How Do I Know if the Cochlear Implant is Working?.
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Transcript of How Do I Know if the Cochlear Implant is Working?.
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How Do I Know if the Cochlear Implant is Working?
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Gail S. Murray, Ph.D., CCC-A
Associate Professor, CWRUDirector, Audiology Services
Clinical Director, Cochlear Implant ProgramUH Case Medical Center
Rainbow Babies & Children’s HospitalAugust 5, 2009
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Introduction
• Cochlear Implant Manufacturers– Cochlear Americas (Nucleus)– Advanced Bionics (AB)
• Also known as Clarion
– Med-EL
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Introduction• Each manufacturer supports multiple
sound processor models.• Each manufacturer has “current”
sound processor technology that is back-ward compatible with “older” implant technology.
• Each sound processor requires slightly different troubleshooting procedures.
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Identical Main Modules
Different Controllers
Troubleshooting made easy . . .
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Recommendations for Schools
• At least one person at school become familiar with the student’s sound processor.
• Learn the model name of your student’s sound processor.
• Learn the components or parts of the sound processor by name.
• Practice preventative maintenance
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Troubleshooting Toolbox• Be prepared to troubleshoot • Work with the parents & audiologist
to have the following on hand:– Appropriate back-up batteries – Appropriate battery holder/rack– Monitor Headphones– Signal Check– Back-up transmitting cables– Lapel or Auxiliary Microphone
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Nucleus Freedom Standard BTE Sound Processor
• Sound Processing Module
• Microphone(s)• Transmitting
Coil/Cable Coil• Coil & Magnet• Controller• Batteries or
Rechargeable Battery Module
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Nucleus Freedom Body Worn Sound Processor
• Sound Processing Module
• Microphone(s)• Transmitting
Cable/Coil• Coil & Magnet• Controller• Controller Shoe &
Cable• Batteries or
Rechargeable Battery Module
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Nucleus Esprit 3G Sound Processor
• Sound Processor• Microphone(s)• Transmitting
Cable/Coil (missing in slide)
• Coil & Magnet• (missing in slide)• Controls• Battery module
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Advanced Bionics Harmony BTE Sound Processor and Components
• Sound Processing Module & Controller
• Microphone & Ear Hook
• Transmitting Cable/ Coil
• Coil & Magnet• Rechargeable Battery
Module
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There are two other models of BTE processors
Auria Platinum/CII BTE
Advanced Bionics Harmony BTE Sound Processor and Components
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MED-EL Ear-level Speech Processors
• Tempo+/OPUS 1– Program/volume
switches– Sensitivity dial
• OPUS 2– Switch free design– FineTuner™
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MED-EL Tempo+ BTE Sound Processor
• Sound Processing Module & Controller
• Microphone(s)• Transmitting
Coil & Magnet• Transmitting
Cable• Ear Hook• Battery Module
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MED-EL Opus BTE Sound Processor
• Sound Processing Module & Microphone(s)
• Coil & Magnet• Transmitting
Cable• Earhook• Battery Module• Connecting piece
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Basic Troubleshooting Concepts
• Establish a two-way communication & notification method with the student’s parent.
• Incorporate an action plan for daily equipment checks into the student’s IEP
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Basic Troubleshooting Concepts
• Establish reliable speech-base feedback tools to use for daily listening check.– Ling 6 sounds test (aa, oo, ee, sh, ss, mm)– Closed set spondees (baseball, airplane)– Closed set words (colors, familiar names)– Open set words/sentences (What did you
eat for breakfast; Who drove you to school).
