Reference Manual Itera II
Reference Manual Itera II
Reference Manual Itera II
Itera II
Reference Manual
Doc. No.7-50-0860-EN/26
Part No.7-50-08600-EN
Copyright notice
© 2010, 2019 Natus Medical Denmark ApS. All rights reserved. ® Otometrics, the Otometrics Icon, AURICAL, MADSEN, Otoscan,
ICS and HORTMANN are registered trademarks of Natus Medical Denmark ApS in the U.S.A. and/or other countries.
Version release date
2019-06-11 (214086)
Technical support
Please contact your supplier.
2 Getting started with MADSEN Itera II and the OTOsuite Audiometry Module 11
2.1 Unpacking 11
2.2 Getting started 11
2.3 Customizing your setup 12
6 Tone testing 61
6.1 Air Conduction threshold test 61
6.1.1 Testing 61
6.1.2 Sound Field testing 62
6.2 Bone Conduction threshold test 62
6.2.1 Testing 63
6.3 Testing with masking 64
6.3.1 When is masking required? 64
6.3.2 Air conduction with masking - suggested procedure 66
6.3.3 Bone conduction with masking - suggested procedure 66
6.4 Storing thresholds 67
7 Speech testing 69
7.1 Monaural Speech testing 69
7.1.1 Selecting input 69
8 Special tests 75
8.1 MCL tone testing 75
8.2 UCL tone testing 75
8.3 SISI (Short Increment Sensitivity Index) 75
8.3.1 Masking during SISI 76
8.3.2 Using STORE in the SISI test 77
8.4 ABLB (Alternate Binaural Loudness Balance) 77
8.4.1 Using STORE in the ABLB (Fowler) test 77
8.5 STENGER Test 78
8.6 Hearing Instrument Simulation (HIS) 79
8.6.1 The HIS procedure 79
8.6.2 Viewing thresholds and filters 81
8.6.3 Manually adjusting the HIS filters 82
8.7 Overview of monaural/binaural test signals and the masking side 84
10 Setup of parameters 87
10.1 What does SETUP do? 87
10.2 How to use SETUP 87
10.2.1 Permanent changes in the setup 87
10.2.2 Return to default settings 87
10.2.3 Temporary changes in the setup 88
10.3 SETUP items 89
17 Abbreviations 113
Index 127
• MADSEN Itera II can be used in connection with the OTOsuite Audiometry Module software for online monitoring
of test results, data export and storage, printing, and NOAH compatibility.
• MADSEN Itera II can be used as a portable instrument or as a desktop unit (fixed installation).
Operation
The front panel buttons have indicator lights, which clearly show the device's current settings.
Sound level, frequency and other information are shown clearly on the device display.
Speech input signals can be taken from a CD player, tape recorder and internal or external microphones. The masking sig-
nal for speech audiometry can be presented together with the speech signal for the ear being examined - "Speech in
Noise".
Output options
There are three output options:
• standard headphones (AC),
• bone conductors (BC)
• special output (SF), which can be connected for instance to a free-field loudspeaker or insert phone (see available out-
put in SETUP items ► 89).
MADSEN Itera II can be calibrated for several types of headphones simultaneously.
The OTOsuite Audiometry Module is designed to operate with MADSEN Itera II as the test device.
As the module is part of OTOsuite, audiograms can be used directly in other OTOsuite modules such as the PMM and
Immittance modules for an optimized workflow independent of NOAH, and for combined reporting.
The OTOsuite Audiometry Module supports
• basic tone audiometry and
• speech testing
• a range of special tests.
Masking AssistantTM
The special Masking AssistantTM feature will notify you of thresholds that you might consider checking again with masking
applied. You may use this feature not only during testing but also to pinpoint possible masking issues with previously recor-
ded audiograms. The applied masking rules match the general recommendations in the audiometry literature.
Note • If you are using the Audiometry Module with NOAH, we recommend that you are familiar with the screens and
functions provided in NOAH.
Training
It is recommended that you read this manual and the OTOsuite Platform User Manual, and make yourself familiar with
MADSEN Itera II before you begin testing a patient.
Terminology
The correct term for the person being tested/evaluated/serviced may depend on the setting in which the system is being
used. For this manual the term “Patient” was chosen, but when you use MADSEN Itera II with OTOsuite, you can configure
OTOsuite to use another term.
1.3.1 Safety
This User Manual contains information and warnings which must be followed to ensure the safe performance of MADSEN
Itera II and the OTOsuite Audiometry Module.
Warning • Local government rules and regulations, if applicable, should be followed at all times.
Safety information is stated where it is relevant, and general safety aspects are described in Standards and safety ► 115.
• Standards and safety ► 115 gives you an overview of device labelling and standards.
• Warning notes ► 115 contains relevant warning notes.
Warning • Indicates that there is a risk of death or serious injury to the user or patient.
Caution • Indicates that there is a risk of injury to the user or patient or risk of damage to data or the device.
• Click the Set Options icon on the toolbar or select Tools > Options...
Safety
For safety information, see
• Standards and safety ► 115
Installation
• To install the new system, see Unpacking and installing ► 105
• If you are using OTOsuite, install OTOsuite from the OTOsuite Installation disk. See the OTOsuiteInstallation Manual.
Printing
• See the OTOsuiteUser Guide.
Example
1. Set dB STEP to 1 dB (press button 1 in the dB STEP column).
2. Press SETUP twice to enter setup mode.
3. Turn the Left dB LEVEL knob until SAVE TEST SETUP is shown on the display.
4. Press STORE.
5. Turn Itera II off and then on again. It now remembers your preferred settings.
Shortcuts
A number of functions in Itera II can be activated by a shortcut so that you just have to press and hold the appropriate but-
ton and turn the knob.
For a full list of shortcuts, see Temporary changes in the setup ► 88.
Example
1. Press the SPEECH button to select Speech mode.
2. Press MIC to select microphone.
3. Press and hold MIC while you turn the Right level knob. You will then adjust the sensitivity of this microphone.
B. On/Off switch
The side panel contains the On/Off switch. See Side panel ► 28.
C. Display
Settings and the test as it progresses are shown on the display. See Dis-
play ► 13.
3.1 Display
A. Test signal indicator
B. Audiogram symbols
C. Stored threshold
D. Ear indicator
E. Function key markers
During start-up the display briefly shows information regarding the device type and version, followed by the test screen last
used.
The abbreviations used on the display are explained in Abbreviations ► 113.
Top line
• During Tone testing the upper line in the display shows the intensity numerically in dB HL for the left and right ear.
• During Speech testing and HIS the upper line is transformed into one or two VU meters.
Ear selection
The ear being tested is indicated with L or R in the display. The display side for L and R can be changed in the settings. See
SETUP items ► 89.
Frequency
The selected test frequency for tone testing is shown at the center.
Masking
If masking for the contralateral ear is enabled, this is shown on the opposite side.
Symbols used
Left ear Right ear
Response/No response Response/No response
Air, unmasked
Air, masked
Other symbols
Beep
If you try to use a button which is not enabled, you will hear two short beeps.
MADSEN Itera II also beeps when the SISI test is completed.
• TONE
Selects the Tone Threshold test.
• SPEECH
Selects the Speech test.
• SPECIAL
Press to see the optional test types. Press the desired function key to select.
On versions of Itera II supplied with more than three special tests, press SPECIAL again while its LED is
flashing. This will display the names of more Special tests.
The most recently used special test always appears in the first row the next time you select SPECIAL.
• AC
Selects the Air Conductor
• BC
Selects the Bone Conductor
• SF
Selects the Special Transducer
The identity of the transducer selected under SETUP is displayed as long as you press the button.
If a headphone/transducer is not selected under SETUP, SETUP items ► 89, SETUP items ► 89 and SETUP
items ► 89, the relevant transducer cannot be selected.
Warble frequency To change the warble frequency, press and hold WARBLE, while you turn the
left LEVEL selector.
Warble modulation To change warble modulation width, press and hold WARBLE, while you turn
the Right level selector.
PULSE
The test signal is presented with a Pulse/Pause ratio of 50%.
Pulse frequency To change the pulse frequency, turn the Right level selector while you
press and hold PULSE.
IMPULSE
The test signal is presented within a preset period of time.
Test signal duration To change the duration of the test signal, turn the Right level selector
while you press and hold IMPULSE.
CD.
Press CD to select the signal from external CD/TAPE input.
Input signal sens- You can adjust the input signal sensitivity by holding down the MIC or CD button
itivity, MIC/CD and turning the LEVEL selector that is closest to the test signal side.
REVERSE
Press REVERSE to toggle the function of the Interrupter between:
• REVERSE (lamp lit)
If REVERSE is on (the test signal is activated continuously), the test signal is interrupted when you press INT.
• Normal
The test signal is applied when you press INT.
Note • The presentation only applies to the test signal. The masking signal is normally always ON. You can change
the masking interrupter's function under SETUP, SETUP items ► 89.
The permitted signal source depends on the TEST selected, see Display ► 13.
The indicators are located on either side of the display. They light up when the selected test signal is presen-
ted in the corresponding ear.
Extended Range has three modes (to select, see SETUP, SETUP items ► 89):
• Auto
All levels at all frequencies are always accessible, but the Extended Range button is lit when a level above the safety
limit is reached.
• Manual
You must manually press the Extended Range button to test above the safety limit.
• Timeout
Selection of the time interval that passes between the device standing untouched and the EXTended (sound intensity)
RANGE is deactivated.
EXT. RANGE is automatically disabled when:
• the intensity falls below the limit selected under SETUP, SETUP items ► 89,
• the duration set for Ext. Range Timeout is exceeded and the device has been inactive (SETUP, SETUP items ► 89),
• you select a new test, or
Speech test
• Press twice (L+R) during the speech test to send the test signal to both ears, giving "Binaural Speech".
