Race Car Tympanometer Models MI22 and MI23 Operating Instruction Rev D

Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) TABLE OF CONTENTS WARRANTY... 1 1.0 SPECIFICATIONS... 2 2.0 INTRODUCTION ... 4 2.1 UNDERSTANDING TYMPANOMETRY AND AUDIOMETRY EXAMS ... 4

3.0 SETTING... 5 3.1 UNPACKING ... 5 3.2 WHERE TO SET UP ... 5 3.3 HOW TO SET UP ... 6

4.0 KEYS ... 7 4.1 KEY PAD FOR THE RACE CAR TYMPANOMETER (MI 22)... 7 4.2 KEY PAD FOR THE RACE CAR TYMPANOMETER WITH AUDIOMETER (MI 23) ... 8

5.0 SET UP MODE ... 9 5.1 USER MENU AND SET UP OPTIONS ... 9 5.2 SCREEN ADJUST ... 9 5.3 USER SET UP ... 9

6.0 GETTING STARTED... 10 6.1 6.2 6.3 6.4 6.5 6.6 6.7

PERFORMING AN AUDIOMETER TEST... 10 ACCESSING THE AUDIOMETER OPTION THROUGH THE KEY PAD... 10 PATIENT RESPONSE USING THE PATIENT RESPONSE KEY ... 11 PROGRAMMING THE SET UP SCREEN FOR THE AUDIOMETER ... 12 PREPARING A CHILD FOR A TYMPANOMETRY EXAM ... 12 PERFORMING THE TYMPANOMETRY TEST... 13 GRAPHICS AND SCREENS ... 13

7.0 THE TYMPANOGRAM... 16 7.1 NORMAL TYMPANOGRAMS ... 16 7.2 ABNORMAL TYMPANOGRAMS... 16

8.0 FREQUENTLY ASKED QUESTIONS ... 18 8.1 HOW DO I LOAD THE PAPER ROLL? ... 18 8.2 REMOVING OLD PAPER ROLL ... 19

9.0 ROUTINE CARE... 20 9.1 9.2 9.3 9.4 9.5 9.6

CARE OF THE UNIT ... 20 CARE OF THE TYMPANOMETER PROBE... 20 CARE OF THE EAR TIPS ... 20 CARE OF THE AUDIOMETER HEADPHONES (RACE CAR TYMP W/AUDIOMETER) ... 20 CALIBRATION OF THE INSTRUMENT ... 21 SHIPPING INSTRUCTIONS FOR RE-CALIBRATION AND REPAIR ... 22 i

Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) WARRANTY This warranty is extended to the original purchaser of the Race Car Tympanometer (MI 22), Race Car Tympanometer W/Audiometer (MI 23) by Maico, through the authorized Special Instrument Distributor from whom it was purchased. This warranty covers defects in material and workmanship for a period of one year from date of delivery. Should the Maico Race Car Tympanometer or Race Car Tympanometer W/Audiometer require service due to a defect in material or workmanship, Maico, at its option, will repair or replace the instrument at no charge except for transportation to and from the point of service. It is the purchaser’s responsibility to return the Race Car Tympanometer or Race Car Tympanometer W/Audiometer to the Maico Special Instrument Distributor from whom it was purchased or directly to Maico after receiving a return authorization. This warranty does not cover breakage or failure caused by tampering, misuse, carelessness, accident or modification. The warranty is void if the instrument is serviced by other than an authorized Maico Special Instrument Service Center.

NOTE: Specifications in this manual are in effect at the time of printing. Maico reserves the right to modify or change specifications or design at any time without notice or incurring obligation.

WARNING The Maico Race Car Tympanometer (MI 22) and Race Car Tympanometer W/Audiometer (MI 23) are designed to be used only with the supplied 18 VAC adapter. Injury to personnel or damage to equipment can result if this adapter is modified or replaced with an incorrect adapter. NOTE: Warranty service is provided by your authorized Maico Special Instruments Distributor.

