Interacoustics Eclipse Installation manual

Additional Information
Eclipse
D-0105222 - E - 2017/09
Valid from software version:
EPx5 4.5
ASSR 1.2.7
ABRIS 1.06.2
DPOAE 1.03.2
TEOAE 3.04.3

Table of contents
1Launching the software.................................................................................................................... 1
1.1 Starting up from OtoAccessTM ............................................................................................... 1
1.1.1 Module Setup in OtoAccess™.................................................................................. 1
1.2 Starting up from NOAH (ASSR only)..................................................................................... 2
1.3 Change & view License......................................................................................................... 3
2Ensuring the Eclipse is working properly......................................................................................... 5
2.1 Calibration of Eclipse............................................................................................................. 5
2.1.1 peSPL to nHL correction values............................................................................... 6
2.2 Limiting noise in the test environment................................................................................... 7
2.2.1 Grounding................................................................................................................. 7
2.2.2 The best Test Site & Setup for ABR recordings....................................................... 7
2.2.3 Limiting noise - Equipment setup ............................................................................. 8
2.2.4 Limiting noise - During testing.................................................................................. 9
2.2.5 Changing protocol settings to limit electrical interference........................................ 9
2.2.6 Determination of noise during a recording ............................................................... 9
2.3 Service check using the Loop back box (LBK15)................................................................ 10
2.4 Testing noise level on the artificial patient LBK15............................................................... 12
2.4.1 Check the amplitudes of the EEG with LBK15....................................................... 13
3EP15/25......................................................................................................................................... 15
3.1 About EP15/25 Module ....................................................................................................... 15
3.2 Brief Introduction to ABR..................................................................................................... 16
3.3 The EP15/25 Menu Items.................................................................................................... 17
3.4General Operation of EP 15/25........................................................................................... 18
3.4.1 Toolbar.................................................................................................................... 18
3.4.2 Record tab.............................................................................................................. 20
3.4.3 Rejection level ........................................................................................................ 21
3.4.3.1 Advanced Rejection ................................................................................ 22
3.4.4 Fmp and Residual Noise........................................................................................ 23
3.4.5 Graph area.............................................................................................................. 25
3.4.5.1 Changing the Gain and Time scale......................................................... 25
3.4.5.2 Right click in the graph area.................................................................... 25
3.4.5.3 Right click on the curve handle............................................................... 26
3.5 Edit tab ................................................................................................................................ 29
3.5.1 Assigning Waveform Markers and Labels.............................................................. 29
3.5.1.1 Latency times.......................................................................................... 31
3.5.2 Double Cursor / measuring individual differences.................................................. 32
3.5.3 Filter settings .......................................................................................................... 32
3.5.4 Show Condition / show Fmp Graph........................................................................ 33
3.5.5 Latency Template................................................................................................... 33
3.6 Latency tab.......................................................................................................................... 34
3.7 System Setup...................................................................................................................... 36
3.7.1 Auto Protocols ........................................................................................................ 36
3.7.1.1 Predefined protocol settings.................................................................... 36
3.7.1.2 Type of measurement............................................................................. 37
3.7.1.3 Print Wizard............................................................................................. 37
3.7.1.4 Stimulus properties ................................................................................. 37
3.7.1.5 Filter properties ....................................................................................... 41
3.7.1.6 Display properties ................................................................................... 45
3.7.1.7 Recording properties............................................................................... 46
3.7.1.8 Recording begin and end........................................................................ 47
3.7.1.9 Rejection ................................................................................................. 47

