> ## Tympanogram

> The Tymps tab lets you display and modify tympanograms. Tympanogram waveforms can be downloaded directly into the computer using a serial port device (see Working with an audiometer or tympanometer). You can also type in key tympanogram values into the Tympanometry table. However, in this case, there are not enough data points to generate a graph.

> Note: If you use the serial port to download graph data and the graph type is not currently being displayed you will receive a warning indicating that the computer has received the data but does not have a way to display it.

> Use the pop-up lists below each graph to select the desired tympanometry test and select which ear to view (Right, Left, or Both). The tympanometry test displayed by default for new records can be specified as a user preference (see AudBase). If both ears are displayed on a single graph, the left ear is shown in blue and the right ear is shown in red. Additionally, if needed, the axis will automatically re-scale to fit both ears on the same graph.AudBase stores the data for all of the tympanometry tests entered on this form in a single record.

> If a tympanometer is connected for download, the Tympanometry table will be automatically completed by AudBase once the graph is displayed. You may override the values in the table. However, overriding the values in the table will permanently change the data set. In other words, you will lose some of the original downloaded data as it is replaced by your manual values.

> Note: Clicking on Erase Displayed Tymp will erase the graph and the downloaded data that created that graph. Users who have privileges to unlock and modify saved records can use the Erase Displayed Tymp function after a record has been saved.

> If a related tympanogram record has been previously created, you can connect that tympanogram to your audiogram record.

> To select a related tympanogram
> 1. Click on the Select Related Tympanogram button to choose between available
>    records.
>    The list of tympanograms associated with the subject appears as a Related record.
> 2. Select the tympanogram related to this audiogram and click on OK. If there are no tympanograms listed, or the subject's most recent one is missing, you need to update the appropriate records for this subject. (See Tympanogram).

> The tympanogram information appears. AudBase automatically enters the Tympanogram Date.

> Note: An audiogram record may only be related to a single tympanogram record. However, a tympanogram record may be related (using the Tympanogram tab on the Subject Studies form) to multiple audiogram records.

> #### Reflex/Reflex Decay tests

> The Reflexes tab of the Audiogram form lets you add further values to the graph based on acoustic reflex testing. Rather than using the palette to place icons, you enter values in the Acoustic Reflexes table below the graph, which then appear on the graph. The pure tone testing results remain on the graph to allow quick comparison.

> The table allows you to enter dB values for 500, 1000, 2000 and 4000 Hertz tones as well as noise for AD and AS ear stimulus both contralateral and ipsilateral ear measurement. All entry is by pop-up list, and you can specify No Response values.

> To record reflex test results
> 1. Locate the Acoustic Reflexes table on the bottom of the Reflexes tab of the Audiogram form.
> 2. Select the dB value from the pop-up list that corresponds to the appropriate measurement value field.
>    When appropriate, icons appear on the graph corresponding to the value you have entered. Selectable values inclue CNT "Could Not Test" and UdB "Unspecified". The UdB value is available to maintain compatibility with tympanometers which screen for reflexes, but do not specify the dB level.
> 3. Indicate No Response values by first entering the highest test value in the dB field and then clicking in the Absent field to its right.
>    The "@" symbol appears in the field, and a downward arrow is attached to the icon on the graph.
> 4. Enter reflex decay results by selecting from the pop-up lists in the corresponding table.
>    You can also select C(ontralateral) and I(psilateral) stimuli.

> #### Notes

> ####

> The Notes field on the Notes tab allows you to record and store text that you can use later as search terms in the database (see Searching) and for printing on the appropriate forms. You can either type directly in the field or enter comments from the pop-up Standard Comment List. The pop-up list includes standard comments and special text items designated by brackets. The standard comments can be up to 255 characters long and the list of standard comments can be modified (see Modifying lists). Special text items include the spondee stimulus and word recognition test information as well as a extended comments which can be up to 32,000 characters in length. Extended comments can be used to create a history and physical template with blanks to be filled in. Extended comments are modified in preferences (see Audiology (Admin)).

> The Masking Info and Bone Transducer Info fields contain text that has been automatically entered by AudBase. These fields are not recorded in a database field. However, you can copy and paste any information from them into the Notes field so that it can be used as a search term.

> #### Other Note page items

> For audiology practices with multiple facilities (locations) and/or multiple audiology booths (sublocations) these can be selected from the appropriate pop-up lists and printed on the forms (see Customizing Print Form Footers in Audiology (Admin)). The individual lists can be modified (see Modifying lists).

> The Other Information list is a modifiable list which allows individual items to have different pop-up list values associated with them (see Modifying lists). An item in the list can be dragged-and-dropped onto the Notes field where it will be added along with its associated pop-up value for printing purposes.

> #### AMA Handicap

> AMA Handicap can be calculated using the Special > Calculations > AMA Handicap menu item. The result will be placed in the Notes field on the Audiogram Notes tab, which is saved in the Notes data field.

