Page 1 Operation Manual Audio Traveler AA222 Valid from serial no. 776588 software version 2.00200 80658225 – vers. 02/2011...
Page 3: Table Of Contents
Tympanometry - only ............... 50 Tympanometry with High Probe Tone ..........52 Automatic Reflex Test - only ............54 Manual Reflexes ................56 Editing Automatic and Manual Reflexes .......... 57 Manual Reflex Decay............... 58 Eustachian Tube Function ............... 60 AA222 Operation Manual Page 3...
Page 4 Speech Audiometry Setup Menu ........... 129 Common Setup Menu..............130 Appendix B: Installing the USB Driver on the PC ....... 134 Appendix C: General Maintenance Procedures ......137 Return Report .................. 139 Drawing of Front Plate ..............141 AA222 Operation Manual Page 4...
Page 5: Introduction
Eustachian tube function test and AC audiometry. The AA222 tympanometer and audiometer is intended to be used by an audiologist, hearing healthcare professional, or trained technician in a quiet environment (tymp and reflexes) and extremely quiet environment (Audiometry).
Page 6 4. Do not drop or otherwise cause undue impact to this device. If the instrument is dropped or otherwise damaged, return it to the manufacturer for repair and/or calibration. Do not use the instrument if any damage is suspected. AA222 Operation Manual Page 6...
Page 7: Explanation To Symbols
Explanation to Symbols Explanation to symbols which may be found on the instrument: Caution. Check the accompanying documents Type B applied part Alternating Current AA222 Operation Manual Page 7...
Page 8: Warranty
Warranty INTERACOUSTICS warrants that:  The AA222 is free from defects in material and workman ship under normal use and service for a period of 12 months from the date of delivery by Interacoustics to the first purchaser.  Accessories are free from defects in material and...
Page 9 Interacoustics any other liability in connection with the sale of Interacoustics products. INTERACOUSTICS DISCLAIMS ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING ANY WARRANTY OF MERCHANTABILITY OR FOR FUNCTION OF FITNESS FOR A PARTICULAR PURPOSE OR APPLICATION. AA222 Operation Manual Page 9...
Page 10: General Theory Of Impedance Measurements
The equivalent volume of the middle ear, also called the compliance, is easily derived by subtracting the two volume measurements above. This is done automatically on the AA222 and the result is presented as "Compliance", measured in ml. The impedance curve, drawn by a gradual sweep across a wide pressure range, can reveal a great deal of information about the state of the middle ear, the tympanic membrane, and the ossicular chain.
Page 11: Understanding Tympanograms
A given curve drawn in a co-ordinate system will always have its shape dictated by the vertical and horizontal graduations. The printout of the AA222 complies with the international standards in this respect, and therefore may not produce tympanogram shapes directly comparable to other instruments if these do not meet the standard requirements.
Page 12: Classification Of Tympanograms
Please refer to the chapter "Examples of Interpretations" in this manual for illustrations of the classic curve categories, and the names given to them by Liden and Jerger. On the following pages a more detailed description of each category is presented. AA222 Operation Manual Page 12...
Page 13 (serous or adhesive otitis media), retracted eardrum, blockage of the external ear canal, or perforated eardrum e.g. with drainage tube. Note: Ears with type B tympanograms should be tested for peak identification down to -600 daPa. AA222 Operation Manual Page 13...
Page 14 Depicted by a broad, deep, often multiple notching. "W" shaped. This tympanogram is usually caused by ossicular discontinuity, but may also indicate restored ossicular chain one year or more after stapedectomy. Note: May be better detected with an 800 Hz probe. AA222 Operation Manual Page 14...
Page 15: Interpretation Of Test Results
Decreased / Flattened Increased slope: Altered smoothness: slope: 1) Eardrum 1) Eardrum abnormality abnormality 2) Ossicular 1) Serous otitis 2) Ossicular discontinuity 2) Ossicular fixation discontinuity 3) Vascular tumours 3) Tumours of middle 4) Patulous Eustachian tube AA222 Operation Manual Page 15...
Page 16: Reflex Interpretation
A negative reflex may occur due to the following interference of noise: Prior to recording the reflex activity an acoustic reference level is measured in the ear canal without any Stapedius activity. The difference between this reference level and the level AA222 Operation Manual Page 16...
Page 17 Stapedius muscle action, also at slightly lower stimulus intensities. This procedure (see "Example of Popular Fixed Intensity Reflex Test") is recommended for establishing the absolute reflex threshold. Generally, noise stimuli elicit reflexes at lower levels than pure tones do. AA222 Operation Manual Page 17...