DO NOT ATTEMPT TO REMOVE THE INSTRUMENT CASE YOURSELF. THIS SHOULD BE DONE ONLY BY AN AUTHORIZED MAICO SERVICE TECHNICIAN.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 1.0

SPECIFICATIONS TYMPANOMETRY MODE Probe frequency: Probe intensity:

Uncompensated compliance: Compensated range:

226 Hz ± 3%, typical 85 dB SPL ± 2.0 dB measured into a 2cc cavity, AGC controlled Less Than 5% +200 to -400 daPa, Sweep stops -200 daPa from the peak ± 15% or ± 10 daPa, whichever is greater 400 daPa/sec 5 seconds 0.2 to 6.0 cc 0.2 to 4.5 cc ± 0.1 cc or 5% whichever is greater over the Compliance Range 5.0cc 0.0 To 1.0 cc, 0.0 To 2.0 cc, 0.0 To 3.0 cc

REFLEX MODE Reflex tone: Reflex level: Accuracy: Total harmonic distortions: Determination: Pressure:

1 Khz 100 dBHL ± 3% <5% Compliance Change >.062 cc Automatically Returns To Peak Compliance Point

DISPLAY Type:

LCD

PRINTER Type:

Thermal

PROBE Weight: Dimensions:

4 Oz. 1” X 2 ½” X 1 ¼”

MECHANICAL Dimensions: Weight: Voltage:

11 ¾" X 8 1/2" X 5 1/2" Envelope 5 Lbs. 117v ±10%

ENVIRONMENTAL Operational temperature: Storage temperature: Relative humidity:

15 to +40C 0 to +60C 5% To 90%

Probe distortion: Pressure range: Pressure accuracy: Rate of sweep: Test time: Ear Canal volume range: Compliance ranges: Compliance accuracy:

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) AUDIOMETRY (Race Car Tympanometer W/Audiometer only) Frequencies: 250,500,1000,2000,3000,4000,6000, and 8000 Hz Decibel range: 0-85dB in 5dB steps Frequency accuracy: ± 2% Noise level: -10 dBHL or 70 dB Below The Test Tone, Whichever Is Greater Distortion: Less Than 3% tHD Level accuracy: ± 3 dB Of Levels Specified In Ansi S3.6-1996 TONE PRESENTATION Rise/Fall time: On/Off ratio:

35 ± 15 Milliseconds Greater Than 70 dB At All Frequencies

OUTPUT Earphones: Crosstalk:

TDH-39 With 100 Ohm Coils -70 dB Or Less Than - 5 dBHL, Whichever Is Greater

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 2.0

INTRODUCTION Maico specifically designed the Race Car Tympanometer and Race Car Tympanometer W/Audiometer to meet the unique challenge of performing tympanometry.

2.1

UNDERSTANDING TYMPANOMETRY AND AUDIOMETRY EXAMS Tympanometry can determine: • Whether there is fluid behind the eardrum in the middle ear space • The mobility of the Tympanic membrane • The presence of negative pressure in the middle ear space • The presence of a perforation in the Tympanic membrane Acoustic/Ipsilateral Reflex (with tympanometry exam) • Tests the stapedial muscle response, indicating normal activity of the ossicular bone chain. Audiometry can determine: • Permanent hearing loss • Temporary hearing loss due to otitis media or other factors • The return of “normal” hearing levels after treatment Tympanometry is a test of middle ear function, not a hearing test. It is possible to be completely deaf and still have normal tympanograms. Tympanometry is painless and takes seconds to complete. During the test a soft “hum” tone is presented at 85dB SPL through the probe and air is released, changing the air pressure in the outer ear canal. The tympanometer provides an automatic recording of the air pressure in the external canal and the change in mobility of the Tympanic membrane (eardrum). Your unit has been equipped with an optional acoustic reflex tone. When programmed to be turned on, at the end of the tympanometry test, a tone at 100dB HL at 1000 Hz is provided to test the acoustic reflex (ipsilaterally). The graph on the display and on the printout (tympanogram) is a graphic representation of the mobility of the eardrum. For example, a patient with otitis media has a build up of fluid behind the eardrum causing the eardrum to be stiff. When a tympanogram is done on this patient, an abnormal or flat graph line or “peak” will be shown indicating a lack of mobility due to the pressure of fluid behind the eardrum. This is illustrated in graphs As, B and C on the front of your unit. Tympanometry gives the medical provider precise information about the middle ear and allows the caregiver to plan the best treatment for the patient. A thorough caregiver will use both tympanometry and audiometry to ensure the patient has normal hearing and middle ear function before referral to a specialist. Audiometry testing determines how well the patient can hear. Testing is done using tones that combine different levels of frequency (Hertz-Hz) with different levels of loudness (Decibel-dB). 4

Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 3.0 3.1

SETTING UP UNPACKING The Race Car Tympanometer and Race Car Tympanometer W/Audiometer units come in their own box specifically designed to provide the best protection during transportation. Save the box and packing material for your transporting needs. Your unit should contain the following: • Race Car Tympanometer (MI 22) or • Race Car Tympanometer W/Audiometer (MI 23) •

