channel distance (°) Set the distance between the horizontal and vertical channel. Otometrics...

  • Page 77: Further Tests

    • To change the name of a test, click on it to mark it, then click on it again. Press when you have changed the caption. Do not delete all letters from the test Enter caption. This will delete the test. Otometrics...
  • Page 78 Select the analysis profile to be used to detect nys- Analysis profile tagmus in the measurement. The analysis profiles can be configured from the menu bar: Settings > Nystagmus analysis Otometrics...

  • Page 79: Printing A Report

    File > Print On the printout the patient’ ID, name, and birth date appears in the header. Find- ings, operator, diagnosis and notes appear near the bottom of the page. Otometrics...

  • Page 80: Configuring The Standard Report

    Printing a report Configuring the standard report Configuring the standard report Setting for items that define the standard report printout are accessed from Settings . These settings also define the basic setup for multi-test > Program > Printout reports. Otometrics...
  • Page 81 Select the number of copies to be printed each time the Copies report is printed. Customize the original tag names to preferred abbrevia- Tags tions. Tags allow you to enter the patient name and other patient data quickly and consistently eliminating typing errors. Otometrics...

  • Page 82: Multi-Test Report

    The report window displays the current settings including the name of the template  applied to the report. For information about creating templates, see Note · No name appears for reports using the standard template. Template name listed here. Otometrics...

  • Page 83: Changing A Multi-Test Report

    . To print without pre- viewing, click To see a preview of the report before printing, click Print. Create Pre- view To scale the preview for viewing, change the percentage by moving the slider. Zoom To print, click Print Slider Otometrics...

  • Page 84: Creating A New Multi-Test Report Template

    Select items to include Customize item size and position Click on the name of the item. The name is highlighted. The corresponding item in the preview changes is highlighted. Click on item name Item corresponding to selection is highlighted Otometrics...
  • Page 85 Distance from the bottom of the header or the bottom Top (mm) edge of the item appearing directly above this item. Width of selected item. Width (mm) Height of selected item. Height (mm) Otometrics...

  • Page 86: Changes To Cover Page

    Tags defined in the printout settings can be inserted as required. It is possible to replace the standard cover page with a text file created in another application. The file must be saved as an RTF (rich text format) file. Click Import to insert the file. RTF file Otometrics...
  • Page 87 Creating a new multi-test report template Import file created in another application Edit existing text Add/delete tags Note · The cover page is included in the report only when selected from the list of items on the tab. Report items Otometrics...

  • Page 88: Changes To Document Settings

    Set the height of the top margin. Right (mm) Set the width of the right margin. Left (mm) Set the width of the left margin. Bottom (mm) Set the height of the bottom margin. Header (mm) Set the height of the header. Otometrics...

  • Page 89: Importing Patient Data

    The position is determined by New Page setting. New Line Click . Enter the template name and click Save Importing patient data 1. Click Open 2. Click the icon Browse 3. Browse to locate patient file. Otometrics...
  • Page 90 Note · If the file is saved in Vestlab, the data will never be able to be accessed with the CNG analyzer software. To save the file in the Vestlab database, use the Save As icon Otometrics...

  • Page 91: Troubleshooting

    • The eye position is too far • Adjust the horizontal eye posi- from the center of the video tion of the VG 40 Video Gog- cameras. gles (see the VG 40 User Manual). Otometrics...
  • Page 92 Troubleshooting Vestlab Software Otometrics...

  • Page 93: Vestlab Safety

    Used in error message dialogs if program fails. See the detailed information in the dia- log box. Hortmann Vestlab 100 Symbols Hortmann Vestlab 100 is marked with this symbol to indi- cate compliance with Type BF of the safety standard EN 60601-1. Hortmann Vestlab 100 is marked with this symbol when it is important that the user refers to associated informa- tion given in this manual.

  • Page 94: Warning Notes

    Note 1: There are no user-serviceable parts inside the Hortmann Vestlab 100 cabinet. For the sake of safety, and in order not to void the warranty, the cabinets should only be opened and serviced by authorized service personnel. In case of defects, please make a detailed description of the defect(s) and contact your supplier.
  • Page 95 Such noise may interfere with the process of recording correct measurements. Many types of electrical devices, e.g., mobile telephones, may generate radio fields. We recommend that the use of such devices in the vicinity of Hortmann Vestlab 100 is restricted as much as possible.

  • Page 96: Manufacturer

    Vestlab Safety Manufacturer Manufacturer GN Otometrics A/S 9 Hoerskaetten, DK-2630 Taastrup, Denmark Phone: +45 45 75 55 55, Fax: +45 45 75 55 59 www.otometrics.com 7.3.1 Responsibility of the Manufacturer The manufacturer is to be considered responsible for effects on safety, reliability, and performance of the equipment ONLY IF: •...

  • Page 97: Technical Specifications

    Technical Specifications Hortmann Vestlab 100 Interface USB to PC Type Identification Hortmann Vestlab 100 is Type 1086 from GN Otomet- rics A/S Power Supply AC/DC Adapter Type W7362M/15 from Friwo Input 100-240 VAC / 50-60 Hz / 700 mA Output...
  • Page 98 Technical Specifications Hortmann Vestlab 100 System Capabilities Weights Hortmann Vest- 2.7 kg (5 lbs 7 oz) lab 100 Video Goggles 430 grams (15.2 oz) Operating Mode Warm-up time <2 min Mode of operation Continuous Operating Environment Temperature ° C to +35 °...
  • Page 99 Technical Specifications Hortmann Vestlab 100 Dimensions Hortmann Vestlab 100 (HxWxD) 4.9 cm x 34.2 cm x 28.7 cm (2" x 13.6" x 11.3") Weight 2.7 kg (5 lbs 7 oz) Calibration None Required Standards Safety EN 60601-1, UL2601-1, CAN/CSA-C22.2 NO 601.1-90...
  • Page 100 Technical Specifications Hortmann Vestlab 100 Otometrics...
  • Page 101 Fixation Index Calculation 69 Further tests 75 Safety 91 Symbols 91 Single-test Report 77 Gaze 54 Software Installing 9 Uninstalling 12 SPV Analysis 69 History 45 Star Gait 48 Stimulus devices 28 System components Hardware 5 Minimum computer requirements 5 Software 5 Otometrics...
  • Page 102 Gaze 54 History 45 Position 58 Positioning 61 Troubleshooting Vestlab software 89 Unterberger 48 Vestlab software Icons and menus 16 Main window 15 Menu bar 18 System startup 15 Test icons 17 Video goggles Cleaning 35 Video playback 40 Otometrics...

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