3.7.1.10 Optimized recording................................................................................ 48
3.7.1.11 Wave Reproducibility (Wave repro) ........................................................ 50
3.7.1.12 Research availability (only with research licence) .................................. 50
3.7.1.13 Special tests............................................................................................ 50
3.7.2 General Setup......................................................................................................... 51
3.7.2.1External Trigger Output........................................................................... 51
3.7.2.2 Auto Protocol Options (Separating ears)................................................ 51
3.7.2.3 Language ................................................................................................ 52
3.7.2.4 ECochG Area Function ........................................................................... 52
3.7.2.5 Quick stimulus rate.................................................................................. 52
3.7.2.6 Special Waveform Markers..................................................................... 53
3.7.2.7 Display Options....................................................................................... 53
3.7.2.8 Level measure method............................................................................ 55
3.7.2.9 Export Waveform .................................................................................... 55
3.7.3Latency Template................................................................................................... 56
3.7.4 Report Templates................................................................................................... 58
3.8 Printing ................................................................................................................................ 59
3.8.1 Print options from file menu.................................................................................... 59
3.8.2 Printer Setup........................................................................................................... 61
3.8.3 Print Wizard............................................................................................................ 61
3.9 Preparation Prior to Testing ................................................................................................ 64
3.9.1 Instruction of the patient ......................................................................................... 64
3.9.2 Visual inspection of the ear canal........................................................................... 64
3.9.3 Preparation of the Skin........................................................................................... 64
3.9.4 Placement of Electrodes......................................................................................... 65
3.10 Impedance Check................................................................................................................ 66
3.10.1 Insertion of eartips.................................................................................................. 66
3.10.2 Placement of bone conductor................................................................................. 67
3.11 ABR Masking....................................................................................................................... 67
3.12 ABR Threshold Determination............................................................................................. 68
3.12.1 Protocol Settings for Threshold Determination....................................................... 68
3.12.2 ABR Threshold Results .......................................................................................... 69
3.12.3 Protocol Settings for Bone Conduction ABR.......................................................... 70
3.13 Neuro Latency Examination................................................................................................ 71
3.13.1 Protocol Settings for Neuro Latency Examination.................................................. 71
3.14 Neuro Rate Study Examination........................................................................................... 72
3.14.1 Protocol Settings for Neuro Rate Study Examination............................................. 72
3.15 eABR – Trigger Enabled (if included in your license).......................................................... 73
3.15.1 Protocol Settings for eABR..................................................................................... 73
3.15.2 Using the Eclipse Trigger ....................................................................................... 74
3.16 ECochG (Electrochochleargraphy) (if included in your license).......................................... 76
3.16.1 Protocol Settings for ECochG................................................................................. 76
3.17 Cochlear Microphonic (CM) (if included in your license)..................................................... 77
3.17.1 Protocol settings for CM ......................................................................................... 77
3.18 AMLR (if included in your license)....................................................................................... 78
3.18.1 Protocol settings for AMLR..................................................................................... 78
3.19 ALR (if included in your license).......................................................................................... 79
3.19.1 Protocol settings for ALR........................................................................................ 79
3.20 P300 (if included in your license) ........................................................................................ 80
3.20.1 Protocol settings for P300 (if included in your license)........................................... 80
3.21 MMN (if included in your license)........................................................................................ 81
3.21.1 Protocol settings for MMN...................................................................................... 81
3.22 Loop Back............................................................................................................................ 82
3.23 EP 15/EP25 PC shortcuts ................................................................................................... 83
4Research Module........................................................................................................................... 85
4.1 Logging data (while recording)............................................................................................ 85
4.2 Exporting the single curve................................................................................................... 86

