Welch Allyn MicroTymp 2 Operating Instructions Manual
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Welch Allyn MicroTymp 2 Operating Instructions Manual

Welch Allyn MicroTymp 2 Operating Instructions Manual

Portable tympanometric instrument
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Summary of Contents for Welch Allyn MicroTymp 2

  • Page 1 Audio Menu Service Manual Portable Tympanometric Instrument Operating Instructions...
  • Page 2 Ph.D. of the University of Minnesota for his assistance in preparing the Guide to Tympanometry and Glossary sections of this manual. Trademarks Welch Allyn and MicroTymp are registered trademarks of Welch Allyn, Inc. in the United States and other countries. Patents MicroTymp –...

  • Page 3: Table Of Contents

    MicroTymp 2 – Introduction MicroTymp 2 Handle Components ............. 2 MicroTymp 2 Printer/Charger Components ..........3 Preparing to Use the MicroTymp 2 Handle and Printer/Charger ....3 Setting up the MicroTymp 2 Handle and Printer/Charger ...... 4 MicroTymp 2 – Completing a Test Obtaining a Tympanogram .................
  • Page 4 Recalibration ..................E-55 Warranty ....................E-56 MicroTymp 2 Instrument ..............E-56 MicroTymp 2 Rechargeable Battery ..........E-56 Appendix F – Technical Specifications ..........F-57 Appendix G – MicroTymp 2 Replacement Parts and Accessories . G-61 References ....................63 Glossary ..................... 65...

  • Page 5: Microtymp 2 - Introduction

    This results in more thorough diagnoses, and more effective monitoring, treatment, parent consultation, and referrals. Data stored in the memory of the MicroTymp 2 Handle may be printed using the Printer/Charger. The Printer/Charger reads the information from the Handle and quietly prints out tympanograms from two ears with test results in five seconds.

  • Page 6: Microtymp 2 Handle Components

    MicroTymp 2 Handle Components Liquid Crystal Display (LCD) -400 -200 PRESSURE - daPa Probe Left Memory TEST Button Test Button Right Memory Button Ejector Battery Cover Charging Infrared Data Contacts Transfer Window Figure 1A...

  • Page 7: Microtymp 2 Printer/Charger Components

    Printer/Charger The following is a list of important facts to note before using the MicroTymp 2. • Please complete and return the warranty registration card. It validates the warranty, and allows Welch Allyn to communicate recalibration notices and software changes.

  • Page 8: Setting Up The Microtymp 2 Handle And Printer/Charger

    • If the MicroTymp 2 set has not been stored at room temperature, allow 45 minutes for it to return to operating temperature range (15-35˚C or 59-95˚F) before using. • Do not store either the MicroTymp 2 Handle or Printer/Charger at temperatures which exceed 66˚C (150˚F).

  • Page 9: Microtymp 2 - Completing A Test Obtaining A Tympanogram

    MicroTymp 2 – Completing a Test Obtaining a Tympanogram Selecting a Probe Tip 1. After examining the subject’s ear canal opening, select a tip which is large enough to seal the entrance of the ear canal. See Figure 2. To change tips, either pull the tip off by hand or slide the tip ejector towards the tip.

  • Page 10: Testing

    Testing 3. Turn on the MicroTymp 2 Handle by pressing the TEST button below TEST the Liquid Crystal Display (LCD). The word “OPEN” appears on the LCD. Figure 3 illustrates the TEST button and the OPEN message. TEST Figure 3 NOTE: The MicroTymp 2 automatically turns off 15 seconds after the last test or activation of any button.

  • Page 11: Storing And Erasing Data

    NOTE: Due to changes in air pressure during a test, the subject will feel slight pressure in the ear canal. During the brief seconds when tympanometric measurements are made, it is important that the practitioner’s hand is steady, and that the subject does not talk, yawn, chew gum, cry, or make any other similar movements.

