Introduction
The ERO·SCAN is the most
versatile OAE test device in its category. It has four different
testing programs that include a very basic OAE screening protocol
and more diagnostic parameters adjustable by the end user. The test
data is quickly transferred to a printer for immediate visual results,
displayed numerically and graphically.
 |
OAE
Hearing Screening:
This new hearing screening technology (OAE) will identify hearing
loss and middle ear disorders (otitis media) in school age populations.
The hard copy of the printout is generated in 3 seconds.
|
Product Overview
and Description
The ERO·SCAN Distortion Product Otoacoustic Emission test
instrument is a hand-held device, designed to provide an objective
measure of outer hair cell function, through the measurement of
cochlear emissions. It consists of the hand-held unit, printer,
single-use eartips and other accessories. The ERO·SCAN instrument
may be used as a screening tool or in conjunction with conventional
tests as part of a full audiological evaluation.
The ERO·SCAN instrument contains the hardware and software
for generating the test tones, measuring and displaying the DPOAEs,
and storing the results until they are printed. The plastic housing
contains circuit boards that provide the signal processing and displays
the test results.
The instrument also contains 4AA/UM-3/R6 alkaline batteries to power
the device. The instrument uses liquid-crystal display (LCD) and
three light-emitting diodes (LEDs) to provide a visual display of
test data and test conditions to the operator. The probe section
of the instrument houses a microphone and two speaker tubes which
produce test stimuli and measure the sound pressure level (SPL)
present in the sealed ear canal. Interface of the instrument to
the ear canal is accomplished through disposable eartips made of
industrial elastomer, which fit onto the probe tip. The disposable
eartips are color coded to facilitate easy selection by size. Four
membrane-type push buttons located on the keypad of the device allow
the user to control testing and printing, and to reset test protocols.
Printing will commence upon placement of the instrument into the
cradle.
|
There
are five different versions of the ERO·SCAN
unit. They are as follows: |
| Screener: |
| Choice
of DPOAE or TEOAE |
| One
default screening program |
Remote
probe included
|
| Standard: |
| |
Choice
of DPOAE or TEOAE |
| Screening
program plus 3 custom, user-defined programs |
Remote
probe included
|
| Combo: |
| Both
DPOAE or TEOAE in the same unit |
| Screening
program plus 3 custom, user-defined programs |
| Remote
probe included |
|
Optional
for all units: |
| Customized
database software |
| Storage/carrying
case(shockproof and waterproof) |
Product
Use and Procedure
|
Routine
Uses: |
| Screen
infants in the newborn nursery. |
| Performs
follow-up testing on infants from the nursery screening, and
at well-baby checks. |
| Obtain
objective results of cochlear outer hair cell function from
both ears of toddlers. |
| Identify
and monitor middle ear pathology (e.g. otitis media). |
| Assess
cochlear function (without the need for a behavioral response)
following the insertion of pressure-equalization (PE) tubes. |
| |
Monitor
hearing in children at-risk for progressive hearing loss. |
| Screen
patients of all ages for cochlear (sensory) function so that
appropriate recommendations for hearing evaluation and/or
amplification can be made. |
|
Differential
Diagnosis: |
| Differentiate
cochlear from retrocochlear pathology when used in combination
with auditory brainstem response (ABR). |
| Observe
changes in cochlear function during episodes of Méniére's
Disease. |
| Confirm
suspected non-organic hearing loss (malingering). |
| Monitor
the effects of ototoxic medications. OAEs will often be abnormal
before audiometric changes are noted. |
| Detect
early signs of hearing loss from noise exposure (musicians,
factory workers, others). |
| |
Useful
to help detect possible auditory neuropathy. The presence
of normal OAEs and abnormal ABR findings distinguishes this
low-incidence disorder. |
|
Set-Up:
Setting the minimum amplitude to "OFF" and the averaging
time to 4 seconds will enhance your testing success in ambient
noise levels up to 70 db, SPL.
Hints for Successful Testing:
Probe Tip Removal on the Hand Held
Unit:
The probe tip should be replaced when it becomes clogged,
do not attempt to clean it. To replace the probe tip, squeeze
the tabs on the two sides of the probe tip. The tabs should
audibly snap off the probe assembly. Pull the probe tip directly
off the probe and discard it.
Replacing Probe Tip on the Hand Held
Unit:
The probe tip will only fit on one way; be careful not to
force the tip in place. Push the tip directly down onto the
probe. Once the probe tip is in place on the probe, push firmly
downward on the top of the tabs one at a time until an audible
click is heard. Tug lightly on the probe tip to verify that
the tip is securely attached.
Probe Tip Removal on the Remote Probe:
Using a small pointed object, such as a pen or small screwdriver,
push in the notches on the left and right sides on the rear
of the remote probe until each tab is released. Then slide
the probe tip off the front of the probe and discard it.