4.3 Exporting the whole session................................................................................................ 86
4.4 Exporting waveform when offline ........................................................................................ 87
4.5 Exporting data from another laptop..................................................................................... 87
4.6 Exporting other data............................................................................................................ 87
4.7 Technical details of the research module............................................................................ 88
4.8 Import of XML-file in external program................................................................................ 89
4.8.1 Import in Excel........................................................................................................ 89
4.8.2 Import in Notepad ++ (freeware), Microsoft notepad or Internet Explorer.............. 92
4.9 A practical demonstration of export:.................................................................................... 92
4.10 Has the insert tubing time delay been compensated?........................................................ 95
4.11 How to import WAV files for stimuli..................................................................................... 96
4.12 Da, Ba & Ga wavefile sounds.............................................................................................. 99
4.13 Extracting all sessions for selected patient. ........................................................................ 99
5VEMP........................................................................................................................................... 103
5.1 About the VEMP module................................................................................................... 103
5.2 The VEMP Menu Items ..................................................................................................... 103
5.3 General Operation of VEMP.............................................................................................. 104
5.3.1 Edit Tab ................................................................................................................ 106
5.4 System setup..................................................................................................................... 111
5.5 General Setup - VEMP...................................................................................................... 114
5.6Protocol settings cVEMP................................................................................................... 115
5.7 Preparing for the cVEMP................................................................................................... 116
5.7.1 Visual inspection of the ear canal......................................................................... 116
5.7.2 Preparation of the skin.......................................................................................... 116
5.7.3 Electrode placement............................................................................................. 116
5.7.4 Impedance check button ...................................................................................... 117
5.7.5 Test procedure and Instruction of Patient ............................................................ 117
5.7.6 Insertion of foam ear tips...................................................................................... 117
5.8 Performing a cVEMP measurement.................................................................................. 118
5.9 cVEMP Results.................................................................................................................. 119
5.10 Protocol settings oVEMP................................................................................................... 121
5.11 Preparing for the oVEMP .................................................................................................. 122
5.11.1 Visual inspection of the ear canal......................................................................... 122
5.11.2 Preparation of the skin.......................................................................................... 122
5.11.3 Electrode placement............................................................................................. 122
5.11.4 Impedance check button ...................................................................................... 123
5.11.5 Test procedure and Instruction of Patient ............................................................ 123
5.11.6 Insertion of eartips................................................................................................ 123
5.12 Performing an oVEMP measurement................................................................................ 124
5.13 oVEMP Results ................................................................................................................. 125
6ASSR........................................................................................................................................... 127
6.1 About the ASSR module ................................................................................................... 127
6.2 Brief Introduction to ASSR ................................................................................................ 127
6.2.1 Analysis ................................................................................................................ 127
6.2.2 NB CE-Chirp® for ASSR...................................................................................... 128
6.2.3 SNR in ASSR........................................................................................................ 129
6.3 The ASSR Menu Items...................................................................................................... 130
6.4 General operation of ASSR............................................................................................... 131
6.4.1 Toolbar.................................................................................................................. 131
6.4.2 The ASSR tab....................................................................................................... 133
6.4.2.1 The left panel user interface.................................................................. 133
6.4.2.2 EEG....................................................................................................... 134
6.4.2.3 Frequency Curves................................................................................. 134
6.4.2.4 Right clicking on a handle..................................................................... 135
6.4.2.5 The Table.............................................................................................. 136
6.4.3 The Audiogram tab............................................................................................... 137

6.4.3.1 Correction factors in Estimated Audiogram .......................................... 137
6.5 System setup..................................................................................................................... 139
6.5.1 Auto Tests Setup.................................................................................................. 139
6.5.2 General Setup....................................................................................................... 141
6.5.3 Report Templates................................................................................................. 142
6.5.4 Correction Factors................................................................................................ 143
6.5.4.1 Correction factor values ........................................................................ 143
6.6 Preparing for an ASSR measurement............................................................................... 145
6.6.1 Visual inspection of the ear canal......................................................................... 145
6.6.2 Instruction of patient ............................................................................................. 145
6.6.3 Preparation of skin................................................................................................ 145
6.6.4 Electrode placement............................................................................................. 146
6.6.5 Insertion of the Eartips.......................................................................................... 146
6.6.6 Impedance check.................................................................................................. 146
6.7 Performing an ASSR......................................................................................................... 148
Starting ASSR from OtoAccess™ or NOAH ..................................................................... 148
Performing an ASSR measurement.................................................................................. 148
6.8 ASSR Results.................................................................................................................... 149
6.9 BC ASSR........................................................................................................................... 151
6.9.1 Incorrect detection by transducer induced ElectroMagnetic Interference (EMI) .. 151
6.9.2 Placement of bone conductor............................................................................... 152
6.10 ASSR Masking .................................................................................................................. 153
6.11 NOAH Compatibility........................................................................................................... 155
6.12 ASSR PC shortcuts........................................................................................................... 155
7ABRIS.......................................................................................................................................... 157
7.1 About the ABRIS module .................................................................................................. 157
7.2 The ABRIS Menu Items..................................................................................................... 157
7.3 General Operation of ABRIS............................................................................................. 158
7.4 System setup..................................................................................................................... 160
7.4.1 General Setup....................................................................................................... 160
7.4.2 Report Setup......................................................................................................... 161
7.4.3 Password.............................................................................................................. 162
7.5 Preparing for a ABRIS measurement................................................................................ 163
7.5.1 Visual inspection of the ear canal......................................................................... 163
7.5.2 Instruction of patient ............................................................................................. 163
7.5.3 Preparation of skin................................................................................................ 163
7.5.4 Placement of Electrodes....................................................................................... 163
7.5.5 Impedance Check................................................................................................. 164
7.6 Performing a ABRIS measurement................................................................................... 164
7.7 ABRIS Results................................................................................................................... 165
7.8 ABRIS PC shortcuts.......................................................................................................... 166
8DPOAE ........................................................................................................................................ 167
8.1 About the DPOAE module................................................................................................. 167
8.1.1 Brief Introduction to DPOAE................................................................................. 167
8.2 The DPOAE Menu Items................................................................................................... 168
8.3 General Operation of DPOAE20....................................................................................... 169
8.4 DPOAE20 System Setup .................................................................................................. 173
8.4.1 Auto Test Setup.................................................................................................... 173
8.4.2 Template............................................................................................................... 174
8.4.3 Norm Data ............................................................................................................ 175
8.5 Preparing for a DPOAE measurement.............................................................................. 176
8.5.1 Visual inspection of the ear canal......................................................................... 176
8.5.2 Instruction of patient ............................................................................................. 176
8.5.3 Probe selection..................................................................................................... 176
8.6 Performing a DPOAE measurement................................................................................. 177
8.7 Results............................................................................................................................... 178

