听力筛查仪的使用说明
纯音听力测试仪操作规程
纯音听力测试仪操作规程第一部分：准备工作1.将纯音听力测试仪放置在平稳的桌面上，确保其稳定性。
2.确保纯音听力测试仪的电源线已经插入电源插座，并连接好所有必要的线缆。
3.打开纯音听力测试仪的电源开关，等待仪器启动。
第二部分：仪器设置1.确保纯音听力测试仪的音量设置在适当的范围内，既不太大也不太小。
可以先将音量调至中等程度，然后根据需要进行微调。
2.设置测试模式。
根据需要选择空气传导或骨传导测试模式，并在菜单中进行相应设置。
第三部分：测试准备1.检查耳机或骨传导器的连接。
确保它们已正确插入设备上的相应插孔，并牢固固定。
2.检查测试环境的噪音水平。
确保测试环境足够安静，以免影响测试结果。
3.确定被测试者的位置。
被测试者应坐在距离纯音听力测试仪适当的距离，并确保其面对测试仪器。
第四部分：测试操作1.开始测试前，请先向被测试者解释测试过程并告知测试的目的。
2.选择适当的音频频率和强度进行测试。
根据被测试者的要求或医生的建议，选择相应的频率和强度水平。
3.在每次测试之前，先向被测试者说明将发出的声音或信号，并确保被测试者已准备好。
4.依次播放不同频率和强度的纯音信号，并记录被测试者的反应。
一般来说，被测试者会使用手势、按钮按下或口头回应等方式表达其听到声音的情况。
5.根据被测试者的反应，适时调整音频频率和强度，确保测试的准确性和客观性。
6.在测试过程中，保持适当的交流和沟通，确保被测试者感到舒适和放松。
第五部分：测试结束1.当完成所有测试时，关闭纯音听力测试仪的电源开关。
2.拔出耳机或骨传导器，并妥善存放它们。
3.对使用的线缆、耳机或骨传导器进行清洁和消毒，以确保下次使用时的卫生和安全。
4.记录和整理测试结果，并将它们存档，以便之后的分析和参考。
第六部分：仪器维护1.定期清洁纯音听力测试仪的外部和内部部件，包括电源插口、控制按钮和显示屏等。
2.使用适当的维护工具，例如吹气罐或棉签，清理仪器上的灰尘和污垢。
耳鼻喉仪器操作方法
耳鼻喉仪器操作方法耳鼻喉仪器操作方法因具体的仪器种类而异，下面以常见的一些耳鼻喉仪器为例介绍其基本操作方法：1. 喉镜（Laryngoscope）：a. 首先，确保喉镜清洁，并安装好光源，确保光线充足。
b. 让患者坐直或脖子稍微后仰，打开口腔内窥镜随后沿牙龈背侧滑入口腔。
c. 慢慢推进喉镜，同时观察喉镜显示的声门及声带的图像。
d. 检查完成后，缓慢取出喉镜。
2. 鼻内窥镜（Nasal endoscope）：a. 首先，确保鼻内窥镜清洁，并涂抹适量的润滑剂。
b. 让患者坐直或躺平，鼻孔矫正，以便于将鼻内窥镜缓慢插入鼻孔内。
c. 慢慢推进鼻内窥镜，同时观察鼻腔及鼻咽部的图像。
d. 检查完成后，缓慢取出鼻内窥镜。
3. 听力筛查仪（Audiometer）：a. 根据说明书正确链接仪器及耳机，并测试其工作状态。
b. 安排患者坐在安静无扰动的环境下，按照指示要求进行听力测试，例如，测试时按要求按按钮或听到声音时以手势反应等。
c. 记录测试结果，包括每个频率的左右耳听力水平。
d. 根据测试结果，将数据输入计算机或将结果记录在听力图表上。
4. 鳞状细胞癌筛查仪（Squamous cell carcinoma screening device）：a. 将仪器与电源连接，并确保仪器处于正常工作状态。
b. 要求患者张开口腔，将设备用特定方式接触到检查部位。
c. 遵循仪器操作说明，使用光线照射及放大功能检查口腔黏膜的细节。
d. 根据所观察到的颜色、形状和其他异常特征，判断病灶可能的恶性程度，并记录相应结果。
以上只是一些常见耳鼻喉仪器的基本操作方法，具体操作应依据具体的仪器型号及使用说明进行操作。
使用过程中需注意仪器的清洁和安全以及患者的舒适感。
如需使用或操作耳鼻喉仪器，请遵循相关的操作指南或在专业人士的指导下进行。
听力筛查仪
听力筛查仪随着人们生活水平的不断提高，人们开始更加重视自己的健康状况。
听力问题是一个常见的健康问题，它不仅会影响一个人的生活质量，还可能加剧一些心理问题，如焦虑和抑郁症。
为了尽早检测和解决听力问题，越来越多的人开始关注听力筛查仪。
听力筛查仪的作用听力筛查仪是一种用于测试人听力的设备，它可以测量人耳朵的灵敏度，以判断一个人是否存在听力问题。
听力筛查仪可以被广泛应用于医疗机构、企事业单位、学校、社区以及家庭等场所，对人们进行听力检查。
听力筛查仪的作用主要有以下几个方面：1.早期检测听力问题：听力筛查仪可以用于早期检测听力问题，如听力衰退、耳聋等。
通过检测人耳朵的灵敏度，可以判断人是否存在听力问题，及早发现并解决听力问题，使患者早日康复。
2.监控听力问题的发展趋势：对于那些已经发现听力问题的人，听力筛查仪可以起到监控听力问题发展趋势的作用。
通过持续性的听力检查，可以对听力问题的治疗效果进行监测，并对治疗方案进行调整。
3.为职业选择提供帮助：对于那些职业需要特定听力条件的人，如售票员、飞行员、语言专家等，听力筛查仪可以帮助他们选择适合自己的职业，避免因听力问题导致职业失误。
听力筛查仪的类型听力筛查仪的类型很多，目前应用最广的包括以下几种：1.耳机式听力筛查仪：是一种利用耳机测量受试者听觉敏感度的设备，非常适合用于医院及诊所等医疗机构。
2.声桶式听力筛查仪：是一种利用声桶测量受试者听觉敏感度的设备，适用于大规模的听力筛查工作。
3.便携式听力筛查仪：是一种体积小巧、便于携带的听力设备，非常适用于家庭使用以及一些偏远地区的听力检查。
听力筛查仪的使用方法使用听力筛查仪主要包括以下几个步骤：1.做好准备工作：一般情况下需要在一个安静的房间内进行听力检查，去除干扰噪音。
2.穿上耳机并调整音量：如采用耳机式听力筛查仪，则需要把耳机戴紧，调节音量到合适的水平。
3.开始测试：按照设备提示进行测试，如点击按钮、按下键盘等。
新生儿听力筛查仪的介绍
新生儿听力筛查仪的介绍听力筛查仪是一种硬件与软件合一的仪器,具有客观性、敏感性和无创伤性等特点,在新生儿听力功能检测中具有其特殊的应用价值,因此已成为新生儿听力筛查的一项常规技术。
新生儿疾病筛查是《母婴保健法》规定的内容，听力筛查是卫生部规定的新生儿筛查项目之一。
新生儿听力筛查是通过耳声发射、自动听性脑干反应和声阻抗等电生理学检测，在新生儿出生后自然睡眠或安静的状态下进行的客观、快速和无创的检查。
听力损失如不能被及时发现，不但影响儿童(言语和认知发育、教育、就业、婚育)及家庭(沟通障碍、心理、经济负担)，而且还会成为社会沉重的负担，影响社会经济发展。
现代科学技术已经可以对新生儿及婴幼儿进行早期听力检测和诊断，如能对明确诊断为永久性听力损失的婴幼儿在出生6个月内进行科学干预和康复训练，绝大多数可以回归主流社会。
新生儿及婴幼儿听力早期检测及干预项目包括听力筛查、诊断、干预、随访、康复训练及效果评估，是一项系统化和社会化的优生工程，需要严格的质量控制。
目前我国使用的听力筛查仪器，主要有耳声发射(OAE)和自动听性脑干反应(AABR)。
筛查的结果都以“通过”或“未通过”表示。
一般而言，OAE和AABR的敏感度及特异度均可以达到95%以上，而OAE略低于AABR。
新生儿听力筛查仪技术1.耳声发射: 耳声发射是通常声波传入内耳的逆过程，即产生于耳蜗的声能经中耳结构再穿过鼓膜，进入耳蜗的外毛细胞，然后由外毛细胞反射出能量，在外耳道记录得到。
耳声发射据其有无外界声刺激分为自发性耳声发射（SOAE）和诱发性耳声发射(EOAE),后者按刺激的类型分为瞬态诱发耳声发射(TEOAE)、畸变产物耳声发射(DPOAE)和频率刺激耳声发射(SFOAE)。
耳声发射与内耳功能密切相关，任何损害耳蜗外毛细胞功能的因素使听力损害超过40dBHL时，都能导致耳声发射明显减弱或消失。