• Use L <--> R to mix the signals in speech testing.
• Use L <--> R to control setup masking in one ear in binaural speech testing.
3.2.9 Setup
Changing the setup temporarily
To change the setup temporarily, use the Shortcut function (Temporary changes in the setup ► 88). These changes will
not be saved when you switch off the device.
1. Press SETUP twice to change default settings, see Setup of parameters ► 87. This serves to prevent
accidental changes in the setup.
– SISI
Press SETUP to enable the number of small increments to be changed using the right LEVEL
selector.
– Fowler (ABLB)
Press SETUP to enable changing the frequency of the alternating tone using the right LEVEL
selector.
You can choose to have the test signal and/or the masking signal switched ON or OFF in the monitor headphone (SETUP,
SETUP items ► 89).
Setup - volume To adjust the volume, press and hold TALK BACK while turning the right LEVEL selector.
3.2.11 Masking
• By default, you always adjust the stimulus signal level on the Left Level knob, regardless of whether you are testing
the right or left ear.
OFF
No masking
ON
To adjust the masking intensity independently of the signal level use the Right level knob.
LOCK
Makes the masking level follow the stimulus signal level. You can adjust the difference between the stimulus
signal and the masking signal by using the Right level knob.
Masking transducer selection When masking is already selected and you press the same masking button once
more, the masking transducer, the masking signal type and the name of the trans-
ducer, and (if applicable) the serial no. appear in the display.
The transducer button flashes and you can then select a different masking trans-
ducer by pressing one of the three TRANSD buttons AC, BC or SF .
Masking noise in Speech Select the masking ear: press and hold MASK ON and press L <--> R to toggle
between left, right and both ears.
3.2.12 dB steps
Choose between the following attenuator steps:
1 dB
2.5 dB
5 dB
If the indicator light on the selected button flashes, this indicates that the display has been set up to show
SPL values (SETUP, SETUP items ► 89) instead of HL.
3.2.13 Microphone
The internal microphone for Talk Over and Speech testing.
Use this microphone as an alternative to the goose neck microphone or the boom microphone on the mon-
itor headset.
The test signal and any masking signal is interrupted during this period.
When you release the button the test signal returns.
Shortcut functions
When you press and hold TALK OVER (see SETUP items ► 89), you can adjust the following:
The change-over from "INTERN." to "EXTERN." occurs automatically if an external microphone is connected (see 3.3 ►
26).
3.2.16 Start/Pause/Stop
Press to Start, Pause or Stop the counter/timer function in different tests as required.
SISI
• Press to Start/Pause and Stop.
HIS
• Press to activate the filters.
• If a previously stored threshold is present, it will be replaced by the new threshold when you press STORE.
Intensity change
• Changes the intensity for the stimulus signal regardless of whether the signal is being sent to the left
or right ear. Turn clockwise to increase the intensity and counter-clockwise to decrease.
To change this setting, select SETUP, SETUP items ► 89.
Shortcut functions
dB LEVEL left - shortcut functions
Signal type, SISI The signal type for the SISI test.
Intensity change
Changes the intensity of the masking signal in the selected dB steps. To change this setting, select SETUP,
SETUP items ► 89.
When you turn the knob clockwise, the intensity is increased and when you turn the knob counter-clock-
wise, the intensity is decreased.
Shortcut functions
You can also use the right LEVEL selector to
Word counting method, Choice of word counting method for speech testing.
speech
Presentation of test signal. This function depends on whether presentation mode is set to normal, or
REVERSE is activated. This is shown by the output indicator (see Signal indicators ► 19).
Normally the test signal is present when you press the button.
If you press REVERSE the test signal disappears.
• Speech testing (Stimulus/speech count buttons ► 24)
Press this button to count "unheard words" (FAIL).
3.2.20 Frequency
Change of frequency.
When you turn the knob clockwise, the frequency is increased and when you turn the knob counter-clock-
wise, the frequency is decreased.
Both octave and inter-octave frequencies are available when you use the Frequency knob. The exception is
125 Hz, which follows the setting in SETUP, SETUP items ► 89
Display graphs, HIS If you turn this knob in HIS mode, various graphs will be shown (see Hearing Instrument Sim-
mode ulation (HIS) ► 79).
3.2.21 Erase
Note • Switching off the power does not erase stored thresholds from the memory.
Additional functions
Speech Audiometry and a number of special tests, various counter values:
• Press to reset to zero.
See the description of Test column ► 16, and Special tests ► 75),
SISI:
• Press to stop test completely during the pause.
• Press to delete data at a specific frequency if it is activated during a test (see SISI (Short Increment Sensitivity Index) ►
75).
3.2.22 Xmit
This button is not active.
Socket Description
A. SF (AC) Connection for the "SF Transducer output". Here you can connect any headphone
or free field system.
Connect the blue 1/4" jack plug for left (SF Left) and the red 1/4" jack plug for
right (SF Right).
B. AC Connection for the AC transducer to the headphone. Blue 1/4" jack plug for left
(AC Left) and red 1/4" jack plug for right (AC Right).
C. BC Connect the black 1/4" jack plug from the bone conductor.
Socket Description
Caution • When you connect other electrical equipment to MADSEN Itera II,
remember that equipment that does not comply with the same safety stand-
ards as MADSEN Itera II can lead to a general reduction in the system's
safety level.
E. EXTERNAL Connection for the gooseneck microphones for speech audiometry or monitor
MIC./MONITOR HEADSET headset with internal microphone.
F. MONITOR Connection for the monitor head set without internal microphone. Can be used if
a stereo microphone is connected to EXTERNAL MIC./MONITOR HEADSET.
G. TALK BACK Connection for the Talk Back microphone, for communication from patient to
operator. Set the switch on the Talk Back microphone to ON.
I. PATIENT RESPONSE Connect the black 1/4" jack plug from the Patient Response switch. When the
patient presses the Patient Response switch, this lights the RESPONSE indicator
light and gives an audible "beep" from Itera II.
J. DC POWER OUT Power supply for the CD/TAPE player. Adjustable from SETUP, SETUP items ► 89
(OFF and 1.5 - 10 volt DC, 500 mA). Use the right LEVEL selector to select.
Note • Remember to use an adapter if necessary so that the CD has the cor-
rect polarity. The center pin is + and the sheath is 0V.
Socket Description
K. RS 232 INTERFACE To connect the device to a PC, use the optional 9-pole PC- RS232 interface cable.
For information on how to use the device with a PC, see Managing Data and Res-
ults ► 85.
Power On/Off
Screen descriptions
You will find descriptions of the actual screens and how to use and view them in:
The Tone test screen ► 39
The Speech test screen ► 46
Audiometry icons
Tone audiometry
Speech audiometry
New Audiogram Select new audiogram. You will be prompted to save or cancel current data.
Audiometric prop- Ctrl+U Click to enter Tester name, Test Date, and air conduction transducer for a manu-
erties... ally entered audiogram.
Note • The air conduction transducer is stored when you have selected it in
the transducer section of the Control Panel (or with device controls, if
applicable) and data points are entered on the audiogram.
Combined Audiogram Click to toggle between viewing both ears in a single audiogram (com-
bined audiogram) or both a left and a right audiogram on your
screen.
Combined View
• Click to view both ears in a single audiogram.
Split View
• Click to view separate audiograms for each ear.
Left - Right Click to display the left ear audiogram on the left side of the window
and the right ear audiogram on the right side of the window (when
Dual Graph View is enabled in Options > Audiometry > Tone >
Misc).
Right - Left Click to display the right ear audiogram on the left side of the win-
dow and the left ear audiogram on the right side of the window
(when Dual Graph View is enabled in Options > Audiometry >
Tone > Misc).
Audiogram Legend Click to enable or disable the display of the audiogram legend. The
legend contains the most commonly used symbols for the audiogram.
It is not configurable.
Standard / All / High The graph shows up to 20,000 Hz. MADSEN Itera II presents stimulus
frequencies up to 12,500 Hz.
• Click to choose between viewing:
Standard Frequencies
Displays the audiogram from 125 to 8000 Hz.
All Frequencies
Displays the audiogram from 125 to 20,000 Hz.
High Frequencies
Displays the audiogram from 8000 to 20,000 Hz.
Select Orientation Click to select the perspective of the patient's ears as presented on
the screen for graph and table views.
Curves and Symbols Click to select the Curves and Symbols dialog box.
This dialog box and its related function are specific to configuring the curves and symbols to
be displayed on the audiogram or speech graph during testing.
See Curves and symbols selection ► 42.
Options... See description of how to work with user options and User Tests in the OTOsuiteUser Guide.
Additional icons
Menu item Description
Import Audiometry Click to import audiometry data from AURICAL Plus and MADSEN Conera. See the OTO-
Data suiteUser Guide.
• Green
Indicates that the patient is pressing the Patient
Responder.
• Red
Indicates that the patient is pressing the right
response button.
• Blue
Indicates that the patient is pressing the left
response button.
The Masking Assistant is a tool provided to help you with an indication that there may be frequencies where testing with
masking1 is recommended.
• The audiogram symbol will flash at the specific frequencies where contralateral masking may be recommended2.
1(Katz, J., Lezynski, J. (2002). Clinical Masking. In J. Katz, ed., Handbook of Clinical Audiology, Williams and Wilkins, Bal-
timore.)
2Based on criteria described in Clinical Masking, Essentials of Audiology, Stanley A. Gelfand, Thieme 1997, and Meas-
urement of Pure Tone Hearing Thresholds, Audiologists’ Desk Reference - Vol 1, James W. Hall III, H. Gustav Mueller
III, Singular Publishing Group 1997. and Munro K.J., Agnew N. A comparison of inter-aural attenuation with the Ety-
motic ER-3A insert earphone and the Telephonics TDH-39 supra-aural earphone. Br J Audiol 1999; 33: 259-262.
