otometrics Hortmann Vestlab 100 User Manual Download Page 4

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Otometrics

Table of Contents

Hortmann Vestlab 100

• User Manual

3.6.1

VNG measurement window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

3.6.2

Video Goggles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

3.7 Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

3.7.1

Calibration Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

3.7.2

Nystagmus Editor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

3.8 Keyboard commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Test Battery

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

4.1 History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

4.1.1

History test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

4.2 Clinics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

4.2.1

Clinics test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

4.3 Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

4.3.1

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

4.3.2

Patient instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

4.3.3

Performing the Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

4.3.4

Calibration results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

4.3.5

Calibration editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

4.3.6

Calibration test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

4.4 Gaze test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

4.4.1

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

4.4.2

Patient instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54

4.4.3

Performing the Gaze test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

4.4.4

Gaze test score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

4.4.5

Gaze test editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

4.4.6

Gaze test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

4.5 Position test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

4.5.1

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

4.5.2

Patient instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

4.5.3

Performing the Position test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

4.5.4

Position test score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

4.5.5

Position test editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

4.5.6

Position test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

4.6 Positioning test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

4.6.1

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

4.6.2

Patient instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

4.6.3

Performing the Positioning test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

4.6.4

Positioning test score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

4.6.5

Positioning test editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

4.6.6

Positioning test settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

4.7 Calorics test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

4.7.1

Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

4.7.2

Patient instructions and preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

4.7.3

Performing the Calorics test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

4.7.4

Calorics test score . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67

Summary of Contents for Hortmann Vestlab 100

Page 1: ...Hortmann Vestlab 100 User Manual Doc no 7 50 0940_02 Part no 7 50 09400 0459 ...

Page 2: ...the prior written con sent of GN Otometrics A S Copyright 2011 GN Otometrics A S Printed in Denmark by GN Otometrics A S Denmark All information illustrations and specifications in this manual are based on the latest product information available at the time of publication GN Otometrics A S reserves the right to make changes at any time with out notice Version release date 6 September 2011 Technic...

Page 3: ...anual 13 1 5 1 Safety 13 1 6 Typographical conventions 13 1 6 1 Navigating this manual 13 2 Vestlab software 15 2 1 System startup 15 2 2 Main window 15 2 2 1 Icons and menus 16 2 2 2 Test icons 17 2 2 3 Menu bar 18 3 General test information 21 3 1 Patient consideration 21 3 2 Entering new patient data 21 3 3 Accessing existing patient data 23 3 3 1 Open patient folder 23 3 4 Program settings 23 ...

Page 4: ... 4 4 1 Description 54 4 4 2 Patient instructions 54 4 4 3 Performing the Gaze test 55 4 4 4 Gaze test score 55 4 4 5 Gaze test editing 56 4 4 6 Gaze test settings 57 4 5 Position test 58 4 5 1 Description 58 4 5 2 Patient instructions 58 4 5 3 Performing the Position test 58 4 5 4 Position test score 59 4 5 5 Position test editing 60 4 5 6 Position test settings 60 4 6 Positioning test 61 4 6 1 De...

Page 5: ...ng the standard report 78 5 3 Multi test report 80 5 3 1 Displaying the report window 80 5 3 2 Changing a multi test report 81 5 4 Creating a new multi test report template 82 5 4 1 Customize report items 82 5 4 2 Changes to cover page 84 5 4 3 Changes to document settings 86 5 5 Importing patient data 87 6 Troubleshooting 89 6 1 Vestlab Software 89 7 Vestlab Safety 91 7 1 Symbols used 91 7 2 Warn...

Page 6: ...4 Otometrics Table of Contents Hortmann Vestlab 100 User Manual ...

Page 7: ... ings and in generating relevant reports The system can be configured for a variety of tests with Irrigators and the ICS Bal ance Platform This User Manual describes the use of the Vestlab software in combination with the above mentioned devices It is intended to be read by medical personnel These read ers are assumed to have prior knowledge of the medical and scientific facts underlying the proce...