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Ling 6 Sound Check
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Cochlear Implant Accessories – to have on hand
• Monitor Headphones• Lapel or Auxiliary Microphone• Signal Check or System Sensor• Battery Charging System• Earhooks (T-Mic, Direct Connect, etc)• Audio or Interface Cables• User Manual (CD)
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Nucleus Freedom BTE Accessories
• Monitor Headphone• Lapel or Auxiliary
Microphone• Signal Check/System
Sensor• Battery Charging System• Earhooks (T-Mic, Direct
Connect, etc)• Audio or Interface Cables• User Manual (CD)
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Sprint Body Worn Accessories
• Monitor Headphone• Lapel or Auxiliary
Microphone• Signal Check/System
Sensor• Battery Charging
System• Audio or Interface
Cables• User Manual (CD)
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Freedom Sound ProcessorHelp Messages
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Freedom Sound ProcessorHelp Messages
• H1 = Battery flat– Check for proper battery insertion– Change batteries; change battery holder
• H2 = Battery low– Change batteries
• H3 = Coil error– Check for proper coil insertion & placement– Check for cable damage– Change coil
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Freedom Sound ProcessorHelp Messages
• H4 = Sound/stimulation error– Turn processor “Off”, “On”– Check/change microphone protector cover– Check/change coil– Check sensitivity & volume settings > 0– Use the lapel microphone to sound processor
check microphone– Contact parent &/or student’s cochlear
implant center
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Freedom Sound ProcessorHelp Messages
• H5 = MAP corrupt– Try alternate program– Contact student’s cochlear implant
center
• H6 = RF interference– Contact student’s cochlear implant
center
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Harmony Sound ProcessorHelp Messages
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Harmony BTE 3 Color Help Messages
• Red: – A communication error with implant– Processor/ear is mismatched– Headpiece off or loss of communication
• Green: – Microphone is working– Program slot is empty
• Orange: – Battery is low– Battery needs to be changed/dead– Battery charge status
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MED-EL: Verifying normal equipment function
• The red LED will illuminate 4-5 seconds when the processor is first activated (brief flashes for Opus 2)
• This uploads the map, & performs a diagnostic check.
• LED light continues to blink only when communicating a problem.
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LED Indicator in MED-EL Processors • Processor status• Program errors• Low battery • Flashing patterns can
be deactivated by the CI audiologist
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MED-EL TEMPO+/OPUS 1
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FineTuner Tips• Not needed during the
day unless:– Child has need of the
telecoil feature– Child needs to make a
program or volume change
• If processor batteries are changed, it reverts to the same settings previously in use– One exception: Telecoil on
reverts to mic on
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Basic Troubleshooting Concepts
• Check for power– Processor turned on
& in proper program– Check for visible
signal light or LCD display
– Replace batteries
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Power Options
• Ask parents to provide disposable battery pack option
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Basic Troubleshooting Concepts• Check for visible defects
– Frayed cables– Cracked casing or controller– Loose connections
• Cables, component parts, batteries
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Basic Troubleshooting Concepts• Check Transmitting Coil & Cables – Steps:
1. Confirm that cable(s) is plugged in correctly.
2. Hold the signal check over the transmitting coil when power is on.
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Basic Troubleshooting Concepts• Check Transmitting Coil & Cables – Steps:
3. Red light should illuminate.
4. Replace transmitting coil one at a time; apply signal check after each component change.
5. Check microphone if no transmission.
MED-EL signal check: Nucleus:
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Basic Troubleshooting ConceptsAdvanced Bionics
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Basic Troubleshooting ConceptsAdvanced Bionics
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Microphone Check
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Basic Troubleshooting Concepts• Microphone Check Steps:
– Turn off sound processor– Attach monitor headphones– Turn sound processor on– Perform listening check
• Use Ling sounds & running speech• Own voice should be clear & static free• Move cables around & listen for static or
intermittency
– Apply Aux mic & compare sound
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Use of Auxiliary Microphone• When the student’s headset or sound
processor microphone produces no sound or sound of poor quality, the Aux/Lapel microphone may be used until a replacement microphone is available
• Attach the lapel mic outside the student’s shirt, near the chin, and away from objects that may produce sound interference (e.g. jewelry).
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Don’t forget about the internal device• When all else fails – refer the student back to the implant
center &/or surgeon
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Other Learning Tools
• Join the hands-on demonstration at today’s Break-Out Sessions.
• Accompany your student to the CI Center for a mapping session.
• Attend the Greater Cleveland Cochlear Implant Support Group Meetings – 3 per year.
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Help by Phone . . .
• Cochlear Americas 800-523-5798• Advanced Bionics 800-678-2575• MED-EL 888-633-3524
Ask for Customer Service, or for the “Audiologist on call”
• The student’s Cochlear Implant Audiologist
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Help on the Web . . .
• http://www.cochlearamericas.com/PDFs/TeachersGuide.Chpt6.pdf
• http://www.bionicear.com/tfs_– Interactive Troubleshooting guide on-line
• http://www.medel.com/ENG/INT/60_Contact_and_support/020_download_center.asp
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All questions will be honored and answered at the end of the morning proceedings. Please write your questions on a provided note card.