Terminology
AC AC test ear
ACc AC contra
BC BC
BCc BC contra
Min IA Minimum inter-aural attenuation.
Only stored thresholds measured without masking are checked. Levels which did not evoke a response are excluded from
the check. This means that as soon as a masked threshold has been stored, the flashing stops for that frequency.
* denotes configurable Air/Bone gap criterion (Tools > Configuration Wizard > Audiometry - Configure... > Masking
Assistant).
1Katz, J., Lezynski, J. (2002). Clinical Masking. In J. Katz, ed., Handbook of Clinical Audiology, Williams and Wilkins, Bal-
timore. Munro, K.J., Agnew, N. A comparison of inter-aural attenuation with the Etymotic ER-3A insert earphone and
the Telephonics TDH-39 supra-aural earphone. Br J Audiol 1999; 33: 259-262. Hall, JW., MUELLER, HG. (1997). The audi-
ologists’ desk reference, Volume I., Singular Publishing Group, San Diego.
Hz dB
125 35 Katz & Lezynski, (2002)
250 48 Munro & Agnew, BJA (1999)
500 44 Munro & Agnew, BJA (1999)
750 40 N/A - fulfill traditional approach
1000 48 Munro & Agnew, BJA (1999)
1500 40 N/A - fulfill traditional approach
2000 44 Munro & Agnew, BJA (1999)
3000 56 Hall J.W. III & Mueller G.H. III / Munro & Agnew, BJA (1999)
4000 50 Katz J / Munro & Agnew, BJA (1999)
6000 44 Hall J.W. III & Mueller G.H. III / Munro & Agnew, BJA (1999)
8000 42 Katz J / Munro & Agnew, BJA (1999)
Hz dB
125 60 N/A - traditional value
250 72 Munro & Agnew, BJA (1999)
500 64 Munro & Agnew, BJA (1999)
750 60 N/A - traditional value
1000 58 Munro & Agnew, BJA (1999)
1500 60 N/A - traditional value
2000 56 Munro & Agnew, BJA (1999)
3000 58 Munro & Agnew, BJA (1999)
4000 72 Munro & Agnew, BJA (1999)
6000 54 Munro & Agnew, BJA (1999)
8000 62 Munro & Agnew, BJA (1999)
Note • The appearance of the Control Panel depends on the test device used.
The general function of the Control Panel is described in the OTOsuiteUser Guide.
The Audiometry Module Control Panel shows the settings selected on the connected audiometer for the specific test.
Note • You cannot operate MADSEN Itera II from the Control Panel.
The Control Panel is divided into a number of sections where you can view various settings, and a section for controlling
communication with the audiometer.
Stimulus The Stimulus panel shows the stimulus type used and the selected test ear.
Masking The Masking panel shows the masking used and the selected test ear.
Connection
Note • If there is a risk that patient selected in the audiometer does not correspond with the
patient shown in OTOsuite or NOAH status bar, a warning triangle will be shown on the
screen.
• Make sure that you select the correct patient, either in the audiometer or in OTOsuite.
A. Intensity E. Frequency
B. Stimulus indicator F. Stimulus bar color
C. Transducer indicator G. Routing indicator
D. Stimulus being presented H. Masking on
Intensity
The stimulus/masking type, the transducer and the routing for each channel.
A. Symbol B. Frequency
Symbol
• Indicates the symbol that will be displayed on the audiogram(s) when a data point is stored. The symbol shown
reflects the current audiometer measurement settings.
Frequency
A. VU meter
B. Speech score
C. Word count
• Displays the percentage correct/incorrect and the amount of words correct/incorrect out of a given number of
words. You can display speech score and word count either as “% Correct” or as “% Incorrect”. To set your pref-
erence, select Tools > Options > Speech > Misc. > Score Presentation.
% Correct is the default setting.
VU Meter
• Displays the level (in volume units) of the test microphone or speech material from Source A or Source B. Speech
should always be delivered at 0 dB on the VU meter so that the dB level on the stimulus intensity bar represents
the level actually being delivered to the patient.
A. Stimulus bar
B. Work area
C. Legend box
Indicates your current stimulus level and frequency. The color indicates the rout-
ing:
• Blue = left
• Red = right
• Black = binaural
Mouse cursor
Indicates where you place the mouse. The color indicates the routing:
• Blue = left
• Red = right
• Black = binaural
Audiogram
When you use the dual graph viewing option, the graph that
corresponds with the stimulus ear will have a gray outline to
denote the active audiogram.
You can switch the position of the right and left graphs to cor-
respond to your viewing preference.
1. Select Tools > Options > Tone > Misc. > Dual Graph View
or in the menu bar under View.
Below the audiogram, the intensity levels used for masking can be displayed. It is an option to display the masking
levels. Select Tools > Options > Tone > View > Misc. > Masking Levels.
• In combined view, the non-test ear masking levels are shown below the graph.
Masking levels
• In Dual Graph View, the masking level used for masking the non-test ear is by default displayed under the graph
for the test ear. The masking level can be set to be displayed either under the test ear or under the non-test ear:
select Tools > Options > Tone > View > Misc > Masking Table Placement.
Note • If the symbols are created larger, this may severely compromise the performance of OTOsuite.
The standard symbols are drawn within a centered inner frame of 1.5 x 1.5 cm (0.6 x 0.6 inches).
The area between the inner and outer frames is used for additions to the main symbol, such as arrows for No
Response or Response at Limit, and designators for Aided Left or Aided Right.
3. Before you store the new graphic, make sure that the outer and inner frames are invisible: Select the frame, and set
the line color to No Line. Repeat this for each frame.
4. To save as an *.emf graphics file, select all elements in the drawing (including the invisible outer frame as well as the
symbol itself centered within the frame). Right-click and select Save as picture...
5. Name the file and select the file type *.emf.
6. Save it in C:\Program Files\GN Otometrics\OTOsuite\AudSymbols.
7. Launch the OTOsuite Audiometry Module and select Tools > Curves and Symbols.
The new symbol should appear on the list of symbol options.
In this dialog box, you also have options for setting the color, line type, and horizontal and vertical offsets that will
apply when you use the new symbol.
4. If you decide to make a new audiogram, then a new Current audiogram is generated in the Compare Audiograms fea-
ture box list, and what was previously the current audiogram consequently becomes a historical one, displayed with
measurement date.
5. If you deselect the viewing of a Current audiogram so that it is no longer shown, then it will instantly be reselected if
you try to edit a curve.
6. You can keep any previously collected audiogram visible in the graph while collecting the current audiogram simply by
keeping it selected in the Compare Audiograms feature box while measuring.
Overlays
Select the overlay to be displayed on the audiogram.
These overlays assist in the counseling process.
• Select Tools > Options > Audiometry > Tone > Overlay Selection Box.
The overlay options are:
Pictures
Displays pictures representing common environmental sounds at their approx-
imate dB level (e.g. bird, plane).
Severity
Displays the audiometric severity levels (normal, mild, moderate, moderate-to-
severe, severe, profound).
Speech Banana
Displays the speech banana of a listener with normal hearing.
Speech Letters
Displays speech sounds at their approximate dB level.
Unusable area
Shades the area which is outside the patient's dynamic range of hearing.
Graphs and Tables Click to select the way you view the patient in relation to your mon-
itor.
Control Click to select the position of the stimulus channel on the screen.
A. Stimulus bar
B. Work area, tabular view
C. Audiogram
Feature boxes
Pure Tone Data Displays the pure tone average for air conduction and bone conduction as well as the articulation
index.
• To configure pure tone average (PTA) calculation, select Tools > Options > Audiometry > Gen-
eral > Misc. > PTA Frequency AC/BC.
• The AI is calculated according to the “Count-the-dot” method.
• Score
Percentage of correct/incorrect words.
• Level
dB level at which the words were presented.
• [Msk]
Effective masking level (dB EML) used for contralateral masking.
• SNR
Signal-to-Noise Ratio.
• PTA - AC
Pure Tone Average for Air Conduction thresholds.
• PTA - BC
Pure Tone Average for Bone Conduction thresholds.
If you perform a test which is not available in a predefined Speech table, a speech row is created automatically. This tem-
porary row will exist as long as there is stored test data for that measurement setup.
The Speech Graph screen displays the speech graph which includes SDT, MCL, UCL noted by a line (blue = left, red = right)
at the corresponding dB level.
For SRT and WRS/SRS, or WRS/SRS with noise, symbols will be shown based on the location corresponding to the dB level
of presentation and the percentage of correct responses.
Adaptive rows
The rows in the adaptive legend always show the current measurement settings and the measurements you have made. A
new row will be added to the legend every time you make a new test.
Example
The adaptive Speech legend showing the current measurement settings. Data has not been stored at this point.
The adaptive Speech legend showing the three first measurements followed by a blank row with the current measurement
settings ready to be stored.
Pinned rows
You can pin a row to make it available in advance in order to reflect the measurements usually performed in your clinic. A
legend with pinned rows will always look the same when you start testing a new patient.
This customized layout provides you with a consistent work environment and makes it easy to see what to do next, or if
any test has been deliberately left out.
A test that is not pinned to the legend is added automatically below the pinned rows.
Pinning a test
You can pin one test per measurement condition.
Note • You can pin a test to the legend, if you have not already pinned an identical test. To edit a pinned test, make
sure that User Tests are not write protected in the Configuration Wizard.
To pin a row, simply select the row, right-click and select Pinned Tests > Pin Test. Here you can also rearrange pinned
rows by moving them up or down in the legend.
