Phonak Lyric Manuel utilisateur

Autres manuels pour Lyric

4

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Troubleshooting Guide

Important Information

The information contained in this document is the conﬁdential and proprietary property of

Phonak. Any reproduction, dissemination, or distribution of this document in whole or in

part is strictly prohibited without the prior written permission of Phonak.

Phonak, Lyric, and the Life is on are registered trademarks of Phonak, The Lyric & Phonak

logo, are trademarks of Phonak

Please note that while every eort has been made to ensure that the data provided in this

document are accurate, the information, ﬁgures, illustrations, tables, speciﬁcations, and

schematics contained herein are subject to change without notice.

This Troubleshooting manual and all materials contained herein have been prepared for the

sole purpose of providing instruction, review, and reference material to Lyric providers.

No part of these materials may be reproduced, stored in an information and retrieval system

(physical or electronic), or transmitted in any form or by any means electronic, mechanical,

photocopying, recording, or otherwise, without ﬁrst obtaining the written permission of

Phonak.

Please read and maintain the important safety information when working with Lyric as

outlined in the Lyric user guide.

© 2013 Phonak. All rights reserved. No portion of this manual may be reproduced or

transmitted in any form or by any means without the express prior written consent of

Phonak.

1

1 Programming Assistance.............................................................................................. P.2

2 Troubleshooting Programming .................................................................................. P.3

3 Troubleshooting Feedback........................................................................................... P.4

4 Troubleshooting Migration.......................................................................................... P.6

5 Troubleshooting Occlusion .......................................................................................... P.8

6 Troubleshooting Discomfort and Pain........................................................................ P.11

7 Troubleshooting Dead Device...................................................................................... P.14

8 Device Removal and Re-Insertion ............................................................................... P.15

Content Troubleshooting Guide

2

1 Programming Assistance

Soft Level Gain (SLG)

nSLG controls the compression knee point.

nTip:

–An increase in SLG will lower the compression knee point and increase relative gain.

–A decrease in SLG will raise the compression knee point and decrease relative gain.

Low Frequency Cut (LFC)

nLFC reduces gain 6dB/octave below the selected frequency.

nTip:

–Patients typically prefer lower LFC settings; especially when the device is set at a lower volume.

Volume (Vol)

nVolume should be based on the patient’s preferences and communicative needs.

Maximum Volume (MaxVol)

nSet MaxVol +1 or +2 of your set Vol.

nTip:

–This is more important for patients with lower volume settings as you do not want them to have the

ability to cycle through 6 settings. These adjustments do not aect the MPO.

High Frequency Boost (HFB)

nHFB provides approximately 4-6 dB boost above 2000 Hz.

nTip:

–HFB “ON” may over amplify high frequencies resulting in feedback and cause Lyric to compress.

3

2 Troubleshooting Programming

Background

nApply the methods mentioned in the previous section “Programming Assistance”.

nOnce the device is programmed and in place, conﬁrming Lyric’s sound quality can be as easy as asking 2

questions:

– Volume related issues

– Own voice related issues

Query the patient & troubleshoot

nVolume related issues:

– Ask the patient “if you had a remote control, would you turn the volume up, down or leave it as

it is?”

�Based on the patient response to this question you should set the volume to where the patient is

comfortable and then set MaxVol to Vol +1 or +2.

�Changes to SLG should be saved for complaints of background noise, soft sounds or pumping.

nOwn voice related issues:

– Ask the patient “from where do you hear your own voice?”

�Options may be needed to help facilitate an answer, for example:

�On top of the head

�Back of the head

�From the mouth

�From far away

nIf the patient response is anything other than from the mouth, changing LFC is recommended. Lowering

the LFC increases the frequency response bandwidth and increasing the LFC decreases low frequency gain.

– If the voice is coming from the back of the head or there is an echo: Raise LFC.

– If the voice is coming from the nose or is tinny: Lower LFC.

– If the voice is coming from the throat: Lower or raise LFC.

– If the voice sounds or feels like it is underwater: Lower LFC.

If questions about volume and own voice related issues were adressed, the overall

sound quality the patient is experiencing should be positive.

4

3 Troubleshooting Feedback

Background

nThe most common cause for feedback is due to an incomplete seal. Always check the physical ﬁt of the

device if there is feedback and before re-programming.

nTo troubleshoot feedback follow these steps:

– Query the patient

– Inspect the ear canal with the device in place and the pinna at rest

– Inspect the canal with the device removed (if necessary). See chapter 8 for more information.

Query the patient

nAsk the patient “what he/she is experiencing?”

– Squealing

– Hissing

– Static/Distortion

nAsk the patient “when is feedback occurring?”

– Always

– Intermittently

– Only when_________

nAsk the patient “what he/she thinks is the cause of the feedback?”

– Did the feedback start after showering or any other activity?

– Did the patient manipulate the device?

– Did the patient adjust the volume to a higher level?

nAsk the patient “how much of a bother is the reported feedback?”

– Intolerable

– Annoying, but tolerable

– Tolerable, just concerned that it happens at all

5

3 Troubleshooting Feedback

Inspect the ear canal with the device in place and the pinna at rest

nCheck the placement of the device: Are there any gaps or folds?