> #### Working with an audiometer or tympanometer

> Users with a special cable can connect an audiometer to a serial port on their computer and download test values directly into AudBase. Three menu items pertain to this function:

> - File > Serial Comm Protocol: Opens a Serial Port Settings form where you can set port, protocol, baud rate, and other parameters. You can also set up default values for these settings (see Audiology (3)).
> - Audiogram > Open Serial Port/Close Serial Port: This menu item opens and closes the serial port for connection to the audiometer or other instruments. You can also set up the serial port to automatically open (see Audiology (3)).
> - Audiogram > Display Serial Port Info: This menu item opens a floating windowwhich displays the serial port data stream. This information can be useful for troubleshooting serial port connections.
> - Special > Serial Port Device: This item allows you to choose the type of serial device you will be using. You can also set up default values for these settings (see Audiology (3)).
> - Special > Audiometer Options: This menu item controls how the data being downloaded can be reinterpreted on the fly. (1) When Sub(stitute) selected soundfield types or Sub(stitute) bone types are selected generic soundfield or bone field values being downloaded from the audiometer are converted to the types selected in the icon palate. Please note that all soundfield values being downloaded at the same time will be interpreted the same way. Some audiometers can download `long' records which include all the soundfield values collected during an audiogram. If Soundfield Left and Right values are sent together they will all be interpreted the same way and the order they are sent in will affect the values which are saved (see the next menu item) (2) Multi-input: clear all pure tones erases all previously entered pure tone values before interpreting a `long' data record. In contrast to `short' records which typically download single pure tone values from an audiometer, `long' data records sent by some audiometers include all the pure tone values stored by the audiometer. If this menu item is NOT selected any N.D. values sent by the audiometer will not overwrite previously saved values. An example of how to use this feature would be when collecting all combinations of a subject with a hearing aid and a cochlear implant with each turned on or off (AR, CL, ARCL). Each test condition could be run for all the frequencies then downloaded using the `long' record form and choosing the Sub(stitute) selected soundfield types menu item. Each would be added in turn to the accumulating audiometric data. (3) If Soundfield SAT\SRT\WR Entry is selected generic speech values being downloaded from the audiometer are converted to the type currently being displayed on the form. (4) Fill next open WR position feeds speech values into the next open word recognition position.

> #### Resetting audiograms

> ####

> You can erase all or part of the values entered on the Audiogram form using the Audiogram > Reset Audiogram menu item. A dialog appears giving you four choices:

> - Reset all entries
> - Reset audiogram/PTAs
> - Reset reflexes
> - Reset SRTs/Word Recs

> Users who have privileges to unlock and modify saved records can use the Reset Audiogram function after a record has been saved.

> #### Deleting audiograms

> The administrator, or a subadministrator who has been given the privilege, can delete audiogram records using the Audiogram > Delete Audiogram menu item. Other users can only delete an audiogram by clicking Cancel before saving the record.

> #### Change Hearing Level Standard

> The administrator can set the default value for new audiogram records using the Preferences form (see Audiology (Admin)). If the audiogram is unlocked the hearing level standard can be modified for this audiogram by selecting the Audiogram > Change Hearing Level Standard menu item. Other users can only delete an audiogram by clicking Cancel before saving the record.

> #### Display Comparison Audiogram

> If other audiograms exist for this subject they can be displayed in a floating window by using the Audiogram > Display Comparison Audiogram menu item.

> #### Display Word Lists

> Word Listscan be displayed in a floating window by using the Audiogram > Display Word List menu item. Word lists can be added by using the Preferences form (see Audiology (Admin)).

> #### Printing audiograms

> You have several options for printing audiogram results. The printing forms are available by using the File > Audiology Print Forms menu item. The Audiology Print Style form appears.

> Choose the desired print form from the list in the left box, and drag it to the right box. You may print multiple forms at the same time by dragging the desired forms, in order, into the box on the right. Once you have selected the desired print forms, click Update. To print the selected forms, go to File > Print Audiogram.

> Note: You can set default preferences for the print forms. (seeAudiology (3)). You can print the default forms by using the File > Print Audiogram menu item. To override the default settings temporarily, go to File > Audiology Print Forms. Add additional forms by dragging them from the left box into the right box. Delete unwanted forms by dragging them into the trash. Click Update, then go to File > Print Audiogram.

> AudBase also generates printouts of multiple audiogram records for a subject, which allows for side-by-side comparison. To generate these printouts, from the Subject Studies form click Print Multiform. Prior to the standard print dialog appearing you will be able to select the audiograms you want in the comparison. If a Related Tympanogram has been selected, the tympanogram record will also be printed as appropriate.

> Click on the Select Multiforms button to choose forms. An Audiology Print Style form appears.

> Choose the desired print form from the list in the left box, and drag it to the right box. In addition to the special multi-audiogram forms you can select single audiogram forms which will be printed for each selected audiogram. You may print multiple forms at the same time by dragging the desired forms, in order, into the box on the right. Once you have selected the desired print forms, click Update. To print the selected forms, click the Print Multiforms button.

> Note: You can set default preferences for the print forms. (see eAudiology (3)). You can print the default forms by clicking on the Print Multiform button on the Subject Studies form. To override the default settings temporarily, click Select Multiforms on the Subject Studies form. Add additional forms by dragging them from the left box into the right box. Delete unwanted forms by dragging them into the trash. Click Update, then click on Print Multiform.