Note • When you use Click 'n' Get to apply settings, the AC transducer as well as the speech stimulus are loaded as
your preferred starting point. You can always adjust them in the Control Panel or in the Speech Player panel.
Example 1:
You typically use insert phones but you have a patient with an ear infection and you wish to use supra-aural head-
phones. Use Click 'n' Get to load the desired test, and simply switch to Phone in the Control Panel before you start the
test.
Example 2:
You typically wish to start the Speech test by familiarizing the patient with a specific word list before starting the
actual test with a different word list. Use Click 'n' Get to load the desired starting point, and simply switch to any
word list you wish to use after the familiarization.
Editing a row
Click on the data you wish to edit and use the right-click menu to change the value.
Deleting a row
Right-click on the field you wish to delete and select Delete Measurement.
Furniture
The test environment should include
• a comfortable chair for the client,
• a child-sized chair if testing pediatrics,
• a comfortable chair for the assistant.
The examiner should be able to see the client/patient. The client/patient should be seated so that it is not possible to see
what the examiner is doing or how the equipment is being operated. This reduces the likelihood that the client/patient
can anticipate when the stimulus will be presented.
For pediatric testing consider using a highchair, which is a familiar environment for most children and will place them
closer to eye level with the visual reinforcement toys. Make sure if performing visual reinforcement audiometry that the
reinforcing toys can be seen by the child. A child cannot look over and up at a toy until approximately 9 months of age.
Lighting
The lighting in the booth should be bright enough for the examiner to adequately see the client.
Toys
If testing pediatrics, several interesting toys are needed to center the child (obtain the child's attention toward the assist-
ant or tester) prior to stimulus presentation. It is best if these toys do not produce sounds.
The child should be conditioned to respond to the sound of the stimulus only. Competing sounds from toys can confuse
the child and reduce the reliability of the test.
Soft toys are needed to keep a young child's attention during behavioral observation or visual reinforcement audiometry.
Younger children like to tap the toy on the highchair tray and therefore a toy that does not create much sound would be
more appropriate during testing.
Blocks, buckets, puzzles are needed to keep a child's attention during play audiometry.
USB/RS232 connection
For PC or Laptop with USB port or RS232 cable for PC or Laptop with serial port.
A. Patient responder
Free-field
See Free Field ► 107 for a description of how to connect to MADSEN Itera II.
Note • During automatic testing, if the patient presses the switch repeatedly during a stimulus
presentation, the response is ignored.
Note • During automatic testing, if the patient does not release the switch, a beep is issued in the headphones. If this
situation is repeated, the test is paused. Reinstruct the patient.
• Before testing, check that the Response indicator lights up when the patient presses the responder.
Fitting on patient
• Place the patient facing away from the device, in a sound booth, if one is available.
• Set the switch on the Talk Back microphone to ON and set the level of Talk Back (Input - MIC, CD, REVERSE ► 18).
• Fit the headphones on the patient, with the red phone on the right ear.
• Choose the ear with the better hearing to be tested first.
Note • The bone conductor cable and insert phone cable must not be removed or tampered with while
MADSEN Itera II is powered on. Either disconnect the bone conductor or insert phone entirely from the
instrument, or make sure that the instrument itself is disconnected from the power source.
• If a sound booth is not available, place the patient facing away from MADSEN Itera II. This is to avoid visual
clues during testing.
• If applicable, set the switch on the Talk Back microphone to ON and set the level of Talk Back.
• Position the bone conductor/vibrator so that it rests comfortably against the mastoid bone (behind the ear)
and is not in contact with the pinna, or against the patient’s forehead.
• If MADSEN Itera II is calibrated for this, see SETUP, SETUP items ► 89 to choose between Forehead and Mastoid,
depending on the preferred placement of the bone conductor.
Important • The masking transducer must not under any circumstances block or cover the bone conduction test ear. If
it does, this will invalidate the test due to the occlusion effect.
Make sure that there is no contact between the headband, which holds the bone conductor in place, and the headset
or headband supporting the headphones. This will prevent vibrations from being conducted from one to the other.
Leave it in this position until the test is finished.
Warning • To prevent cross-infection, use new eartips when you test the next client.
Test types
• Manual air conduction testing
To perform manual air conduction testing, see Tone testing ► 61.
• Bone conduction testing
To perform bone conduction testing, see Bone Conduction threshold test ► 62.
• Speech testing
To perform speech testing, see Speech testing ► 69.
• Special tests
MCL tone testing ► 75
UCL tone testing ► 75
SISI (Short Increment Sensitivity Index) ► 75,
ABLB (Alternate Binaural Loudness Balance) ► 77,
STENGER Test ► 78,
Hearing Instrument Simulation (HIS) ► 79
These tests are optional. To add any of these tests to your configuration, contact your local supplier.
Note • If the headphones are not placed properly, there is risk of causing the ear canal to collapse which will result in
elevated thresholds.
Insert Earphones
Young children tolerate insert earphones better than headphones.
The insert earphones are color-coded:
• the blue indicator for the left ear,
• the red indicator for the right ear.
1. Select the largest foam eartip that will fit into the patient's ear.
If the eartip is too small the sound will leak out and the dB level will not be accurate at the eardrum.
Insert earphones have greater attenuation between ears especially at the low frequencies; this reduces the need for
masking.
2. It is best to clip the insert earphone transducers behind the child or on the back of their clothing and then fit the
foam eartip into the child's ears.
If the foam eartip is a little too large, consider cutting it down to make it a little smaller.
Bone Oscillator
Note • For unmasked bone thresholds, you can store binaural data:
Note • If there is a difference of 10 dB or greater between the bone conduction threshold and the air conduction
threshold of the same ear, masking is needed. The Masking Assistant can assist you in determining which thresholds
need to be masked.
Note • If the SRT of the test ear and the SRT or PTA of the nontest ear differ by 45 dB or more, masking is needed.
If the SRT of the test ear and the bone conduction PTA of the nontest ear differ by 45 dB or more, masking is needed.
Mastoid placement
1. Move any hair covering the mastoid out of the way and place the flat round part of the bone oscillator securely on the
boniest portion of the mastoid without any part of the transducer touching the external ear.
2. Make sure the bone oscillator is tight on the mastoid but still comfortable.
3. If you are going to perform masking with earphones, position the other end of the bone oscillator headband over the
patient's temple on the opposite side of the head so that the headband of the earphones and bone oscillator fit on
the patient's head.
Prerequisites
• Press TONE.
• Press AC.
• If needed, select WARBLE or PULSE as stimulus type(an advantage when you test children).
• If you want to predefine the duration of the signal presentation when you press the INT button, press IMPULSE.
• If you wish to use masking, select the masking type: Press MASK ON. See also Testing with masking ► 64.
• If required, turn the FREQUENCY knob to set the starting frequency: The typical starting frequency is at 1000 Hz.
The signal is usually presented for each tone in the following order:
1000 Hz and increasing frequencies
followed by
1000 Hz (cross check) and decreasing frequencies.
• Set the initial level of the presented signal to an audible level: Turn the LEVEL knob to 40 dB HL.
This is to familiarize the patient with the test signal. Other familiarization procedures may be preferred.
• Test the better ear first. If this is unknown, start with the right ear. Press L<-->R to select the ear you wish to test.
• Give the Patient Responder to the patient and explain how it should be operated (see The patient responder ► 54).
6.1.1 Testing
1. Press the INT button (right or left) to present the tone to the patient for 1 to 1.5 seconds.
2. Use the corresponding LEVEL knob to set the intensity to approx. 20 dB above the patient's presumed threshold.
If the patient does not respond to the presented signal, turn the LEVEL knob to increase the signal level in steps of
10 dB until the patient responds.
3. Reduce the signal level by 20 dB until the patient does not respond to the signal.
4. Increase the signal level in steps of 5 dB and present the signal to the patient at each level until the patient responds
to the signal.
5. Reduce the signal level by 10 dB and present signals at levels increased by 5 dB until the patient responds.
6. Repeat item 5, 1 to 3 times until the patient has responded 3 times at the same level.
This level represents the hearing threshold at 1000 Hz based on 3-5 ascending series.
In some situations, it may be satisfactory with two responses at the same level.
If the patient has responded less than 3 times at the same level after 5 series, present a signal at 10 dB above the level
where a response was last registered.
Then repeat item 6.
7. When the threshold is determined, press STORE to store that particular threshold. See Store/toggle threshold status
► 23.
8. Select the next frequency.
You can link the Store and Next Frequency functions, so that the test progresses with the next frequency when you
press STORE. See SETUP items ► 89.
9. Continue to use the right and/or left LEVEL knob to increase/decrease intensities until you have determined all
thresholds.
Note • If the thresholds measured at 1000 Hz in the ear differ by 10 dB or more, even the other frequencies should
be retested.
10. Continue to press STORE after each threshold is found to store that particular threshold.
11. After each threshold is determined and stored, you will notice that as you turn the LEVEL knob to scroll frequencies,
each stored threshold at that particular frequency will be marked by an asterisk (*) and the relevant audiogram symbol
indicating the stored threshold.
12. If you are not performing the test online with the OTOsuite Audiometry Module, plot the results in an audiogram
sheet.
13. Repeat this procedure for the other ear.
Note • If there are differences between the thresholds in the two ears, see Testing with masking ► 64.
Tip:
If ear-specific data is retrieved by blocking the contra-lateral ear, activate the masking on the audiometer to use the cor-
rect symbols. This is especially important when you use MADSEN Itera II with the OTOsuite Audiometry Module.
Set the masking level to e.g. -10 dB, and note in the Comments field that the contra-lateral ear was blocked.
