Electro-Acoustic Stimulation (EAS) Naída CI Q90 EAS System. Naída CI Q90 EAS System Components. Naída CI Q90 Acoustic Earhook

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1 Electro-Acoustic Stimulation (EAS) EAS is a general term that refers to the simultaneous delivery of electric stimulation (cochlear implant) and acoustic amplification (hearing aid) to the same ear. Naída CI Q90 EAS System The Advanced Bionics Naída CI Q90 EAS system is designed to provide amplification of the low frequencies up to 1600 Hz in combination with electrical stimulation delivered along the full range of the implanted electrode. The Naída CI Q90 sound processor integrates both the acoustic and electric sound processing within one device. Fitting of the acoustic and electric parameters of the system is completed within the SoundWave software program in one simplified workflow. Naída CI Q90 EAS System Components The Naída CI Q90 EAS system includes the following components: Naída CI Q90 sound processor Universal Headpiece (UHP) Power Source (PowerCel battery) Naída CI Q90 Acoustic Earhook Earpiece (SlimTip or Dome) Acoustic Earhook Sound Processor Power Source (PowerCel) Dome Universal Headpiece (UHP) Naída CI Q90 Acoustic Earhook The Naída CI Q90 Acoustic Earhook is required for the delivery of acoustic amplification to the implanted ear. It is connected to the Naída CI Q90 sound processor and consists of the following parts: xreceiver Unit the speaker is inserted into the ear canal to deliver an amplified acoustic signal. The Naída CI Q90 Acoustic Earhook uses a Phonak xp receiver adapted to attach to the Naída CI Q90 sound processor. Sound Outlet where the amplified acoustic signal exits the receiver. It is important to keep the Sound Outlet clean and clear of wax and debris. Retention Hook may be used to securely maintain the receiver within the ear canal. Retention hook guide dash xreceiver unit Sound outlet Retention hook Retention Hook Guide Dash illustrates where and how to place the retention hook on the xreceiver unit. Refer to the guide included with each Naída CI Q90 Acoustic Earhook for detailed instructions on the removal and placement of the retention hook on the xreceiver unit. Side Indicator indicates which ear the receiver is designed for, blue for left and red for right. Side indicator (Note that red indicates the right side and blue indicates the left side) The Naída CI Q90 Acoustic Earhook may be ordered in one of five different lengths (00, 0, 1, 2, 3) for either the left or right ear. The length is noted on the xreceiver unit on the side indicator (ex. 2xP). We have provided you with a measurement tool that you can use to determine the appropriate length for your patient. Please refer to the guide included with each Naída CI Q90 Acoustic Earhook for detailed instructions on how to attach the Earhook to the sound processor using the pin removal tool provided. 1

2 Naída CI Q90 Acoustic Earhook Accessories Several accessories are provided with each Naída CI Q90 Acoustic Earhook. Power Domes an earpiece option provided in three sizes (S, M, L). Closed Domes a less occlusive earpiece option provided in three size (S, M, L). Cerustop WaxGuard required for minimizing damage to the xreceiver from wax buildup. Pin Removal Tool and Pin required for attachment and removal of the Naída CI Q90 Acoustic Earhook. The SlimTip earpiece is the recommended ear coupling for better retention and optimal sound delivery. The SlimTip is a custom earpiece that must be ordered from Phonak and is not provided with the Naída CI Q90 Acoustic Earhook. If Phonak is unable to manufacture the SlimTip due to the small size of the recipient s ear canal then the Power or Closed dome options can be used. Power dome Closed dome Small Medium Large SlimTip removal tool SlimTip removal filament Custom SlimTip Cerustop pack Cerustop holder Replacement Cerustop Programming in SoundWave The Naída CI Q90 EAS system is fit using SoundWave 3.0 software. You will find that fitting the Naída Q90 EAS system is very similar to fitting the Naída CI sound processor with SoundWave with a few additional steps as described below. Set-Up Before Programming in SoundWave Verify that the recipient has good residual hearing by performing unaided Pure Tone Audiometry across the frequency range: a) Obtain Air Conduction Thresholds (AC) b) Obtain Uncomfortable Loudness Levels (UCL) optional; defaults will be used if not measured For Existing Recipients - Upload programs from Naída CI sound processor Open SoundWave 3.0 software and connect the recipient s Naída CI sound processor to the CPI-3. Recipient s name will appear in the Action Pane. Select Open [Patient Name]. Recipient s current Naída CI programs will download and synchronise with SoundWave 3.0. Once the programs have been downloaded, disconnect the Naída CI sound processor. For New Recipients - Create Patient File Choose the Patients Tab, then select New in the Action Pane. Enter all required information into the New Patient window, then select OK. The Implants window will open. Select New, enter the required information, then select Yes for EAS, and click OK. Note: The New Implant window will also appear when the headpiece is placed on the recipient. 2

