SOUNDWAVE 2.0. Quick Reference Cards. Contents. Programming: Initial Fitting. Programming: Clinical Programming Tools. NRI: Steps and Procedures

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Quick Reference Cards Contents 1 2 3 4 Programming: Initial Fitting Programming: Clinical Programming Tools NRI: Steps and Procedures NRI Troubleshooting 5 Performing

1 Quick Reference Cards Contents Programming: Initial Fitting Programming: Clinical Programming Tools NRI: Steps and Procedures NRI Troubleshooting 5 Performing NRI in the OR 6 Programming: Harmony Upgrade for C1 7 Program Window Keyboard Shortcuts AUG10_ F 2010 Advanced Bionics, LLC and its affiliates. All rights reserved.

2 1 Programming: Initial Fitting Programming Quick Reference Cards

Stimulation Task Group Ribbon Bar Preview Pane Management Grid Program

3 Initial Fitting Task Groups Select Input to Adjust Gains Shaping Tools Global Tool Patient Management Window Action Pane Program Window Ms Ts Stimulation Task Group Ribbon Bar Preview Pane Management Grid Program Parameter Groups Programming Quick Reference Cards Auto T Initial Fitting

4 Initial Fitting Guidelines Get Started Launch SoundWave 2.0. Connect the patient s sound processor and place the headpiece on the patient s head. Check the Fitting Hardware Task Group in the Ribbon Bar and make sure your CPI is recognized. Step 1: Select Patient From the Patient Management Window, select New, enter the required information, and select OK. The New Implant Window will open. Enter the required information and select OK. Step 2: Condition Electrodes Click on the down arrow below the implant icon in the Fitting Hardware Task Group on the Ribbon Bar. Select Run Conditioning. Note: Conditioning can be performed also from the Action Pane and Impedances Tab. Review impedance values. Step 3: Create Programs Go to the Programs Tab and select New Right or New Left in the Action Pane. Select a Strategy (Hi-Res P is the default). Set M Levels using Speech Burst, Live Speech, or Tone Burst stimulation to find the most comfortable loudness level (Speech Burst is the default). Adjust other programming parameters as needed. Select Save and Close from the Program Task Group in the Ribbon Bar. Create additional programs as desired. Step 4: Initialize Processor Click on the down arrow below the sound processor icon in the Fitting Hardware Task Group on the Ribbon Bar. Select Initialize Processor. Select Yes to initiate this action. SoundWave 2.0 does not require the sound processor to be initialized prior to patient fitting. If necessary, you will be prompted to initialize prior to downloading programs to a sound processor. Note: Initialization can also be performed from the Processor Pane in the Programs Tab. Step 5: Download Programs Click and drag or type the program number into the program slot in the Processor Pane. Make changes to LEDs and/or alarms when applicable. Click Download in the Processor Pane. Wrap-Up: Reports The following reports are available: Program, Visit History, Impedance, and NRI. To print any of these reports, go to the appropriate tab. o For example, to print a program report, go to the Programs Tab. Select the items in the Management Grid that you want to be included in the report. o For example, select programs 1, 2, and 3 in the Management Grid. Click on Report in the Action Pane. Click Print to print the report or click Save to save the report as a PDF. Programming Quick Reference Cards Should you have questions or need programming support, please contact the Advanced Bionics Audiologist-On-Call at (within the US) or contact your local AB representative. Initial Fitting

5 2 Programming: Clinical Programming Tools Programming Quick Reference Cards

Clinical Programming Tools You may Sweep & Balance from a unilateral or bilateral program window when in Tone Burst or Speech Burst stimulation modes.

Balance: Delivers alternating stimulation between two selected electrodes or speech bursts. Note: It is not required that you select adjacent channels to Sweep or Balance.