8.8 DPOAE PC shortcuts ........................................................................................................ 182
9TEOAE......................................................................................................................................... 183
9.1 About the TEOAE25 module............................................................................................. 183
9.2 Brief Introduction to TEOAE.............................................................................................. 183
9.3 The TEOAE25 Menu Items ............................................................................................... 184
9.4 General Operation of TEOAE25........................................................................................ 185
9.5 TEOAE25 System Setup................................................................................................... 187
9.5.1 Auto Test .............................................................................................................. 187
9.5.2 General Setup....................................................................................................... 189
9.5.3 Printer Layout ....................................................................................................... 190
9.5.4 Report Templates................................................................................................. 191
9.5.5 Auto Screening..................................................................................................... 192
9.6 Preparing for a TEAOE measurement .............................................................................. 193
9.6.1 Visual inspection of the ear canal......................................................................... 193
9.6.2 Instruction of patient ............................................................................................. 193
9.6.3 Probe selection..................................................................................................... 193
9.7 Performing a TEAOE measurement.................................................................................. 194
9.7.1 Probe Check......................................................................................................... 194
9.7.2 Rejection level ...................................................................................................... 194
9.7.3 Start the test ......................................................................................................... 194
9.7.4 TEOAE Results..................................................................................................... 195
9.8 TEOAE PC shortcuts......................................................................................................... 197
10 FAQ & Trouble Shooting.............................................................................................................. 199
10.1 General FAQ ..................................................................................................................... 199
10.2 FAQ – ABR........................................................................................................................ 204
10.2.1 ABR preparation................................................................................................... 204
10.2.2 ABR Recordings................................................................................................... 204
10.2.3 ABR user interface................................................................................................ 207
10.2.4 ABR Latency data................................................................................................. 208
10.2.5 ABR Disposables & Accessories.......................................................................... 209
10.2.6 ABR System ......................................................................................................... 210
10.3 FAQ – VEMP..................................................................................................................... 211
10.4 FAQ – ASSR ..................................................................................................................... 212
10.5 FAQ – DPOAE................................................................................................................... 215
11 Dictionary..................................................................................................................................... 217
12 References & Relevant articles ................................................................................................... 223

Throughout this manual the following meaning of warnings, cautions and notices are used:
WARNING indicates a hazardous situation which, if not avoided, could re-
sult in death or serious injury.
CAUTION, used with the safety alert symbol, indicates a hazardous situa-
tion which, if not avoided, could result in minor or moderate injury.
NOTICE NOTICE is used to address practices not related to personal injury.

Eclipse Additional Information Page 1
1Launching the software
1.1 Starting up from OtoAccessTM
Ensure that the Eclipse is on, before performing recordings and then open the software module. If the hard-
ware is not detected the selected Eclipse module can still be opened in reader mode.
When the system is in reader station mode, it is not possible do any recordings. However, it is still possible to
examine, filter and label all recordings.
To start from OtoAccess™:
1. Open OtoAccess™
2. Select the patient you want to work with by highlighting it blue.
3. If the patient is not yet listed:
press the New client button
fill in at least the mandatory fields, marked with a red asterisk.
save the patient details by pressing the Save patient information button.
4. Select Instrument will show the modules you have for your Eclipse. EP15/25, ASSR, DPOAE, TEOAE,
and ABRIS are modules related to the Eclipse. Double click on the module to start the test.
1.1.1 Module Setup in OtoAccess™
If the software module icon does not appear in the Select Instrument box in OtoAccess™:
1. Go to File | Setup | Instruments tab
2. Create a new instrument, by:
a. Type in the Software module name in the New Instrument name field
b. Select the relevant module from the Software modules dropdown menu
c. Select Eclipse from the Hardware dropdown menu
d. Select USBconnection
e. Press Create
f. Press Apply Settings
g. Press OK to exit

Eclipse Additional Information Page 2
.
For further instructions about working with the database, please see the operation manual for OtoAccess™.
1.2 Starting up from NOAH (ASSR only)
1. Open NOAH
2. Select the patient you want to work with by highlighting it orange
3. If the patient is not yet listed:
press the Add a New Patient button
fill in the required fields
save the patient details by pressing the OK button.
4. Double click on the ASSR module.
For further instructions about working with the NOAH database, please see the operation manual for NOAH.