而且，耳声发射是一项无创伤性技术，操作简便，测试两耳仅需要10分钟。
新生儿听力筛查操作指南
新生儿听力筛查操作指南小儿听力筛选这一概念为Down及Sterrit(1964)提出，应用唤醒（arousal）反应对所有新生儿进行听行为筛选。
1972年美国言语听力学会（ASHA）等联合会议推荐对听力高危儿进行筛选，并于1982年认定7项听力高危因素，建议这些高危儿应在生后3-6月进行筛选，对不能通过筛选者进一步作听力测试，并继续追踪观察。
1993年美国NIH召开“婴幼儿听力减退早期确定”会议，一致认为只对听力高危儿筛选可能有50%～60%先天性耳聋被遗漏或误导，因而推荐对全部新生儿进行筛选。
第一节国内外新生儿听力普遍筛查的概述一、先天性听力障碍的发病率及早期发现、干预的意义。
听力障碍是常见的出生缺陷。
国外的研究表明，正常的新生儿中，双侧听力障碍的发病率在0.1%～0.3%，其中，重度至极重度听力障碍的发病率约为0.1%。
国内尚缺乏完整的流行病学资料，但现有研究结果与次相仿。
根据调查,每1000名出生的新生儿中,约有1名～3名听力障碍。
我国现有0岁～7岁聋儿80万人,每年还以3万名的速率递增。
世界各国的情况也大致相仿，为此,1994年美国儿科学会发表声明,倡导新生儿听力筛查,要求至少在出生3个月内对所有新生儿或婴儿进行听力筛查。
1995年世界卫生组织专门成立了防聋机构,发起世界范围内的防聋运动。
听力筛查的意义是对一个特定群体通过简单快捷测定方法，并根据特定指标来区分或发现其中有高度可疑病态的个体或亚群，并需要进一步行确定诊断或追踪观察。
其目的是尽可能早地发现有听力障碍的个体，使其在语言发育的关键年龄段之前就能得到适当的干预, 以使语言发育不受到损害。
那么，听力障碍发现的早与晚，与患儿最终的语言发育状况有什么关联呢? 研究结果发现：①听力障碍在6月龄前被发现者语言理解商(receptivelanguage quotient)和语言表达商（expressive language quotient）明显高于6个月后被发现者,得分差值达20分,有非常显著的统计学意义。
MAICO MA 40 耳部诊断仪操作指南说明书
th MA 40Operating InstructionsTABLE OF CONTENTSWarranty (1)1.0SPECIFICATIONS (2)2.0INTRODUCTION (4)2.1Instrument Description (4)3.0UNPACKING AND INSPECTION (5)3.1External Inspection (5)3.2Unpacking (5)3.3Accessories Supplied (5)4.0FRONT AND REAR PANEL CONTROLS AND DESCRIPTIONS (6)4.1Front Panel Controls (6)4.2Rear Panel Controls (8)5.0INSTALLATION AND SETUP (9)5.1Headset/Insert Phones (9)5.2Bone Conduction Transducer (9)5.3Patient Response Switch- Optional (9)5.4Sound Room Patch Cords - Optional (9)5.5Power Up (9)6.0OPERATION - PURE TONE AUDIOMETRY (11)6.1Air Conduction Testing (11)6.2Bone Conduction Testing (12)6.3Masking (12)7.0MAINTENANCE (13)7.1Preventive Maintenance (13)7.2Cleaning the MA 40 (13)7.3Calibration (14)7.4Shipping Instructions for Calibration and Repair (15)8.0NOAH INSTALLATION INSTRUCTIONS (16)8.1Maico Audiogram Module Installation (16)8.2Activating the Audi-Link Driver (16)WARRANTYThis warranty is extended to the original purchaser of the MA 40 Portable Diagnostic Audiometer by Maico, through the authorized Special Instrument Distributor from whom it was purchased. This warranty covers defects in material and workmanship for a period of one year from date of delivery of the MA 40.Should the Maico MA 40 require service due to a defect in material or workmanship, Maico, at its option, will repair or replace the instrument at no charge except for transportation to and from the point of service. It is the purchaser’s responsibility to return the MA 40 to the Maico Special Instrument Distributor from whom it was purchased or directly to Maico after receiving a return authorization.This warranty does not cover breakage or failure caused by tampering, misuse, carelessness, accident or modification. The warranty is void if the instrument is serviced by other than an authorized Maico Special Instrument Service Center.NOTE:Specifications in this manual are in effect at the time of printing. Maico reserves the right to modify or change specifications or design at any time without notice or incurring obligation.WARNINGThe Maico MA 40 is designed to be used with a hospital grade outlet. Injury to personnel or damage to equipment can result when a three-prong to two-prong adapter is connected between the power plug and an AC outlet or extension cord.1.0 SPECIFICATIONSTest signals:Pure