  • Page 12: Displaying Memory Contents

    Understanding the Liquid Crystal Display (LCD) and Its Messages The following messages may be displayed on the LCD during MicroTymp 2 Handle operation: Gradient (Width) Measurements When a tympanometric tracing is complete, the MicroTymp 2 measures the gradient or width of the tympanogram.
  • Page 13 LIQUID CRYSTAL DISPLAY Normal Static Normal Static Admittance and Admittance and TPP (Adults) TPP (Children) Gradient (Width) Adult Gradient (Width) Child Admittance Axis -400 -200 PRESSURE - daPa Pressure Axis Figure 8 A sample of the Liquid Crystal Display is shown in Figure 8. OPEN -400 -200...
  • Page 14 TEST -400 -200 PRESSURE - daPa Figure 10 The TEST message indicates that the test has started. Immediately following this message, test data will begin to appear. BLOCK -400 -200 PRESSURE - daPa Figure 11 The test cannot continue since the measured admittance is less than 0.2 mmho. Possible causes: •...
  • Page 15 LEAK -400 -200 PRESSURE - daPa Figure 12 The test cannot proceed since desired pressures within the ear have not been achieved. Possible causes: • probe tip is not completely sealed in the ear canal • excessive movement of patient or practitioner •...
  • Page 16 Stored data is not lost when the battery is removed. NOTE: The battery must be removed if the MicroTymp 2 Handle is to be stored or placed anywhere other than in the powered Printer/Charger for more than one month.
  • Page 17 RANGE ERROR -400 -200 PRESSURE - daPa Figure 16 The RANGE ERROR message indicates that a large pressure change occurred during a test. If this message appears, press the TEST TEST button and start the test again. ZERO ERROR -400 -200 PRESSURE - daPa Figure 17...
  • Page 18 Annual recalibration is recommended to insure instrument accuracy. See Appendix E, “Service and Warranty Information,” for details on service locations and recalibration. DATA XFER(transfer) -400 -200 PRESSURE - daPa Figure 19 The data stored in the MicroTymp 2 Handle is being transferred to the Printer/Charger.

  • Page 19: Printing Memory Contents

    Follow the steps listed below to print tympanometric data stored in the MicroTymp 2 Handle: 1. Place the MicroTymp 2 Handle in the well with the Liquid Crystal Display (LCD) and buttons facing you. See Figure 20. When the MicroTymp 2 is properly seated in the well, the green CHARGE indicator illuminates.

  • Page 20: Microtymp 2 Printout Formats

    Handle from the well causes the data to be removed from the Printer/ Charger memory. NOTE: • The Printer/Charger has been pre-set at Welch Allyn to print a complete printout as illustrated in Figure 21 on page 17, and to print in manual mode. To change formats or print in automatic mode, follow the instructions on page 20.
  • Page 21 Tympanogram Data (Optional) Interpretive Message (Optional) Figure 21 Tympanogram Section of Printout The tympanogram is a graph which records the admittance of the ear as a function of air pressure. Data Section of Printout The data section displays numeric values for the four key characteristics of the tympanogram: •...
  • Page 22 If the numeric values are greater or less than the 90th percentile of the normative data for a child or an adult, an asterisk appears under the C(hild) or A(dult) column. The normative data are listed in Table 1 below. For some tympanometric results, no data will be printed.
  • Page 23 FOR THOSE USING THE ORIGINAL MICROTYMP HANDLE NOTE: The original MicroTymp Handle functions identically to the MicroTymp 2 Handle with respect to printing. However, since the original MicroTymp’s range is from +200 daPa to -300 daPa, no data points will print from -300 daPa to -400 daPa.

  • Page 24: Selecting Printout Formats

    Selecting Printout Formats The four switches used to select the printout format and printer mode of operation are located on the bottom of the Printer/Charger. See Figure 22. NOTE: Switch #4 is used during manufacturing only. If Switch #4 is ON, the Printer/Charger will not operate normally. Changing from Manual to Automatic Printout Use Switch #1 to change from manual to automatic printout.