Eclipse Additional Information Page 3
1.3 Change & view License
The License keys of the Eclipse are specific for each serial number and define which modules and tests
functionalities are available.
As a user you always have the opportunity to upgrade your software to a newer version. The License is
found under Help | About for all module on the Eclipse.
If for instance you want to upgrade from EP15 to EP25, this can be done by a change of the license key
number written in the dialog box About. Interacoustics A/S has to get the serial number from the customer in
order to create a new license key.
The Eclipse serial number is located on the backside of the Eclipse. Alternatively the DSP serial number
01.003.230 can be used.
This license key is stored in Eclipse, as well as in the Interacoustics manufacturing database, so that we can
find the license key already stored in the box, even if the customer gives us only the serial no of the DSP
board mentioned above.
When pressing the license button you open the License Manager. In this dialog box it is possible to enter the
new license key. When the dialog box comes up, the old license key is already marked, so that it is possible
to press Ctrl+C and then paste this string into an email, in order to send the old license key to us.
When you receive the new License number from your manufacture enter/copy it in the field New License
Key. When entered press OK.
Note In the License Manager, it is only possible to press OK, if a valid license key is entered. Therefore it is
not possible for you as a user to enter an invalid license key and this way make the system un-useable.

Eclipse Additional Information Page 4
When pressing OK the program asks to store the new license key. Press Yes to overwrite the old License
key. The application has to be restarted in order to activate the new features.

Eclipse Additional Information Page 5
2Ensuring the Eclipse is working properly
2.1 Calibration of Eclipse
It is recommended that an Interacoustics distributor calibrate the instrument once a year.
Two types of calibration are used in the world of AEP – peSPL (peak equivalent Sound Pressure Level) and
nHL (normal Hearing Level).
peSPL is an objective measure of the sound stimulus pressure level. For a given peSPL dB value, the max
acoustical or vibration level is calibrated to match the level of continuous tones used to obtain the same
dBSPL reading on a sound level meter. As the duration of sound stimuli for AEP are extremely short, the en-
ergy delivered is not perceived with the same subjective loudness as the equivalent stimulus would provide,
if it were a continuous tone. Therefore the acoustical or vibration value given in dB peSPL does not corre-
spond very well with normal HL figures. For Clicks there is a 35.5dB difference (70dBpeSPL sounds as
35dBHL), and for Tone Bursts the differences are in the 20-30dB range depending on frequency and number
of sine waves used in burst.
Stimulus intensity is limited to 135.5dBpeSPL by the transducers.
nHL is a correction, which compensates for the difference in perceived loudness of the very brief stimuli like
Clicks and tone bursts. There is therefore a direct similarity between the indicated level in nHL and the HL
levels well known from normal audiometry. Brief tone burst correction values from peSPL to nHL are based
on a 2-1-2 manual burst as specified in ISO 389-6-2007. Longer duration tone bursts for AMLR and ALR are
employing peRETSPL values similar to continuous pure tones (as used in conventional audiometers) since
the temporal integration of tones lasting at least 50ms is considered sufficiently trivial to ignore.
Note Reference calibration values for the CE-Chirp®stimulus family are not specified in the current interna-
tional calibration standard (ISO 389-6), and the applied peRETSPL values have therefore been derived from
two studies: (1) by PTB in Germany (2008), and (2) by DTU in Denmark (Gøtsche-Rasmussen et al., 2012).
The mean of the values obtained in the two studies, rounded to the nearest 0.5 dB, are used by Interacous-
tics A/S to calibrate the broad-band CE Chirp® LS and the four frequency specific NB CE-Chirp® LSs deliv-
ered by the ER-3A earphone.
The following tables give the reference equivalent thresholds for various stimuli in dB peSPL and dB peVFL
Note The RETSPL figures given for ABR 3A inserts are for measurements made in an occluded ear simula-
tor (IEC 60318-4 / 60711) not a 2cc / HA-2 coupler, for which different values apply. Unofficial figures for the
HA-2 coupler are available at: http://hearing.screening.nhs.uk/calibration.
Remember to check Eclipse stimuli levels. An easy sound check with the transducer left on the table
is often a good manual weekly procedure.