tone, pulsed, warble; narrow band masking noise Frequency accuracy: To within±1% maximum of indicated frequencyFrequency and HL ranges:Frequency Air conduction HL range125 Hz -10 to +80 dB HL250 HZ -10 to +100 dB HL500 Hz -10 to +110 dB HL750 Hz -10 to +110 dB HL1000 Hz -10 to +110 dB HL1500 Hz -10 to +110 dB HL2000 Hz -10 to +110 dB HL3000 Hz -10 to +110 dB HL4000 Hz -10 to +110 dB HL6000 Hz* -10 to +110 dB HL8000 Hz* -10 to +100 dB HL*Maximum level for insert phones is 10 dB HL lower at 6000 Hz and 8000 Hz.Attenuator Linearity: ± .5 dB per 5 dB step, ± 3 dB overallDistortion:.5% typical, 2% maximumSound pressure levelcalibration accuracy: ± 3 dBPulsed stimulus: 2.5 pulses/second, 50% duty cycleRise/Fall time: 35 msec. typicalFreq. mod. rate:±5% triangle wave modulation at 5 Hz modulating rate Dimensions: 12.5” W x 6.25” H x 15.5” D32cm W x 16cm H x 40cm DWeight: 16.5 lb/7.5 kgCase: Structural foamVoltage requirements: 117/234 volts AC, switchableNarrow band noise and bone specifications:Frequency Narrow band HL range Bone conduction HL range 125 Hz -10 to +60 dB HL -----250 Hz -10 to +80 dB HL -10 to +40 dB HL500 Hz -10 to +100 dB HL-10 to +70 dB HL750 Hz -10 to +100 dB HL-10 to +70 dB HL1000 Hz -10 to +100 dB HL-10 to +70 dB HL1500 Hz -10 to +100 dB HL-10 to +70 dB HL2000 Hz -10 to +100 dB HL -10 to +70 dB HL3000 Hz -10 to +100 dB HL -10 to +70 dB HL4000 Hz -10 to +100 dB HL -10 to +70 dB HL6000 Hz -10 to +100 dB HL -10 to +60 dB HL8000 Hz -10 to +80 dB HL -----Roll-off is 12 dB per octave minimum; narrow band calibration is for effective masking. Masking levelattenuation: Variable intensity with a 5 dB step detentOutputs: Air, bone, insert phoneCalibrated to ANSI S3.6 1996.2.0 INTRODUCTION2.1 Instrument DescriptionThe MA 40 is a portable, one and a half-channel audiometer, offering pure toneaudiometric testing.It performs tests using DD-45 headphones, a B-71 bone conduction receiver oroptional insert phones. Built-in test signals include pure tone, pulse tone, warbletone, narrow band noise. Outputs have separate jacks for DD-45s, optional insert phones and bone conduction.The MA 40 offers air conduction frequencies from 125 Hz to 8 kHz, with intensitylevels from -10 dB HL to 110 dB HL. Bone conduction test frequencies are 250 Hz to 6 kHz with intensity levels of -10 dB HL to 70 dB HL.The MA 40 has a built-in RS 232 interface. Calibration is performed via the frontpanel and thus simplifies annual service calibrations.3.0 UNPACKING AND INSPECTION3.1 External InspectionYour MA 40 was carefully inspected and packed for shipping. However, it is goodpractice to thoroughly inspect the outside of the shipping container for signs ofdamage. If any damage is noted, please notify the carrier immediately.3.2 UnpackingRemove the upper layer of packing material from the top of the instrument. Carefully lift the instrument from the shipping carton and remove the plastic bag. Inspect the casefor sign of any damage. Notify the carrier immediately if any signs of mechanical orphysical damage are noted. This will ensure that a proper claim is made. Save all packing material so that the claim adjuster can inspect it as well. When the adjuster hascompleted the inspection, notify the Maico Special Instrument Distributor you purchased this unit