Replacing the Probe Tip on the Remote
Probe:
Align a replacement tip with the front of the probe. The tip
will only fit in one direction. If the tip does not fit securely
on the probe, remove the probe tip and re-orient it. Then
press lightly on the tabs to snap them into place. The tabs
should be flush with the outside of the probe.
Note: If the probe tip is not inserted
completely, the ERO·SCAN will not perform a test.
Installing the Remote Probe:
Remove the protective cover from the top of the
ERO·SCAN using a fingernail or small screwdriver. Turn
off the ERO·SCAN and plug the remote probe connector
into the inlet on the top of the ERO·SCAN. The connector
will fit in only one direction. The arrows on the connector
should face the display on the ERO·SCAN. Turn on the
ERO·SCAN. The yellow TEST light on the display will
light briefly, indicating the ERO·SCAN has detected
the presence of the remote probe. Disconnect and reinsert
connector if yellow light is not seen. Note:
All testing is done through this probe until it is unplugged.
ERO·SCAN settings do not need to be changed in order
to use this probe.
Testing:
The remote probe uses the same disposable eartips
as the ERO·SCAN probe. Place the eartip fully onto
the probe tip. Never use the remote probe without an eartip
installed. Use the clip on the preamp box to secure the preamp
to clothing or bedding. Check the ear canal for cerumen or
vernix before inserting the probe. Turn on the ERO·SCAN
and select the ear to be tested.* Insert the probe into the
ear canal. Pull down and back on the outer ear for an infant
or young child during probe insertion to straighten the ear
canal and ensure proper placement. The outer ear should be
pulled up and back to insert the probe tip in the ear canals
of adults. The autostart function automatically begins the
test when the probe is inserted correctly. If the ERO·SCAN
does not start the test, reposition the probe. *Note:
When testing infants or young children it is recommended that
the probe be placed in the ear before selecting the test ear
on the ERO·SCAN. When the child is quiet, select the
ear to be tested.
|
Features
and Benefits
 |
OAEs
are quick. Some devices on the market will measure OAEs bilaterally
in less than 1 minute. |
|
No
response is required from the child. This is a distinct advantage
in children 3 years of age and under and for children speaking
a language other than English. |
|
Technicians
can easily be trained to do testing. |
|
The
test is easy to administer and east to tolerate as a patient. |
|
The ERO·SCAN system is easy to use and offers repeatable,
accurate results in seconds. |
|
A printout is generated automatically when the unit is placed
in the cradle. |
The ERO·SCAN
can be used to test babies, children, and adults in hospitals, schools,
clinics and medical offices.
|
Handheld;
portable |
|
Easy to use |
|
Completely self-contained |
|
Complete test in 7 seconds (may be longer if the averaging
time is set to the recommended 4 seconds) . |
|
Short-form printout generated in 3 seconds |
|
Printer included |
|
Test results can also be downloaded to a PC |
Frequently
Asked Questions
| Q: |
What
are DPOAEs? |
| A: |
Distortion
product otoacoustic emissions are acoustic signals that can
be detected in the ear canal of a person with normal cochlear
outer hair cell function, subsequent to stimulation of the
auditory system with a pair of pure tone at frequencies f1
and f2. The resulting emission of interest is the distortion
product tone at the frequency 2f1-f2.
|
| Q: |
What
do Otoacoustic Emissions results tell us? |
| A: |
Available
evidence suggests that otoacoutsic emissions (OAEs) are generated
by the cochlea's outer hair cells, and that the presence of
OAEs is an indication that the outer hair cells are normal.
Although OAE test data provides no indication of inner hair
cell function, or of hearing ability, current research indicates
that the majority of hearing-impaired individuals will be
identified by a simple OAE test. Patients who fail to generate
OAEs should be rescreened and/or referred for additional audiological
testing.
|
| Q: |
How
does the ERO·SCAN devices measure DPOAEs? |
| A: |
The ERO·SCAN
instrument generates a series of test tones, directs them
into the ear canal, and then measures the level of the DPOAE
tone generated by the cochlea. By using different test frequencies,
the ERO·SCAN device provides an estimate of outer hair
cell function over a wide range of frequencies.
|
| Q: |
How
does the ERO·SCAN device work? |
| A: |
The digital
signal processor in the instrument generates two pure tones
(f1 and f2) through a digital-to-analog converter. These tones
are presented to the ear via speaker tubes located in the
probe. A microphone in the probe measures the sound in the
ear canal and transmits the signal to the analog-to-digital
converter. The digital signal processor then uses Fast-Fourier
Transforms (FFTS) to filter the signal into narrow frequency
bands, and detects any emissions present in the 2f1-f2 frequency
band. The level of these emissions can be compared with the
average level of the noise in adjacent frequency bands. An
emission is judged to be present when the level in the emission
band is 5 db or more above the level in adjacent bands. (The
actual pass-fail criterion used in the ERO·SCAN instrument
uses a more sophisticated statistical test).