Probe

•

Power supply module

•

Ear tip kit

•

4” thermal paper rolls (2)

•

TDH-39 Headphones (for Race Car Tympanometer W/Audiometer)

•

Response Switch (for Race Car Tympanometer W/Audiometer)

•

Warranty card

•

User’s guide

•

Calibration Certificate

If any item is missing, please call your local sales representative or MAICO. 3.2

WHERE TO SET UP The ideal area for setting up the Race Car Tympanometer or Race Car Tympanometer W/Audiometer is in a quiet room furnished with a desk or table. If a separate room is not available, locate a private area where distractions and noise can be minimized.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 3.3

HOW TO SET UP 1) Plug the connector of the hand held probe firmly into the circular jack, which is located on the back of the unit, on the right side, (you will see a small white plastic connector directly above the jack). Plug the small white plastic air hose into the white connector directly above the probe jack. 2) Plug the circular connector of the AC adapter firmly into its circular jack, which is located on the back of the unit on the top left side. Then plug the AC adapter into the wall outlet.

NOTE: Always plug the AC adapter into the unit first. 3) If you have purchased the Race Car Tympanometer W/Audiometer (MI 23), plug the headphones into the headphone jack on the far right side, then plug the response switch into the lower left-hand jack, just below the power module jack. 4) Verify there is paper in the printer, lift up on the side bar of the printer cradle cover: To access paper, lift here

NOTE: Your unit is equipped with an internal printer. There are no additional wires to plug in to print an exam. The unit will print tympanograms with ipsilateral reflex result and audiogram on the same sheet.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 4.0 4.1

KEYS KEY PAD FOR THE RACE CAR TYMPANOMETER (MI 22) Six (6) keys operate the Race Car Tympanometer (MI 22). The function of each key is as follows: •

POWER Press this key to “power up” the system. The system will first go through a quick “self test” and the screen will alternate between the “Race Car logo” and the “cheering crowd”. The system is now ready to begin testing. •

NEW Press this key before you test each new child. The two “race cars” will appear on the screen. NOTE: All previous test results will be cleared and erased from memory once the NEW key is pressed. •

SELECT Can be used to program and customize the unit by your clinic needs and preferences. Performs two separate functions: 1) Press this key when you want to toggle between race car graphics and tympanogram. Ideal when using the unit to test children or adults who do not need to be visually distracted to perform the exam. 2) Hold down this key for four (4) seconds to view the OPTIONS screen offered for customization. Please turn to the “User Menu Options” section in this manual, when you wish to review available selections. •

RETEST Press this key when you want to retest an ear. The two “race cars” will appear on the screen. NOTE: The results from the ear “just tested” will be deleted from memory. If you wish to have a partial test shown, this can be changed in the SELECT mode. The previous L or R test will be saved if a retest was necessary in only one ear. •

R/L EAR Press this key to switch to the “other” ear. “L” (left) or “R” (right) will be displayed on the screen and printed on the test results. This key can be pressed to “toggle” between (left and right) screens to compare test results before printing •

PRINT Press this key to print the results after testing one or both ears.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 4.2

KEY PAD FOR THE RACE CAR TYMPANOMETER W/AUDIOMETER (MI 23) Twelve (12) keys operate the Race Car Tympanometer W/Audiometer (MI 23). You may conduct a test immediately before or after a tympanometry exam, or an audiometry exam alone. You will see all of the previous keys in addition to the following: LEVEL ⇑ Press this key to increase decibel level of tone. Each time this key is pressed, the tones will go up by 5 dB’s.

•

•

STIM Administers the tone to the patient. When the STIM key is depressed, a “+” signal will show on the screen. As long as this key is depressed, the tone will be presented. LEVEL ⇓ Press this key to decrease decibel level of tone. Each time this key is pressed, the tones will go down by 5 dB’s. •

•

FREQ Press this key for the next frequency. If a patient does not respond to a tone, the operator will press the FREQ key, and a question mark (?) will appear in the box. The asterisk (*) will automatically move and note the next frequency and decibel to be presented. •

ENTER Press this key to enter the FINAL decibel heard at each Frequency. After establishing the patients threshold (done by the patients response to the tone administered when the STIM key is depressed), the operator should depress the ENTER key to record the final response/threshold. A # will appear on the screen. The asterisk (*) will automatically move and note the next frequency and decibel to be presented. NOTE: Patients respond by raising their hand or by using the patient response key. •

AUDIO/TYMP/CD Will toggle between audiogram and tympanometry exam. At the end of the audiometer screening, the operator has the option to perform a tympanometry exam or vice versa by depressing this key. A review of all exams can be viewed also by depressing this key.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 5.0 5.1

SET UP MODE USER MENU AND SET UP OPTIONS After the system is “powered up” and the NEW key has been pressed, hold down the SELECT key for 4 seconds. The following menu of choices will appear on the screen.

