our new advance vivosonic instruments facilities is--- * ABR/BERA REPORT * FULLY AUTOMATED ASSR * Non-invasive EcochG Fully Automated ASSR Quick and objective hearing threshold estimation The Integrity™ V500 System ASSR module provides an accurate estimate of hearing threshold using sophisticated signal processing techniques to optimize response detection, along with fully automated search capabilities. The module provides user control and flexibility. Auditory Steady-State Response (ASSR) is a quick and simple electrophysiological measure producing frequency-specific information that estimates the behavioral pure-tone audiogram. As an objective measure, ASSR is well-suited for testing infants, young children, and other individuals unable to provide reliable behavioral responses. ASSR measurement is a valuable addition to any diagnostic test battery to aid in more effective clinical decision-making. Furthermore, with the results displayed in the form of an estimated audiogram, it provides a familiar and convenient tool to communicate the degree of hearing loss when counselling families. Clinical Applications Objective estimate of frequency-specific behavioral thresholds for hearing aid fittings Diagnosis of central auditory nervous system (CANS) lesions (40 Hz ASSR) An adjunct to ABR testing to aid in effective clinical decision-making How it Works The VivoLink™ generates steady state chirp stimuli centered at 500, 1000, 2000, and 4000 Hz. Multiple chirp stimuli in both ears can be generated simultaneously for faster testing, or presented one at a time for more accurate threshold estimation. Patented adaptive processing techniques, SOAP™ Adaptive Processing, are used to detect the ASSR response in the presence of noise and handle intermittent muscular artifact that typically makes ASSR detection difficult. ASSR Testing Setting test parameters is intuitive, fast, and easy. With patients quiet and prone during testing, clinicians can simply select the frequencies of interest and proceed to run the test. As testing progresses, stimulus levels and frequency settings can be adjusted as desired. The system efficiently searches for thresholds following pre-defined protocols, and generates an estimated audiogram. There is no need to interpret results. ASSR Audiogram ********************************************* Awake ABR Maximize convenience and efficiency The Integrity™ V500 System ABR module is able to measure auditory brainstem response in difficult clinical situations. Auditory brainstem response is an objective electrophysiological test of the function and integrity of the auditory system from the inner ear to the brainstem. The electrical response starts in the inner ear and travels through the auditory nerve and balance nerve to the brainstem. The response is very small relative to myogenic EEG and is consequently very difficult to find using traditional equipment when patients are awake during testing. The Integrity V500 System contains advanced technologies that reduce electric and magnetic interference, and facilitate recording ABR in children even when they are awake. Awake ABR utilizes all of the unique capabilities of Vivosonic advanced technologies including the patented Amplitrode®, SOAP™ Adaptive Processing, and VivoLink™ Wireless Recording Technology. Clinical Applications Hearing screening of newborns Estimating hearing levels of difficult-to-test patients including those with developmental delays, autism, infants, and small children Evaluating patients with suspected retro-cochlear pathology Evaluating patients with Ménière's Disease or similar disorders Diagnosis of Auditory Neuropathy/Dyssynchrony How it Works The Amplitrode® pre-filters and amplifies the ABR at the recording site to minimize the effects of surrounding electrical and magnetic interference, electrophysiological artifacts, and motion artifacts from electrode leads. Patented signal processing algorithms, SOAP™ Adaptive Processing (SNR-Optimized Adaptive Processing), adapt to the characteristics and level of noise to reduce the myogenic and electromagnetic interference in the responses. The VivoLink™ wireless recording technology records the ABR and sends the data wirelessly, up to a distance of 30 feet (10 meters) away, to the computer for further processing. Auditory Neuropathy Spectrum Disorder (ANSD) The video shows the averaging process for a click-ABR in a NICU patient with ANSD. The Vivosonic Integrity V500 System allows the audiologist to send rarefaction- and condensation-responses to separate memory bins to identify the cochlear microphonic. Note that the ongoing raw activity contains considerable muscle artifact as well as periodic electrical interference, but the averaged response is quite clean. *********************************************************************** Non-Invasive ECochG Safety and comfort The Integrity™ V500 System ECochG module is one of the most patient-centric systems on the market promoting safety and comfort through the use of non-invasive techniques. Electrocochleography (ECochG) is an objective technique that records stimulus-evoked potential responses. It is particularly valuable in the assessment of adults requiring additional tests for Ménière's disease or endolymphatic hydrops. In the pediatric population, the cochlear microphonic of ECochG can provide an indication of Auditory Neuropathy/ Dyssynchrony wherein the cochlea is intact, but the auditory nerve is damaged. Clear ECochG recordings are obtained using gold foil ear tips, without the need to touch the tympanic membrane. Discomfort and risks of perforation are avoided. ECochG measurement can proceed safely, non-invasively, and comfortably. Clinical Applications Assessment of hearing pathology associated with increased inner ear fluid pressure (Ménière's disease, endolymphatic hydrops) Enhancement of wave I in ABR recording Enhancement of cochlear microphonic and the diagnosis of auditory neuropathy How it Works The VivoLink™ generates a click and the response of the auditory nerve is detected by the Amplitrode® which amplifies the difference between the gold foil ear electrode in the ear canal and an electrode placed on the opposite ear. An ECochG evoked response is a very small magnitude of less than 1 µV, therefore a high stimulus intensity is required when recording a diagnostic ECochG. In addition, advanced noise filtering and amplification are essential to obtain clear recordings. It is typically recommended that multiple waveforms using rarefaction, condensation, and alternating polarities be recorded. With most conventional systems, these must be collected as separate runs. With the Integrity V500 System, however, recordings can be collected in a single run by using the dual A, B buffers with alternating polarity. The availability of alternating split polarity helps to provide evidence of the cochlear microphonic.