The SPL and frequencies of the test tones and the averaging
times used to process the signals can be determined by the
tester through adjustable settings maintained in static memory
within the ERO·SCAN instrument.
|
| Q: |
How
do I clean my ERO-SCAN unit? |
| A: |
The instrument and
its accessories may be wiped clean with a damp cloth using a mild
antiseptic solution (e.g. cetylcide). Take care not to put excessive
pressure on the clear display window or allow any utensil to puncture
the display window or keypad. Do not allow any fluid to enter the
device. Do not immerse the instrument in fluids or attempt to sterilize
the instrument or any or its accessories. Probe tips should be replaced
when they become clogged. Replacement probe tips are included with
the instrument. Do not attempt to clean the probe tips, they are disposable
and must be replaced when they become clogged. For instructions on
replacing probe tips, see the Product Use and Procedure section under
"Hints for successful testing".
|
| Q: |
Does
the unit need to be calibrated? |
| A: |
The instrument
requires no regular maintenance beyond routine cleaning and
battery replacement.
|
| Q: |
How
can the ERO·SCAN save me time in my busy day? |
| A: |
The ERO·SCAN
cuts in half the usual time to screen a child's hearing. Typical
school screening requires two tests, pure-tone testing and
tympanometry. Otoacoustic emissions can replace these two
tests and requires no response from the child. This is a definite
advantage for children with physical disabilities, young children,
and children who do not use English as their primary language.
Some children simply will not respond to conventional pure-tone
testing despite time consuming attempts at conditioning.
|
| Q: |
How
old does the child have to be before being able to get screened
with the ERO·SCAN? |
| A: |
The ERO·SCAN
can be used to screen from newborn to adult.
|
| Q: |
What
does a refer mean? |
| A: |
A refer
means that the child did not pass the test. This could be
due to many reasons including: ear wax; middle ear fluid;
noise; improper test technique; or hearing loss. All refer
results should be immediately repeated. If the test result
continues to be "refer", the child should be screened
using pure-tone testing and tympanometry. If passing results
are not achieved on these tests, then a referral to an audiologist
and/or physician should be made.
|
| Q: |
Can
I test kids with pressure equalization (PE) tubes? |
| A: |
Children
with PE tubes can be tested by bypassing the auto-start function
of the unit. This is accomplished by first inserting the ERO·SCAN
with appropriate ear tip into the ear canal and obtaining
a proper seal. To disable auto-start, at the main menu select
the ear to be tested by holding down the right or left arrow
keys for 3 seconds until the green "test" light
turns off. Once the key is released, the ERO·SCAN will
calibrate and test as before.
|
| Q: |
How
many tests can I print on a roll of paper? |
| A: |
Approximately
250 tests can be printed using one roll of paper.
|
| Q: |
What
size tips should I be using on what age group of children? |
| A: |
All ears
are different and eartip sizes therefore will vary from child
to child. The eartip must seal the ear canal, so the best
test results can be obtained when the eartip is inserted deeply
into the ear canal instead of flush with the ear canal opening.
|
| Q: |
What
is the difference between TEOAE and DPOAE? |
| A: |
DPOAE
is a more frequency-specific test stimulus. TEOAE uses a more
broadband signal (composed of many frequencies). One difference
lies in the frequencies that can be tested using the two different
types. In general, TEOAEs can test lower frequencies and DPOAEs
can test higher frequencies. There is, however, a large area
of overlapping frequencies in the speech range that can be
tested using either type. The typical screening test frequency
range for TEOAEs is 700 - 4000 Hz and for DPOAEs is 1500 -
6000 Hz. (ERO·SCAN standard model configuration)
|
| Q: |
I
do third party billing, what are the reimbursement codes for
the unit? |
| A: |
92587
- Screening & 92588 - Comprehensive
|
| Q: |
If
a child's ear is impacted with wax can I still screen them? |
| A: |
No, impacted wax
will yield a refer result. In addition, any significant amount of
wax can potentially cause a refer result. For information on clearing
an ear of ear wax, click here.
|
| Q: |
If
a child has otitis media can they still be screened with the
ERO·SCAN unit? |
| A: |
Middle ear fluid
will yield a refer result. This should then be followed up with pure
tone testing and tympanometry and a determination can be made of otitis
media based on the flat tympanogram.
|
| Q: |
I
see five different units on your website and one is more expensive
than the other. What is the difference between the less expensive
alternatives? |
| A: |
The lower
priced screener has a set test protocol in the unit, which
cannot be altered by the user. The more expensive unit allows
the user to modify the test protocol allowing for the testing
of more frequencies at different levels. The higher priced
unit will allow for billing of the 92588 reimbursement code
for comprehensive otoacoustic emission testing.
