Langenbeck

The Langenbeck test is designed to locate the hearing

impairment and is recommended for a falling hearing curve.

A) Select the desired test ear (11, 12).

B) Activate the “Langenbeck” test by holding down “shift” (10)

while pressing “function” (18) one or more times until
“Langenbeck” is displayed in the right hand side of the screen.

C) From the audiogram the lowest and the highest hearing loss is
determined. The noise level to be used is in the middle of the
two values (usually between 50 to 60 dB). Set the noise level
by means of “HL dB” (22).

D) The frequency to be tested is usually between 1000 - 4000

Hz. Set by means of “Frequency” (20, 21). Set the “Intensity”
level below the hearing threshold level and turn up for the
intensity until the tone can be heard by the client. Activate
“Store” (15) and proceed with the next frequency.

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 Békésy
Békésy is a type of automatic audiometry. It is diagnostically
important from the classification of the results into one of five
types (after Jerger, et al) when responses to continuous and
pulsed tones are compared.

The Békésy test in the AD229e is a fixed frequency Békésy test. The
test can be performed with either pure tone or narrow band noise as
stimuli (chosen in setup item no. 10). Before the Békésy mode is
entered the wanted stimuli must be chosen. As standard, continuous
tone is selected for the Békésy test. If pulsing tones are preferred,
“Pulse” (17) must be activated twice before Békésy test is selected.

Békésy Procedure:
A) Select desired test ear Right or Left (11) (12).

B) Instruct the patient:

- that he will hear tones with different frequencies
- that he is supposed to keep the patient response
button activated whenever a tone is audible to him

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 - and that he must release the patient response button
again as soon as the tone becomes inaudible etc.

C) To start the Békésy test activate “Auto Threshold” (7).

(Békésy must be pre-selected in setup item no. 6).

D) If a familiarisation with the Békésy test is preferred then

hold down "shift" (10) while activating "fam" (7) - a fixed
frequency Békésy function will now start for familiarisation.
When the patient has learned to respond correctly via the
patient response signal the test will start automatically.

When the test is completed for the calculated ear the other ear will
be tested similarly and the test will stop.

After completing the test a Buzzer will start - (if it is selected in the
setup item no. 9).

Display Thresholds:
To view the thresholds stored, hold down “shift” (10) and while
activating “disp thr” (5). Then activate the “Auto Threshold” (7).
The thresholds for the various frequencies will now be
displayed on the LCD.

To get back to normal mode, deactivate the “Auto Threshold”

(7). Then hold down “Shift” (10) and while activating “disp thr”
(5) again.

Automatic control of test validity:

If the test result exceeds certain limits regarding number of
reversals dictated by the patient signal button as well as
maximum deviation between peaks or valleys, the test will
automatically be terminated. The thresholds set for test
acceptance regarding a minimum number of reversals and
maximum deviation between peaks or valleys in the Békésy
tracing can be entered in the setup item no. 11and 12.

Békésy Printing Options:

Printout will be made of the tracing or of the calculated
audiogram (average) or all data, according to whether Tracing
or Average or All is selected in setup item no. 14. In setup item

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 no. 15 it is possible to select the Békésy Stimuli Print: All,
Continuous or Pulse.

English Békésy Categorisation:

In setup item no. 13 the English Categorisation can be
activated so the test results will be categorised. When "Auto
Threshold" (7) is activated the information needed to calculate
the categorisation upon test completion must be entered.

Use "HL dB" (22) and the "Frequency" (20), (21) to enter the
following data:

- Age: The patient’s age.

- MSLT: Months Since Last Test.
- Thresholds for Right ear: 500,1000, 2000, 3000, 4000,
6000 Hz.
- Thresholds for Left ear: 500,1000, 2000, 3000, 4000,
6000 Hz.

The AD229e is now Ready - activate the Békésy test by

selecting "Auto Threshold" (7).

In the setup item no. 5 you can choose to have some of the
frequencies deactivated in the Auto Threshold mode.

Please note:
In the setup item no. 6 the Békésy test can be changed from
“Békésy” to Hughson Westlake (and “OSHA” in USA
versions), so that the Hughson Westlake (or OSHA). This
gives the operator the option to choose which threshold test
that he wants to power up when Auto Threshold is activated

In the setup items no. 7 to 18 parameters of the Békésy test

can be modified to individual needs.

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 Master Hearing Aid Fitting Method
Master Hearing Aid (MHA) is a hearing aid fitting procedure
consisting of three hearing aid simulating high pass filters of -6
dB, -12 dB, -18 dB per octave and a HFE filter (High Frequency
Emphasis). The filters can be activated individually on both
channels enabling the AD229e to serve as a 2 channel master
hearing aid.

Before the MHA mode is entered the wanted stimuli must be chosen.
To enter the MHA mode hold down "shift" (10) while pressing
“function” one or more times until “MHA” is displayed in the right
hand side of the screen.

A) In order to simulate a situation with a hearing aid on one ear

select desired test ear with "Right" (11) or "Left" (12). The
power up intensity is 70 dB SPL. Adjust the intensity
individually to suit the patient. Then engage the filter on the
selected ear by holding down "shift" (10) while browsing
through the different filters with the left "Frequency" button

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