Page 18: Pathways For The Stapedius Reflexes
Increased stimulation level will produce a stronger reflex. Cochlear and retrocochlear pathology may show less rapid growth of reflex amplitude versus stimulation amplitude. AA222 Operation Manual Page 18...
Page 19 Below is shown the tactile sensitive area of the face to be stimulated with e.g. a piece of wool. Stimulation may also be a blow of air into the eye region of the patient. Figure 3: Touch AA222 Operation Manual Page 19...
Page 20: Reflex Decay Interpretation
This is due to the prolonged test time and the high sensitivity of the test. Also great care should be taken to have the probe kept in a very fixed position relative to the ear during testing. AA222 Operation Manual Page 20...
Page 21: Examples Of Interpretation
: Present. Audiogram : No hearing loss. Pathology : Cochlea lesion. Volume : Normal. Pressure : -100 daPa to +100 daPa. Ventilation : Present. Reflex : Present or absent. Audiogram : Sensory neural hearing loss. AA222 Operation Manual Page 21...
Page 22 : Disruption of ossicular chain with bones fixated to the tympanic membrane, resonating. Supranormal eardrum (floppy). Volume : Normal. Pressure : -100 daPa to +100 daPa. Ventilation : Present. Reflex : Absent / Present. Audiogram : Conductive loss. AA222 Operation Manual Page 22...
Page 23 Audiogram : Mild to moderate conductive loss (20 dB). Pathology : Otosclerosis or stapes fixation. Volume : Normal. Pressure : -100 daPa to +100 daPa. Ventilation : Present. Reflex : Absent or elevated (rare). Audiogram : Moderate conductive loss. AA222 Operation Manual Page 23...
Page 24 Positive middle ear pressure is rarely observed in tympanometry. Usually it is a consequence of sneezing or valsalvation. One pathological condition that may cause positive pressure in the middle ear is acute serous otitis media in the early stage. AA222 Operation Manual Page 24...
Page 25 Status of middle ear drainage tubes: Otoscopic or "visual" inspection of the drainage tube is difficult, as it can easily be blocked from the inside. All three situations below will result in a mild conductive loss. AA222 Operation Manual Page 25...
Page 26: General Theory About Air And Bone Conduction
If necessary, the audiometric headphone can be equipped with our Audiocup Exclosures type 21925. Please contact the distributor. Instruction of subject: Prior to hearing threshold level measurements, the following instruction of the subject about the test tones and the response AA222 Operation Manual Page 26...
Page 27 3) Proceed to the next frequency. Decrease the level by 10 dB and begin another ascending level series. Continue until three responses out of a maximum of five occur at the same level. AA222 Operation Manual Page 27...
Page 28: Bone Conduction
The output switch is set to Bone and the test is performed in the same way as for the air conduction test. AA222 Operation Manual Page 28...
Page 29: General Considerations About Masking
50 dB (AC dB -50 dB). With AC-BC loss in the masked ear: The AC tone level minus 50 dB plus the AC-BC loss of the masked ear. (AC dB - 50 dB + AB gap of masked ear.) AA222 Operation Manual Page 29...
Page 30 Otherwise, the masking procedure is the same. As the test ear is open during the BC test with insert masking, it is important that the test is performed in a sound cabin with no background noise. AA222 Operation Manual Page 30...
Page 31: Masking Procedure - Step By Step (Hoods Plateau)
Increase the masking in 10 dB steps with the rotary switch channel 2 (allow approximately 2 seconds at each step), and have the subject letting you know when he first starts to hear the noise. AA222 Operation Manual Page 31...
Page 32 Over-masking is much more likely to occur in Bone Conduction testing. As soon as the masked threshold has been determined, reduce the noise to a level below the subject's threshold. AA222 Operation Manual Page 32...
Page 33 Record masked thresholds with appropriate symbols. Do not record both the unmasked and masked results. In addition, indicate the type of noise utilised and the upper level of the noise when the masked threshold was determined. AA222 Operation Manual Page 33...
Page 34: Basic Functions
Pause The pause function operated from “Pause” (10) has been built in to AA222 to prevent the instrument from automatically starting the test as soon as an air tight fit has been obtained. The pause function is mainly used when using the clinical headset or shoulder strap on the patient.
Page 35: Preparing The Test
AA222, may show slightly wrong pressure results. If the AA222 has been subject to very high or low temperatures e.g. from being kept in a hot or cold car, the temperature of the °...
