El eco del experto

The cupula-endolymphatic system can be described through the physical model of the pendulum with critical damping, (i.e., the cupula after deflection quickly returns to the neutral position without overshooting) of which three constituent elements are represented by:

The vHIT consists of the selective analysis of each of the six semicircular canals through head impulse stimuli realized at high velocity ≥ 200°/sec for the horizontal canals and ≥ 150°/sec for the vertical canals.

Some elements are fundamental for a correct outcome and interpretation of the exam:

Prescriptive fitting algorithms are pivotal in the hearing device fitting process, aiding professionals in setting the initial device configuration, which should then be refined in collaboration with the patient. Most such algorithms require, at minimum, an assessment of air conduction hearing thresholds and frequency-specific amplification needs, while considering patient-specific variables like bone conduction thresholds, discomfort levels, gender, age, and earmold type.

IMC (Inter Module Communication) allows direct communication between the hearing aid fitting software, which controls the hearing aid, and the Real Ear Measurement (REM) software, such as the Inventis Maestro which controls the Inventis Trumpet REM system, through the popular hearing care software Noah. 

Every ear is very different! Automatic fittings take into account average data. Factors such as morphology as well as shape and length of the ear canal vary from person to person. Furthermore, two hearing aids may not deliver the exact same response curve. Variations in speaker response, microphone response, tubing length, depth of ear mold insertion, and so forth, can all influence the output of the hearing aid in the patient's ear. When the fitting is not correct, there is a good chance that the patient will come back many times in order to have the hearing aid adjusted.

In 1988, Gabor M. Halmagyi and Ian S. Curthoys introduced the Head Impulse Test (HIT) for the first time. In this test, the patient focuses on the examiner's nose tip while experiencing rapid, unpredictable, and rebound-free head movements. Its primary goal is to assess the canal function during high-velocity head rotations.

Accurate measurement of the Vestibular-ocular reflex (VOR) is crucial for diagnosing and managing neuro-vestibular disorders. While it might seem counterintuitive, alerting the patient is essential. Some clinicians skip this step when testing for vestibular nystagmus, which can lead to inaccurate results or missed diagnoses.

The vestibular system is a complex sensory system closely interconnected with the visual and central nervous systems. It responds to specific stimuli such as angular and linear head movements, with receptors divided into two types: type I (phasic) and type II (tonic) cells, each with distinct clinical expressions and evaluation methods.

The verification of hearing aid fittings be solely based on Real Ear Measurements (REMs) and validated prescriptive verification formulas like NAL-NL2 or DSLv5. Validating the verification process is equally important to ensure that the end user receives what they desired or required. This goes beyond addressing audibility and intelligibility, extending to their perception of loudness.