5.2

SCREEN ADJUST The first screen before entering the User Setup Up mode will be for lightening or darkening the screen. To dim the screen graphics, press the RETEST key several times , or until the desired appearance has been achieved. To brighten the screen graphics, press the R/L EAR key several times, or until the desired appearance has been achieved.

5.3

USER SET UP •

REFLEX: ON/OFF (default: OFF) (Ipsilateral/Acoustic Reflex Test)

•

VISUAL DISTRACTION: ON/OFF (default: ON) (“race car” display graphics)

•

AUTOABORT: ON/OFF (default: ON) (When “ON”, the unit will “automatically” reset the test when the probe seal is broken, saving time. When “OFF” the unit provides the opportunity (when necessary) to obtain “partial” test results.)

•

OFFICE INFORMATION: (Name, Address and Phone Number. If programmed, this information would PRINT on every patient exam.) To select a letter, number, or character from the listing: •

Press the RETEST key to scroll “up” or the R/L EAR key to scroll “down” (through the letters, numbers or characters).

•

Press the SELECT key to move forward one space along that line.

•

Press the NEW key to move backward one space along that line.

•

Press the PRINT key when that line is complete.

•

Press the SELECT key to scroll to the next line.

•

Press the SELECT key to scroll down the list.

•

Press the ENTER key to change an option.

•

Press the NEW key when the selections are completed.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 6.0

GETTING STARTED Once the Race Car Tympanometer or Race Car Tympanometer W/Audiometer is plugged in and the POWER key is depressed, the unit will be “standing by” and “ready” for keypad operation.

6.1

PERFORMING AN AUDIOMETER TEST The audiometer option of your Race Car Tympanometer W/Audiometer (MI 23) can be used for all your pure tone screening and threshold testing requirements. The Race Car Tympanometer W/Audiometer (MI 23) comes with one set of TDH-39 headphones. With the back of the unit facing you: 1) Plug the connector of these headphones firmly into the circular “Headphones” jack located to the right of the probe connector on the backside of the unit. 2) If you wish to conduct the test using the response switch as opposed to “raising the hand when a tone is presented”, plug the response switch into the lower left hand jack, just below the power module jack. 3) Place the headphones onto the patient. Please note that the TDH-39 headphones have a “right” and a “left” ear cup. As the headband is fitted over the patient’s head, the cup with the red marker should be positioned on the patient’s right ear and the cup with the blue marker should be positioned on the left. The cups should be positioned so that they cover the ears and fit snugly to the patient’s head. Long hair should be moved away from the ears before positioning the headphones.

6.2

ACCESSING THE AUDIOMETER OPTION THROUGH THE KEY PAD After your unit is powered up, press the NEW key and press the bottom right key labeled TYMP AUDIO CD. The following screen will then be displayed: kHz R dB L dB

.25 25* 25

.5 25 25

1 25 25

2 25 25

3 25 25

4 25 25

6 25 25

8 25 25

The top row (kHz) indicates the frequencies that each tone will be presented at. NOTE: This row cannot be changed, but frequencies can be turned “on” or “off”. The row on the left (R dB and L dB) indicates the ear that will be receiving the tone. All center columns and rows (where 25 is shown) indicates the decibel (dB) levels for both ears and is preset at the factory (25dB). This can be reprogrammed based on your clinic needs. Please refer to the section below under “PROGRAMMING THE SET UP SCREEN”.