Page 36 Insert the probe tip into the ear canal until you have an airtight fit. Pull the transducer house upwards again, until the probe in the ear is hanging by the tubes from the transducer. AA222 Operation Manual Page 36...
Page 37 Vaseline or cerumen. For decay test an absolutely airtight fit is needed to avoid test results indicating decay, where the test result is actually just an artefact caused by a poor fit. AA222 Operation Manual Page 37...
Page 38: Main Menu
Power-up setting selected in the Common Setup Menu. To go to AA222’s Main Menu press “Back” (7) one or more times, or hold down “shift” (18) while pressing “Back” (7) – this will bring you to the Main Menu from wherever you are in the instrument.
Page 39: Test Procedures
Pressing F1 “Test” will bring you back to the Test Screens. Pressing F2 “Setup” will bring you to the Main Setup Menu. The program version of AA222 is written in the middle of the screen. Test Procedures Before every test is performed it is recommended to delete all stored patient data from the instrument.
Page 40: Printing Test Results
Printing Test Results To print test results obtained by the AA222 press "Print" (8) and the internal thermal printer will start printing. It is possible to print out the present screen by holding down “shift” (18) while pressing “print screen” (8). Please see below some typical examples of printouts from...
Page 41 Printout 3 contains the following:  Printout 4: Tympanogram.  Printout 4 contains the Reflexes (sequence following: method with 5 individual  ETF 1 test (Eustachian reflexes starting at 80 dB Tube Function test). at 4 different frequencies). AA222 Operation Manual Page 41...
Page 42: Connection To Pc
Connection to PC The data from AA222 can be transferred to a PC by means of a USB cable. The software needed for AA222 for transferring data to a PC is one of the following Windows compatible software:  OtoAccess™ Database Program + diagnostics modules minimum version 1.25...
Page 43: Installing Printer Paper
Installing Printer Paper 1. Open the plastic cover of the paper compartment of AA222. 2. Place the new paper roll in the paper compartment in such a way that the paper ascends from the lower part of the paper roll. With a pair of scissors cut two triangles of paper away.
Page 44 Make sure that the paper is aligned correctly – see picture 6 and 6. Now guide the paper through the slot of the cover of the paper compartment. 7. Close the plastic cover of the paper compartment again. AA222 is now ready to print. AA222...
Page 45: Reflex And Tympanometry
In the Reflex and Tympanometry mode both indication lights of the “Tymp/Reflex” key (10) will be active. 1. Select test ear by means of “Right” (27) or “Left“(28). 2. Select the wanted reflex test “Test A” or “Test B” with (F4). AA222 Operation Manual Page 45...
Page 46 Note: In the Setup Menu of AA222 it is possible to pre-program two separate reflex tests “Test A” and “Test B”. When starting a test procedure “Test A” is always default. Therefore if “Test B” is wanted press F4 “Test A B”.
Page 47 3 ml tympanogram. When the compliance peak exceeds the 3 ml scale like in figure 9 AA222 will give the operator the possibility to change between 1.5 ml, 3.0 ml and 6.0 ml scale by pressing...
Page 48: Modifying Reflex Test A And B
To modify reflex “Test A or B” press (F6): Figure 12: Figure 13 shows the Modify Menu for Reflex Test A – it is similar for Reflex Test B: Figure 13: AA222 Operation Manual Page 48...
Page 49: Ipsilateral And Contralateral Reflexes
In the Setup Menu for Reflex A or B it is possible to set up a reflex test procedure to perform either ipsilateral or contralateral reflexes only. Alternatively AA222 can be set up to perform ipsilateral and contralateral in the same test procedure.
Page 50: Tympanometry - Only
In the Tympanometry mode the left indication light only on the “Tymp/Reflex” key (10) will be active. 1. Select test ear by means of “Right” (19) or “Left” (20). 2. Place the probe in the test ear. AA222 Operation Manual Page 50...
Page 51 The pressure range is indicated by two small, bold, vertical lines on the horizontal 0 ml line. To go back to the standard pressure range press F6 once again. AA222 Operation Manual Page 51...
Page 52: Tympanometry With High Probe Tone
Tympanometry with High Probe Tone Note that high probe tone tympanometry and its settings are only available and visible if the AA222 contains the proper license (for AA222h). If this is not the case and you would like to use high probe tone tympanometry, please contact your Interacoustics dealer.
Page 53 (with normal or High Probe Tone) press “High Probe Tone” (4) in order to enter or exit “High Probe Tone” mode. Now the next curve will be drawn automatically. Press “Print” (1) and a printout presenting both curves will appear: Figure 16: AA222 Operation Manual Page 53...