3 Connect the Naída CI Q90 sound processor to SoundWave Connect the recipient s Naída CI Q90 sound processor to the CPI-3. Prepare and initialise the processor, if necessary. Run an impedance measurement. Enter Acoustic Parameters Select the Acoustic Parameters Tab and then select New Right or New Left. Enter the Audiogram In the Audiogram tab, enter the recipient s unaided Pure Tone Audiometry Air Conduction (AC) Thresholds and Uncomfortable Loudness Levels (UCL) across the frequency range. Note: Values may be typed into the data grid or clicked and entered directly on the audiogram. If no response was noted for a specific frequency, select the highest tested level, and then right-click on the value in the audiogram to select Mark as No Response. If a value is skipped, the data will be interpolated. If UCL values are not entered, default values will be determined by the system based on the recipient s AC threshold values. Enter RECD values (optional) Select the RECD tab, and enter the recipient s RECD values. If no values are entered, default adult RECD values will be applied. 3

4 Select Earpiece Under Configuration, select the appropriate Earpiece from the dropdown menu. Available options: Power Dome, Closed Dome, and SlimTip (with various vent sizes). The recommended SlimTip vent size is based on the entered audiogram and will be indicated with an asterisk (*). Save and Close the Acoustic Parameters. Create a Program Creating a Baseline Program Select Programs Tab. For recipients with existing programs, select their everyday program and open a copy of it. For new recipients, create a new program. Verify/set electric settings (e.g., Strategy, M-levels, T-levels, ClearVoice, etc.) as per usual. Verify/set general settings (e.g., Audio Mixing, Mic Mode). For the everyday EAS program, an Omnidirectional Microphone Mode and Mic Only Audio Mix is recommended. Note: Mic Source will default to Processor Mic and this is not editable in SoundWave. Turn on Live Speech stimulation and verify that the baseline program is at a comfortable level, making changes as needed. Turn off Live Speech stimulation. Enable EAS in Program Under Acoustic Settings, enable the EAS Program by selecting On. 4

5 Select Fitting Formula Select Fitting Formula: AB-Phonak, NAL-RP, or DSL v.5. Default Fitting Formula is AB-Phonak. Verify the Acoustic and Electric Cutoffs Recommended Acoustic and Electric Cutoffs will be indicated with an asterisk (*). Both Acoustic and Electric Cutoffs will default to the point at which the subject s thresholds exceed 70 db HL. The default includes little to no overlap between acoustic and electric stimulation. Acoustic and Electric Cutoffs may be independently adjusted as desired, with any degree of overlap allowed (full to no overlap). Verify the Desired Volume Range for Acoustic Stimulation Default range is -20 db to +10 db. Verify Sound Quality Verify the sound quality and comfort level with subject using Live Speech stimulation. In the ribbon bar, select Start Electro-Acoustic stimulation. Optimise the program based on subjective feedback. Save and Close program. 5

6 Create Other Programs and Download Consider creating other programs based on the recipient s listening needs, e.g., Noise, Music, etc. Download programs to the processor. Either drag and drop programs into the appropriate slot in the Processor Pane, or manually enter the program numbers into the appropriate slots. Select the appropriate ComPilot mixing ratio and LED setting for each slot, as appropriate. In the processor-wide dropdown, enable internal alarms and/or standby mode, as desired. Click Download which will Download programs to processor and run Battery Estimation. 028-M RevC 2016 Advanced Bionics AG and affiliates. All rights reserved. 6