Oticon Sumo XP Instrucciones de montaje

Fitting Guide Sumo XP

Introduction

Advanced technology and fitting strategies provide vastly improved hearing instrument solutions for

people with severe to profound hearing loss. However, this distinctive group of clients continues to

present challenges that require careful and intelligent fitting.

Studies have shown that this population may have reduced dynamic range, "dead zones" within

the cochlea, large variability in speech perception scores, increased distortion, lower audibility

of signal, and often quite poor speech perception. Fortunately, SUMO assists you through advanced

super power technology and Genie enables the implementation of tools to achieve the best fitting

possible. This guide will suggest a number of answers and provide additional explanation to enable

you to provide the best possible fitting.

Step 1: Select Instrument and Rationale

Select Hearing Instrument

Manually selecting the hearing instru-

ment is also an option. The intuitive

software makes it easy to select the

correct hearing aid for the client. Click

on the Select button and then choose

SUMO.

Choose Rationale, venting, damping, etc.

The fitting software offers five different linear

rationales, including three of the most popular

for power fittings: POGO II + BC, NAL-RP, and

DSL i/o, as well as Correll-2 and SSM+. Click

on the Change button to access the rationales.

Detect Instruments

For a fast and easy fitting; connect the

instruments to the HI-PRO and click

on the Detect Instruments button. The

instruments will then automatically be

detected showing the model, type and

rationale.

SUMO is fitted using Genie 2.1 (or higher). SUMO

incorporates linear gain amplification, which is

applied as specified by standard gain rationales.

There are 3 main issues to deal with when fitting severe or profound hearing losses: MPO, Feedback and

Frequency Response.

The structure of this guide follows the recommended fitting flow as shown in the following 5 steps:

In addition to these steps, important information is provided in this guide about Fitting SUMO to children,

Earmould Considerations and Troubleshooting.

Step 2: Fitting SUMO

Step 2b

Check for

Feedback

Step 2a

Check the

MPO level

Step 2c

Check the

Frequency Response

Step 2d

Check Programmable

Volume Control

Step 2e

Check the T-coil

and FM settings

Step 2a: Check the MPO Level

The fitting software will always prescribe an MPO based upon the hearing threshold and the age of the

wearer. Despite this, due to the restricted dynamic range associated with severe to profound hearing losses,

it is very important to begin the fitting session by checking that the MPO is set correctly.

A too high level of the UCL (MPO) control may cause the client to decrease the VC, and thereby reduce the

audibility of speech. Alternatively, setting the UCL control too low may produce complaints of poor sound

quality of own voice and reduced speech intelligibility.

To test the UCL control setting the following procedure can be followed:

• Start talking loudly in front of the client.

• Then talk closer and closer to the ear.

You should always start carefully so you do not cause unnecessary discomfort.

Try to distinguish between a loud sound as being indeed too loud or being uncomfortably loud.

• If the sound is not uncomfortably loud, increase the UCL control and test again.

• If the sound is found to be uncomfortably loud, decrease the UCL control and test again.

The client should also talk and listen to their own voice to evaluate their own voice quality.

Fitting tip:

If the preferred MPO setting is not

at the maximum setting, a 5dB

damped hook should be considered.

This will enable the level of low-

frequency output to be increased,

which may be preferred by users who

need increased low-frequency amplifi-

cation (e.g. left-corner audiogram).

MPO Level

UCL (dB HL)

Adjusts the maximum power

output (MPO) according to the

user's uncomfortable level (UCL).

Fitting tips:

1) If clients complain that the sound

is harsh or distorted with PC, then try

one of the AGC options.

2) Changing from PC to either AGC

method will cause the MPO level to

decrease 3dB. Test if the new MPO

level is correct. You may need to

increase the level to maintain the

same loudness.

3) The release time for both AGCs is

fast so that the gain for subsequent

speech sounds is not unnecessarily

decreased.

Then Select Limiting Options

MPO Level

AGC fast + PC:

AGC fast + PC has a fast attack time

(5 ms.) which results in rapid gain

reduction, preventing distortion even

for quickly changing sounds.