from.Save all the original packing material and the shipping carton so the instrument can be properly packaged if it needs to be returned for service or calibration.3.3 Accessories SuppliedStandard accessories are packaged and shipped inside the MA 40 storage compartment.Open the compartment by unsnapping the side latches and folding the cover up andback. Please check that all accessories listed below are received in good condition. If any accessories are missing or damaged, notify your Maico Special Instrument Distributorimmediately.Standard Accessories PartDD-45 headset 4716B71 Bone Vibrator 1034-105Bone Cord 2068Bone headband 1037-37Audiogram pad 1162-417Operator’s Manual1162-0002Optional Accessories:Patch cords 1025-352Audiocup headset 4695Insert phones 4790Patient Response Switch 21694.0 FRONT AND REAR PANEL CONTROLS AND DESCRIPTIONS4.1 Front Panel Controls1. STIMULUS - stimulus present/interrupt switch. Stimulus is present when the LEDabove the switch is lit.1A. Masking ON/OFF2. + Hz - Frequency select increase key.3. - Hz - Frequency select decrease key.4. PHONE / INSERT – Selects DD-45 or optional insert phones5. STIM - Press to enable this option:6. PULSE - PULSE LED on = Pure tone stimulus will be pulsed.7. FM - FM LED on = Pure tone stimulus will warble.8.LEFT / RIGHT SELECT – Selects LEFT or RIGHT for test tone. Masking isautomatically routed to the opposite side.9.BC / AC – Selects either bone conduction or air conduction mode.10.INTENSITY - Displays intensity level of the test tone in the selected ear.11.PATIENT RESPONSE - LED lights when patient response switch is pressed.12.FREQUENCY - Displays the frequency test setting.13.MASKING – Displays the intensity level of the masking signal.14.INTENSITY CONTROL DIAL - Adjusts the intensity for the test tone.15.INTENSITY CONTROL DIAL - Adjusts the intensity for the masking signal.4.2 Rear Panel ControlsFigure 21.AC INPUT - Power input.2.RS 232 PORT - 9-pin RS 232 port.3.PATIENT RESPONSE - Input for the optional patient response switch.4.BC - Bone conduction output jack.5.INS - Right and left jacks for optional insert phones.6.AC - Right and left jacks for air conduction DD-45 earphones.7.ON/OFF - On/Off power switch.5.0 INSTALLATION AND SETUP5.1 Headset/Insert PhonesPlace the MA 40 on a stable counter or table. Flip open the side latches and fold the lid back. Fold the lid back one more time to reveal the accessories that are packaged within the rear storage compartment. If you haven’t already done so, unpack and insp ect the accessories.The DD-45 headphones are serialized and should match the serial number on theinstrument. Check to see that the numbers match, as this will confirm that theheadphones and MA 40 were calibrated together. The optional insert phones do not havea serial number, but if they were ordered at the same time as the MA 40, they werecalibrated to that particular instrument and should not be used on another withoutcalibration.Turn the MA 40 around so that you can view the rear jacks. Insert the RED (right) plug of the DD-45 headset into the right air conduction earphone jack labeled R, under AC (A irC onduction). Insert the BLUE (left) plug into the left AC earphone jack labeled L.The insert phones are installed in the same manner. Insert