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) A flashing asterisk (*) will appear to the right of each decibel value to indicate that a response has not been recorded for the ear being tested by frequency. (For example: in previous chart, the asterisk appears next to the 25 dB of the right ear (R dB) at the frequency of 250 kilohertz (.25 kHz). When administering a tone, press the STIM key. The asterisk (*) will change to a plus sign (+) to indicate that a tone is being presented. If the patient responds to the tone, usually by raising their hand, the operator may depress the ENTER key to go to the next frequency or the LEVEL ⇑ or LEVEL ⇓ key to proceed to the next decibel value. NOTE: Each time a decibel level is changed, (by pressing the LEVEL ⇑ or LEVEL ⇓ key), the STIM key must be depressed to deliver the tone. Once the desired response is achieved and the operator wishes to move to the next frequency, the ENTER key should be pressed to record the response. 6.3

PATIENT RESPONSE USING THE PATIENT RESPONSE SWITCH When using the patient response key, if the patient responds to the tone while the STIM key is depressed, the frequency box will turn to black. The operator should then depress the ENTER key to go to the next frequency or the LEVEL ⇑ or LEVEL ⇓ key to proceed to the next decibel value.

NOTE: Each time a decibel level is changed, (by pressing the LEVEL ⇑ or LEVEL ⇓ key), the STIM key must be depressed to deliver the tone. Once the desired response is achieved and the operator wishes to move to the next frequency, the ENTER key should be pressed to record the response. If the patient does not respond to a tone, the operator may press the FREQ key to skip that frequency/decibel level. A question mark (?) will appear in the box to indicate nonresponse. The asterisk (*) will automatically move on to the next frequency to be presented. When the screening of the right ear is completed, the asterisk (*) will automatically move to the left ear (L dB). During the screening, the operator can increase or decrease the preset decibel levels of each box by pressing the LEVEL ⇑ or LEVEL ⇓ key. When the decibels are increased or decreased to the desired level, the operator should press the STIM key to deliver the tone to the patient. At the end of the audiometer screening, the operator has the option to: • •

Print out the audiogram by pressing the PRINT key. If tympanometry was performed before the audiogram, these results will print out on the same sheet. To review the tympanogram before printing the results. The operator can “toggle” back and forth between the audiogram and the tympanogram by pressing the TYMP AUDIO CD key. 11

Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 6.4 PROGRAMMING THE SET UP SCREEN FOR THE AUDIOMETER To reprogram the factory preset decibel (dB) levels for each screening, enter the Set up Screen: After the system is “powered up” press the NEW key and then the TYMP AUDIO CD key. When the audiometer screen appears, press and hold down the SELECT key for 4 seconds. The following screen will appear on the screen: KHz Tst: DB:

.25 Yes 25

.5 Yes 25

1 Yes 25

2 Yes 25

3 Yes 25

4 Yes 25

6 Yes 25

8 Yes 25

The selected frequency to be programmed is indicated by the flashing “∧” symbol. Pressing the LEVEL ⇑ or LEVEL ⇓ keys will increase or decrease the set decibel (dB) of each frequency. To go to the next frequency, press the FREQ key. Toggle the ENTER key for each frequency to select Yes (to test) or No (do not test at this frequency). When the operator has completed the desired programming, press the NEW key to return to the audiometer screen. The reprogramming (dB and frequencies: yes/no) will be saved in memory and will continue to appear on the audiometer screen each time the power is turned on unless reprogrammed at a later date. 6.5 PREPARING A CHILD FOR A TYMPANOMETRY EXAM The best way to prepare a child is to pretend that he/she is going to play “a game.” Suggesting that the child is going to “play a game” will assist in reducing the anxiety that may be associated with the test. Tympanometry can be performed while sitting or standing. The most important consideration is to make the patient as comfortable as possible so he/she can be “still” for just the few seconds necessary to perform the test. The child should be told that his/her part in the Race Car game is to remain “as still as possible” so the race car on the screen can speed down the track and cross the finish line a “WINNER.” Explain that this is the only way to win the race and avoid getting a “flat tire.”

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 6.6 PERFORMING THE TYMPANOMETRY TEST •

INSERTING THE PROBE: While the child is distracted by the graphics, Place the hand held probe (with proper ear tip) inside the child’s ear while gently pulling the earlobe down. Check for excess wax or obstructions. Because children have very small ear canals, this allows the operator to maintain a seal easily. During the testing, concentrate on holding the probe steady. BLINKING RED = Unit is in “stand by” GREEN LIGHT = Test is in progress SOLID RED (with steady tone) = Probe is blocked FLASHING RED (with three beeps) = “broken” probe seal NOTE: The ear tip does not need to go into the ear canal. It should only seal the canal opening. Attempt to point the end of the ear tip into the canal, toward the eardrum. Depending on the child, a smaller (white or blue) or larger (gray or red) size ear tip may be needed to secure a proper seal. 6.7 GRAPHICS AND SCREENS The Race Car Tympanometer or Race Car Tympanometer W/Audiometer has eight (8) graphics:

GRAPHIC # 1

GRAPHIC # 2 When the unit is first powered up the screen will alternate between graphic # 1 the “Race Car logo” and graphic # 2 the “cheering crowd”

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23)

GRAPHIC # 3 Graphic # 3 with the two race cars will illuminate when the NEW or RETEST key is pressed before performing a test.