Page 8: ...tery charged laptop computer or a PC designed especially for use in medical environments that features an isolation transformer Depending on the configuration devices should be connected as follows Operating System Windows XP Professional Service Pack 3 Windows 7 32 bit only CPU Intel Pentium Dual Core or AMD Athlon 64x2 2200MHz Memory 1 GB Disk Space 10 GB Connectors 1x USB 2 0 port only for Hort...

Page 9: ... Hortmann Vestlab 100 hardware power cord to DC power supply AC DC converter to isolation transformer 5 Isolation transformer cable to medical grade outlet 6 Printer cable to printer port on laptop 7 Printer power cable to isolation transformer 8 Laptop power cable to isolation transformer 1 2 8 4 3 6 7 5 Printer Laptop Computer DC power supply Medical grade AC outlet Video Goggles Isolation Trans...

Page 10: ...n Device setup and software installation 3 4 6 2 5 1 7 8 Vestlab 100 Back Panel Connections 1 Video goggles 2 Footswitch or Irrigator cable 3 USB 4 PC laptop 5 USB 6 Light bar not available 7 Power input fuse 8 DC power input ...

Page 11: ...oftware 12 The data is stored in a separate location and will remain intact 1 Log on as administrator before installing the software 2 Insert the Vestlab Software CD The installation program will start up automati cally If it does not select Start Run and type the drive name for your CD ROM drive as in d setup exe where d denotes your CD ROM drive and setup exe is the command for starting the Setu...

Page 12: ... installation folder is C Program Files Vestlabxx It is recommended that the installation software be installed in this default folder in case technical support is needed The digits that you see in the folder name in place of the xx shown here identify the software version The digits are automatically inserted as part of the folder name ...

Page 13: ...cs 11 Introduction Device setup and software installation 6 After clicking Close double click the Vestlab icon on the desktop to start the Vestlab software When prompted click Yes to invoke the licensing dialog ...

Page 14: ... See Stimulus devices 28 To change the language displayed in Vestlab see Program settings 23 1 4 3 Uninstalling software 1 Close the Vestlab software 2 Right click on the Vestlab Indexer icon and choose End 3 Click on the Start button and click on Control Panel 4 Double click on Add or Remove Programs 5 Scroll through the list to find the current version of Vestlab 6 Click on the program name and ...

Page 15: ...ab 100 System for the first time 1 5 1 Safety This manual contains information and warnings which must be followed to ensure the safe performance of the Hortmann Vestlab 100 System Local government rules and regulations if applicable should also be followed at all times 1 6 Typographical conventions The use of WARNING CAUTION and NOTE For safety reasons and appropriate use of the Vestlab Software ...

Page 16: ...14 Otometrics Introduction Typographical conventions ...

Page 17: ...software 2 1 System startup 1 Switch on the computer 2 Initialize the software by double clicking on the Vestlab icon 2 2 Main window 1 Menu bar 2 Icon bar 3 Available tests depending on the configuration of your system 1 2 3 ...

Page 18: ...le tests 7 Review tab shows list of previous tests carried out on current patient 8 Test window 2 2 1 Icons and menus 4 5 6 7 8 Icons and menus New Ctrl N Enter new patient data Open Ctrl O Open existing patient data Close Close patient data Save Ctrl S Save patient data under current patient name Save As Save patient data under current patient name ...

Page 19: ... subtract its value before displaying data in diagrams Available for Calorics RIDT and Trapezoidal tests only Show video Show the video of the eye movements continu ously Available with video goggles only Goggles Video goggles are used as measurement device Only available in tests with measurements Balance Platform The ICS Balance Platform is selected as an input device Only available for Balance ...

Page 20: ...form a Balance Training test Balance Screening Perform a Balance Screening test Limits of Stability Perform a Limits of Stability test Test icons File New Enter new patient data Open Open existing patient data Close Close patient data Save Save patient data under the current patient name Save as Save patient data under user defined name Email it Email patient records to another party Print Print r...