6 Clinical Programming Tools You may Sweep & Balance from a unilateral or bilateral program window when in Tone Burst or Speech Burst stimulation modes. Sweep Balance Sweep: Delivers alternating stimulation between three or more selected individual electrodes or speech bursts. Balance: Delivers alternating stimulation between two selected electrodes or speech bursts. Note: It is not required that you select adjacent channels to Sweep or Balance. To begin, open a new or saved program window, then follow these steps: Step 1: Select Speech Burst or Tone Burst in the Stimulation Task Group on the Ribbon. Step 2: Select target channels. Step 3: Click on the drop-down menu associated with the Start button in the Stimulation Task Group to further refine the operation of the Sweep & Balance functions. Set Stimulation Level based on % M Level Set number of Presentations per electrode or speech burst band Step 4: Select Start Sweep will sequentially stimulate across the selected electrodes in an apical to basal direction. Programming Quick Reference Cards Sweep & Balance Note: Increase the number of presentations during sweep to allow more time to observe the patient response on each channel. Clinical Programming Tools F Programming Quick Card Clinical Programming Tools.doc 2 8/16/10 5:30 PM

Balance will alternate stimulation between two selected electrodes or two electrode groups in an apical to basal direction. Note: The first group or most apical electrode retains the focus.

Sweep & Balance can be conducted in the unilateral or bilateral programming window. The following is important to note: Bilateral Click Start and Stimulation begins in the ear with focus.

7 Balance will alternate stimulation between two selected electrodes or two electrode groups in an apical to basal direction. Note: The first group or most apical electrode retains the focus. The M level(s) of a focused group can be increased or decreased utilizing the up or down arrow keys on your keyboard during active stimulation. Sweep & Balance can be conducted in the unilateral or bilateral programming window. The following is important to note: Bilateral Click Start and Stimulation begins in the ear with focus. Once Stimulation begins, click Start again to initiate bilateral stimulation. Alternatively, choose the Stimulation option desired from the drop-down menu. Interpolate Interpolation allows measured M values to be applied on channels with unmeasured M values. Interpolation can be applied on a single channel or on multiple channels at one time. As a clinical programming tool, Interpolation can save time and provide the basis for an optimal program. Interpolation can be performed in a unilateral or bilateral program window. Examples of when to Interpolate are: applying tnri values to a new program (see NRI Quick Reference Card), creating a new program from the Programs Tab, and shaping a program. Create a New Program To interpolate M Levels, begin in a new program window with Live Speech or Tone Burst Stimulation. Step 1: Right-click within the program window. A menu displays. Select Interpolate and then Enable All. Select Yes in response to the pop-up asking if you would like to only Interpolate zero value channels. Step 2: Click on a channel to measure. This channel will become an anchor as soon as the M Level increases. The M Level markers update to reflect which channels are interpolated and which is an anchor. The interpolated markers will follow changes made to the anchor. Interpolated Anchor Programming Quick Reference Cards Clinical Programming Tools

Step 1: Measure M Levels for select channels or Speech Burst Bands. Step 2: From Tone Burst or Live Speech stimulation, double-click on M Level markers to be interpolated.

8 Create additional anchors by double-clicking on a channel s M marker; however, Interpolation can be done with a single anchor. Shape a Program Interpolation on a channel can be turned on/off simply by double-clicking on the M Level marker for that channel. Step 1: Measure M Levels for select channels or Speech Burst Bands. Step 2: From Tone Burst or Live Speech stimulation, double-click on M Level markers to be interpolated. For example: Double-click to enable Interpolation Interpolated value Reference Extended Low Standard Frequency Allocation Programming Quick Reference Cards Note: Center frequency information is available on the Input Tab of the Program Window and full frequency information is available in the Program Report. Clinical Programming Tools

9 3 NRI: Steps and Procedures NRI Quick Reference Cards

excluded from the EP Growth Function Represents N1 Represents P2 Indicates data point is selected NRI Measurements Tab Action Pane

10 NRI Steps and Procedures NRI Measurement Window Parameter Settings To enlarge individual tracings, double-click on the tracing or select a tracing, and click on the three small triangles Key Indicates data point is included from the EP Growth Function Indicates data point is excluded from the EP Growth Function Represents N1 Represents P2 Indicates data point is selected NRI Measurements Tab Action Pane Indicates Data Point is selected for N1/P2 Adjustment Management Grid NRI Quick Reference Cards Preview Pane NRI Steps and Procedures Introduction