Page 54: Automatic Reflex Test - Only
Reflex and Tympanometry Test browse with the “Tymp/Reflex” key (10). Figure 17 shows the Reflex Test Screen: Figure 17: In the Reflex Test mode the right indication light only on the “Tymp/Reflex” key (10) will be active. AA222 Operation Manual Page 54...
Page 55 3. Remove the probe from the first ear when the test sequence has finished. Select the other ear “Right” (19) or “Left” (20), move the probe to the second ear and repeat the test sequence once again. AA222 Operation Manual Page 55...
Page 56: Manual Reflexes
Manual Reflexes With AA222 there are two different ways to perform manual reflexes. Manual reflexes can be performed subsequently to an automatic test session or on their own. After an automatic session where a number of reflexes have been recorded, there might be a need for making one or more manual reflexes.
Page 57: Editing Automatic And Manual Reflexes
This is done simply by pressing the ”Tone Switch” (29). Now the reflex is repeated at the same frequency and intensity as the previously recorded reflex. This action can be repeated several times. When satisfied press “Store” (24) to store the reflex. AA222 Operation Manual Page 57...
Page 58: Manual Reflex Decay
Manual Reflex Decay There are two different ways to perform reflex decay tests with AA222. Reflex decay tests can be performed subsequently to an automatic test session or on their own. After an automatic session where a number of reflexes have been recorded, there might be a need for making one or more manual reflex decay tests.
Page 59 The parameters for the manual reflex can be changed by pressing the “Frequency Decr / Incr” keys (27 and 28) and dialling the “HL dB” rotary dial (26). Figure 22: AA222 Operation Manual Page 59...
Page 60: Eustachian Tube Function
Eustachian Tube Function With AA222 it is possible to perform a Eustachian Tube Function test for non-perforated ear drums, the so-called Williams Test. With AA222 the test is semi automatic and will suggest the operator how to operate the instrument and how to instruct the patient.
Page 61: Aa222 Operation Manual
Now press the blinking “Pause” (9) key once again and the test will make its second sweep. When the second sweep has been carried out another information window will appear on the screen: AA222 Operation Manual Page 61...
Page 62: Child" Function
“Pause” key (9) to be controlled from the Remote Switch of the probe. ”Child” Function AA222 has been equipped with a special Child Function. The intention of this function is to help the operator keeping the child concentrated for the short while it takes to perform the test.
Page 63 Figure 27 shows the Reflex and Tympanometry Test with the Child Function activated: Figure 27: The train will continue moving until the selected reflex test session has finished. When the test session has finished the train will automatically disappear. AA222 Operation Manual Page 63...
Page 64: Automatic And Manual Audiometry
HW test procedure. In the Automatic Audiometry Test mode the right indication light of the “Man/Auto” key (17) will be active and the indication light of the “Pause” key (9) will be blinking. Figure 28: AA222 Operation Manual Page 64...
Page 65 Now, manual audiometry can be performed. Select frequency by pressing “Frequency Decr / Incr” (27 and 28) and intensity by dialling the “HL dB” rotary dial (26). To store thresholds for the audiogram press “Store” (24). AA222 Operation Manual Page 65...
Page 66: Masking
Figure 30: In the horizontal bar right above the audiogram display of AA222 it is possible to monitor 1) the masking intensity and 2) the type of noise chosen NB or WN. See figure 26. In the audiogram just below the horizontal bar the cursor will indicate the present masking intensity and frequency.
Page 67: Speech Audiometry
“CD1/CD2” (17) for presentation of pre-recorded speech material (CD or tape). Figure 31: Figure 31 shows the Speech Audiometry Test Screen with two recorded speech curves and permanent benchmark reference curve. AA222 Operation Manual Page 67...
Page 68 (26). To store the VU setting press “Store” (27). To calibrate the CD signal press “shift” (18) while holding down “CD1/CD2” (8) for approximately two seconds. The message box shown in Figure 33 will now show up. AA222 Operation Manual Page 68...
Page 69 In order to see the two stored VU settings hold down “shift” while pressing “CD1/CD2” (8). 3. When calibration is finished, select the desired test level for the speech test by dialling “HL dB” (26) rotary key. AA222 Operation Manual Page 69...
Page 70: Automatic Speech Scoring Counter
Automatic Speech Scoring Counter With AA222 it is possible to perform automatic speech score calculation. The procedure is as follows: 1. Present a word to the patient. 2. Select “Incorrect” (27) or “Correct” (28) according to the response from the patient.