Page 21: ...editor Display the Template editor dialog box to create a new template See Printing a report 77 New Display the Report Editor dialog box to create a new report Edit Display the Report Editor dialog box to edit the cur rent report Print Print the displayed report Settings Program Access the program settings See Program settings 23 Tests Access the test settings for each test see each test for expla...

Page 22: ... on top of each other horizon tally Tile Vertically Display all windows side by side each other vertically Close All Close all windows List List of all open windows Help Hortmann Vestlab 100 Display the electronic version of the manual ICS Balance Platform Display the electronic version of the manual Info Display the software version Licensing Display the license code for this software ...

Page 23: ...ions with a vestibular suppressant depressant or sedative effect all tests The patient should continue any medications that are considered to be life sus taining such as insulin heart seizure blood pressure anti depressant prescrip tions Patient instructions during the test Assure the patient that the test is painless and non invasive Instruct the patient in how to act during the test and make sur...

Page 24: ... date Enter patient s date of birth xx xx xxxx the software calcu lates the patient s age required Note Birth date format dd mm yyyy or mm dd yyyy is deter mined by the main computer setting Gender Select patient s gender male or female Height Enter patient s height in feet and inches or centimeters for mat determined in program settings selection Weight Enter patient s weight in pounds or kilogra...

Page 25: ...a 3 3 Accessing existing patient data 3 3 1 Open patient folder 1 Click the Open icon or select File Open 2 Highlight the desired patient to be selected 3 Click OK 3 4 Program settings 3 4 1 General The settings can be accessed from the menu bar Settings Program General ...

Page 26: ...nits Select Meters and Kilograms or Feet Inches and Pounds Operators Click on the New icon on the right to add operator names or click on the Delete icon to remove an operator s name Layout Select layout options Start switch Choose whether the system should emit a short auditory sig nal at the beginning of each test ...

Page 27: ...e folder where the patient data is to be stored Backup Define the folder where the patient data is to be stored dur ing backup and when backup should occur File name Choose how to display the patient data list and if the patient data is saved automatically If PatientID is selected a mini mum of four digits for the Patient ID is required EDP connection Configure the software to access the GDT inter...

Page 28: ...tual devices can be selected as well Mouse If you select the mouse as virtual device the software will record the movements of the mouse as movements of the eyes Note This feature is for demonstration and training purposes only Simulation If you select this as a device the movement of the eyes will be simulated Note This feature is for demonstration and training purposes only None If you select th...

Page 29: ...rols located on the video goggles allow the operator to make sure the eye image displays centers the pupil in the region of interest and focuses the eye image Software controls located on the Video Adjustments dialog box allow the opera tor to fine tune the video image for the eye 3 4 3 2 Video Adjustments Dialog Box To display the Auto Adjustments dialog box access a test under the New Test tab a...

Page 30: ...es available depending on your configura tion Note Tracking device Optokinetic device Rotary Chair are not available Threshold Slide the control to fine tune the threshold set ting Slowly move the threshold slider until the on screen color of only the pupil area of the eye is blue Brightness Slide each control to fine tune the on screen image brightness for the selected eye Contrast Slide the cont...

Page 31: ...al for caloric tests Profile B is setup to be less sensitive In the settings of every test the user can select the profile to be used This is valuable due to the different kinds of nystagmus beats provoked by dif ferent stimuli None If you select this item the software will disable all tests using the specific stimulus device You can still use the software to view previously collected data Bar Eye...

Page 32: ...a nystagmus beat should have to be counted as valid Minimum and Maximum SPV s Define the minimum and maximum slow phase velocity a nystagmus beat should have to be counted as valid Minimum and Maximum duration s Define the minimum and maximum duration of a nystagmus beat to count it as valid Ignore Artifacts Eye movements that resemble nystagmus but the system determines are artifacts indicated by...

Page 33: ... given time period and then detects the highest value Fastest nystagmus beats Detects the highest average slow phase velocity for the given number of consecutive nystagmus beats Frequency calculation Culmination 15s Counts the nystagmus beats in the 15 seconds before and after the culmination point of the veloc ity computation This is the recommended setting 30s after start for 30s Starts counting...

