How to Use Optivent www.siemens.com Angela Flores, Au.D. Abstract: Optivent is a vent in an Insio instrument where Siemens specifies the vent size and shape in order to achieve the smallest possible instrument size while providing ideal acoustic properties. This paper describes how to order and fit Insio hearing instruments with Optivent. How to UseOptivent 1 Insio micon is a new line of custom instruments built upon proven micon technology. This powerful, yet discreet line of custom instruments is available in a full line of styles and technology levels to meet the needs of your discerning wearer. Insio further builds upon what micon technology has to offer including world-class feedback control, e2e wireless technology, a broad frequency response, frequency compression, noise management and even a tinnitus control. A unique micon innovation dedicated to custom hearing instruments is Optivent, available in all Insio products Simply stated, the Optivent is a vent in an Insio instrument where Siemens specifies the vent size and shape in order to achieve the smallest possible instrument size while providing ideal acoustic properties. In other words, based upon the audiogram, the ear impression, and the style of instrument chosen by the Hearing Care Provider (HCP), Siemens will determine the optimal shape and dimension of the vent for you. As a matter of choice, the HCP also has the option to choose their own venting characteristics based upon their experience. Why would venting size, shape and placement be that important? There are numerous considerations when choosing a vent in order to ensure appropriate gain and listening comfort, while at the same time providing a cosmetically appealing instrument. Get it wrong and the wearer is in your office more than you both like or you’re sending the hearing instrument(s) back for a remake. Considerations include reducing or eliminating the occlusion effect while at the same time minimizing feedback, ventilating the ear and ensuring proper gain/output in the low frequencies. These are all important aspects of the fitting that Siemens considers during the manufacturing process. ORDERING The Insio product can be ordered electronically via mySiemens or via a standard order form. As always, Siemens allows for flexibility in the ordering process and in your choices. That is, the Optivent is one option available, but a vent preference can always be specified. In other words, if an “acoustically optimized vent” or “Optivent” is chosen (Figure 1), Siemens will determine the best vent size, shape and location based upon the audiogram and ear impression. Several different scientific factors are considered including equivalent acoustic mass (EAM), hearing loss at various frequencies and prescribed gain/output. For more information on determining how the vent properties are chosen, please see the Insio Optivent white paper available online or from your Siemens Sales Representative. Alternatively, a specific vent size can be indicated based upon clinical experience or simulation within CONNEXX 7 where a vent diameter proposal is integrated into the software. When a specific vent size is requested, that diameter of a vent will be built into the hearing instrument whenever possible. At the same time and utilizing computer aided design, all components including the vent will be built into a highly cosmetically appealing instrument. Figure 1: Ordering an Insio custom product within mySiemens. A simple drop-down menu under “Vent Type” allows for quick access to the Optivent option. Simply click on “Acoustically Optimized”. It’s all about choice Choice 1: Optivent Copyright © Siemens AG 2013. All rights reserved. How to UseOptivent 2 We make the vent choice for you based upon the wearer’s audiogram, the shell preference selected and ear impression characteristics. The vent information is stored on the micon chip and used to create the optimal First Fit. Choice 2: Standard v ent choice You select one of the ten standard vent choices on the order form. The vent diameter is consistent throughout shell. Vent information is stored on the micon chip and considered in the First Fit process. Fitting At Siemens, our goal is to improve the fitting workflow and ensure an accurate, efficient and simple fitting process. That workflow begins with the 24/7 accessible mySiemens electronic ordering platform and ends with a quick but sophisticated First Fit for the wearer. The First Fit process minimizes the time spent with software adjustments and helps to reduce follow-up visits. For example, when an Optivent is chosen and an Insio product is read out, CONNEXX 7 automatically reads the vent information from the micon chip (Figure 2). At the time of First Fit, this information is utilized to perform the appropriate calculations for gain and output based upon numerous calculations. Variables such as the individual’s hearing loss, microphone locations effects (MLE), critical gain measurements, real-ear to coupler differences (RECD) as well as the specific acoustic properties of that vent are considered when calculating the First Fit. All of this data is easily and seamlessly merged into an individualized fitting. The result—a fast, simple and more accurate fitting. However, as mentioned, you have options. If you prefer a more conventional vent, that information is also read from the Insio product and used to calculate the appropriate fitting and ensure accurate curve simulations within the fitting software. Fig 2: Insio instrument (left) here Optivent was chosen at the time of order. During the fitting, the vent size is stored on the micon chip and used to calculate the displayed fitting curves seen here (Simulated Insertion Gain). Note the red box indicating that “Optivent” was chosen at the time of order. Looking at the curves a little differently within CONNEXX, let’s consider Full On Gain (FOG). As seen in Figure 3, the FOG curve is represented by the shaded red area at the top of the curve display box. In other words, with the hearing instrument turned full on (max gain, input compression off, etc.) the red shaded area represents the maximum gain achievable by that instrument. Remember, the Optivent determines the appropriate venting depending on the audiogram. As seen in these two examples, the Copyright © Siemens AG 2013. All rights reserved. How to UseOptivent 3 size of the vent and, therefore, the corner frequency value will vary by audiogram. The corner frequency is simply defined as the frequency at which the gain begins to diminish (roll off) in the low frequencies. In these two examples, because of the different vents and, therefore, different corner frequencies, the maximum potential gain is different even though current programming is very similar. Observe that as the vent is made larger (1.3mm to 2.5mm), the corner frequency increases, and FOG for 250 Hz drops from 30 dB to 20 dB. This simply illustrates another aspect of venting and its effect on varying acoustical aspects of the instrument. Figure 3: Examples of curves within CONNEXX for an Optivent (1.3 mm vent left and 2.5 mm vent right) in the Real Ear Insertion Gain (REIG) view. The corner frequency can be easily viewed where Full On Gain (FOG) curves are shown. FOG is indicated by the red shaded area. The dotted blue lines and blue arrows indicate where gain begins to roll off in the low frequencies. In summary, Siemens offers numerous tools to assist you, the Hearing Healthcare Provider, during the ordering, fitting and counseling process. Optivent is one option available to you within our new line of custom Insio products. Extensive research and development, therefore, is the cornerstone of each fitting, to ensure that the instrument is not only cosmetically appealing but also provides the wearer with the perfect balance of sound quality and audibility. Copyright © Siemens AG 2013. All rights reserved.