Eclipse Additional Information Page 6
2.1.1 peSPL to nHL correction values
Toneburst
ECochG/ABR15/ABR30/AMLR/Neuro/VEMP 0 dB 2-1-2 cycle
linear envelope
Toneburst
ALR/MMN 0 dB 25-50-25 ms
Hz
Insert Phone
Headphone
Bone
Hz
Insert Phone
Headphone
Bone
250
28
32
74.5
250
17.5
27
67
500
23.5
23
69.5
500
9.5
13.5
58
750
21
19
61
750
6
9
48.5
1000
21.5
18.5
56
1000
5.5
7.5
42.5
1500
26
21
51,5
1500
9.5
7.5
36.5
2000
28.5
25
47.5
2000
11.5
9
31
3000
30
25.5
46
3000
13
11.5
30
4000
32.5
27.5
52
4000
15
12
35.5
ISO 389-6:2007
ISO 389-1:2000, ISO 389-2:1994, ISO 389-3:1994
Click
ECochG/ABR15/ABR30/AMLR/Neuro/VEMP 0 dB
Click
ALR/MMN 0 dB
Insert Phone
Headphone
Bone
Insert Phone
Headphone
Bone
Click
35.5
31
51.5
Click
35.5
31
51.5
NB CE-Chirp® LS
ECochG/ABR15/ABR30/AMLR/Neuro/VEMP 0 dB
NB CE-Chirp® LS
ALR/MMN 0 dB
Hz
Insert Phone
Headphone
Bone
Hz
Insert Phone
Headphone
Bone
500
25.5
25
74
500
25.5
25
74
1000
24.0
21.0
61.0
1000
24.0
21.0
61.0
2000
30.5
27
50
2000
30.5
27
50
4000
34.5
29.5
55.0
4000
34.5
29.5
55.0
CE-Chirp® LS
ECochG/ABR15/ABR30/AMLR/Neuro/VEMP 0 dB
CE-Chirp® LS
ALR/MMN 0 dB
Insert Phone
Headphone
Bone
Insert Phone
Headphone
Bone
31.5
27.0
51.0
31.5
27.0
51.0
Only toneburst correction values change for ALR & MMN testing.
For Click and CE-Chirps® LS, the same correction is applied.
Maximum stimulus intensity is limited to 100dBnHL by the air conduction transducers.
The ABR unit leaves the factory with nHL calibration, but it can easily be changed to peSPL values. Please
refer to the FAQ or contact your local Interacoustics distributor if you are interested in changing the calibra-
tion unit.

Eclipse Additional Information Page 7
2.2 Limiting noise in the test environment
The smallest ABR signals are in the size of 100-150nV close to threshold, so it can be difficult to obtain a
good SNR.
Proper grounding is essential in order to obtain a response with a minimum of electrical noise.
Try to ensure:
1. A dedicated ground for the Eclipse will reduce noise, please consult with the chapter Grounding.
2. Electrical interference must be minimize in order to get the best ABR waves for threshold estimation;
please turn off other equipment’s not used or move them further away from patient.
3. Always connect the patient bed/chair to the Eclipse ground outlet; this will reduce electrical noise fur-
ther.
4. An electrical shielded room can be used to avoid electrical noisy from the environment.
2.2.1 Grounding
Grounding is crucial for cleaner ABR waves and safe operation. The ABR system cabinet is connected to the
ground lead. If the ground lead is not connected or poor, the ABR system will pick up electrical noise/interfer-
ence. This is on the screen as very large harmonic distortion curves completely overlaying the ABR curves.
An electrician can often easily wire a separate ground to the power outlet and swap the ground in this
socket. The time/money the electrician spends is much worth when it comes to the saved time for less noisy
ABR measurements.
Due to High Voltage, only experienced technicians/ properly trained staff must change and check the ground. Typically
an electrician has a dedicated ground tester where they can measure the quality of the ground.
Do not connect the Eclipse to a safety transformer, as a safety transformer is built in to the Eclipse already.
When ensuring grounding be aware of the following:
1. We must instruct the electrician that we are trying to record ABR signals as tiny as 100nV, as most of
them will determine that their ground is good enough for the house. Yes is might be good enough for
laptops, PC’s or televisions – BUT NOT for ABR!
2. It is highly recommended to use a separate ground, as other equipment in the building can easily pol-
lute the ground (discharging current, spikes and noise to the ground).
3. There should be maximum 8 ohm between the earth rods to the place where ground is used with the
Eclipse.
2.2.2 The best Test Site & Setup for ABR recordings
1. If Laptop/PC is connected to power outlet – an optical USB cable must be used in order to maintain
patient safety (optical cable available).
2. An electric magnetic shielded room – typically soundproof.
3. Dedicated separated ground for only the ABR recording site.
4. The bed framing may act as an antenna. Ground it to the backside of the Eclipse and turn of the
power when connecting the cable . In worst case replace the bed with a wooden/plastic chair bed
and check whether the metal bed was the reason for noise.