the RED (right) plug of theinsert phone cord into the insert phone jack labeled R, under INS (INS ert phones). The BLUE (left) plug is inserted into the jack labeled L.5.2 Bone Conduction TransducerInsert the bone conduction plug into the port labeled BC (B one C onduction).5.3 Patient Response Switch - OptionalLocate the PATIENT RESPONSE jack on the rear panel and insert the plug end of theoptional switch.5.4 Sound Room Patch Cords - OptionalWhen using the MA 40 in a sound room, connect the patch cords from the sound room to the proper right and left earphone/insert phone jacks, patient response jack, and bone conduction jack.5.5 Power UpInsert the power plug into the rear socket, then into a three-conductor electrical outlet (or the appropriate outlet for your country).WARNINGThis Maico instrument has been designed to meet the most exacting electrical safety requirements for patient care equipment.The hospital grade, 117 volt alternating current, three-prong plug should be inserted into a mating three-prong hospital grade receptacle that is properly grounded. This will ensure reliable and safe operation of this precision instrument. The use of a three-prong to two-prong adapter should be avoided. If you have any questions, check with your Maico Special Instrument Distributor.NOTICEThis Maico product is equipped with a universal power interlock to change thepower/mains input voltage from 115 VAC to 230 VAC.To change the power/mains voltage input:1.2.cover and remove the voltage selector3. Replace fuses with enclosed .25 amp.4. Replace voltage selector switch with 230V label displayed inwindow.5. Apply .25A label to the back panel.Figure 3 Place the power switch to the “ON” position (Figure 2). To ensure accuracy, let the instrum ent warm up 5-10 minutes before running tests.6.0 OPERATION - PURE TONE AUDIOMETRY6.1 Air Conduction TestingAir conduction testing is used to measure the patient’s hearing threshold levels. The test is usually started on the ear with better hearing.1. Turn the MA 40 on and let it warm up for 10 minutes before using. Upon power upthe initial setting will be in audiometric testing mode, left ear on air conduction, 1kHz, 30 dB intensity, right ear on noise, 0 dB.2. Seat the patient so that he/she is facing away from the instrument at a 90° angleand cannot see what the operator is doing. Give a brief description of what thepatient can expect to hear. Using a consistent explanation will help provide morereliable results. Instructions may be expre ssed as follows: “I am going to place theseheadphones on your ears. You will hear a tone or beeping sound, which may beloud or soft. Whenever you hear, or think you hear one of these tones, raise yourhand. Lower it when you no longer hear the tone. Listen carefully because sometones are very soft.”3. Eliminate any obstructions that could interfere with placement of the earphonecushion on the ear (i.e. hair, earring, eyeglasses, hearing aids, etc.). Adjust theheadband so that the earphone cushions are centered over the ears (RED on theright ear, BLUE on the left) and the receivers line up with the ear canals. Theheadband should rest firmly over the center of the head and place firm pressure onboth ears.4. Set the OUTPUT SELECT to AC. Choose PULSE and/or FM