Page 71 “HL dB” rotary key (30). To switch off masking hold down “shift” (18) while dialling the “HL dB” rotary key (30) anticlockwise. While using masking it is possible to synchronies the masking channel “HL dB” (30) to the speech presentation channel “HL dB” (26). AA222 Operation Manual Page 71...
Page 72: Ablb Test
Set the intensity of the tone to the poorer ear at a level 5 dB above threshold. Adjust the level of the tone for the other ear so the loudness levels match. AA222 Operation Manual Page 72...
Page 73: Stenger Test
Stenger test. In the Stenger Test mode the following test parameters can be altered:  Press F3 to select between manual or reverse (continuous) tone presentation.  Press F4 to select pulsing tones.  Press F5 to select warble tones. AA222 Operation Manual Page 73...
Page 74: Sisi Test
SISI Test The Short Increment Sensitivity Index is designed to test the ability to recognise one decibel increase in intensity during a series of pure tones bursts presented 20 dB above threshold. AA222 Operation Manual Page 74...
Page 75 When the patient understands the test procedure, start the actual SISI test by pressing F3 “1 dB”. Now AA222 will present 1 dB modulation increments at random and the patient is meant respond to these increments - if he can discriminate them.
Page 76 F6 “Table”. Figure 38 shows tables of the SISI scores for right and left ear. Figure 38: To reset the SISI test press F1 “Reset”. AA222 Operation Manual Page 76...
Page 77: Handling Of Ear Tips
To clean the small acoustic and air pressure channels of probe tip unscrew the small ribbed plastic nut that holds the probe tip: Picture 8: To clean the small acoustic and air pressure channels of probe tip unscrew the probe cap that holds the probe tip: AA222 Operation Manual Page 77...
Page 78 (nylon wire) which is part of the cleaning tool that can be found in the Ear tips Assortment provided with the AA222. When cleaning the acoustic and air pressure channels of the probe...
Page 79 Place the sealing gasket onto the transducer house like shown in picture 12 and make sure that holes of the gasket are aligned with the holes in the holes of the transducer housing. Picture 12: AA222 Operation Manual Page 79...
Page 80 Place the probe tip onto the transducer housing – a small flange will ensure correct positioning - before the plastic nut is gently tightened. Picture 13: AA222 Operation Manual Page 80...
Page 81: Functions Of Buttons
Monitor TB First push: Monitor active (the presentation to the patient from e.g. via tape or CD can be heard through the built-in monitor of AA222 or via a monitor headset). AA222 Operation Manual Page 81...
Page 82 Second push: Talk Back active (the patient’s comment or response can be heard through the built-in monitor of AA222 or via a monitor headset). Third push: Monitor as well as Talk Back is active. Fourth push: will switch off the three above functions.
Page 83 Tone Switch Stimulus presentation switch for manual audiometry and manual reflex mode. Intensity Incr Rotary dial for browsing between the available intensities when performing masking, ABLB or Stenger Test. AA222 Operation Manual Page 83...
Page 84: Technical Specifications
15VA Mains voltage/fuses: 100-240V~, 50-60Hz, 0.5A max. The AA222 is delivered with a power cord for the relevant national mains socket. But AA222 can be powered by any national AC voltage - Before use, the correct attachment plug/mains cable must be identified and installed.
Page 85: Impedance Measuring System
No difference is measured in the recorded values between static and dynamic measuring mode. Types Tympanometry: Automatic, where the start and stop pressure can be user-programmed from the setup menu. Eustachian Tube Function: Williams test (automatic function). AA222 Operation Manual Page 85...
Page 86 4.5N 0.5N Bone conductor: Radioear B71 with a static force of 5.4N0.5N Definition of units 1 ml at 226 Hz = 1 acoustic mmho, 1 acoustics mho = 10 /Pa·s 1 daPa = 10 Pascal AA222 Operation Manual Page 86...
Page 87: Reflex And Audiometer Functions
Operator can monitor signal when presented to the patient as well as the talk back signal from the patient’s microphone. Contra Earphone: Audiometric headphones for reflex and audiometry measurements. Ipsi Earphone: Probe earphone incorporated in AA222 Operation Manual Page 87...
Page 88 – see table 1. Test Types Manual Audiometry: Manual control of all functions. Automatic Audiometry: Auto threshold according to ISO 8253-1 (Patient controlled Hughson Westlake). Threshold is determined by the activation of the patient response. AA222 Operation Manual Page 88...
Page 89 - spectral properties: 60645-5, but with 500 Hz as lower cut- off frequency. Low pass noise (LP): Interacoustics standard - spectral properties: Uniform from 500 Hz to 1600 Hz, ±10 dB re. 1000 Hz level AA222 Operation Manual Page 89...