Peak clipping is the default MPO

limiting method for SUMO. This will

provide the client with the highest

possible output at every moment,

which many clients with profound

hearing losses prefer.

AGC slow + PC:

AGC slow + PC has a slow attack time

(90 ms.) which prevents brief sounds from

activating the output AGC circuit and

hence the sound reproduction is only

slightly modulated by the AGC. A more

natural sound reproduction may be

obtained.

Although the prescribing algorithm takes the risk of feedback occurring into account when calculating

the prescribed setting, there is still some risk of feedback occuring when the fitting session begins or at

higher volume control levels. This is because these settings are not based on the actual earmould being

used.

The following steps give you suggestions on how to manage feedback:

1. Check for feedback in the prescribed setting.

Ask the client to smile and move their jaw.

• If feedback occurs, run the FBM tool. (For more information see next page)

• If no feedback occurs continue to the next step.

2. Check for feedback at higher volume control settings by increasing the feedback trimmer in Genie.

Ask the client to smile and move their jaw.

• If feedback occurs, run the FBM tool.

• If no feedback occurs, you still may wish to run the FBM tool to provide more high

frequency gain at higher volume control levels.

When adjusting for feedback, it is very important that the client is active during the test. The client

should move their jaw and head and smile to maximize the risk of feedback in any situation.

When the FBM tool has been activated, a Measured Feedback Area is set. If you wish to return

to Default Feedback Area, press “Reset to Default Feedback Area” in the FBM dialogue box.

If a new earmould has been fitted you might wish to run the FBM tool again to define the Feedback

Area for the new earmould.

If you manually eliminate feedback using the Feedback Manager trimmer, never set the trimmer to

below 3.0. If this is necessary in order to eliminate feedback, use the FBM tool instead as this will

provide a more optimal setting.

Step 2b: Check For Feedback

Feedback Mgr.

FBM tool

Feedback Manager

This tool eliminates

feedback during the

fitting session.

(See next page)

Feedback Management Tool

The Feedback Management tool (FBM) tool shows a graph with a marked Feedback Area. There is a high

likelihood of feedback occuring if the prescribed Insertion Gain falls within this area. This area is used in

the initial prescribing algorithm to prescribe a setting without feedback when the fitting session opens.

The Test curve (Simulated Insertion Gain) will follow the Target P1 curve (Target Insertion Gain) in the

Low Frequencies to fulfil the requirement of the selected rationale. However, in the High Frequencies the

Test curve will avoid entering the Feedback Area to prevent unrealistically high gain causing feedback. If

the Test (actual) curve is prescribed within this area then it is likely that there will be feedback unless the

earmould is very tight.

When running the FBM tool a Measured Feedback Area will be reset to match the client's own earmould.

The Feedback Area will either be enlarged or reduced depending on the tightness of the earmould.

Fitting tips:

The FBM tool is a routine to optimize

the settings of the instrument in

relation to feedback. This routine

preserves the frequency response

as far as possible, but if feedback is

encountered and is adjusted for, then

the FBM routine may change the

settings for the A-Gram, Crossover

Frequency, Gain and Volume Control.

In the fitting screen the trimmer,

unlike the FBM tool, only makes

adjustments to the VC level beyond

which the high frequency gain

will no longer be increased (it does

not change the setting or the other

trimmers to provide a better

response).

Gain

Adjusts the preset overall gain of the instrument.

Ideally this should be set to a comfortable level when

the volume control is around 3. This will leave the

user with approximately 10 dB reserve gain. But

for many profound hearing losses, the prescribed

VC setting might be set higher than 3 to provide

sufficient gain.

Step 2c: Check the Frequency Response

Crossover Frequency

Adjusts the frequency at which point

the A-Gram slope circuit cuts the

low and high frequencies. The

trimmer may be used to fine-tune

the frequency response to provide

a better setting if feedback is a

problem. Alternatively it may be

adjusted automatically as part of

the Feedback Management routine

to provide an optimal setting if

feedback is a problem.

A-Gram Slope

Adjusts the low frequency sounds

(LC) or high frequency sounds

(HC) according to the slope of the

audiogram.

Frequency Response

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