GRAPHIC # 4 Graphic # 4 illuminates when a correct probe seal is achieved and the test is initiated.

GRAPHIC # 5 Graphic # 5 “race car on track and crossing finish line” will illuminate while the testing is in process.

GRAPHIC # 6 Graphic # 6 “Winner” will illuminate when test is completed, (followed quickly by Graphic # 2 “cheering crowd” and then Graphic # 7 the tympanometer results. 14

Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 1.0

LEFT

0.5 0 -400

-200

0

+200

GRAPHIC # 7

GRAPHIC # 8 Screen # 8 “flat tires -” will illuminate when a probe seal is “broken” during the testing. NOTE: If the autoabort option is “ON” the screen will be automatically reset to Graphic # 3. If the autoabort option is “OFF” the word “Retest” will appear and then a graph with the “partial” results of that test. (The operator will need to push the RETEST key before the next test can be run.)

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 7.0

THE TYMPANOGRAM The Race Car Tympanometer or Race Car Tympanometer W/Audiometer can display and provide a printed report that is a graphic representation of the mobility of the eardrum. This is called a tympanogram. Please note that tympanometry is a test of middle ear function only. A “normal” functioning middle ear does not mean “normal” hearing. It is possible to be completely deaf and still have a normal tympanogram.

7.1

NORMAL TYMPANOGRAMS Normal tympanograms do not look exactly alike, but they have some common characteristics: 1) There is a “peak” 2) The “peak” generally falls somewhere between +50 daPa and -150 daPa The following is an example of a “normal” tympanogram: 1.0

LEFT

0.5 0 -400 7.2

-200

0

+200

ABNORMAL TYMPANOGRAMS Abnormal functioning of the middle ear system will be reflected in the tympanogram. The following are examples of common abnormal tracings. •

Type B

The following diagrams show a variety of Type B abnormal tympanograms. The characteristics of a Type B tympanogram are: 1) There is no “peak” 2) The tympanogram tracing is (primarily) flat 1.0

LEFT

0.5 0 -400

-200

0

+200

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) The shape of the tympanogram in these tracings may be indicative of a variety of different ear disorders including: 1) Fluid in the middle ear space 2) Severely retracted Tympanic membrane 3) Perforated Tympanic membrane 4) Complete blockage of the external canal with wax or debris 5) The presence of a ventilation tube in the Tympanic membrane •

Type C

Type C tympanograms may indicate a retracted Tympanic membrane. They exhibit a peak on the left side of the graph or at a point more negative than -200 daPa. The height may vary from normal, indicating different degrees of mobility. 1.0

LEFT

0.5 0 -400 •

-200

0

+200

Type As

Type As tympanograms may indicate normal middle ear pressure, but limited mobility. The shape is the result of very small changes in compliance. The “stiff” middle ear system may be indicative of pathology. However, it may be considered normal in young children or patients with a thickened or heavily scarred membrane. 1.0

LEFT

0.5 0 -400

-200

0

+200

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Operating Instructions ® ™ Race Car Tympanometer (MI 22), ® ™ Race Car Tympanometer W/Audiometer (MI 23) 8.0 8.1

FREQUENTLY ASKED QUESTIONS HOW DO I LOAD THE PAPER ROLL? Your unit is equipped with an automatic feed printer. The unit has a 4” thermal paper roll that allows for 70 tympanometer (both right and left ear) and audiometer readings. 1) Turn the power “ON”. After unit is powered up, depress the NEW key as if you were going to begin an exam. 2) Open the door on the front of the unit (paper cradle). 3) Gently remove the remaining paper and spool from paper cradle and discard (see “Removing old paper roll” for instructions). 4) Remove the tape from paper roll and discard any portion of paper that has the tape or adhesive still on it. If necessary, cut off any portion of paper roll with adhesive. If you must cut off excess paper, cut it in a straight line. You do not have to cut into a “v” shape. 5) Unroll 6-7 inches of paper from roll. 6) Load paper in a downward direction and insert the paper under the printer roll. Once the printer “eye” recognizes the paper, the unit will AUTOMATICALLY FEED THE PAPER under the paper roll. This happens very quickly.

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