Inspire
Click here to see this page in full context

Tinnitus for Evolv AI 2400 and Livio Edge AI Products

Tinnitus generates a stimulus that can either be a flat white noise response, shaped based on the patient’s audiogram, or personalized with In-situ testing. 'Stimulus Personalization' shapes the tinnitus stimulus based on the Minimum Detection Level (MDL)Minimum Detection Level (MDL)(Measures the stimulus detection threshold.) and Minimum Masking Level (MML)Minimum Masking Level (MML) (Measures the lowest stimulus level that masks the tinnitus.) measurements. A tool guides you through the entire process which includes measuring both the MDL and MML in three frequency groupings (low, mid, and high) and applying the customized stimulus shape.

 

Tinnitus also allows you to make discrete, frequency-specific Band adjustments per memory. Band changes adjust the specific output settings. The level of the Tinnitus Stimulus can be controlled via User Controls. Adjustments can be made to each individual band, to groups of bands labeled low frequencies, mid frequencies or high frequencies, or to all bands simultaneously. The rate of modulation, which changes the frequency and amplitude (level) of the signal over time, can be selected. This feature allows you to select how quickly these changes take place.

 

The Tinnitus screen displays the current numerical output values per ear side for specific frequency ranges or individual bands depending on the state of each frequency range control (expanded or collapsed). Adjustments to the selected cells can be made via up and down arrows and the settings can be copied from one memory to another in select products.

 

Configuring tinnitus based on the patient's unique experiences can be achieved by understanding his/her difficulties with tinnitus. The Tinnitus Handicap Inventory assessment assists in identifying the patient's frustrations and severity of tinnitus.

 

Enabling/Disabling Automatically, Target Match Tinnitus, User Controls, and Acoustic OptionsEnabling/Disabling Automatically, Target Match Tinnitus, User Controls, and Acoustic Options

 

If Best Fit All Memories is applied during any fitting, the Stimulus is automatically set to Off. To configure any memory with Tinnitus Stimulus only functionality, select the Stimulus and uncheck Microphone On. The Tinnitus Stimulus will be heard in that memory even though hearing aid amplification will be muted. If Tinnitus is enabled for a specific memory, the spectrum of the stimulus is represented in purple on the fitting graphs on the Tinnitus screen and icons display in the upper left hand corner on most fitting graphs.

 

The default Tinnitus Stimulus output settings are based on the Stimulus selected. If adjustments are made, the output settings can be set back to their original defaults at any time via the Target Match Tinnitus button.

 

If Tinnitus Stimulus is enabled for any memory but the tinnitus level user control is disabled via User Controls, or if Tinnitus Stimulus is disabled for all memories but the tinnitus level user control is enabled via User Controls, an alert displays to the right of Fitting on the Left Navigation Menu. Point to and click Navigate to User Controls or Navigate to Tinnitus, respectively to resolve the conflict.

 

If Audiogram-shaped is selected and the acoustic options are changed, the low frequency bands are automatically adjusted for vent compensation.

  1. Connect and select the desired hearing aid(s) to configure Tinnitus via Get Started.

  2. Click on the Read Device Settings or Load a Previous Session radio button and then click Start.

  3. Click Tinnitus.

     

    Table View
    Note:  Only the average numerical output values per frequency range displays. The column headings indicate the frequency range for that group when collapsed. The frequency range of adjustment displays in a tool tip by pointing to the column heading.
    Tip:  If more space is needed to view the tables, click at the bottom of Left Navigation Menu to hide the menu. Click to redisplay the menu.
  4. Click for the specific frequency range (Low, Mid, or High) or Expand All to display the numerical output values for all available bands within the frequency range or all bands respectively.

     

    Table View
    Note:  The numerical table values always reference 2cc Coupler Output, which may differ from the graphical view currently selected. Only output graphs, including 2cc Coupler Output and Real Ear Response, can be selected to display. If 2cc Coupler Gain was selected prior to accessing Tinnitus, Inspire automatically changes the display to 2cc Coupler Output. If Predicted Insertion Gain was selected prior to accessing Tinnitus, Inspire automatically changes the display to Predicted Real Ear Response. Audiometric thresholds are never displayed even if Display Thresholds and UCLs is selected via General Preferences.
    Tip:  Click for the specific frequency range (Low, Mid, or High) or Collapse All to hide the numerical values.

  5. Click on the specific memory to adjust if applicable or click to adjust all memories simultaneously.

    Note:  If one-way memory linking is enabled , only gain and output adjustments made to *Normal will be applied simultaneously to all one-way linked memories. Custom memories created in the Thrive Hearing Control app for Evolv AI, Livio Edge AI, Livio AI, and Livio products can be adjusted during a live fitting. See Adjusting Custom Programs During a Live Fitting for more information.
    Note:  If a memory is changed or Best Fit Current Memory is applied during any fitting, the Stimulus is automatically set to Off. If a memory is changed to Disabled or any Telephone memory, or Stream Boost is selected, Stimulus is disabled because tinnitus is not supported in these memories.

  6. Inspire automatically defaults to a binaural Select Binaural view if applicable. To adjust only the right or left hearing aid, click Select Right Only or Select Left Only.