Eclipse Additional Information Page 8
5. Always disconnect any powering of the patient bed during ABR test. It will cause more noise. We
have several cases where the noise was more than halved after the patient bed was disconnected to
power. A bed with a battery can cause noise even when the bed is not plugged into the wall, and
should be replaced with a bed without a battery.
6. Try to move the test site within the room; patient might be close to a power cord etc. perhaps hidden
in the wall close to patient and electrodes.
7. Position patient/child with head towards center of the room, not the wall, especially if there is a power
source at the head of the bed.
8. Request a quiet room, preferably away from roads, rooms containing power supplies/fuse boards.
9. Do not position equipment near mains sockets.
10. The test room should be placed away from devices causing electrical interference (e.g. autoclaves,
microwave ovens, mobile phones, hospital pager systems, lifts, escalators, air conditioning systems,
etc.).
11. Light and other electrical equipment not being used should be turned off as the patient will work as
an antenna and pick up electrical interferences.
12. Remember to turn off all other electrical equipment not used in the room, especially sources with
neon lights.
13. Do not use light dimming switches (a notorious source of interference).
14. Electrical interference may also appear through the ground lead if this is interconnected to many
computers, autoclaves, instruments using high power etc.
15. Unplug any non-essential networked computers in the room, remembering to remove the network
cable from the data socket located on the wall.Make the patient lay down to reduce interference
from neck muscle contractions.
16. For babies be prepared to suggest alternative positions, e.g. for the baby to be placed in a car seat,
rather than being held by a parent.
17. In some cases, it may be necessary to find another test location if there is too much ambient acousti-
cal or electrical noise.
Operating rooms
1. Operating rooms are usually acoustically noisy. Insert earphones help attenuate ambient acoustic
noise and are safer in post-myringotomy cases where blood could make an electrical connection be-
tween the patient and the transducer, but the transducer should be held (with a drip stand) at a
higher level than the tip to avoid blood entering the transducer under gravity.
2. Pulse oximeters are sometimes the source of electrical interference. Try turning it off to see if this
eliminates the interference (if so, then negotiate with the anaesthetist to do without if possible). If an
oximeter is used, position as far away from patient and equipment as possible (at patient’s feet end).
Even if the oximeter is run on battery it may create interference.
3. Sedation pumps (mostly running on batteries) should at any time be positioned as far as possible
away from the patient electrodes.
4. If many types of equipment are connected to the patient, use the same power outlet to minimize the
small current leakage through patient.
2.2.3 Limiting noise - Equipment setup
1. Always check the wall outlet for a proper ground when establishing an ABR test room. Sometimes
the ground lead is found inside the wall outlet, but is not connected to ground.
2. Carry out listening check if no responses are seen or unusual waveforms are recorded.
3. Odd-looking responses can be recorded if the electrode leads are incorrectly connected (response
may be inverted) and a flat-line is likely if we inadvertently record across the mastoids.
4. If interference occurs try running the laptop on battery, disconnected from its power supply and with
the power supply unplugged (check battery charge is adequate to complete the test).
5. Do not cross over any leads or cabling, especially electrode, transducer, and power supply leads.