Note • In Bone Conduction testing, masking is always necessary in order to determine in which ear the presented tone
signal is actually heard. This is because of the reduced level of inter-aural attenuation.
Note • Make sure that there are no interfering ambient sounds, particularly at low frequencies. If necessary, place the
patient in a sound booth.
Prerequisites
• Press TONE.
• Press BC.
• If needed, select WARBLE or PULSE as stimulus type.
• Press the REVERSE button to set the stimulus signal to continuous presentation (use full for placing the bone con-
ductor correctly on the patient).
• Set the dB level to a level that will be heard clearly by the patient.
• Place the bone conductor on the patient. See Preparing for bone conduction testing ► 55.
• Find the best position for the bone conductor. Ask the patient to report when the tone seems the loudest.
• Make sure that the bone conductor stays securely in place with no contact to the pinna.
• Give the Patient Responder to the patient and explain how it should be operated (see The patient responder ► 54).
• Press REVERSE to deactivate the REVERSE function.
• If you want to use a predefined duration of the signal presentation when you press the INT button, press IMPULSE.
• If you wish to use masking, see Testing with masking ► 64.
• If needed, turn the FREQUENCY knob to set the starting frequency: Typical starting frequency: 1000 Hz.
The signal is usually presented for each tone in the following order:
1000 Hz and increasing frequencies,
followed by
frequencies below 1000 Hz in descending order.
The typical test frequencies are:
250 Hz to 4000 Hz.
• Set the initial level of the presented signal to an audible level: Turn the LEVEL knob to 40 dB HL.
This is to familiarize the patient with the test signal. Other familiarization procedures may be preferred.
• If you intend to test both ears, test the better ear first. If this is unknown, start with the right ear. Press L<-->R to
select the ear you wish to test.
6.2.1 Testing
1. Press the INT button (right or left) to present the tone to the patient for 1 to 1.5 seconds.
2. If the patient does not respond to the presented signal, turn the LEVEL knob to increase the signal level in steps of
10 dB until the patient responds.
3. Reduce the signal level by 20 dB until the patient does not respond to the signal.
4. Increase the signal level in steps of 5 dB and present the signal to the patient at each level until the patient responds
to the signal.
5. Reduce the signal level by 10 dB and present signals at levels increased by 5 dB until the patient responds.
6. Repeat item 5, 1 to 3 times until the patient has responded 3 times at the same level.
This level represents the unmasked hearing threshold at 1000 Hz based on 3-5 ascending series.
In some situations, it may be satisfactory with two responses at the same level.
If the patient has responded less than 3 times at the same level after 5 series, present a signal at 10 dB above the level
where a response was last registered.
Then repeat items 3 to 6.
7. When the threshold is determined, press STORE to store that particular threshold. See Store/toggle threshold status
► 23.
8. Turn the FREQUENCY knob to select the next frequency.
You can link the Store and Next Frequency functions, so that the test progresses with the next frequency when you
press STORE. See SETUP items ► 89.
9. Continue to use the right and/or left LEVEL knob to increase/decrease intensities until you have determined all
thresholds.
10. Continue to press STORE after each threshold is found to store that particular threshold.
11. After each threshold is determined and stored, you will notice that as you turn the LEVEL knob to scroll frequencies,
each stored threshold at that particular frequency will be marked by an asterisk (*) and the relevant audiogram symbol
indicating the stored threshold.
12. Repeat this procedure for the other ear.
Note • If the difference between the air conducted threshold and the unmasked bone conduction threshold of the
same ear is 15 dB or greater, it is recommended that you retest bone conduction thresholds with masking applied
to the contralateral ear. See Testing with masking ► 64.
1(Katz, J., Lezynski, J. (2002). Clinical Masking. In J. Katz, ed., Handbook of Clinical Audiology, Williams and Wilkins, Bal-
timore.)
In order to use the insert phone for masking bone conduction, the EAR-3A must be included as a transducer for your
audiometer. It will be available either as the standard AC transducer, or as an SF transducer. Make sure that it is selec-
ted in SETUP, SETUP items ► 89.
The test procedure is similar to that described in Bone conduction with masking - suggested procedure ► 66.
Min IA TDH-39
Hz dB Source
Min IA EAR-3A
Hz dB Source
Hz dB Source
Testing
1. Press MASK ON to activate contralateral masking.
2. Set the masking level at the threshold of the masking ear and make sure that it is heard by the patient.
If it is not, increase the masking level.
3. Present the tone to the test ear at the unmasked threshold level.
If the tone is not heard, increase the level in 5 dB steps until the patient responds.
4. When the patient responds, increase the masking level in 5 dB steps.
After each increase, present the tone no more than twice. The tone is considered heard if the patient responds at
least once.
If the tone is heard when the masking level has been increased with at least three 5 dB steps, the so called masking
plateau has been reached and the test tone level is considered the masked hearing threshold level.
5. If the tone is not heard when the masking level is increased, increase the test tone level until the tone is heard by the
patient.
Repeat from step 4.
6. If the test tone level at the masking plateau (established in step 4) is within 5 dB from the unmasked threshold level,
you can skip step 7.
7. Keep the established masking level and confirm the masked hearing threshold level. To do so:
Decrease the test tone level by 10 dB and increase in 5 dB steps.
The patient should respond within 5 dB from the previously determined masked threshold level.
If not, repeat from step 2.
8. If required, test the remaining frequencies in the same way and switch to the other ear.
• It is recommended to use the default setup used in connection with selecting MASK ON for presenting the masking
signal as continuous presentation.
This means that you will not be using the INT button to control the masking signal.
Testing
1. Establish the unmasked bone threshold. If this has been done previously, and a different level is established in this
step, do not overwrite the previously recorded threshold. The conditions may have changed if the masking trans-
ducers were placed following the first test (for example due to the occlusion effect).
2. Press MASK ON to activate masking.
3. Set the masking level at the air conduction threshold of the masking ear and make sure that it is heard by the patient.
If it is not, increase the masking level.
4. Present the tone to the test ear at the previously confirmed unmasked bone conduction threshold level.
If the tone is not heard, increase the level in 5 dB steps until the patient responds.
5. When the patient responds, increase the masking level in 5 dB steps.
After each increase, present the tone no more than twice. The tone is considered heard if the patient responds at
least once.
If the tone is heard when the masking level has been increased with at least three 5 dB steps, the so called masking
plateau has been reached and the test tone level is considered the masked hearing threshold level.
6. If the tone is not heard when the masking level is increased, increase the test tone level until the tone is heard by the
patient.
Repeat from step 5.
7. If the test tone level at the masking plateau (established in step 5) is within 5 dB from the unmasked threshold level,
you can skip step 8.
8. Keep the established masking level and confirm the masked hearing threshold level. To do so:
Decrease the test tone level by 10 dB and increase in 5 dB steps.
The patient should respond within 5 dB from the previously determined masked threshold level.
If not, repeat from 3.
9. If needed, test the remaining frequencies in the same way and switch to the other ear.
1. When you select Speech testing, the display shows the following:
– the VU meter for the test signal in the top line of the display,
– a speech counter to count the number of words heard correctly or incorrectly by the patient,
– indication of any masking signal,
– the intensity for left and right ear, shown in the bottom line.
MIC. If you press MIC. , the microphone selection is shown briefly in the display, as follows:
EXTERN MIC., or
INTERN MIC.
The display then shows the selected microphone input for the current ear:
MIC1 (default), or
MIC2
You can set the sensitivity independently for MIC1 and MIC2 (Adjusting input sensitivity ► 70), regardless
of whether both MIC input channels are routed from:
• a single microphone (the internal microphone, an external table-top microphone or an external mon-
itor headset),
or from
• two different external microphones (gooseneck microphones).
If you are using a MADSEN Itera II with two built-in gooseneck microphones, the following selections apply
(gooseneck microphones are external microphones):
MIC1 = left gooseneck microphone
MIC2 = right gooseneck microphone
Note • If you connect an external microphone, which can be the monitor headset or the gooseneck
microphones, to EXTERN MIC, this automatically disables the internal microphone (INTERN MIC.). If
no external microphone is connected, the corresponding internal microphone will automatically be
selected.
Important • Be careful not to change the dB level before you have made a note of the results.
Note • There are no interrupt buttons in Speech mode, since they are used for counting words.
One-channel binaural test- CD_1 is the default input channel for both ears. If you wish to use CD_2 for one-channel
ing (default) testing, you must change both input channels.
• The stimulus level is interlocked and cannot be adjusted separately.
• Masking is available on the audiometer.
Two-channel binaural test- Select two different input channels, one for each ear.
ing • The stimulus levels can be adjusted independently.
• Masking is available on the audiometer.
Caution • You should only use speech materials with a stated relationship between the level of the speech signal and
the calibration signal.
Speech materials delivered on CD or other media are normally accompanied by a description of this relationship. You
should follow the instructions supplied with the speech materials, using the VU-meter in OTOsuite for adjustment of
input gain
Note • If masking noise is switched on, the input signals cannot be mixed (see Binaural Speech with masking ► 73).
• If you press and hold CD or MIC and then press L <--> R, the selected
test input source is sent to the left ear, indicated by an arrow from right
to left.
• Press once more to send the input to the right ear.
• Press once more to send the input to each ear in the normal way. The
arrow disappears.
1. To adjust the masking dB level, use the LEVEL knob on the masking side
to select.
1. To transmit the masking signal to both ears, press and hold MASK ON and then press twice on L <--> R. To disable this
setting, press twice on L <--> R.
When the masking signal returns to normal (contralateral) masking (i.e. when you press MASK OFF or press L <--> R),
the arrow(s) disappears.
1. Press SPECIAL one or more times until SISI appears and press the appro-
priate function key to select the test.
The top line shows the intensity (dB HL) to which the increments have
been added, the test name, and the current SISI % score.