Page 90 Maximum difference error between tow steps is less than ±3 dB Residual noise is less than 25 dB (A) Signal to noise ratio is larger than 80 dB (A) ON-OFF ration is larger than 80 dB (A) Rise-/fall time: 35 ms (±10 ms) AA222 Operation Manual Page 90...
Page 91 Variation of ipsi stimulus levels for different volumes of the ear canal Relative to the calibration performed on an IEC 126 coupler 0.5 ml 1 ml [Hz] [dB] [dB] 1000 2000 11.7 3000 -0.8 -0.5 4000 -1.6 -0.8 AA222 Operation Manual Page 91...
Page 92 -0.5 -0.5 1000 36.5 1000 -0.5 1250 1250 1500 1500 1600 1600 2000 2000 2500 2500 3000 3000 3150 3150 -10.5 4000 39.5 4000 -10.5 5000 5000 6000 6000 6300 6300 -10.5 8000 42.5 8000 AA222 Operation Manual Page 92...
Page 93 IEC 60318-3  Insert phones are calibrated using a 2cc acoustic coupler made in accordance to IEC 60318-5  Bone Conductor is calibrated using a mechanical coupler made in accordance to IEC 60318-6 AA222 Operation Manual Page 93...
Page 94 Monitor Jack, 6.3mm Voltage: Up to 2.0V rms. by 8 load mono Min. load impedance: 0 Phones, Jack, 6.3mm Voltage: Up to 5.5V rms. by 10 load Contralateral mono Min. load impedance: 5 (Insert masking) AA222 Operation Manual Page 94...
Page 95 Table 6: General properties for earphones. Sound attenuation values for earphones Frequency Attenuation TDH39 with MX41/ EAR-Tone 3A AR or PN 51 cushion EAR-Tone 5A [Hz] [dB] [dB] 33,5 34,5 34,5 1000 35,0 1250 AA222 Operation Manual Page 95...
Page 96 43,5 Table 7: Audiometry frequencies and intensity ranges Frequency Audiometry Bone TDH39 EAR-Tone Insert Masking Free Field conduction Max* Max* Max* Max* dB HL dB HL dB HL 1000 1500 2000 3000 4000 6000 8000 AA222 Operation Manual Page 96...
Page 97: Parts
Additional Parts: EARtone 5A Audiometric Insert Phones 50250 Peltor noise exclosures 21925 Amplivox noise exclosures ACC400 carrying case CAT50 calibration unit 0.2-0.5-2.0-5.0 ml IES impedance ear simulator GSE10 RS232 Galbanic isolation adapter USB cable 2m black AA222 Operation Manual Page 97...
Page 98: Connection Panel
Printer compartment Connection Connection Piece for air for internal printer for USB supply to probe system Please note that the built-in test cavities are intended for a daily check only and not for calibration purposes. AA222 Operation Manual Page 98...
Page 99: Unpacking / Inspection
If service is required, please contact your nearest sales and service office. Contents of Shipment When AA222 is delivered as a standard unit the case contains the following: Quantity Item Order No.
Page 100: Reporting Imperfections
Reporting Imperfections Inspect before connection: Prior to connecting AA222 to mains it should once more be inspected for damage. All of the cabinet and the accessories should be checked visually for scratches and missing parts.
Page 101: Care And Maintenance
Care and Maintenance The performance and reliability of the AA222 will be prolonged if the following recommendations for care and maintenance are adhered Great care when handling the transducers: Great care should be exercised when handling the transducers of AA222 as dropping them may alter the calibration.
Page 102: Trouble Shooting
Check if the transducer / probe system is connected on the connection panel of AA222. The small rubber tube of the probe cable must be connected on the connection panel of AA222. "Blocked" is displayed in Tymp mode: The probe is blocked at the ear tip, either by wrong insertion into the ear canal, or by cerumen.
Page 103 Simply turn around paper roll. Please refer to the chapter “Installing Printer Paper”. Display is too bright or too dark: From the Main Menu it is possible to adjust the brightness by means of “LCD-“ and “LCD+” (F5 and F6). AA222 Operation Manual Page 103...
Page 104: Frequently Asked Questions
Note: The modifications carried out in the Modify Menu are current only until all previous data have been deleted by pressing “new subject” (9) while holding down “shift” (18). AA222 Operation Manual Page 104...
Page 105 The function of the remote switch on the probe is defined under Remote Switch in the Common Setup Menu of AA222. It is possible to set up the remote switch to: “L/R” – in this way you can select between left and right ear.
Page 106 Gradient is explained in the chapter “Tympanometry Setup Menu” of this manual. My AA222 only displays 4 reflexes boxes. I need 6 reflex boxes: In the Common Setup Menu under Reflex Icon Boxes it is possible to select between either 4 or 6 reflex boxes. Make sure that you select the right number of reflex boxes according to personal preferences.
Page 107: Recommended Literature
Harford, Earl R.: Impedance Screening for Middle Ear Disease in Children. (Grune & Stratton. 1978) Jerger, J.: Clinical Experience with Impedance Audiometry. (1970) Katz: Handbook of Clinical Audiology, Fourth Edition 1994 (Williams & Wilkins 1985) AA222 Operation Manual Page 107...