11 Step 1: Set NRI Measurement Settings NRI Steps and Procedures Stimulating Electrode Select a stimulating electrode. Note: If only conducting NRI measurements on a subset of electrodes, select a few electrodes that are distributed across the electrode array, such as: 3, 7, 11, and 15. Recording Electrode Set the electrode that SoundWave 2.0 will use to measure the response during NRI measurement. o The default setting is 2 apical unless the stimulating electrode is at the apical end of the array. Note: Do not use extracochlear contacts or electrodes with shorts, opens, or exceeding compliance limits when conducting NRI measurements. Stimulation Range Set the starting and ending stimulation levels in Clinical Units (CU), as desired. o The default setting is from CU. Note: Stimulation Range may be set as ascending or descending. Data Points Set the number of points to achieve an increment step size of CU. o The default setting is 5 data points. Stimulation Sequence Set the polarity of the pulse used during NRI stimulation o The default is Cathodic First. Averages per Data Point Set the number of stimulus presentations that will be delivered and averaged at each stimulation level. o The default is 128 averages. NRI Quick Reference Cards Recording Gain Set the gain applied by the recording amplifier. o The default is 300. Note: Recording Gain may need to be increased if you are obtaining noisy responses. NRI Steps and Procedures

Step 2: Run and Save NRI Measurement Select Start from the Recording Task Group in the Ribbon Bar. NRI will run on each Data Point until completion of the NRI measurement.

Select Save from the NRI Measurement Task Group in the Ribbon Bar. Step 3: Using Interpolation to Create Programs Based on NRI After completing NRI, go to the Programs Tab.

12 Step 2: Run and Save NRI Measurement Select Start from the Recording Task Group in the Ribbon Bar. NRI will run on each Data Point until completion of the NRI measurement. Note: Use Next, found in the Data Point Task Group on the Ribbon Bar, to move on to the next Data Point if a response is obtained before 128 averages are completed. Select Save from the NRI Measurement Task Group in the Ribbon Bar. Step 3: Using Interpolation to Create Programs Based on NRI After completing NRI, go to the Programs Tab. Select New Right or New Left from the Action Pane to open a New Program. If tnri values are not displayed in the Fitting Window, perform the following steps to display them. o o Right-click on any electrode. Select tnri Show All. Select Live Speech or Tone Burst from the Stimulation Task Group in the Ribbon Bar. NRI Quick Reference Cards Right-click on any electrode and select Interpolation Enable All. Select Yes when a pop-up window is displayed asking if you would like to only Interpolate zero value channels. Set M Levels for electrodes with tnri measurements. Note: By default, tnri values will not display in a program window; however, you can change this in Preferences. NRI Steps and Procedures

13 Electrodes with set M values now have filled M markers and become anchors for Interpolation. o M Levels for the non-anchor electrodes will be automatically set based on the M Levels for anchor electrodes. Lower the volume control on the sound processor or reduce M Levels globally and turn on stimulation. Gradually increase volume control or M Levels to user settings. Note: You may initially set M Levels at the more conservative 10 20% level below tnri and then use the volume control to increase loudness or raise Ms while monitoring performance. Verify settings (using Ling Sounds, for example). Select Save from the Program Task Group in the Ribbon Bar. Step 4: Create Additional Programs Based on NRI You can use the following recommendations for creating programs based on the data collected using NRI. If tnri is <200 CU: Program 1: M Levels set to tnri Program 2: M Levels set to 20% above tnri Program 3: M Levels set to 40% above tnri If tnri is between CU: Program 1: M Levels set to tnri Program 2: M Levels set to 10% above tnri Program 3: M Levels set to 15% above tnri If you cannot measure tnri, set M to behavioral levels obtained. If there are no reliable behavioral measures, contact AB for assistance. NRI Quick Reference Cards NRI Steps and Procedures