if you wish. Set theINTENSITY and FREQUENCY to the desired level.5. Press STIMULUS to present the test tone. The STIM LED should light. If the patienthears the tone he/she will raise their hand or press the patient response switch,indicated by the patient response LED.The most commonly used hearing threshold procedure is called a modified Hughson-Westlake procedure.1. Start at 1000 Hz with a level of 0 dB and present a signal for at least 1 second. If noresponse, increase in 10 dB steps until the patient responds.2. Increase another 10 dB for a confirmation and orientation. If the patient respondsagain, decrease the presentations in 10dB steps until the patient no longer responds.3. Increase in 5 dB steps until the patient responds. Once the patient responds,descend 10 dB until there is no response. Increase again in 5 dB steps.4. Repeat until you have 2 out of 3 ascending responses at the same level. Change thefrequency and repeat above procedure until you have thresholds for the number offrequencies that you wish to test.The hearing threshold is defined as the lowest hearing level at which the patientresponds to two out of three ascending stimuli at the same level.6.2 Bone Conduction TestingBone conduction is the transmission of sound waves through the skull directly to the inner ear. This test conveys useful information about the function of the inner ear and whether there is neural hearing loss. Threshold differences between air conduction and bone conduction are a good indicator of middle ear disease or external ear canal obstruction.1. Place the bone conduction receiver so that the flat, circular side of the transducer isseated on the mastoid, right on the ledge of the cranial bone behind the auricle. The other side of the headband is placed in front of the opposite ear.2. Set the OUTPUT SELECT to BC (bone conduction). Perform the test in the samemanner as for air conduction testing (see section 6.1). Record all measurements and results.6.3 MaskingTo ensure that the patient does not experience crossover (sound transmitted through bone conduction over to the opposite ear) you must mask the opposite ear. Masking is performed with a noise signal in the headphone. A narrowband noise is used in pure tone audiometry. The noise automatically changes its center frequency following the frequency of the test signal.1. The masking noise is continuously presented for effective masking. You mayinterrupt the masking signal by pressing the STIMULUS key.2. To mask while performing bone conduction tests, place the headphone on the non-test ear so that the receiver is directly in line with the ear canal. Adjusting theheadband, place the other headphone so that it sits directly on the cheekbone.3. Adjust the masking intensity level whenever you change the test signal level.7.0MAINTENANCE7.1Preventive MaintenanceTo maximize the service life of your audiometer and accessory equipment, we suggestthe following:1. Turn off the instrument overnight.2. Wipe the headset cords, ear cushions and casing occasionally with a cloth dampened(not dripping wet) with warm water. Dry with a soft cloth.3. Leave the accessories such as the headset, bone vibrator and monitor phonepermanently connected to the audiometer to minimize strain on the