  • Page 25: Changing Printout Format

    Manual Print Depress the OFF portion of the switch to select this option. This causes the printout to begin only when the PRINT button is depressed. NOTE: In the manual mode, a beep will occur as a reminder that data has been transmitted; however, it is not necessary to wait for the beep before pressing the PRINT button.
  • Page 26 Printing Interpretive Messages (Switch #2) No messages Depress the ON portion of the switch to select this option. This causes messages which interpret the tympanogram to not be included on the printout. Refer to Description of Formats on page 16 for more information on these messages.

  • Page 27: Printer Function Messages

    (LOW BATT message does not appear). The MicroTymp Handle Call your nearest is not functioning Welch Allyn service properly. location, distributor, or factory representative. No Data Both right Insure that data is Nothing in Memory...

  • Page 28: Printer Service Codes

    Welch Allyn service location. NOTE: If the green POWER indicator is not illuminated, verify connection to live power source. If the problem persists, return the Printer/Charger to the nearest Welch Allyn service location.

  • Page 29: Appendix A Guide To Tympanometry

    Recent technological advances have paved the way for MicroTymp 2, a low-cost, portable, precision instrument that can be of significant value for determining the need for medical referral, for diagnosis of ear disease, and for monitoring the course of medical/ surgical intervention.

  • Page 30: Tympanogram Characteristics

    Tympanogram Characteristics Figure 24 illustrates a MicroTymp 2 tympanogram. A description of the key characteristics of the tympanogram follows. Figure 24 Static Admittance (Peak Ya) is a measure of the height of the tym- panometric peak. Given appropriate normative values, static admittance is a useful indicator of middle ear disease.

  • Page 31: How The Microtymp 2 Instrument Works

    How the MicroTymp 2 Instrument Works A block diagram of a Welch Allyn MicroTymp 2 is illustrated in Figure 25. Sound Loudspeaker Pressure Airflow Transducer Pump Microphone Sound Microcomputers Liquid Crystal Display (LCD) Figure 25 A 226-Hz probe tone is introduced into the sealed ear canal by a miniature loudspeaker.

  • Page 32: Normative Values For The Microtymp 2

    Table 5 from the MicroTymp 2 Vea Reading. Altitude can also affect MicroTest Cavity results. Refer to Appendix D, “Functional Checks of the MicroTymp 2 Handle and Printer/Charger.” Table 5 — Altitude Adjustments for Vea Readings...

  • Page 33: Interpreting Tympanogram Results

    Interpreting Tympanogram Results Otitis Media with Effusion • Produces low static admittance (low peak height) tympanogram • Tympanogram is also typical of tympanosclerosis, cholesteatoma, and middle ear tumor Oncoming or Resolving Otitis Media with Effusion • Produces normal peak height, but tympanogram which is too wide •...
  • Page 34 Positive Middle Ear Pressure • Produces positive Tympanometric Peak Pressure • Indicative of acute otitis media, if peak is extremely positive Tympanogram with Too Much Artifact • Caused by patient or practitioner movement • Requires repeating measurement Ear Canal Occlusion •...

  • Page 35: Obtaining A Valid Tympanogram

    Research from the 1980s suggests that tympanometry should not be per- formed on infants aged six months or younger. More recent research sug- gests that it is appropriate to use 226 Hz tympanometry (e.g., MicroTymp 2) on infants as young as four months of age (Holte, 1990 and 1991).

  • Page 36: Conditions Which Artificially Flatten The Tympanogram

    The result is that the volume of air in front of the probe will be very small. The MicroTymp 2 Handle will display the occurrence of this condition with the BLOCK message if the volume is less than 0.2 cc. However it is possible to obtain a flat tympanogram with a smaller than expected ear canal volume (less than 0.4 cc for children or less than 0.6 cc for adults), as shown in Figure 27.

  • Page 37: The Normal Ear

    Because the air pressure changes have no effect on the tension of the eardrum, the tympanogram is flat with an unusually high equivalent ear canal volume. If the volume exceeds 2.5 cc, the MicroTymp 2 Handle will not record a tympanogram at all, and the OPEN message will appear.