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2.2.4 Limiting noise - During testing
1. Run electrode cable from one direction to the patient and earphone tubes or cables from the other
direction to the patient – do not let them cross.
2. Run electrode leads close together or better braid the electrodes leads.
3. It is a common mistake to place the active electrode too low and the mastoid electrode too high.
4. The preamplifier electrode “ground” lead can be used to address noise.
5. Ex. Patient is connected to a pulse oxygen meter left arm, or ECG heart monitor move the ground to
left shoulder. Noise is now lead first to the ground and the driven right leg preamplifier which will re-
duce the electrical noise on the Vertex, R/L leads.
6. When the patient is connected noise levels can differ more, relative to when measuring the noise
level without the patient connected. Therefore, it is important to check the noise levels without the
patient connected to the system by using the LBK15 artificial patient.
7. Adjust the rejection on screen. The most appropriate input rejection level on screen is equal to or less
than 40uV. Typically ABR recordings should be made with an input gain level of 40uV. The lower the
rejection the more sensitive the system. The rejection level should be increased until the real time
EEG signal is not red and rejected.The higher the gain the more noise is recorded, always use the
lowest gain possible, without rejection.
8. Make sure that your electrodes are mounted correctly by checking the impedance.
9. Instruct the patient to berelaxed and calm – a sleeping patient can deliver good ABR/ASSR/ABRIS
results. Eyes should be closed. Please refer to the section “Preparation Prior to Testing” for a de-
tailed description of a good ABR procedure including instruction of the patient and placement of elec-
trodes.
Note It’s important to have the same test conditions and parameters in each test when comparing results.
2.2.5 Changing protocol settings to limit electrical interference
In the ABR module go to File | System setup | Auto Protocols setup tab to check how different elements
(filter settings, stimulus rate), which may help you optimize your ABR recordings.
Increase the high pass filter from 33Hz to 100Hz 12/oct.
Choose another stimulus rate ex. 11.1 stim/sec to allow better neural syn-
chronization.
If repeatable noise is recorded, use the feature Minimize Interference.
Please note using a filter setting like this may reduce the amplitude in the ABR waveforms and degrade the
accuracy of hearing threshold measurement tests. However it may be needed if it is impossible to obtain
ABR curves without excessive electrical interference e.g. 50Hz.
2.2.6 Determination of noise during a recording
Before starting a measure with stimuli it can be beneficial to check the amount of noise.
Therefore it is beneficial to have a reference where you start measuring with the electrodes mounted on pa-
tient and the insert phones placed in the ear canal but with the tube of the insert phones clamped.
That will provide you with a baseline of all recorded information collected when no sound is present. The op-
timal recordings for right and left respectively are then two flat lines indicating that picked up noise is aver-
aged out.

Eclipse Additional Information Page 10
2.3 Service check using the Loop back box (LBK15)
The ABR system can be tested using the loop back box LBK15. The test can be used to check the recording
and stimulating circuits of the Eclipse and the Preamplifier with attached cables.
Note that the LBK test can only be used for testing the EP15/25 system and is not valid for functional testing
of the ASSR and ABRIS detection algorithms.
1. Testing the electrical stimuli and recording path
Connect the loop back box to the pre-amplifier using the cable with electrode buttons and connect the
LBK15 jack plug to the right (red) or left (blue) headset channel on the Eclipse.
2. Start the EPx5 software and select the LoopBack - LBK15 from the protocol list.
3. Check the Preamplifier impedance circuit. Choose Impedance mode (IMP) setting on LBK15 and Pream-
plifier and turn the impedance knob on the pre-amplifier to around 3kOhm. The LED´s must change from
red to green when the impedances on the artificial patient (LBK15) are below 3kOhm.
If it does not turn green around 3kOhm, it can indicate a broken electrode cable or preamplifier cable. Ex-
change the broken part.
While Impedance mode is enabled the EEG will indicate full rejection on the screen.
Press the Imp button on the preamplifier again when finished to turn off Impedance mode.
4. You should be able to perform the test with an input gain of +/- 40µV. The EEG curve should be black be-
fore you start the test. Repeat the test on the other channel if both must be tested.
Note If the EEG curve is red it can indicate no/poor ground is connected to the Eclipse or you have to
search for noise sources (see the section “Limiting noise in the test environment” to help you locate the
noise source).
5. To check the signal output, start the test. The evoked potential for right and left with an output at 80dB
should be similar (in fact they are never 100% similar as the individual calibrated transducers are not con-
nected), see picture example below. If one is much smaller/bigger than the other there might be a prob-
lem with the pre-amplifier or output stage to the transducers in the Eclipse, perform a listening check of
the transducers to check if the output are similar.
An intensity deviation can be adjusted with a software calibration (see the service manual for calibration
guidance).