connections. Itis not necessary to disconnect accessories not in use while performing other tests.Should it be necessary to disconnect cords, always grasp the barrel of the plug —never pull the cords. Never drop or snap the headphones together. Mechanicalshock may change the earphone’s electrical and operational characteristics andrequire calibration of the MA 40.4. Close the audiometer cover at the end of each day to minimize dust collection.5. Avoid sharply bending or twisting any of the cords. Although they are designed tobe highly flexible, rough treatment may cause damage. Broken or defective cordscan cause crackling noise and intermittent or weak operation in the headset,microphone and bone vibrator. Headset, bone vibrator and microphone cords maybe replaced without calibrating the audiometer.7.2Cleaning the MA 40First, disconnect the power cord before cleaning. Clean the instrument, headphones,bone conduction receiver, loudspeakers and other accessories with a soft clothdampened with a little warm, soapy water. Do not use alcohol to clean.The ear cushions of the headphones can be detached for cleaning. To remove, gentlypull the cushion away from the headphone. To re-assemble, press it back onto theheadphone. Make sure that the sound outlet hole sits exactly in the middle of theearphone.7.3 CalibrationThe optimum length of time between re-calibrations for audiometers varies, depending upon the treatment given the instrument and the headphones. It is recommended that the instrument have a laboratory calibration at least once every year. Since rough handling, such as dropping the headphones, can easily cause calibration errors it is advisable to establish a biological calibration check as soon as you receive the instrument.Should you feel at a later date that the audiometer’s calibration might be in error, perform a biological check on a known ear. If all re-tests show major changes calibration is probably in error.All repair and calibration should be done at an authorized Maico Special Instruments Distributor service center. This assures the use of quality materials by trained and experienced technicians using the proper, accurate equipment.Maico Special Instruments Distributors are located in major cities throughout the world. To minimize costs and time delays, contact the Distributor that you purchased the instrument from. If you don’t know who that is, or need to find the Distributor closestto you, contact the factory at:Maico Diagnostics7625 Golden Triangle DriveEden Prairie, MN 55344Toll free 888-941-4201Phone 952-941-4200Fax 952-903-4200Customers outside of North America and South America may contact:Maico Diagnostic GmbHSalzufer 13/1410587 Berlin, Germanyphone ++030 70 71 46 50fax ++030 70 71 46 997.4 Shipping Instructions for Calibration and RepairIn the event it becomes necessary to return the instrument for calibration or repair, please follow these instructions:1. Place the instrument in the original shipping carton, using the packaging provided.Be sure to include all accessories, as they are required for proper calibration.2. Enclose an explanatory letter describing the service you require, carefully detailingany operational problems. Be sure to include your name, phone number, the serial number and your full