–Gaps noted: Re-size current size and 1 size larger (if available). Pay close attention to how the insertion

depth interacts with the sizer. You may have to use a larger size at a more shallow depth. Be aware that

reducing the depth of the insertion may contribute to occlusion, reduction in volume and sound quality

issues.

–Folds noted: Re-size current size and 1 size smaller (if available).

nCheck the angle of the device according to the orientation of the ear canal: Should the superior indicator

be towards the 2 o’clock position? 10 o’clock? Noon? If necessary change the position of the device

according to the orientation of the ear canal.

nThe canal wall is touching or close to the microphone. If the inspection revealed no gaps or folds, a

collapsing ear canal might be the cause:

–Consider placing the device slightly short of ideal depth of insertion to ‘prop’ the ear canal open.

–Be aware that reducing the depth of the insertion may contribute to occlusion, reduction in volume and

sound quality issues.

nDid the device migrate? See chapter 4 for more information.

nIs there cerumen adjacent to the lateral end of the device? If yes, replace with the new device to the

same depth of insertion.

nConsider reprogramming Lyric:

– Turn HFB OFF if it is ON. If feedback stops, and there is not a decrease in patient beneﬁt, complete.

– Reduce gain 1 step (Vol or SLG):

�If feedback stops, and there is not a decrease in patient beneﬁt, complete.

�If feedback stops but compromises patient beneﬁt, use recommendations above.

�If feedback continues, use recommendations above.

If feedback remains and the patient perceives it as intolerable, consider

contraindication.

6

4 Troubleshooting Migration

Background

nMigration is deﬁned as movement of the Lyric device from the original insertion depth. Migration is

completely normal and can occur immediately after the patient has been ﬁt with the device or a sizer, or

may take a few hours up to a couple of days after the patient has left the oce.

nThis movement can be classiﬁed as “insigniﬁcant” or “signiﬁcant”:

–“Insigniﬁcant” migration is movement of 2mm or less and occurs while the device ﬁnds its “sweet

spot”. Insigniﬁcant migration has no negative impact on sound quality or patient comfort and therefore

does not require replacement. The patient may or may not desire a program change due to the new

distance from the Tympanic Membrane.

–“Signiﬁcant” migration is movement greater than 2mm and is considered “signiﬁcant” if there are

any reported sound quality, comfort or feedback issues. If you ﬁnd this to be an issue in your practice,

consider using the suggestions in this chapter.

Query the patient

nAsk the patient “what he/she is experiencing?”

–Decrease in sound quality

–Comfort issues

–Feedback

nAsk the patient “when is migration occurring?”

–After sleeping

–Patient manipulated the device

–During/following chewing

7

4 Troubleshooting Migration

Inspect the ear canal with the device in place and the pinna at rest:

nDo you notice any gaps or folds?

–Gaps noted: Re-size current size and 1 size larger (if available). Pay close attention to how the insertion

depth interacts with the sizer. You may have to use a larger size at a more shallow depth. Be aware that

reducing the depth of the insertion may contribute to occlusion, reduction in volume and sound quality

issues.

–Folds noted: Re-size current size and 1 size smaller (if available).

nInspect the ear canal while the patient opens and closes jaw and determine if there is excessive jaw

movement.

–Determine the current depth of the device using the Lyric1 forceps:

–To do so, gently grasp the handle of the device with the forceps and move the depth ring so that it

lines up with the posterior meatus. Remove the forceps and make note of the measurement.

nIf migration is “signiﬁcant”, follow these steps:

–Rule out patient manipulation of device. Remove the device and re-evaluate the device size with sizers.

You may have to upsize to prevent further migration.

–Determine if changing insertion depth will also allow a more secure ﬁt.

–Evaluate TMJ movement with Lyric in the patients ear. When the patient opens and closes their jaw,

does the device move? This may be a contraindication if migration continues to be an issue.

If signiﬁcant migration continues to be an issue, consider contraindication.

8

5 Troubleshooting Occlusion

Background

nThere are two types of occlusion with hearing aids: “Physical occlusion” and “acoustic occlusion”.

nAs long as an acoustic seal in the bony portion of the ear canal is achieved, the patient should not

experience “physical occlusion”.

n“Acoustic occlusion” is caused by under-ampliﬁcation of low-frequencies (insertion loss from device

placement), or giving over-ampliﬁcation of low-frequencies (sound quality and own voice has too much

bass).

Query the patient

nAsk the patient “what he/she is experiencing?”

– Feels plugged up

– Feels like he/she is talking in a barrel

– Voice sounds hollow

– Feels/sounds like he/she has a cold

nAsk the patient “how much of a bother is the reported occlusion?”

– Intolerable

– Annoying but tolerable

– Tolerable, just concerned that it happens at all

Determine type of occlusion

nBefore troubleshooting determine if this is physical occlusion or acoustic occlusion:

– Does the patient feel occluded with the device turned o? Try turning the device to SLEEP mode or

OFF:

�If yes, this is truly a physical occlusion.

�If no, this could be a result of the electronic gain/ampliﬁcation (see page 10 on how to

troubleshoot acoustic occlusion).