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Titan

Probe performance is crucial to TEOAE test results. We recommend that you conduct a probe test at the beginning of each day before starting to test on patients to ensure that the probe is functioning correctly.

  • Before conducting the probe test, ensure that the probe tip is clean and free of wax and/or debris.
  • Always conduct the probe test in a quiet test environment.
  • Only use the recommended cavity for testing. Using a different type of cavity may either not detect probe faults or may incorrectly indicate a faulty probe.

Performing the Probe Test

  1. Select the Probe Test TEOAE protocol on the handheld device or in the PC software.


  2. Insert the probe tip without an ear tip attached into the Probe Test Cavity* or the 0.5cc** cavity provided with the Titan. Press the Start button and let the test run until it stops (approx. 30 seconds). Do not stop the test manually.

  3. If the probe is functioning correctly, none of the TE bands will have a checkmark above them when the test ends. It is possible to continue with daily testing.


  4. If error messages appear during testing or if one or more of the TE bands has a checkmark above it at the end of the test, the probe test has failed. Check and clean the probe tip for wax or debris and redo the probe test. If the probe test fails a second time, the Titan must not be used to test on patients. Contact your local distributor for assistance.

Note: Failure of the daily probe test also indicates that TEOAE measurements performed since the last successful probe test may be invalid and patients may need to be retested. Hence, the importance of performing the probe test daily.

For more information about the probe test, please refer to the Titan Instructions for Use Manual.

* A specifically designed Probe Test Cavity will be available for use shortly. Until such time, please use the 0.5cc cavity provided with Titan. **The 0.5 cc cavity simulates the impedance of neonate and adult ears to an acceptable level for the daily Probe Test. We discourage the use of smaller cavities for the daily check in neonatal screening as such a cavity is not representative of a neonate ear due to soft tissue in the ear canal.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying. Absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Unless the Absorbance is evaluated at tympanometric peak pressure, any positive or negative middle ear pressure will influence the absorbance characteristics and obscure a direct interpretation.
It should be noted, that recordings on ears with negative middle ear pressure will vary between patients – the shown Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:
The Absorbance exhibits a very pronounced peak somewhere in the range slightly below 1 kHz. Absorbance in general increases in the frequency range below 900 Hz and decreases in the frequency range between 2.5 kHz and 3.5 kHz.

Sketched example of an absorbance pattern
Sketched example

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Unless the Absorbance is evaluated at tympanometric peak pressure, any positive or negative middle ear pressure will influence the absorbance characteristics and obscure a direct interpretation.
It should be noted, that recordings on ears with negative middle ear pressure will vary between patients – the shown Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:
The Absorbance at lower frequencies (lower than 1-2 kHz) reduces as the fixation increases. Total fixation does not, however, bring the Absorbance down to a flat line to the same degree as middle ear pressure or fluid in the middle ear tends to do.
Frequencies higher than 1-2 kHz are typically not much affected.

Sketched example of an absorbance pattern
Sketched example

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying. Absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Absorbance measures under more or less blocked conditions will vary. The displayed Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:

  • The Absorbance will be very low across the frequency range
  • Depending on the degree of blockage against the ear canal, the Absorbance might be more or less jerky

Sketched example of absorbance characteristics
Sketched example

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying. Absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
It should be noted, that recordings on ears with negative middle ear pressure will vary between patients – the shown Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:
The Absorbance at lower frequencies tends to be at a very low level – close to a flat reading. This effect might increase with the amount of fluid in the middle ear. With pressures as high as plus or minus 300daPa, the low absorbance might extend up to the 2 kHz area.
Higher frequencies are often not affected by positive pressure in the ear canal. Negative pressure might cause a higher Absorbance at higher frequencies. These high frequency effects are not consistent across all ears.
In general, it can be difficult to distinguish between the condition of Negative Middle Ear Pressure and the condition of partial Fluid in the Middle Ear. If, however, the Absorbance reading is made at tympanometric peak pressure, for purely Negative Middle Ear Pressure condition the Absorbance reading, may not be distorted by the effects of a Negative Middle Ear Pressure.

Sketched example of an absorbance pattern
Sketched example

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying. Absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Absorbance measures under more or less blocked conditions will vary. The displayed Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:
The condition obviously has great variability due to the many ways the probe can be loosely fit. In general, the Absorbance will be at an unusually high level at frequencies below 2 kHz, and the pattern might be jerky.

Sketched example of absorbance pattern
Sketched example

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying. Absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Unless the Absorbance is evaluated at tympanometric peak pressure, any positive or negative middle ear pressure will influence the absorbance characteristics and obscure a direct interpretation.

It should also be noted, that recordings on ears with fluid in the middle ear will vary between patients – the shown Absorbance pattern is a sketched example only.

Absorbance characteristics to look for:
The Absorbance at lower frequencies tends to be at a very low level. This effect might increase with the amount of fluid in the middle ear which might also extend the effected frequency range upwards. At the highest frequencies the Absorbance may be reduced as well (as shown in this sketch), but this effect is not seen in all ears.

Sketched example of an absorbance pattern
Sketched example

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015

Source
The information presented here is based on clinical examples as well as modeled patterns. Text and accompanying absorbance sketch is authored by Navid Shahnaz, PhD, Aud, Associate Professor of Audiology in the School of Audiology & Speech Sciences at the University of British Columbia (UBC).

Note
Firstly, it must be noted that a perforated ear is easiest recognized by the flat curve and high equivalent ear canal volume of the traditional tympanogram. Similarly, the 3D absorbance measure allows recognizing that the measures are constant over the pressure range.
Secondly it should be noted, that recordings on ears with perforations will vary between patients – the shown Absorbance patterns for smaller and larger perforations shown here are sketched examples only. Please see Susan Voss’ article referenced below for more details.

Absorbance characteristics to look for:
The Absorbance generally increases compared to normal ears, and mostly so below 2 kHz as the middle ear cavity absorbs most of the energy. The increase in Absorbance is most pronounced with the smallest(!) perforations. The bump of higher absorbance around 1 kHz shown in this sketch can be very pronounced with a very small perforation and may shift to higher frequencies as the size perforation increases. With larger perforations, the low frequency Absorbance gets closer and closer to normal absorbance levels, but might remain above the Absorbance level the ear would have exhibited without the perforation.

Sketched example of an absorbance pattern
Sketched example

a 3D example of a normal reading
3D example of normal

a 3D example of perforation
3D example of perforation

Consequences of probe fit
All Absorbance measures need to have a good probe fit to be reliable. Evaluating Absorbance as provided by the 3D Tympanometry test ensures that a reasonably air tight probe seal was accomplished, as the air pressure sweep would not have been performed otherwise. In addition to an air tight probe seal, a deeper rather than a shallower probe insertion ensures the most accurate Absorbance measures. Shallow insertions tend to provide more elevated Absorbance readings at lower frequencies. This is somewhat similar to normal Tympanometry measures that are also influenced by probe fit and probe insertion depth.

Suggested reading
Effects of Middle-Ear Disorders on Power Reflectance Measured in Cadaveric Ear Canals, Voss, Susan E., Merchant, Gabrielle R.,Horton, Nicholas J., Ear & Hearing. 33(2):195-208, March/April 2012.

Acoustic Immittance Measures, Basic and Advanced Practice, 2013, Lisa Hunter, Phd, FAAA, Navid Shahnaz, PhD, Aud. (C), Plural Publishing. ISBN10: 1-59756-437-0, ISBN13: 978-1-59756-437-3.

May 2015
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