  • Page 38: Low-Admittance Pathologies

    Low-Admittance Pathologies: Otitis Media with Effusion, Middle Ear Tumor, Ossicular Fixation, Tympanosclerosis Low static admittance of the middle ear is produced by space-occupying lesions in various ways. A lesion that displaces air in the middle ear space causes low admittance by reducing the middle ear volume. The lesion also may interfere with the vibration of the ossicular chain, contributing to the low admittance.
  • Page 39 Middle Ear Tumor A wide variety of neoplastic processes exist that invade the middle ear. The most common is the keratoma (cholesteatoma), a collection of keratinizing squamous epithelium that frequently originates from Shrapnel’s membrane (pars flaccida) of the tympanic membrane or the ear canal wall and invades the middle ear space.

  • Page 40: Tympanic Membrane Abnormalities

    Tympanic Membrane Abnormalities “Floppy” Tympanic Membrane The tympanic membrane is normally a stiff, conically-shaped structure that derives its stiff characteristic from the lamina propria, a layer of connective tissue that is situated between the outer layer of squamous epithelium (skin) and the inner layer of mucous membrane.

  • Page 41: Conditions Which Cause Negative Middle Ear Pressure

    Conditions Which Cause Negative Middle Ear Pressure Figure 32 Negative pressure within the middle ear space will produce a tympanogram with a negative tympanometric peak. Some degree of negative pressure is normal (see normal TPP values listed in Table 1 on page 18). Negative middle ear pressure often accompanies a cold or allergies, or can be a result of eustachian tube dysfunction.
  • Page 42 A-38...

  • Page 43: Appendix B - Guidelines For Screening For Hearing Impairments And Middle Ear Disorders

    Appendix B Guidelines for Screening for Hearing Impairments and Middle Ear Disorders In a non-medical setting, tympanometry can be useful in determining the need for a medical referral. However, abnormal tympanometric results occur not only in patients with ear disease that requires medical attention, but also in subjects with transient conditions that resolve without medical intervention and in ears that have residual effects of previously-controlled disease.
  • Page 44 START Ear Pain, Discharge? Fail Visual Inspection Pass Repeat Fail Fail Audiometric Audiometric Screen Screen Pass Pass WAIT 4-6 WEEKS Volume Peak Ya Too Large? Too Low? Peak Ya 1st Time 2nd Time Too Low 1st or 2nd Time? 1st or 2nd Time Gradient 2nd Time?

  • Page 45: Recommended Screening Protocol

    Recommended Screening Protocol The recommended screening protocol is based on a four-part procedure consisting of case history, visual inspection, pure-tone audiometry, and tympanometry. These guidelines can be used for all ages, however, they are designed specifically for children and young adults (through age 40). Referral criteria are presented in Table 6 on page B-42.

  • Page 46: Audiological Or Medical Referral

    Low static admittance (Peak Y [Ya]) may or may not be associated with significant middle ear disorders. In the absence of other positive findings, a Peak Y (Ya) below the 90% range listed in Table 6 requires observa- tion over an extended period before a medical referral is warranted. Only after two successive abnormal findings over an interval of 4-6 weeks should medical referral be made.

  • Page 47: Appendix C - Maintaining The Microtymp 2 Equipment

    Appendix C Maintaining the MicroTymp 2 Equipment The MicroTymp 2 Battery The MicroTymp 2 rechargeable nickel-cadmium battery is intended for many charge/discharge cycles and is warranted for two years. The warranty expiration date is imprinted on the battery. BATTERY REPLACEMENT: Replace with Welch Allyn model #72900 battery only.
  • Page 48 3. Remove the battery cover by lifting the bottom of the cover away from the probe tip. See Figure 36. USE ONLY SPECIFIED CHARGER RECHARGEABLE BATTERY 2.4 VOLTS 600mAh CATALOG NO. 72900 Figure 36 4. Push down on the positive (+) end of the battery. Battery will eject. See Figure 37.
  • Page 49 5. Insert the replacement battery by placing the positive (+) end of the battery against the spring in the holder. Push the battery lightly to compress the spring, and lower the battery into the compartment. See Figure 38. NOTE: Insert the battery only as shown. Failure to observe the correct polarity will prevent the instrument from functioning.