|
| Q: |
Is
training required before the unit is purchased or can anyone
learn to use the product from the manual? |
| A: |
Anyone can learn
to use the product, however, there is a technique for proper screening,
and practice is required to do the technique properly. A training
video (available soon) will help to learn the technique.
|
| Q: |
How
is the ERO·SCAN different from other OAE test systems
on the market? |
| A: |
The ERO·SCAN
is the only completely hand-held unit. It can test in greater
amounts of background noise and still get reliable test results
due to a patent pending noise reduction algorithm. In addition,
the ERO·SCAN offers more features at a lower price
than any other OAE unit.
|
Technical
Specifications
| PROBE
|
| Measurement
Type |
Otoacoustic
Emissions (OAE) |
| Frequency
Range |
1.5
to 6 kHz (2 to 4 kHz default) |
| (Depends
on ERO·SCAN model configuration ordered) |
| Stimulus
Intensity Range |
40
to 65 dB SPL |
| Maximum
Output (protection) |
90
dB SPL |
| Microphone
System Noise |
-20
dB SPL @ 2 kHz (1 Hz bandwidth) |
| Stimulus
Sampling Rate |
31,250
Hz |
| Averaging
Time |
0.5,
1, 2, or 4 seconds |
| Artifact
Rejections |
Unit
will correctly measure strong |
| OAEs
in speech babble background noise of 65 dBA |
| INSTRUMENT |
| Power
Supply |
(4)
AA cells - alkaline (6V Total) |
| Battery
Life |
Approximately
300 tests |
| Instrument
Life |
10.6
oz. (300g) including batteries |
| PRINTER |
| Type
|
Thermal
dot matrix line printer |
| Speed
|
>10
lines per second |
| Operating
Noise |
<50
dB SPL |
| Weight
|
1.4
lbs. (630g) including battery pack |
| Paper
|
Thermal
roll - 2.25" wide |
| POWER
SUPPLY |
| Ni-Cad
rechargeable battery pack |
| Battery
Pack Recharge |
Plug-In
transformer 12 V 400 am |
| 120
V double-insulated UL544 |
| Battery
Life |
Approximately
300 tests |
| PROCESSOR |
| Digital
Signal Processor |
Motorola
56303 24-bit 66 MHz
3.3V
|
| Storage
|
1
MB flash EEPROM (non-volatile) |
| Battery
Backup |
0.
1F 5.0V (approx. 24 hours) |
| CODEC
|
18
bit D/A, 18 bit A/D 96 dB SNR |
| Display
|
4
line x 10 character STN liquid crystal |
| SWITCHES |
| Membrane
keypad |
1
million + actuation |
Specifications
subject to change without notice
Articles
/ Manual
Click to read
A
PASS/REFER CRITERION FOR SCREENING NEWBORNS USING DPOAEs
By Laurel A. Christensen, Ph.D. & Mead
C. Killion, Ph.D.
Etymotic Research,Elk Grove Village, IL, Northwestern University,
Evanston, IL, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL
Click to read
A GUIDE TO OTOACOUSTIC EMISSIONS (OAES) FOR SCHOOL NURSES
By Steven D. Smith, Au.D., F-AAA
Click to review the ERO·SCAN
User Manual
Adobe Acrobat is required to view or print the article
on Criterion for Screening Newborns and the
ERO-SCAN User Manual click the icon
below to download a free copy.
Sales
Brochure / Demo Disk
If
you would like to receive an ERO·SCAN demonstration video or sales
brochure, please email
us.
Warranty
ONE
YEAR LIMITED WARRANTY:
This warranty
is extended to the original purchaser of the instrument, by Maico,
through the Distributor from whom it was purchased. The warranty
covers defects in material and workmanship for a period of one year
from date of delivery of the instrument to the original purchaser.
Accessories which are purchased from Maico at the same time as the
instrument are warranted for one year from the date of purchase.
For additional information contact School Health Corporation, your
authorized Maico distributor.
Reimbursement
| CPT
Codes |
| 92587 |
Evoked
OAE; limited |
| 92588 |
Diagnostic
OAE |
Reimbursement for use of
the ERO·SCAN, when paid, averages $51 per screening under code 92587
(Evoked OAE; limited). Some ERO·SCAN users also use code 92588 (diagnostic
OAE) when paid, averages $83.00 per screening. If you would like to place
an order, or already have purchased an ERO·SCAN and need additional
reimbursement information, email
or call School Health Corporation.
Product
Ordering Information
| SH
Catalog # |
Product
Name |
| 51057 |
ERO-SCAN
DPOAE Complete Test System |
| 51075 |
ERO-SCAN
DPOAE Screener |
|