return address for return shipping.3. Ship, prepaid, to your Maico Special Instrument service center.NOTE: Warranty service is provided by your authorized Maico Special Instruments Distributor.DO NOT ATTEMPT TO REMOVE THE INSTRUMENT CASE YOURSELF. THIS SHOULD BE DONE ONLY BY AN AUTHORIZED MAICO SERVICETECHNICIAN.8.0 NOAH INSTALLATION INSTRUCTIONSThis section assumes that you have previously installed your own NOAH3 software program. The following instructions will help you use your Maico equipment with your PC after it has been inter-connected with a standard 9 pin RS232 cable.8.1 Maico Audiogram Module Installation1.Make sure NOAH is not running.2.Insert the Audiogram Module CD.3.Run the setup.exe program on the CD.4.Follow the installation instructions on the screen.8.2 Activating the Audi-Link Driver1.Start NOAH.2.Select a client.3.Click on “Open Module Selection.”4.Select “Measurement.”5.Choose the “Maico Aud 3.0” option.6.Select “Online Mode” to start communications with the audiometer.Specifications are subject to change.MAICO Diagnostics10393 West 70th StEden Prairie, MN 55344Tel.: 888.941.4201Fax:952.278.4481E-mail:**************************Internet: 。
TS产品说明
CN-I-TS型系列听力检查仪产品说明CN-I-TS听力检查仪是采用瞬态诱发耳声发射TEOAE方法对不同年龄段的新生儿、婴幼儿、幼儿、学龄前儿童、儿童和成年人进行听力筛查。
我们生产的CN-I-TS听力检查仪是采用最先进的德国技术，具有毋庸置疑的技术优势，是目前性价比最优的听力筛查产品。
自动给出测试结果：通过或转诊，符合国际和国家听力筛查规范的要求。
目前卫生部承认的新生儿听力筛查的方法分为两大类：耳声发射（OAE）和自动听性脑干反应（AABR）；其中耳声发射OAE又可以分为瞬态诱发耳声发射TEOAE和畸变产物耳声发射DPOAE；所以目前临床上共有三种方法可供选择。
TEOAE和DPOAE筛查方法都是利用耳声发射（OAE）这种人体的生理现象作为其理论基础的。
耳声发射（OAE）是一种声能量，它产生于耳蜗，并经过听骨链和鼓膜传导到外耳道。
这种声信号虽然很弱，但是可以被检测到的。
它是由于耳蜗内的震动，通过中耳听骨链，引起鼓膜运动而产生的声波。
当然，只有在中耳功能正常的前提下才能检测到此声信号。
只有在柯蒂氏器的功能正常和接近正常的情况下，才会有耳声发射的现象。
耳声发射按其发生机制，分为两大类：其一是自发性耳声发射(SOAE)，其二是诱发性耳声发射(EOAE)；后者主要包括：瞬态声诱发耳声发射(TEOAE)、畸变产物耳声发射(DPOAE)、刺激频率耳声发射(SFOAE)、电诱发耳声发射(EEOAE)。
目前，在临床听力学中，较为成熟的耳声发射测试方法是(TEOAE)和(DPOAE)测试技术。
耳声发射是耳蜗毛细胞运动的产物，即外毛细胞对基底膜的调制作用，使得微弱的声信号得到了放大。
其临床意义在于，它为我们提供了一条检测耳蜗放大功能和外毛细胞功能完整性的途经。
一般TEOAE适用于对新生儿、婴幼儿等听觉损失概率较小的人群进行初级筛查，而且一般来讲测试速度很快，只要几秒钟就可以完成了。
它测试的是全部耳蜗（外毛细胞）的功能状态，若筛查“通过”，表示外周听力在刺激频率范围内正常。
新生儿听力测试正确体位
新生儿听力筛查仪测试体位
美国纽约西奈山伊坎医学院的李秀敏教授称：许多新生儿在进行听力筛查检测时会因为测试提味不正确导致最终结果不准确。
当新生儿使用听力筛查仪进行筛查时，为了保证听力筛查仪的测试准确，建议使用如下体位：
测试体位一:婴儿平躺或侧躺，仪器放在床上进行测试。
测试体位二:婴儿躺在床上或抱在母亲的怀中，操作者一手拿仪器，一手进行操作，请注意，探头电缆不要和衣物或被褥产生摩擦。
（在测试过程中一定要避免探头电缆和衣物产生摩擦！）
如何避免探头电缆和衣物产生摩擦呢？小窍门：可以用夹子把电缆夹在测试对象的衣服上，或者，直接用手把电缆按在（或捏在）被褥（或衣服）上。
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听力筛查仪的使用说明
听力筛查仪是一种硬件与软件合一的仪器, 具有客观性、敏感性和无创伤性等特点, 在新生儿听力功能检测中具有其特殊的应用价值, 因此已成为新生儿听力筛查的一项常规技术。
但测试结果容易受环境噪音、新生儿外耳道、中耳的特殊生理特点以及测试时状态的影响, 尤其是在出生24 h后,新生儿外耳道胎脂、分泌物和中耳羊水等胎性残留物会对传入的刺激声和传出的反应信号造成衰减, 从而影响测试的通过率。
另外耳塞放置与外耳道轴线不一致或环境条件不理想、仪器不稳定都可导致新生儿听力筛查假阳性结果。
假阳性可带来一系列问题, 如增加产妇及家属的心理负担, 使父母怀疑自己的孩子可能有听力问题, 给家庭带来不安、焦虑和担心, 尽管护理人员进行解释说明, 但有时仍然不能打消产妇的疑虑, 担心婴儿一定有问题。
这实际上对产妇的康复很不利, 甚至潜在诱发产后出血等并发症, 过多的假阳性还可增加医护人员工作量, 增加产妇及家属的就诊次数和费用等。
采用西奈SN系列听力筛查仪对223例新生儿做实验，实验结果证明：随着新生儿天龄的增加, 畸变产物耳声发射的初筛通过率呈上升趋势。
实验结果中24 h及48 h听力筛查通过率较低, 仅为52.16% 及75.87%, 可能与新生儿外耳道胎脂堵塞、中耳羊水未吸收有关；72 h 通过率较高为92.95%, 因此出生后72 h为新生儿听力筛查的最佳时间，此时采用新生儿听力筛查仪筛查最佳。
采用拉耳廓方法与常规听力筛查方法比较, 拉耳廓方法听力筛查通过率高, 具有显著性差异( P <0.01) , 由于新生儿外耳道为软骨结构, 受到挤压由外而内向前上方弯曲, 所以放置探头时, 应向后下方牵拉耳廓, 使耳道变直, 这是提高新生儿听力筛查率的重要环节。
因此，在使用听力筛查仪时采用拉耳廓方法最佳。
对于未通过初筛的新生儿, 应在出院前复查1次,仍未通过者在出院后42天需再次复查, 以确诊有无听力障碍, 便于早期干预性治疗。
了解新生儿听力筛查仪使用的最佳时间和方法才能更好的服务于新生儿，保证宝宝的健康，减少妈妈们的担心。