The bottom line shows the number of dB increments currently trans-
mitted, the test tone frequency and the scale of the SISI dB increments.
2. To set the number of increments for the test, press SETUP once and use
the Right level knob.
3. To start the SISI test press START/STOP.
The test stops automatically when the selected number of steps in
intensity has been reached, and a beep is heard.
Scoring of responses
• The patient must use the patient responder to register each increment that has been heard.
• Manual scoring
If the patient is unable to use the patient responder, but registers an increment heard in another way, you can press
PASS (right INT button) to indicate that the tone was heard.
Intensity
• To change the intensity press and hold the button and turn the Right level knob.
Signal type
• To change the signal type press and hold the button and turn the left LEVEL knob.
Note • A maximum of four different sets of SISI values can be stored for both left and right ear.
Storing results
• You can store a maximum of four test frequencies, which you can select.
If you have stored two or more measurements at the same frequency, you can turn the frequency knob to step
through each of these measurements in turn before changing to the next frequency.
Masking
A tone is transmitted at the same frequency on the left and right sides simultaneously.
The display shows the signal selected as stimulus. This is either TON, WRB or NBN. To change the stimulus, see
Changing stimulus ► 78
4. Press either of the INT buttons to present the tone to the patient.
Changing dB level
1. You can change the dB level setting separately for the right and the left ear: Set the dB level to 10 dB above the
threshold in the better ear, and 10 dB below the threshold in the poorer ear.
2. You can present the signal in two ways:
– present the signal to the patient by pressing the INT button, or
– press the REVERSE button to keep the signal continuous. You can then interrupt the test signal by pressing the
INT button.
Signal presentation (normal/REVERSE) follows the normal rules (see Stimulus/speech count buttons ► 24).
Changing stimulus
You can change the stimulus type from pure tone to Warble (WRB) or Narrow Band Noise (NBN). When you deactivate
these stimulus types, the stimuli return to pure tone (TON).
A brief description
MADSEN Itera II provides an immediate way of demonstrating how helpful amplification can be. For this purpose, the basic
simulation described below is quite sufficient in most cases.
Make yourself familiar with the process before using it on the patient.
The filter characteristics are applied automatically in HIS, depending on the shape of the audiogram. The following is a
description of the HIS approach:
1. High and low frequency filters are applied to match the slope of the audiogram.
2. The steepness of the audiogram slope in dB/octave is calculated, and the HIS is set to about half this approximated
slope (according to half gain rule) using either 6 dB (less steep slope), 12 dB (medium steep slope) or 18 dB (steep
slope).
3. The frequency where the most amplification is wanted (4 kHz is the highest available) is identified, and the cut-off fre-
quency is set accordingly.
4. A gain is set to approximate half the hearing loss at the frequency selected in step 3 (half gain rule again).
5. Apply the simulation, and ask the patient whether it is comfortable or too loud or soft and adjust the reference level
accordingly.
Audiogram
• Use an audiogram stored in MADSEN Itera II.
or
• Enter an audiogram in MADSEN Itera II.
Select test
Sufficient audiogram is available for one ear only (in this case the Right
ear).
Press Yes to copy the right audiogram to the left ear.
If you select No, in this example the Hearing Instrument Simulation will
be made for the right ear only.
No sufficient audiograms are available. Enter the audiogram(s) manually
or set the HIS filters manually (Manually adjusting the HIS filters ► 82).
Transducer AC
Alternately SF
Input MIC (live speech)
Alternately CD (One-channel or two-channel Speech testing ► 72)
HIS reference level 65 dB SPL
The level for normal speech considered for a person with normal hearing is around 65 dB SPL.
Alternately: See Adjust HIS reference level ► 80
Simulating amplification
The HIS always starts in unsimulated mode. The display shows -HIS- to indicate that the simulation filters are not activated.
This means that the sound is presented without simulated amplification.
• Starting simulation
To start simulating, you must activate the HIS filters by pressing the START/STOP button. To show the benefit of a
hearing instrument, use the START/STOP button to switch between simulating and not simulating the amplification.
• The display shows a + symbol for the ear where a simulation filter is activated.
A. Master volume
B. No filter activated
C. Filter activated
Example:
Note • The aspect ratio displayed is scaled, based on the audiogram thresholds listed at the beginning of this
example.
TONE denotes AC
BONE denotes BC
HISF denotes Hearing Instrument Simulator Filter.
2. If the simulation is not satisfactory, use the manual procedure described in Manually adjusting the HIS filters ► 82to
further adjust.
Note • In the standard automatic HIS setup described in The HIS procedure ► 79 this is done automatically.
If you wish to change the HIS filter parameters for the left or right ear, press
either the left or right INT button. The filter characteristics for the selected
ear are shown.
Changing values
The arrow points to a setting which you can change. To change a setting:
• Use the left LEVEL knob to move the arrow to the required setting.
• Use the Right level knob to change the setting.
Moving the arrow also steps between the LP and HP filters.
When you have set up the filter values, press the relevant INT button to return to the normal HIS screen.
You can press the START/STOP here, and the filters are updated online if you change a value while the filter is activated.
Cut-off frequency 250, 500, 1000, 2000 Hz 1000, 2000, 3000, 4000 Hz
Gain above a selectable reference level 0, 5, 10, 15, 20, 25 dB 0, 5, 10, 15, 20, 25 dB
See The HIS procedure ► 79, and The HIS procedure ► 79 to continue the procedure.
Filter examples
Any filter whose amplification is set to 0 dB has no effect.
Fig. 2 ► 83 shows a graph where the characteristics of a low pass (bass) filter are set to an amplification of +20dB for
frequencies under 250 Hz.
Fig. 3 ► 83 shows a graph where the characteristics of a high pass (treble) filter are set to an amplification of +25dB
for frequencies over 2000 Hz.
THR X X
SPEECH X X X X
SISI X X
ABLB X
STEN X
HIS X
Permanent changes
You can change the parameters permanently and save them in a specific test setup of your choice
• How to use SETUP ► 87
• SETUP items ► 89
Temporary changes
You can make temporary changes to the various parameters during a test. These changes will not be saved.
• Temporary changes in the setup ► 88
1 SAVE Saves a test setup, e.g. masking ON, signal type WARBLE and presentation REVERSE, so that this setup is
TEST SETUP used the next time the device is switched on. To use this item, press STORE.
Note • When Itera II is switched on and you choose between various tests, Itera II will always revert
to the setup last used for a given test.
2 SET DEF. Activates the default setting for the relevant test. All settings are set to the "default" values; for the THR
TEST P. test for example, the setting will be as follows: signal="TONE", mask="OFF", dB="5", etc.
If this setting is to apply next time Itera II is switched on, go to 39 DEFAULT SETTING ► 99 afterwards.
To use this item, press STORE.
3 AC Choose between calibrated headphones:
TRANSDUC- • ---- (None)
ER
• HDA 200
• TDH 39
• EAR-T. (E-A-R-TONE® 3A)
Note • If the wrong headphone is selected compared to the one that is physically connected to
Itera II, the measurements will be incorrect!
dB Hz
...continues at 40 1000
• WRAP
If you press STORE at the highest possible frequency, you switch to the lowest possible frequency.
At other frequencies, pressing STORE advances the frequency. See the following example.
dB Hz
...continues at 40 1000
• BUTTERFLY
If you press the STORE button at the highest or the lowest possible frequency, you change to
1000 Hz.
Itera II will automatically test frequencies above 1000 Hz in ascending order, and frequencies below
1000 Hz in descending order. See the following example.
dB Hz
14 DB LEV. Choice of initial volume level for a new transducer, or change between different tests.
NEW TRA. • NO CHANGE or adjustable in the range: -10 to 50 dB
15 DB LEV. Choice of initial intensity when changing frequency.
NEW FREQ • NO CHANGE (the frequency remains the same) or adjustable in the range -10 to 50 dB.
See the example (with setting 13 set to WRAP ):
dB Hz
...continues at 40 1000
• XX dB FIXED
New fixed value.
See the example (with setting 13 set to WRAP ):
dB Hz
• XX dB ABOVE THR
New fixed value above any previously located threshold value.
See the example (with setting 13 set to WRAP )
dB Hz
• With masking
dB Hz Masking level
16 Choice of whether the level remains at its current value (Manual) or automatically adjusts to the
MASKING threshold of the opposite ear (Automatic):
LEVEL • Manual or Automatic
17 PULSE Choice of pulse frequency:
FREQUENC- • 0.25 to 2.50 Hz
Y
18 IMPULSE Selection of the fixed period of time during which the signal will be presented when IMPULSE mode is
LENGTH selected.
• 0.25 to 2.50 seconds
19 WARBLE Set modulation size as a %:
MOD. SIZE • 1 to 25% e.g.: At 5% the signal modulates 5% in relation to default frequency
20 WARBLE 1 Hz to 20 Hz
FREQUENC-
Y
21 SELECT Here you can select (ON) or cancel (OFF) the frequencies to be included for automatically changing fre-
AC FREQ. quencies when you store AC thresholds.
The frequencies are selected using the FREQUENCY selector.
ON/OFF is selected using the right LEVEL selector.
Note • This setting does not influence the Frequency knob, and accordingly, all frequencies (includ-
ing inter-octave frequencies) are available when you use the Frequency knob.
However, if the frequency 125 Hz is not included in the SELECT AC FREQ. setting, then it will not be
included when you use the Frequency knob.
22 SELECT Here you can select (ON) or cancel (OFF) the frequencies to be included for automatically changing fre-
BC FREQ. quencies when you store BC thresholds.
The frequencies are selected using the FREQUENCY selector.
ON/OFF is selected using the right LEVEL selector.