Page 34: ...ors and video camera lenses in the video goggles must be properly aligned with the patient s eyes and the images must be focused In the Auto Adjustments box the patient s eyes are properly aligned in VNG when the pupil is in the square region of interest and focused as the patient looks straight ahead The dialog box provides the operator with the ability to independently adjust and fine tune the d...

Page 35: ...n measured The live video will change accordingly Record button Record button Enabled when the measurement is started Click to start hard disk recording of the video Click again to stop recording Note Only one video clip the last that was per formed will be stored Repeat button Enabled as soon as the dialog is in measurement mode Click to return to standby mode Note To save multiple tests select e...

Page 36: ...back head strap in the other hand Take care not to touch the mirror Place the goggles on the bridge of the patient s nose ensuring the patient can still breathe 5 Pull the back head strap over the back of the patient s head below the inion bump on lower part of the back of the skull 6 Move the goggles on the patient s head to center and level the pupil Verify that the pupil is inside the box as cl...

Page 37: ... Follow all of the cleaning procedures in this section to avoid damaging the goggles Face cushion Note The face cushion of the VG 40 goggles can be replaced in the field This should be done every 6 months or anytime the face cushion shows significant wear See the VG 40 Goggle User Manual 1 Clean and disinfect using a pre moistened non alcohol based pad i e Audio Wipe or apply the solution to a sof...

Page 38: ...ning solution on a cotton swab Use only a cotton swab with an appropriate lens cleaning solution 2 Wipe the surface gently with the cotton swab using a rotary motion until the surface is clean Goggle housing The housing is made of molded PVC material which can be cleaned using a damp cloth moistened with a mild detergent and water solution Never spray or immerse the goggle components with the clea...

Page 39: ...ect the channel you want to edit by clicking the corresponding radio button 3 Click Reset to perform an automatic analysis 4 Click OK to confirm the changes 3 7 2 Nystagmus Editor Applies to all tests except calibration and platform tests Examination Repeat Repeat the data collection for that test The current test will be overridden New Analysis Reanalyze the data Settings Activate the Nystagmus A...

Page 40: ... Move to the beginning of the tracing End Move to the end of the tracing Page Left Move to the beginning of the tracing Page Right Move to the end of the tracing Channel Up Move up one tracing making it active Channel Down Move down one tracing making it active Delete Delete the selected nystagmus beat Edit ...

Page 41: ...is Activate the Nystagmus Analysis Settings dialog Reanalyze Re analyze the measurement Play Video Start video Delete Video Delete video Zoom in Zoom in Zoom out Zoom out Spread channels Spread the channels Overlay channels Overlay the channels Previous beat Select the previous nystagmus beat Delete Delete the currently selected nystagmus beat Next beat Select the next nystagmus beat ...

Page 42: ... video in seconds is reported in the lower right corner of the screen Video settings Start Start the video Pause Pause the video Stop Stop the video Close Close the window Replay Set to replay video continuously Stretch Set to stretch the video to the maximum size Duration of video ...

Page 43: ...ditor The following is an example of a caloric test The following is an example of a Position test The nystagmus editor window can be configured in size by moving the splitter bar between the two parts of the window The nystagmus editor window can be enlarged for larger screens ...

Page 44: ...d select Edit Delete or use delete mark icon H Horizontal channel V Vertical channel F Fixation channel M Mark channel To select channels click on the small buttons to the right To hide or re display chan nels right click on the buttons By left clicking and dragging these buttons upwards or downwards you can move the level of the traces To exclude the beginning and the end of the trace from the ca...

Page 45: ...amplitude as dots Gaze position positioning and further tests show SPV with dots for every nystag mus beat Select a single nystagmus beat by left clicking in the SPV diagram The trace above will move to that specific beat which will be highlighted Right clicking on a nystagmus beat will delete the beat to clean the trace The blue line represents the baseline average of SPV between the right and le...