14 4 NRI Troubleshooting NRI Quick Reference Cards

15 NRI Troubleshooting If NO NRI response is obtained, try the following: 1. Connect a Platinum Series Processor, if you are not already using one, and repeat the measure. 2. Change the Recording Electrode. Start with the closest neighboring electrode (+1 apical, then basal). 3. Increase the number of averages. 4. Increase the maximum stimulation level. 5. Change Stimulating Electrode and perform the NRI measurement on a different electrode. For a clinical programming session, these additional troubleshooting steps may apply: 6. Increase by 25 CU steps (set this new level in both Stimulation Range boxes and set to collect 1 Data Point). 7. Continue to increase in increments of 25 CU as needed. Do not exceed 600 CU (based on average compliance limits) or exceed compliance limits for stimulation of the selected electrode. Exceeding compliance limits is indicated by a warning message that appears to the right of the Stimulation Range. Note: Be cautious. Watch for any behavioral response suggesting stimulation is uncomfortable or loud. Should you have questions or need programming support, please contact the Advanced Bionics Audiologist-On-Call at (within the US) or contact your local AB representative. NRI Quick Reference Cards NRI Troubleshooting

16 5 Performing NRI in the OR NRI Quick Reference Cards

Then, connect the sound processor to the CPI via the programming cable. Step 1: Open SoundWave 2.

17 Performing NRI in the OR Getting Started Set up your fitting equipment as shown in the photo below. Be sure to connect the Clinical Programming Interface (CPI) to the power supply and to the computer. Then, connect the sound processor to the CPI via the programming cable. Step 1: Open SoundWave 2.0 and Select New in the Patients Action Pane. Step 2: Input Patient Information and Implant Information and select OK. NRI Quick Reference Cards Performing NRI in the OR

Step 3: Place the headpiece on the recipient s head.

Note: It is recommended that you do not run NRI on electrodes that are open (yellow) or shorted

Step 5: Go to the NRI Measurements Tab and select New Left or New Right from the Action Pane.

18 Step 3: Place the headpiece on the recipient s head. Then, check the Fitting Hardware Task Group in the Ribbon Bar to ensure that the CPI, Processor, and Implant are recognized as shown below. Step 4: Run Conditioning and review impedance values for each electrode. Note: It is recommended that you do not run NRI on electrodes that are open (yellow) or shorted (purple). Step 5: Go to the NRI Measurements Tab and select New Left or New Right from the Action Pane. Step 6: Under Settings, select the Stimulating Electrode from the drop-down menu. Set the Stimulation Range from 400 CU 50 CU. Use the default values for the remaining parameters. Note: If the error message below appears next to the Stimulation Range, reduce your upper stimulation level. NRI Quick Reference Cards Performing NRI in the OR

Step 7: Select Start in the Recording Task Group in the Ribbon Bar. As the measurement is running, look for an NRI response (shown below).

keyboard. The presence of an NRI response confirms that the auditory nerve responded to stimulation from the selected stimulating electrode.

Run NRI on additional electrodes as desired. Step 10: Select Save and Close when NRI measurements are complete.

19 Step 7: Select Start in the Recording Task Group in the Ribbon Bar. As the measurement is running, look for an NRI response (shown below). Step 8: After a response is visible, stop stimulation by selecting Pause in the Recording Task Group in the Ribbon Bar or by pressing the Space Bar on the keyboard. The presence of an NRI response confirms that the auditory nerve responded to stimulation from the selected stimulating electrode. Step 9: Select Save or Save and Copy (if you would like to make additional NRI measurements) in the NRI Measurement Task Group in the Ribbon Bar. Run NRI on additional electrodes as desired. Step 10: Select Save and Close when NRI measurements are complete. Should you have questions or need programming support, please contact the Advanced Bionics Audiologist-On-Call at (within the US) or contact your local AB representative. NRI Quick Reference Cards Performing NRI in the OR

20 6 Programming: Harmony Upgrade for C1 Programming Quick Reference Cards

Getting Started Print Program(s) from SCLIN Step 1: Open SoundWave 2.0.

Step 3: Run Impedances and Review Values. Important! Choose the correct electrode array.

* Run impedances from the Fitting Hardware Task Group in the Ribbon Bar or the Impedance Tab.