Note • This setting does not influence the Frequency knob , and accordingly, all frequencies (includ-
ing inter-octave frequencies) are available when you use the Frequency knob.
23 SIGNAL • HL
UNIT
• SPL LED-FLASH
If SPL is selected, the dB button will flash to indicate that the display is showing SPL values and not
HL values.
24 MIC Selection of microphone input sensitivity (MIC LED is lit).
INPUT If you press and hold MIC , you can adjust the left microphone with the left LEVEL selector and the right
SENSE microphone with the right LEVEL selector.
If you turn the right LEVEL selector without pressing MIC , both right and left microphones are adjusted
and the display shows an average of the two.
25 CD Selection of CD/Tape input sensitivity (CD LED is lit).
INPUT If you press and hold CD , you can adjust the left input with the left LEVEL selector and the right input
SENSE with the right LEVEL selector.
If you turn the right LEVEL selector without pressing CD , both right and left inputs are adjusted and the
display shows an average value.
34 EXT.R. Selection of the sound intensity range below the maximum value for which selection of EXTended
dB-SPACE RANGE is permitted.
• 30 dB to 70 dB below max.
35 Selection of baud rate for RS232 interface.
BAUDRATE • 9600, 19200 (default value), 38400, 57600.
36 CD Selection of voltage for CD power supply.
POWER • OFF and 1.5 V to 10.0 V set using the right LEVEL selector.
SUPPLY
Note • Remember to use an adapter if necessary so that the CD has the correct polarity.
The centre pin is + and the sheath is 0 V.
37 DISPLAY Controls display setup. Fixes one of the four left/right configurations:
SIGNAL AS L/R • The signal for the left ear is shown on the left side, and that for the
right ear on the right side. Masking is on the opposite side.
SIGNAL AS R/L • The signal for the left ear is shown on the right side, and that for the
right ear on the left side. Masking is on the opposite side.
FIX SIGNAL ON L • The signal is shown on the left side, and masking on the right side.
FIX SIGNAL ON R • The signal is shown on the right side, and masking on the left side.
38 STIMULI Controls the functions of the left and right LEVEL knobs:
KNOB
FIX SIG. TO L • The signal is controlled by the left LEVEL knob and masking by the
right LEVEL knob.
FIX SIG TO R • The signal is controlled by the right LEVEL knob and masking by
the left LEVEL knob.
FOLLOW DISPLAY • The stimuli (signal/masking) controlled by the left and right LEVEL
knobs correspond to the placing (left/right) of the stimuli on the
display.
3: AC TRANSDUCER None
4: BC TRANSDUCER None
5: SF TRANSDUCER None
6: AC MASKING None
7: BC MASKING None
8: SF MASKING None
9: MASK.PRESENT. Continuous
29 - 31 Half gain
Audiometers
Connect to the device you • Click on the device you wish to use.
wish to use for testing. – If the device is not listed, check the check box My device is turned on and
ready to be found, and click on Search.
Test Type
Show "test type" • Click to enable viewing any of these test types as a test tab selection on the Audi-
ometry test screens.
If a User Test is set up to include either of these tests, and they have been dis-
abled in this screen, you will be prompted to enable them here.
Masking Assistant
Masking Criteria Define the masking criteria for insert phone(s), earphones, and high frequency
earphones (if applicable).
Air-Bone Gap Criterion Set the dB level for the Air-Bone gap criterion.
Firmware update
If a Firmware Update message appears, see:
• Updating device firmware ► 102
Warning • For the sake of safety and in order not to void the warranty, service and repair of electro-medical equip-
ment should be carried out only by the equipment manufacturer or by service personnel at authorized workshops. In
case of any defects, make a detailed description of the defect(s) and contact your supplier. Do not use a defective
device.
Note • There are no user-serviceable parts inside the MADSEN Itera II cabinet.
On request, your supplier can obtain a service manual from the factory. The service manual contains electrical diagrams,
descriptions, lists of components and calibration instructions, etc.
13.1.1 Fuses
To replace or inspect a fuse, proceed as explained below.
Warning • Risk of fire. Before replacing a fuse, first switch off the instrument and disconnect it from the
mains power supply.
The fuse-holders are located next to the AC power connector (or they are integrated with the power connector).
To remove a fuse:
• Unscrew the end of the fuse-holder using a screwdriver with a blade at least 6 mm wide (or remove the power con-
nector).
Fuse types
The fuse is a push-fit in the end of the fuse-holder. When you replace fuses, use only fuses of type T 1 A H/250 V, 5 mm x
20 mm.
13.2 Cleaning
• To clean the display, use a dry cloth or soft brush. Note that the display is laminated for maximum readability and must
therefore be treated with care.
Headphones
The headphones are in constant contact with the patient, and should therefore be kept clean.
Clean the headphones between patients, e.g. with a non-alcohol based antibacterial wipe, such as Audiowipes.
Warning • To prevent cross-infection, use new eartips when you test the next client.
The eartips are disposable and therefore should not be cleaned or re-used. There are no special requirements for the dis-
posal of the eartips.
Bone oscillator
Clean the bone oscillator between patients, e.g. with a non-alcohol based antibacterial wipe, such as Audiowipes.
13.3 Calibration
You can download new software to MADSEN Itera II, and if this involves no change to the transducers, MADSEN Itera II
does not need recalibration.
Annual calibration
The audiometer, headphones, bone oscillators, and sound field speakers must be calibrated once a year by your authorized
service department.
The audiometer is dispatched from the factory together with a Test Report (Calibration Certificate). The Test Report spe-
cifies the transducers that have been calibrated (i.e., those which have been supplied together with the instrument),
according to which standards, and the equipment used for calibration. Results are listed for each transducer at all standard
frequencies.
In general, the instrument is calibrated in dB HL and dB masking level using the stated reference equivalent thresholds; dB
HL is related to sound pressure levels, dB SPL = dB re 20 µPa, and force levels (dB re 1 µN).
Caution • Note that calibration has been performed only on the transducers supplied! If you wish to use any other
transducer for testing with the device, please contact your local distributor first.
14.1 Unpacking
Unpack the device carefully.
When you unpack the device and accessories, it is a good idea to keep the packing material in which they were delivered.
If you need to send the device in for service, the original packing material will protect against damage during transport,
etc.Visually inspect the equipment for possible damage.
If damage has occurred, do not put the device into operation. Contact your local distributor for assistance.Check with the
packing list to make sure that you have received all necessary parts and accessories. If your package is incomplete, contact
your local distributor.
1. Check the Test Report (Calibration Certificate), make sure that the transducers (headphones, and bone oscillators) are
the correct ones, and that they comply with the ordered calibration standards.
14.2 Installation
This section provides you with instructions on how to assemble and install MADSEN Itera II.
Note • Install OTOsuite on the PC before you connect to MADSEN Itera II from the PC.
• Before you start using MADSEN Itera II, it is recommended that you leave it at room temperature for 30 minutes - par-
ticularly if it has been stored at very cold or warm temperatures, e.g. if it has been in a car.
• Read the user documentation before you connect or use MADSEN Itera IIfor the first time.
Safety aspects
To ensure safe performance, MADSEN Itera II must be correctly installed and the requirements listed in Standards and
safety ► 115 and MADSEN Itera II ► 119 must be complied with.
Cooling requirements
There are no specific cooling requirements.
Caution • Make sure that MADSEN Itera II is placed in a well ventilated location.
• Place MADSEN Itera II in locations away from sources of heat and direct sunlight.
• MADSEN Itera II must not come into contact with liquids.
Connections
• Connect required accessories such as the headset, the bone conductor, and the Patient Response Switch to their
respective connectors on the back panel according to the instructions in Air conduction ► 106, Bone conduction ►
107, External microphone ► 107 and the locations described in Socket connections - rear panel ► 26.
• The headphone (AC transducer) and SP (SF) transducer connectors and the CD/Tape sockets are color coded as
described in Socket connections - rear panel ► 26.
Installation sequence
1. Install OTOsuite on your PC.
2. Assemble and set up MADSEN Itera II.
– Powering ► 106
– Connecting to a PC ► 106
3. Switch on MADSEN Itera II.
4. Run the Configuration Wizard in OTOsuite to connect to and set up communication with MADSEN Itera II. See Con-
figuring the Audiometry Module ► 101.
14.2.1 Powering
1. Plug the power cord into the power socket of MADSEN Itera II.
See Socket connections - rear panel ► 26.
2. Plug the other end of the power cord directly into an AC mains power outlet with a three-wire
protective ground.
14.2.2 Connecting to a PC
1. You can connect MADSEN Itera II to a PC by using an RS 232 cable.
See RS232 interface sockets ► 109.
2. If required, use a USB converter for your RS232 cable. See your accessories list to order.
Headphones
• Connect the right and left cables (red and blue) from the transducers to the right and left AC sockets in the rear panel
of MADSEN Itera II.
Insert phones
• Connect the Insert phones to the right and left AC socket in the rear panel of MADSEN Itera II.