  • Page 50: Recharging The Battery

    Recharging the Battery To recharge the MicroTymp 2 battery, place the MicroTymp 2 Handle in the Printer/Charger well with the LCD and buttons facing you. See Figure 39. NOTE: Charge only with the MicroTymp 2 Printer/Charger (#71170, #71175) or special AudioScope Charging Stand (#71126).

  • Page 51: Recycling The Battery

    Recycling the Battery Recycling Nickel-Cadmium Batteries (North America Only) Welch Allyn employs the services of an agency which can disassemble and recycle all components of nickel-cadmium batteries so that nothing gets placed in a landfill or incinerated. To recycle an expended Welch Allyn...

  • Page 52: Paper Replacement

    Paper Replacement The MicroTymp 2 Printer/Charger signals the need for changing the paper in one of two ways: • A pink strip appears along the edge of the paper indicating the paper is nearing the end of the roll. • The POWER indicator flashes in single pulses indicating that there is no paper, and no printing can occur.
  • Page 53 2. Depress the FEED button to advance any remaining paper through the printer. Do not pull paper backwards through the printer. Remove and discard old paper roll, saving the black spindle. 3. Pull the paper lever forward. See Figure 41. Figure 41 Figure 42 4.

  • Page 54: Cleaning, Disinfection And Sterilization

    Cleaning, Disinfection and Sterilization Cleaning the MicroTymp 2 Handle Do not sterilize the MicroTymp 2 Handle. Clean the Handle by wiping it with a dry cloth or a cloth that has been lightly dampened with 70% Isopropyl alcohol. Make sure liquid does not seep into the instrument, especially in the probe area.

  • Page 55: Functional Checks Of The Microtymp 2 Handle

    A MicroTest Cavity is included with the MicroTymp 2 Handle. The cavity provides a functional test of the MicroTymp 2 Handle to determine if it is working properly. The 0.5 cc cavity is used to test the Low Range of ear canal volume (Vea).
  • Page 56 2.3 cc to 2.5 cc Cavity If the readings do not fall within the acceptable range, then the MicroTymp 2 Handle requires calibration. Send the MicroTymp 2 Handle to a Welch Allyn service location. See Appendix E, “Service and Warranty Information,” for a complete listing.

  • Page 57: Troubleshooting The Microtymp 2 Handle

    Troubleshooting the MicroTymp 2 Handle Symptom Possible Cause Possible Solution Handle Does No battery. Put battery in. Not Turn On Battery in backwards. Reposition battery observing polarity. Battery not charged/dead. Charge/replace battery. If symptom still persists, return to local Welch Allyn service location for service.
  • Page 58 Software Version The test pattern also includes the software version for the MicroTymp 2 Printer/Charger. Normative Data Reference The test pattern is followed by normative data for tympanometric characteristics for both the original MicroTymp and MicroTymp 2 Handle. This is provided along with the test pattern for the convenience of the user, not specifically as a functional check.

  • Page 59: Appendix E - Service And Warranty Information

    Welch Allyn MicroTymp 2 distributor. A moderate fee is charged for recalibration. The MicroTymp 2 instrument warranty may be extended for up to three years provided the Handle is returned each year for recalibration. A monthly functional check using the MicroTest Cavity is recommended.

  • Page 60: Warranty

    This warranty only applies to instruments purchased new from Welch Allyn or its authorized distributors or representatives. The purchaser must return the instrument directly to Welch Allyn or an authorized MicroTymp 2 distributor or representative and bear the costs of shipping.