Page 108 Tympanometry for the Diagnosis of Ossicular Disruption. (Arch Otolaryngol vol.79 1974). Liden, G.: Audiology (Almqvist & Wiksell. 1985) (Swedish language) Popelka, G. R. et al.: Hearing Assessment with the Acoustic Reflex. (Grune & Stratton 1981) AA222 Operation Manual Page 108...
Page 109: Dictionary
ETF: (Eustachian Tube Function). This function is tested by trying to force air through the Eustachian tube and then by tympanogram recordings checking if the expected change of middle ear pressure has occurred. AA222 Operation Manual Page 109...
Page 110 Probe Ear: The ear into which the probe is inserted. Probe Signal: An acoustic signal that is emitted into the external auditory canal by means of a probe. The signal is used to measure acoustic immittance. AA222 Operation Manual Page 110...
Page 111 Tympanometry: The measurement of the ability of the eardrum and ossicular chain to transmit sound pressure waves. An intact eardrum is subjected to air pressure changes to determine its stiffness (impedance) and compliance (admittance). AA222 Operation Manual Page 111...
Page 112 Blowing forcibly to open Eustachian tube by holding nose and closing mouth. Named for its originator, Antonio Valsalva. Sometimes called Valsalva's experiment. Williams Test: Test designed to determine the function of the Eustachian tube in ears with non-perforated eardrums. AA222 Operation Manual Page 112...
Page 113: Appendix A: Setup
Appendix A: Setup The internal Main Setup Menu of AA222 is reached from the Main Menu by pressing “Setup” (F2). Figure 39: From the Main Setup Menu it is possible to enter the following Setup Menus by pressing F1 to F5: ...
Page 114: Tympanometry Setup Menu
Start Pressure: Indicates the starting point for the pressure sweep for the tympanometric curve. It goes from 25 daPa to 300 daPa. Stop Pressure: Indicates the pressure where the sweep for the tympanometric curve will stop. AA222 Operation Manual Page 114...
Page 115 Pump Speed: With AA222 there are four different pump speed settings:  Minimum (17 daPa/sec).  Medium (50 daPa/sec).  Maximum (>150 daPa/sec).  Automatic (see below). A slow speed will be more time consuming, but may give more detailed information. The horizontal displacement of the tympanometric curve’s peak in the sweeping direction caused...
Page 116 High probe tone frequency: Note that only when the AA222 was licensed to have the high probe tones available, the option to select among three different high probe tones; 678, 800 and 1000 Hz is presented.
Page 117: Setup Menu For Reflex Test A And B
In the below figure 45 the starting conditions for each of the four Reflex Methods can be set up to personal needs: Figure 45: The four arrow keys (F2 to F5) browses between the parameters of the individual reflex. AA222 Operation Manual Page 117...
Page 118: Reflex Methods
“on” via the Modify Menu. Reflex Methods There are four different reflex methods for Reflex Test A and B: Fixed Intensity Method: With the Fixed Intensity Method the parameters of the individual reflex (frequency and intensity) are fixed: AA222 Operation Manual Page 118...
Page 119 Reflex Method line when Screening, Auto or Sequence Method are selected. The software of AA222 uses an algorithm to determine if a reflex is acceptable or not. There is a selection of three different algorithms to choose from, each representing its individual level of Reflex Sensitivity.
Page 120 The pass box is the dotted rectangle in the middle of the 4 figures. Note: The pass box is not shown in the screen of AA222 but serves as an example of what sensitivity is and how it is used.
Page 121 10 dB according to the selected Reflex Sensitivity. If the reflex is above the above mentioned pass box it will be accepted and drawn on the screen. The test will then automatically proceed to the next reflex. Page 121 AA222 Operation Manual...
Page 122 (typically caused by the reaction of the Stapedius muscle). 2) Now the actual reflex test will be performed, using the intensity found in 1). 3) The recorded reflex will be checked automatically to ensure that it meets the criteria (see “Reflex sensitivity” above). Page 122 AA222 Operation Manual...
Page 123 Sequence Method the intensity levels are marked with small arrows pointing right indicating that a number of reflexes are expected to come at a pre-selected increasing intensity. Reflex pr. Sequence: It is possible to choose between 2,3,4,5 or 6 reflexes per sequence. Page 123 AA222 Operation Manual...
Page 124 Choose between 5, 6, 8, 9, or 10. Note: A warning pops up when too high a Level Increase has been chosen together with too high a start intensity level. This will violate the maximum output capabilities of AA222: Figure 55: Compensate for General Drifting: When searching for reflexes with the Sequence Method the compliance may drift a little.