Page 46: ...ft Arrow right Move the trace one second to the right Shift Arrow left Move the trace one second to the left Shift Arrow up Move the level of the channel upwards Shift Arrow down Move the level of the channel downwards Shift Home Spread the channels Shift End Overlay the channels Ctrl Arrow right Move the nystagmus beat mark to the next beat Ctrl Arrow left Move the nystagmus beat mark to the prev...

Page 47: ...st Battery 4 1 History The History window displays answers to questions defined by the tester Left click in the empty box to display the question Right click in the empty box to display optional answers to the questions ...

Page 48: ...ssment Findings In this field you can add clinical findings Enter clinical findings To save the text for future use highlight the text and right click Select Add to list to save for future use Select Delete from list to remove the text from the list Once text has been saved right click to access the text and then click on the text to insert into the Findings box Operator Select the name of the tes...

Page 49: ...t a time Positive Romberg is indicated when the patient sways backwards with head turned toward the affected side Sketching tool Function Arrow When selected click near the area of interest on the sketch and drag to create a line pointing to the area Text can be added to the caption window that appears once the mouse button is released Paint brush When selected click on the area of interest on the...

Page 50: ... patient moves To delete a mark right click Star Gait Instruct the patient to close his her eyes and walk 3 steps forwards and 3 steps back wards Positive Star Gait is when the patient cannot walk in a straight line Use the graph by left clicking the mouse to document where the patient moves To delete a mark right click Assessment In this text box you can enter a summary of the clinical findings A...

Page 51: ...ngs can be accessed from the menu bar Settings Tests Clinics Step test Unterberger Select to view the Unterberger diagram Star gait Select to view the Star gait diagram Romberg Duration s Set the test duration of the measurement Scale mm Set the scaling of the X and Y axis ...

Page 52: ...en using video goggles The Calibration bar optional can provide the stimulus 4 3 2 Patient instructions Instruct the patient to watch the blinking red light on the calibration bar When the left light is on look left When the right light is on look right The patient should only move his her eyes The patient should NOT move his her head 4 3 3 Performing the Calibration 1 Make sure the Goggles icon i...

Page 53: ... the patient is instructed and click the Start button to start the recording 4 3 4 Calibration results The result of a calibration is displayed in the diagrams of the test window Below the tracings is a list of all tests performed including the calibrations ...

Page 54: ...ion once the sliders have been adjusted This curve should have a straight maximum plateau and a minimum plateau where the minimum represents the eye position when watching the left LED and the max imum when watching the right LED These two extremes are used to calculate the calibration factor Note The software must know the calibration angle See Stimulus devices 28 The software can figure out both...

Page 55: ...s Only Horizontal If checked only horizontal calibration is per formed The factor for horizontal will be applied to the vertical channel Deselecting this box will allow the user to calibrate the horizontal and vertical channel Duration s Set the test duration of the calibration Angle Not available for the Hortmann Vestlab 100 Image File blk Not available for the Hortmann Vestlab 100 ...

Page 56: ... straight ahead with eyes as open as possible for 10 20 seconds 2 Instruct the patient to look to the left right and up down in no particular order for approx 10 seconds in each direction The patient should not try to reach extreme eye deviations since this could cause a physiological end point nystag mus of no clinical value Note Patient should only move the eyes The head should not move If the p...

Page 57: ...Gaze test score Gaze The diagram displayed is the Stoll type showing the result of the automatic analysis The relative position of the eye is determined Nystagmus beats of the same position are grouped and assessed for their velocity direction and frequency The arrows in the diagram show the direction points in direction based on patient looking at tester and intensity based on thickness of arrow ...

Page 58: ...f nystagmus beats in the particular gaze direction Ampø The average amplitude of nystagmus beats in the particular gaze direction Assessment Findings In this field you can add clinical findings Add clinical findings To save the text highlight the text and right click Select Add to list to save for future use Select Delete from list to remove the text from the list Once text has been saved right cl...