  • Page 61: Appendix F - Technical Specifications

    Appendix F Technical Specifications 3.68 in 9.35 cm 7.32 in 18.6 cm 1.94 in 4.94 cm POWER CHARGE FEED PRINT -400 -200 PRESSURE - DaPa TEST 4.82 in 12.2 cm 9.70 in 24.6 cm 9.62 in 24.4 cm Figure 46 F-57...
  • Page 62 Display resolution: 0.1 mmho for Ya 0.2 cc for +200 Vea Accuracy: ±0.1 mmho or ±5%, whichever is greater Weight: MicroTymp 2 Handle: 0.61 lb/0.28 kg Printer/Charger: 3.98 lb/1.81 kg Operating Temperature: 15˚ to 35˚C (59˚ to 95˚F). All specifications apply within this temperature range.
  • Page 63 Pink end-of-roll indicator Approximate number of printouts per roll: 200 – Tympanogram, Data, and Messages reports 250 – Tympanogram and Data reports 300 – Tympanogram Only reports Table 8 – MicroTymp 2 Printer/Chargers Welch Allyn Nominal Major Geographic Plug Type...
  • Page 64 ETL listed to comply with UL 2601 ETL listed to compy with CSA C22.2 No. 601-1 ETL listed to comply with IEC 601-1, Amendment 1 MicroTymp 2 Handle: Class I Equipment, Type BF MicroTymp 2 Printer/Charger: Class I Equipment, Type B FCC Part 15, Class A This device complies with CFR 47 Part 15 Class A of the FCC rules.

  • Page 65: Appendix G Microtymp 2 Replacement Parts And Accessories

    Appendix G MicroTymp 2 Replacement Parts and Accessories Battery MADE EXCLUSIVELY FOR #72900 2.4 V USE ONLY SPECIFIED CHARGER Nickel-Cadmium Battery RECHARGEABLE BATTERY 2.4 VOLTS 600mAh CATALOG NO. 72900 Screw for Battery Cover #236081 Screw Driver for Battery Cover #236200 MicroTest Cavity 2.0 cc...
  • Page 66 Replacement Power Cords #761076-0 #761076-2 120 V, Canada, 230 V, Europe Japan, U.S. #761076-4 #761076-6 230 V, United 230 V, Australia, Kingdom New Zealand -400 -200 PRESSURE - DaPa TEST #23640 Carrying Case Handle for MicroTymp 2 and AudioScope3 (#05276) G-62...

  • Page 67: References

    References American National Standards Institute (1987). “Specifications for Instruments to Measure Aural Acoustic Impedance and Admittance (Aural Acoustic Immittance).” New York: ANSI. ANSI S3.39-1987 (ASA71-1987). American Speech-Language-Hearing Association (1985). “Guidelines for Identification Audiometry.” ASHA, 27, 49-52, May, 1985. American Speech-Language-Hearing Association (1990). “Guidelines for Screening for Hearing Impairments and Middle Ear Disorders.”...
  • Page 68 Occupational Safety and Health Administration (1992). “Occupational Exposure to Bloodborne Pathogens.” OSHA 3127, 1992. Terkildsen, K., Thomsen, K. A., (1959). “The influence of pressure variations on the impedance of the human eardrum.” J. Laryngol. Otol. 73:409-418. U.S. Department of Health and Human Services (1994). “Managing Otitis Media with Effusion in Young Children.”...

  • Page 69: Glossary

    (+200 Vea) The volume of air that has the same acoustic admittance as the ear canal/middle ear system when the ear is pressurized. The MicroTymp 2 Handle measures Vea with a 226-Hz probe tone and an ear canal air pressure of +200 daPa. Under these conditions, Vea is a good estimate of the volume of air in front of the probe.
  • Page 70 otorrhea External ear discharge. otosclerosis A genetic abnormality of the temporal bone, frequently causing fixation of the stapes and conductive hearing loss. sound pressure The average (rms) difference between the air pressure that occurs during sound transmission and the ambient air pressure. tympanogram A recording of the admittance of the ear as a function of ear canal air pressure.
  • Page 72 Welch Allyn, Inc. 4341 State Street Road P.O. Box 220 Skaneateles Falls, New York 13153-0220 U.S.A. Tel.: 800-535-6663 (U.S.A. only) 315-685-4560 Fax.: 315-685-3361 Printed in U.S.A. Part No. 236311-2...

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