21 Getting Started Print Program(s) from SCLIN Step 1: Open SoundWave 2.0. Harmony Upgrade for C1 Step 2: Select New and Enter Patient Information. Input required patient and implant information. Step 3: Run Impedances and Review Values. Important! Choose the correct electrode array. Electrode information is found in the upper right-hand corner of the SCLIN report. * Run impedances from the Fitting Hardware Task Group in the Ribbon Bar or the Impedance Tab. By default, impedances will automatically run when a patient record is opened and the fitting hardware is locked to the implant. Note: Normal impedance values for a C1 device are between KΩs. Step 4: Initialize the Harmony Sound Processor. *Initialize the sound processor from the Fitting Hardware Task Group or the Processor Pane. Programming Quick Reference Cards Harmony Upgrade for C1

Step 5: Create a Program. Open a New Right or a New Left Program from the Action Pane in the Programs Tab. Enter the program settings from the SCLIN report.

22 Step 5: Create a Program. Open a New Right or a New Left Program from the Action Pane in the Programs Tab. Enter the program settings from the SCLIN report. o Select strategy and settings in the Action Pane. o Enter Adjusted M and T Levels from the SCLIN report. Note: When creating a program for a patient with an S-Series sound processor, select the S-Series Filter setting and the S-Series AGC. Step 6: Verify Comfort in Live Speech. Select Live Speech Stimulation. Turn down the volume control on the sound processor or reduce M Levels globally and turn on stimulation. Gradually increase the volume control or M Levels to user settings. Make additional programming changes as desired. Step 7: Set RF Level. Set RF Level. o Start Live Speech stimulation. o Decrease the RF value until lock is lost (Live Speech Stimulation stops). o Increase RF by two or three steps and restart stimulation. o Live Speech Stimulation should restart. Note: This level is expected to provide stable lock for the user; however, verify that stable lock is maintained when disconnected from the fitting hardware before the patient leaves the clinic. Programming Quick Reference Cards Harmony Upgrade for C1

Step 8: Save and Close the Program. Step 9: Create Additional Programs as Desired.

A program for T-Mic use and a mixing ratio of Aux Only. Step 10: Download Programs to Harmony.

23 Step 8: Save and Close the Program. Step 9: Create Additional Programs as Desired. Consider: A program with telecoil active and a mixing ratio of 50/50. A program for T-Mic use and a mixing ratio of Aux Only. Step 10: Download Programs to Harmony. Note: The diagnostic LED is turned on/off by clicking on the icon in the Processor Pane prior to download. Should you have questions or need programming support, please contact the Advanced Bionics Audiologist-On-Call at (within the US) or contact your local AB representative. Programming Quick Reference Cards Harmony Upgrade for C1

24 7 Program Window Keyboard Shortcuts Programming Quick Reference Cards

Program Window Keyboard Shortcuts FUNCTION KEY Adjust All Markers Down Page Down Adjust All Markers Up Page Up Adjust Markers Down (M,T, Clipping, Gains) Down Arrow Adjust Markers Up (M, T, Clipping,

25 Program Window Keyboard Shortcuts FUNCTION KEY Adjust All Markers Down Page Down Adjust All Markers Up Page Up Adjust Markers Down (M,T, Clipping, Gains) Down Arrow Adjust Markers Up (M, T, Clipping, Gains) Up Arrow Bilateral Window: Focus Left Side L or Ctrl + Left Arrow Bilateral Window: Focus Right Side R or Ctrl + Right Arrow Data Entry 0 9 Move Entire Channel Selection to the Left Alt+Left Arrow Move Entire Channel Selection to the Right Alt +Right Arrow Move Selection Left Left Arrow Move Selection Right Right Arrow Select All Markers Ctrl +A Select Clipping Marker C Select Gain Marker G Select M Marker M Select Multiple Channels to the Left Shift+Left Arrow Select Multiple Channels to the Right Shift+Right Arrow Select T Marker T Toggle Input/Output Tab I / O Toggle Stimulation On/Off S Program Window Keyboard Shortcuts

SoundWave 2.3 Fitting Manual

SoundWave 2.3 Fitting Manual The Advanced Bionics and HiResolution logo and text are registered trademarks of Advanced Bionics. Other product names or services identified are trademarks of Advanced Bionics. All other organizations,