Page 59: ...o zero this will be greyed out Analysis profile Select the analysis profile to be used to detect nystagmus in the measurement The analysis profiles can be config ured from the menu bar Settings Nystagmus anal ysis Threshold Minimum response setting used to determine when nystagmus is present and displayed in the Stoll diagram View Layout Horizontal vertical Select the channels to be displayed on t...

Page 60: ...d In all 4 positions the measurement is started when the patient is comfortable If nec essary support the patient s head The position test does not measure cervical nystag mus but assesses nystagmus triggered by a certain head position in relation to gravity The patient must keep the eyes as open as possible during testing so that the video goggles can measure any eye movement 4 5 3 Performing the...

Page 61: ...ality of the measurement window is described in Measurement windows 32 4 5 4 Position test score Nystagmus beats Illustration of the occurring nystagmus beats showing the intensity and direction The arrows in the diagram show the direction points in direction based on patient looking at tester and intensity based on thickness of the arrow of the nystagmus A circle indicates no nystagmus detected ...

Page 62: ...agmus Editor 37 4 5 6 Position test settings Assessment Findings In this field you can add clinical findings Add clinical findings To save the text highlight the text and right click Select Add to list to save for future use Select Delete from list to remove the text from the list Once text has been saved right click to access the text and then click on the text to insert into the Findings box Ope...

Page 63: ...BPPV Nystagmus caused by BPPV typically occurs with a slight onset delay after the patient is re posi tioned and it rapidly decreases in severity until absent Position Duration s Set the test duration of the measurement Analysis profile Select the analysis profile to be used to detect nys tagmus in the measurement The analysis profiles can be configured from the menu bar Settings Nystagmus analysi...

Page 64: ... Stenger test The patient sits on the bed looking straight ahead with video goggles closed Note All tests should be started immediately after re positioning the patient to identify any nystagmus 1 To start the measurement double click in the top grid titled Head straight sit ting 2 The measurement window appears in standby mode Click Start to start record ing During recording instruct the patient ...

Page 65: ...head with video goggles closed Note All tests should be started immediately after re positioning the patient to identify any nystagmus It is recommended to video record the eye in order to identify any rota tional nystagmus 1 Move the patient s head to the right 45 and in a smooth quick motion bring the patient into a lying position with the head hanging downward but sup ported from the bed 2 When...

Page 66: ...Nystagmus Editor 37 4 6 6 Positioning test settings Assessment Findings In this field you can add clinical findings Add clinical findings To save the text highlight the text and right click Select Add to list to save for future use Select Delete from list to remove the text from the list Once text has been saved right click to access the text and then click on the text to insert into the Findings ...

Page 67: ...aluation Position Duration s Set the test duration of the measurement Analysis profile Select the analysis profile to be used to detect nys tagmus in the measurement The analysis profiles can be configured from the menu bar Settings Nystagmus analysis View Layout Channel distance Set the distance between the horizontal and vertical channel Channel scaling Set the amplitudes displayed for each meas...

Page 68: ...After each measurement open the visor to give the patient some time to recover usually 3 to 5 minutes between irrigations 7 Observe the pauses between the irrigations so that the labyrinth has a chance to return to a non stimulated state 4 7 3 Performing the Calorics test 1 Record the patient s spontaneous nystagmus 2 Start the measurement by double clicking in the grid or select Measurement Spont...

Page 69: ...ure the decreasing nystagmus curves 6 After the measurement the goggle visor is opened for the patient to recover before the next irrigation 7 Perform the other irrigations following the same procedure as above 4 7 4 Calorics test score Spontaneous nystagmus Shows the presence of any spontaneous nystagmus before the irrigation is started SPV diagram The diagram shows the slow phase velocity of eac...

Page 70: ...in a 30 second window t s Midpoint of the 30 second window where the peak frequency occurred FI Fixation index Is only calculated if the measurement included a fix ation period Assessment Findings In this field you can add clinical findings Enter clinical findings To save the text for future use highlight the text and right click Select Add to list to save for future use Select Delete from list to...

