Tinnitus

Tinnitus generates a stimulus that can either be a specific 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, including measuring 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 program. 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 band, to groups of bands labeled low, mid, 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 Fine Tuning section 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). Up and down arrows allow for adjustments to the selected cells, and the settings can be copied from one program to another.

 

Understanding the patient's unique experiences can help configure tinnitus based on their difficulties. The Tinnitus Handicap Inventory assessment assists in identifying the patient's frustrations and tinnitus severity.

 

Enabling/Disabling Automatically, Target Match Tinnitus, User Controls, and AcousticsEnabling/Disabling Automatically, Target Match Tinnitus, User Controls, and Acoustics

 

Playing/Pausing the StimulusPlaying/Pausing the Stimulus

 

Shape OptionsShape Options

1. Connect and select the desired hearing aid(s) to configure Tinnitus via Connect.
2. Click Connect.
3. Click Tinnitus from the Left Navigation Menu.

4. Click on the specific program to adjust if applicable, or click to adjust all programs simultaneously.

   Note:  If one-way program linking is enabled , only gain and output adjustments made to *Personal will be applied simultaneously to all one-way linked programs. Custom programs created in the My Starkey mobile application can be adjusted during a live fitting. See Adjusting Custom Programs During a Live Fitting for more information.

   Note:  If a program changes or Best Fit Current Program is applied during any fitting, the Stimulus is automatically set to Off. If a program is changed to Disabled or any Telephone program, Shape is disabled because tinnitus is not supported in these programs.

5. Pro Fit automatically defaults to a binaural view if applicable. To adjust only the right or left hearing aid, click or .

   Note:  If fitting CROS/BiCROS devices, only the receiver aid can be adjusted; therefore, the side cannot be selected.

6. Click to expand the Stimulus section if not currently expanded.

    

   

   Note:  Only one section can be expanded at a time. Therefore, if Tinnitus Fine Tuning is currently expanded, when Stimulus is expanded, Tinnitus Fine Tuning will automatically collapse.

7. Select the ShapeShape from the drop-down list.

   Note:  The available options depend on the product's tier. Either Audiogram-shaped or White Noise automatically defaults for the "Tinnitus" program. Custom is only enabled during a live fitting or retrieved session if 'Stimulus Personalization’ was completed and applied to the fitting. Click for descriptions.

   Shape	Weighted	Description	Examples
   Audiogram-shaped	N/A	Automatic shaping based on the patient's hearing loss.	N/A
   White Noise	N/A	Signal level based on PTA and comprised of equal energy distribution across frequencies.	N/A
   Pink Noise	Low-Frequency	Comprised of less high-frequency energy compared to White Noise.	Light rain, river, and wind
   Red Noise	Low-Frequency	Comprised of less high-frequency energy compared to Pink Noise.	Rumbling thunder, waterfall, and heavy rainfall
   Blue Noise	High-Frequency	Comprised of less low-frequency energy compared to White Noise.	Stream, computer fan, and water spray
   Purple Noise	High-Frequency	Comprised of less low-frequency energy compared to Blue Noise.	Water faucet, hiss, and dentist drill
   Ocean Noise	Low-Frequency	Mimics the sound of the ocean for an alternative masker to traditional options.	Waves
   Custom	N/A	Signal configured based on the patient's audiogram and personal perceptions through Minimum Detection Level (MDL) and Minimum Masking Level (MML) measurements.	N/A

   Note:  All previous adjustments are automatically cleared if the output level was adjusted in one or more bands within the program, and then a different Shape is selected.

8. Click  to decrease high-frequency output while increasing low-frequency output or click  to increase high-frequency output while decreasing low-frequency output binaurally or for the ear side selected if necessary. Repeat as needed until the desired shape is achieved.
9. Select the rate of Modulation from the drop-down list.

   Note:  The rates available are Off, Slow, Medium, and Fast. The default is Off for all Shapes except Ocean Noise, which is Medium.

10. Enable or disable Mic On to turn the hearing aid's microphone on or off.

    Note:  If the microphone is disabled, a "Tinnitus Only Mic Off" watermark appears across the frequency response curve, and some features (e.g., feedback canceller, frequency lowering, etc.) are turned off and disabled.

11. Click Play or Pause to start or stop the stimulus.

    Note:  The stimulus does not play automatically if Tinnitus was disabled previously.

12. Click to expand the Tinnitus Fine Tuning section.

     

    

    Note:  Only the average numerical output values per frequency range are displayed. The column headings indicate the frequency range for that group when collapsed. The frequency range of adjustment is displayed in a tooltip by pointing to the column heading.

13. 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.

     

    

    Note:  The numerical table values always reference 2cc Coupler Output, which may differ from the selected graphical view. Only output graphs, including 2cc Coupler Output and Real Ear Response, can be selected to display. If 2cc Coupler Gain was selected before accessing Tinnitus, Pro Fit automatically changes the display to 2cc Coupler Output. If Predicted Insertion Gain was selected before accessing Tinnitus, Pro Fit automatically changes the display to Real Ear Response.

    Tip:  Click for the specific frequency range (Low, Mid, or High) or Collapse All to hide the numerical values.

14. 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.

15. 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.

16. Click to expand the Copy Settings & Target Match section.
17. To copy the settings to another program, click on the origination program to copy From.

    Note:  Custom programs can only be copied From but not To.

18. Select the To or destination program from the drop-down list.

    Note:  The From and To program cannot be the same number, and the To program cannot be Disabled or any Telephone program.

19. Click Copy.

    Note:  All settings in the origination program were automatically copied to the destination program.

20. To copy the settings to another program, repeat steps 17-19.
21. To reset the current program's or all linked programs' output settings back to their original defaults based on the Shape selected, click Target Match Tinnitus.

Stimulus PersonalizationStimulus Personalization