how do i know if the cochlear implant is working?
TRANSCRIPT
How Do I Know if the Cochlear Implant is Working?
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
Introduction
• Cochlear Implant Manufacturers– Cochlear Americas (Nucleus)– Advanced Bionics (AB)
• Also known as Clarion
– Med-EL
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.
Identical Main Modules
Different Controllers
Troubleshooting made easy . . .
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
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
Nucleus Freedom Standard BTE Sound Processor
• Sound Processing Module
• Microphone(s)• Transmitting
Coil/Cable Coil• Coil & Magnet• Controller• Batteries or
Rechargeable Battery Module
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
Nucleus Esprit 3G Sound Processor
• Sound Processor• Microphone(s)• Transmitting
Cable/Coil (missing in slide)
• Coil & Magnet• (missing in slide)• Controls• Battery module
Advanced Bionics Harmony BTE Sound Processor and Components
• Sound Processing Module & Controller
• Microphone & Ear Hook
• Transmitting Cable/ Coil
• Coil & Magnet• Rechargeable Battery
Module
There are two other models of BTE processors
Auria Platinum/CII BTE
Advanced Bionics Harmony BTE Sound Processor and Components
MED-EL Ear-level Speech Processors
• Tempo+/OPUS 1– Program/volume
switches– Sensitivity dial
• OPUS 2– Switch free design– FineTuner™
MED-EL Tempo+ BTE Sound Processor
• Sound Processing Module & Controller
• Microphone(s)• Transmitting
Coil & Magnet• Transmitting
Cable• Ear Hook• Battery Module
MED-EL Opus BTE Sound Processor
• Sound Processing Module & Microphone(s)
• Coil & Magnet• Transmitting
Cable• Earhook• Battery Module• Connecting piece
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
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).
Ling 6 Sound Check
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)
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)
Sprint Body Worn Accessories
• Monitor Headphone• Lapel or Auxiliary
Microphone• Signal Check/System
Sensor• Battery Charging
System• Audio or Interface
Cables• User Manual (CD)
Freedom Sound ProcessorHelp Messages
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
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
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
Harmony Sound ProcessorHelp Messages
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
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.
LED Indicator in MED-EL Processors • Processor status• Program errors• Low battery • Flashing patterns can
be deactivated by the CI audiologist
MED-EL TEMPO+/OPUS 1
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
Basic Troubleshooting Concepts
• Check for power– Processor turned on
& in proper program– Check for visible
signal light or LCD display
– Replace batteries
Power Options
• Ask parents to provide disposable battery pack option
Basic Troubleshooting Concepts• Check for visible defects
– Frayed cables– Cracked casing or controller– Loose connections
• Cables, component parts, batteries
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.
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:
Basic Troubleshooting ConceptsAdvanced Bionics
Basic Troubleshooting ConceptsAdvanced Bionics
Microphone Check
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
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).
Don’t forget about the internal device• When all else fails – refer the student back to the implant
center &/or surgeon
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.
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
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
All questions will be honored and answered at the end of the morning proceedings. Please write your questions on a provided note card.