    Note:  If fitting CROS/BiCROS devices, only the receiver aid can be adjusted, therefore, the side cannot be selected.
  7. Select the Stimulus from the drop down list.
    Note:  Custom is only enabled if 'Stimulus Personalization’ was completed and applied to the fitting.
    Note:  If the output level was adjusted in one or more bands within the memory and then a different Stimulus is selected, all previous adjustments are automatically cleared.
  8. Select the Rate of Modulation from the drop down list.
    Note:  The rates available are Off, Slow, Medium, and Fast. The default is Off.
  9. Click on the frequency or group of frequencies to adjust.
    Tip:  To select a sequential group of frequencies, click on the beginning column header or frequency cell, press and hold Shift and click on the ending column header or frequency cell and all columns or frequencies between the two clicks will be selected, or press and hold the left mouse button and drag to the left or right until the desired group of frequencies are selected and then release the left mouse button. To select a non-sequential group of frequencies within a row, press and hold Ctrl and click on the desired frequencies. To select all frequencies, click All. Selected frequencies are represented in dark purple on the fitting graph and blue on the table.
  10. Click or within the table to increase or decrease the output binaurally or for the ear side selected.
    Note:  The adjustment arrow keys only display when the mouse hovers over the selected frequencies.
    Tip:  To reset the current memory's or all linked memories' output settings back to their original defaults, which are based on the Stimulus selected, click Target Match Tinnitus.
  11. Check or uncheck Microphone On to enable or disable the hearing aid's microphone.
    Note:  If the microphone is disabled, a "Tinnitus Only Microphone Off" watermark appears across the frequency response curve and all features (e.g., sound manager, frequency lowering, etc.) are turned off and disabled.
  12. To copy the settings to another memory, click Copy Tinnitus.
  13. Select the destination memory from the drop down list.
  14. Click Copy.
    Note:  All settings in the origination memory were automatically copied to the destination memory.
  15. To copy the settings to another memory, repeat steps 13-14.

Stimulus PersonalizationStimulus Personalization

  1. Click Stimulus Personalization.
    Note:  This button is only enabled during a live fitting and for all memories except Disabled, any Telephone memory, and Stream Boost.
    Note:  Both the Minimum Detection Level (MDL) and Minimum Masking Level (MML) tests must be measured within all three frequency groupings (low, mid, and high) in order to generate a customized stimulus.
    Tip:  Click Information for more information on the test.

  2. Inspire automatically defaults to a binaural Select Binaural view if applicable. To adjust only the right or left hearing aid, click Select Right Only or Select Left Only.

    Note:  If fitting CROS/BiCROS devices, only the receiver aid can be adjusted, therefore, the side cannot be selected.
  3. To test the Minimum Detection Level (MDL) in the low frequency channels, click Stimulus. To start the test in the mid or high frequency channels, click Increase test frequency and then click Stimulus. A continuous stimulus is presented in both ears simultaneously, if applicable, and a blue frame displays around the fitting graph.
    Note:  The hearing aid(s) is automatically muted during the measurement and the Stimulus button changes to Pause. Click Pause to pause the stimulus presentation and unmute the aid(s).
    Tip:  Click Cancel at any time to cancel Stimulus Personalization. If viewing or retesting existing measurements and Cancel is selected, all new and existing measurements will be lost.
  4. Click Decrease db level or Increase db level to increase or decrease the sound level in 2 dB increments if necessary.
  5. Once the measurement is complete in the selected frequency channels, click Increase test frequency or Decrease test frequency to test the next grouping.
    Note:  The hearing aid(s) is automatically unmuted, and the Pause button changes back to Stimulus. A solid dark purple line at the top indicates the MDL for the grouping tested.
  6. Click Stimulus.
    Note:  The hearing aid(s) is automatically muted during the measurement and the Stimulus button changes to Pause. Increase or decrease the sound level if necessary.
  7. Repeat steps 5-6 to test MDL in the last frequency grouping.
  8. Click Next to proceed to Minimum Masking Level (MML).
    Note:  This button is only enabled if MDL was measured in all three frequency groupings. A solid dark purple line at the top indicates the MDL for all groupings.
  9. Repeat steps 3-7 to test MML.
    Note:  A solid light purple line at the top indicates the MML for all groupings.
    Note:  If the channels within the selected frequency grouping cannot be measured due to tolerance, maximum level reached, etc., click Could Not Test for the applicable ear side to bypass that grouping. Inspire stops the stimulus presentation in the specific ear side and mutes the channels, which no longer display on the graph. If 'Could Not Test' was selected in error or you want to retest, navigate to the grouping, and click Could Not Test again. To redisplay the channels on the graph, click Decrease db level to increase the dB sound level, which unmutes the channels.
  10. Click Apply to apply the customized shape and close Stimulus Personalization.
    Note:  This button is only enabled if MML was measured in all three frequency groupings.
    Note:  The customized shaping displays on the graph and ‘Custom’ is selected from the Stimulus drop down list per applicable ear side. Any frequency grouping marked 'Could Not Test' is hidden on the graph.

 

QuickTIP