oticon Sumo XP Istruzioni per il montaggio
Fitting Guide Sumo XP
3
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.
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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.
Or
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.
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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
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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).
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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.
PC
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.
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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)
9
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.
10
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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