Gooseneck
BC socket 10 V AC ±10 V DC
pin 2 (RxDout) 15 V AC *± 15 V DC
pin 3 (TxDin) 30 V AC *± 30 V DC
pin 4 (DTR) 30 V AC *± 30 V DC
pin 6 (DSR) 30 V AC *± 30 V DC
pin 7 (RTSin) 30 V AC *± 30 V DC
pin 8 (CTSout) 15 V AC *± 15 V DC
10000 n/a 90
11200 n/a 85
12500 75 80
14000 60
16000 50
16.2 NBN
Frequency TDH39 Bone conductor Insert phone HDA 200 HolmCo
(B-71) (E-A-RTONE® 3A)
125 65 95 80 50
9000 n/a 90
10000 n/a 85
11200 n/a 85
12500 70 70
14000 60
16000 40
P parameters
PC personal computer
PCT percent
R right
SF sound field
SIG signal
SISI short increment sensitivity index
SP special output (same as SF)
SPL sound pressure level
SPN speech noise
STEN Stenger
THR threshold
TON tone
TRA transducer
TRANSD transducer
UCL UnComfortable Level
VU volume unit
WARB warble
WBN wide band noise (white noise)
WRB warble
x left ear
MEDICAL - General Medical Equipment as to electrical shock, fire and mechanical hazards only in accord-
ance with ANSI/AAMI ES60601-1 (2005) + AMD 1 (2012), IEC 60601-1-6, CAN/CSA-C22.2 No. 60601-1
(2014) and CAN/CSA-C22.2 No. 60601-1-6 (2011).
Power ON.
Power OFF.
Do not reuse.
3. No parts may be eaten, burnt, or in any way used for purposes other than the applications defined in the Intended Use
section of this manual.
4. The device and any device to be connected which has its own power supply should be turned off before any con-
nections are established.
5. For safety reasons and due to effects on EMC, accessories connected to the equipment's outlet fittings must be
identical to the type supplied with the system.
6. It is recommended that an annual calibration be performed on accessories containing transducers. Furthermore, it is
recommended that calibration be performed if the equipment has suffered any potential damage (e.g. headphones
dropped on the floor).
Note that calibration has been performed only on the transducers supplied! If you wish to use any other transducer for
testing with the device, please contact your local distributor first.
7. Unwanted noise may occur if the device is exposed to a strong radio field. Such noise may interfere with the per-
formance of the device. 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 MADSEN Itera II be restricted.
8. The bone conductor cable and insert phone cable must not be removed or tampered with while
MADSEN Itera II is powered on. Either disconnect the bone conductor or insert phone entirely
from the instrument, or make sure that the instrument itself is disconnected from the power
source.
9. When assembling an electro-medical system, the person carrying out the assembly must take into
account that other connected equipment which does not comply with the same safety require-
ments as this product may lead to a reduction in the overall safety level of the system.
10. When selecting accessories connected to the RS232 socket and DC output of the device, the fol-
lowing points must be considered:
– Use of connected equipment in a patient environment
– Proof that connected equipment has been tested in accordance with Medical Electrical Sys-
tems in IEC 60601-1 3.1 edition: 2012, ANSI/AAMI ES60601-1 (2005) + AMD 1 (2012) and
CAN/CSA-C22.2 No. 60601-1 (2014).
– Do not touch the connectors of the device or connected devices and the patient at the same
time.
11. Grounding continuity should be checked periodically.
12. Avoid using extension cables. The increased length of the cable may increase the resistance of the protective earth
conductor beyond an acceptable level.
13. Operating at the wrong voltage may blow the fuses.For continued protection against fire hazard, replace fuses with the
same type and rating only.
14. To comply with Medical Electrical Systems in IEC 60601-1 3.1 edition:2012, computer and printer must be placed out
of reach of the client, i.e. not closer than approx. 1.5 meters/5 ft.
15. If the patient microphone is located within the patient area, the microphone should be classified as type B.
Used in error message dialogs if software program fails. See the detailed information in the dialog box.
18.4 Manufacturer
Natus Medical Denmark ApS
Hoerskaetten 9, 2630 Taastrup
Denmark
+45 45 75 55 55
www.natus.com
Channels
Modulation
Attenuator
Attenuator accuracy
HL Range
HIS function
Masking
Narrow band noise, Speech noise and White noise (Wide band noise)
Narrowband noise
Selectable transducers
Outputs
External inputs
Interrupter
Operator output
Two stereo monitor sockets (8-pole DIN horseshoe) for headphones. One socket is fitted with a Talk Over Mic. Input
option. The monitor signal follows the test signal, although the volume can be adjusted individually for each channel.
The Talk Back signal from patient to operator is mixed with the monitor signal.
RS232 interface
Operating environment
(Operation in temperatures exceeding -20°C (-4°F) or +60°C (140°F) may cause permanent damage.)
Warm-up time
< 10 min.
Disposal
MADSEN Itera II can be disposed of as normal electronic waste, according to WEEE and local regulations.
Dimensions
Weight
Power supply
Power consumption
< 60 VA
Fuses
T 1 A H/250 V
Standards
Miscellaneous
19.2 Accessories
Standard accessories and optional accessories may vary from country to country - please consult your local distributor.
Guidance and manufacturer's declaration - electromagnetic emissions for all equipment and systems
MADSEN Itera II is intended for use in the electromagnetic environment specified below. The user of MADSEN Itera II should ensure that it is used in such an
environment.
RF emissions Group 1 MADSEN Itera II uses RF energy only for its internal function. There-
CISPR 11 fore, its RF emissions are very low and are not likely to cause any
interference in nearby electronic equipment.
RF emissions Class A MADSEN Itera II is suitable for use in all establishments other than
CISPR 11 domestic and those directly connected to the public low-voltage
power supply network that supplies buildings used for domestic
purposes.
Note: The emissions characteristics of this equipment make it suitable for use in industrial areas and hospitals (CISPR 11 class A). If it is used in a residential envir-
onment (for which CISPR 11 class B is normally required) this equipment might not offer adequate protection to radio-frequency communication services. The
user might need to take mitigation measures, such as relocating or re-orienting the equipment.
Guidance and manufacturer's declaration - electromagnetic immunity for all equipment and systems
MADSEN Itera II is intended for use in the electromagnetic environment specified below. The user of MADSEN Itera II should ensure that it is used in such an envir-
onment.
Electrostatic dis- +/- 6 kV contact +/- 6 kV contact Floors should be wood, concrete or ceramic tile. If floors are covered with syn-
charge (ESD) +/- 8 kV air +/- 8 kV air thetic material, the relative humidity should be at least 30 %.
IEC 61000-4-2
Power frequency 3 A/m 3 A/m Power frequency magnetic fields should be at levels characteristic of a typical loc-
(50/60 Hz) magnetic ation in a typical commercial or hospital environment.
field
IEC 61000-4-8
Guidance and manufacturer's declaration - electromagnetic immunity - for equipment and systems that are NOT life-supporting
MADSEN Itera II is intended for use in the electromagnetic environment specified below. The user of MADSEN Itera II should ensure that it is used in such an envir-
onment.
d = 1.2
d = 1.2 for 80 MHz to 800 MHz
d = 2.3 for 80 MHz to 2.5 GHz,
Note 1: At 80 MHz and 800 MHz the separation distance for the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and
people.
a. The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283
MHz; and 40.66 MHz to 40,70 MHz.
b. The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz are intended to decrease the
likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into patient areas. For this reason, an
additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in these frequency ranges.
c. Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio
broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which MADSEN Itera II is used exceeds the applicable RF
compliance level above, the MADSEN Itera II should be observed to verify normal operation. If abnormal performance is observed, additional measures
might be necessary, such as reorienting or relocating MADSEN Itera II.
d. Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
Recommended separation distances between portable and mobile RF communications equipment and MADSEN Itera II
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be estimated using the equa-
tion applicable to the frequency of the transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter
manufacturer.
Note 1: At 80 MHz and 800 MHz the separation distance for the higher frequency range applies.
Note 2: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and
people.
Index
Audiometry
basic functions 29
A menu bar 29
Abbreviations 113 OTOsuite toolbar 29
ABLB 77 preparing for testing 11
AC connection 26 training 11
AC key 17 user interface 29
AC masking
select transducer 90 B
AC transducer Baud
select headphones 90 rate setting 99
Accessories BC connection 26
AC connection 106 BC key 17
BC connection 107 BC masking
connections 26 select transducer 90
specifications 123 BC transducer
AI 48 select bone conductors 90
Air conduction Beep
testing 61 function 16
with masking 64 ON/OFF, setting 98
Air conductor 17 Binaural speech test
AC connection 26 input selection 72
Alternating frequency input sensitivity 72
Fowler 24 masking 73
Amplitude 24 masking level 73
Attenuator mixing input signals 72
specifications 119 Bone conduction
steps 21 BC transducer 90
Audiogram testing 62
combined, enabling/disabling 31 Bone conductor 17
show combined view, Audiogram BC connection 26
Module 31 Butterfly 92
show split view, Audiogram Mod-
C
ule 31
Cables
viewing frequency range 32
connecting test equipment 54
viewing left-right 31
Calibration 104
viewing legend box 31
certificate 104
viewing right-left 31
CD
work area in screen 47
power supply voltage, setting 99
work area in screen, Audiogram
Module 39-40 selection 18
Audiogram symbols, Audiogram mod- CD key 18
ule 44 CD/tape
Audiogram symbols, Itera II 14 connection 27
select input sensitivity 97
Training
Audiometry 11 W
TRANSD. key 17 Warble
Transducers frequency 97
AC 17 modulation size 96
AC connection 26 selection 23
AC, headphones 90 setup selection 24
BC 17, 90 WARBLE key 18
calibration 104 Warning notes 115
dB level for new t. 93 Word count 24, 71
selection 17 failed word 24
SF 17, 90 heard word 25
SF connection 26 select method 91
specifications 120 Wrap 91
Transmission
X
data 26
XMIT key 26
U
UCL, Itera II 75
UnComfortable Level, Itera II 75
Unpacking
the test device 105
User interface 29
V
Value selection
HIS 24
View menu
audiogram legend 31
combined audiogram 31
frequency range 32
left-right audiogram 31
Masking Assistant 31
Overlays 31
right-left audiogram 31
View menu (Aud)
audiogram legend 31
combined audiogram 31
frequency range 32
masking assistant 31
Overlays 31
Voltage
maximum non-destructive 109