Page 125: Audiometry Setup Menu
–10 dB to 50 dB in steps of 5 dB and Off. If the value is set to “Off”, the intensity will not change when changing transducer. Page 125 AA222 Operation Manual...
Page 126 The transducer must be connected to the Left (30) and Right (29) sockets.  Contra: The masking stimuli can be presented either via single audiometric headphone which is normally used for contralateral reflex presentations, or via the CIR22 Contralateral Insert Phone. Page 126 AA222 Operation Manual...
Page 127: Manual Audiometry Setup Menu
Selects between Manual or Automatic Audiometry as default when pressing “Audiometry” (25). Manual Audiometry Setup Menu The Manual Audiometry Setup Menu is reached from the Main Menu by pressing F2 “Setup”, “Aud” and finally F5 “Manual” . Figure 59: Page 127 AA222 Operation Manual...
Page 128 Pulse Key Function the tone presentation and intermitted pause is equal. Level Decr/Incr: Selects 1 or 5 dB increments or decrements when dialling the “HL dB” rotary key (26) between 1 dB and 5 dB. Page 128 AA222 Operation Manual...
Page 129: Speech Audiometry Setup Menu
Score Method: It is possible to select between Default or German method. Default mode will calculate the % of correct answers when Incorrect or Correct button is activated.  Correct  Percent  Incorrect Correct Page 129 AA222 Operation Manual...
Page 130: Common Setup Menu
The characteristics of these curves have been pre- programmed in the AA222. However, should you wish to alter the characteristics of these curves this is possible simply by browsing with the “, , , ” keys (F2 to F4). The changing of the characteristics is carried out by the “Change”...
Page 131 Manual Reflex Attenuator: Selects the intensity increase and decrease levels for manual reflexes when dialling the “HL dB” rotary dial (26) (1, 2 or 5 dB. Page 131 AA222 Operation Manual...
Page 132 There are two different “Printer” settings; “Off” and “Internal”. “Off” means that there will be no printing possibilities. 2. “Internal” means that the internal printer of AA222 is activated and can be used, if an internal printer is installed. Subject Data Printout (when “Printer” is set to “Internal”): Subject Data Printout can be set to either “On”...
Page 133 Figure 64: To enter the above Clinic screen a keyboard must be connected to the AA222 and the “Keyboard Connected” point in the Common Setup Menu must be set to “Yes”. To enter your own Clinic data press F1 “Edit” and then F2.
Page 134: Appendix B: Installing The Usb Driver On The Pc
Windows Update if the PC is connected to the internet or it can be found on the CD with the operation manual. Click Next and the following window should appear. Insert the CD, if the PC is not connected to the internet, click Next. Page 134 AA222 Operation Manual...
Page 135 COM port to use when communicating with the instrument start the Device Manager (Click Start, My Computer -> properties, Hardware -> Device Manager). The Port is recognized as “USB Serial Port” use the one with the lowest number. Page 135 AA222 Operation Manual...
Page 136 USB Serial Port, then Click Hardware and Advanced, the following window should appear: Change the COM port number in the drop down box. Page 136 AA222 Operation Manual...
Page 137: Appendix C: General Maintenance Procedures
To ensure that the reliability of the instrument is kept, it is recommended that the operator at short intervals, for instance once a day, perform a test on a person with known data. This person could be the operator him/herself. Page 137 AA222 Operation Manual...
Page 138 The use of organic solvent and aromatic oils must be avoided.  Great care should be exercised by the handling of earphones and other transducers, as mechanical shock may cause change of calibration. Page 138 AA222 Operation Manual...
Page 139: Return Report
 Return Report Page 139 AA222 Operation Manual...
Page 140 Page 140 AA222 Operation Manual...
Page 141: Drawing Of Front Plate
Drawing of Front Plate 1 2 3 4 5 6 10 11 14 15 Page 141 AA222 Operation Manual...

Audio Traveler AA222 Operation Manuals

Introduction

General Theory of Impedance Measurements

Interpretation of Test Results

General Theory about Air and Bone Conduction

Basic Functions

Reflex and Tympanometry

Automatic and Manual Audiometry

Handling of Ear Tips

Functions of Buttons

Technical Specifications

Unpacking / Inspection

Trouble Shooting

Frequently Asked Questions

Recommended Literature

Dictionary

Appendix A: Setup

Appendix B: Installing the USB Driver on the PC

Appendix C: General Maintenance Procedures

Return Report

Quick Links

Need help?

Questions and answers

Summary of Contents for Audio Traveler AA222

Table of Contents