Page 71: ...ng at the frequency is not recom mended However Vestlab is capable of determining the frequency of nystagmus beats in a trace Depending on the settings the frequency can be calculated as an average over the whole measurement as an average of a 30 second period starting 30 seconds after the start of the measurement or as an average of the 30 second period around the culmination which was determined...

Page 72: ...t ear CL Cold irrigation left ear Original Formulas Vestibular Paresis VP Directional Preponderance DP 100 s irrigation s irrigation s irrigation all ear left ear right 100 CL WL CR WR CL WL CR WR 100 CL WL CR WR CL WL CR WR 100 s irrigation s irrigation s irrigation all left beats nyst right beats nyst 100 CL WL CR WR WL CR CL WR 100 CL WL CR WR WL CR CL WR ...

Page 73: ...he right side The reaction of the irrigation is not 35 s but 25 s because there were already 10 s before the irrigation And this is also valid for the opposite which shows the reaction of a cold irrigation of the right ear of the same patient a velocity of only 15 s to the left the velocity of the spontaneous nystagmus has to be added because the reaction didn t move from zero to 15 s but from 10 ...

Page 74: ...pontaneous nystagmus has to be subtracted which doesn t change the result for the VP but changes the DP significantly 4 7 9 Calorics test editing The result of the Calorics test is displayed in the test window To edit the result double click on one of the diagrams or select Measurement Calorics or right click and select Edit in the diagram See Nystagmus Editor 37 Directional Preponderance DP Calcu...

Page 75: ...dur s Define for how long the fixation light will turn on Fixation onset s Set when the fixation light will turn on Analysis profile Select the analysis profile to be used to detect nys tagmus in the measurement The analysis profiles can be configured from the menu bar Settings Nystagmus analysis Order Set the order in which the different tests are per formed Pause s Set the duration of the pause ...

Page 76: ...iagram Min nystagmus beats Set the number of nystagmus beats that should be present before they are taken into account for eval uation of the patient This is only activated if the Take into account box is checked Duration s Set the test duration of the measurement Analysis profile Select the analysis profile to be used to detect nys tagmus in the measurement The analysis profiles can be configured...

Page 77: ...n to move the marked test one position upwards in the list Click the Down icon to move the test one position downwards in the list To change the name of a test click on it to mark it then click on it again Press Enter when you have changed the caption Do not delete all letters from the test caption This will delete the test Channel scaling Set the amplitudes displayed for each measure ment 40 will...

Page 78: ...ms 40 will be displayed as 20 to 20 on the y axis SPV Scaling s Set the range displayed in the SPV diagrams if con figured see below Extra page for each meas urement If checked in the printout each measurement will be printed on an extra page Uncheck to save paper SPV diagram 3 meas urem Max If checked in addition to the traces a SPV diagram will be displayed with each measurement This option is o...

Page 79: ...atient file A multi test report contains the tests you select organized according to your prefer ences and can be saved with the patient file 5 1 Single test report Display the test desired for printing gaze position positioning calorics etc From the menu bar select File Print or click the print button On the printout the patient ID name and birth date appears in the header Find ings operator diag...

Page 80: ...onfiguring the standard report 5 2 Configuring the standard report Setting for items that define the standard report printout are accessed from Settings Program Printout These settings also define the basic setup for multi test reports ...

Page 81: ...ile under a new name To insert the new file follow these steps 1 Launch the Vestlab software 2 From the menu bar choose Settings Program Printout 3 Select Header Bitmap 4 Click the Browse button 5 Browse to the location of the new file and select the file Text Enter text to insert in the header Font Click Select to choose the font type and size Page Margins Change the top left right and bottom mar...

Page 82: ...report The standard template includes the standard report settings See 78 For an existing report select Report Edit Note If one or more reports for this patient already exist the report that is displayed or the most recent report is the one being edited The report window displays the current settings including the name of the template applied to the report For information about creating templates ...

Page 83: ... list of available templates For information about creating templates see 82 Additional changes can be made using the same procedures one uses when designing a new template See 82 With the report configured to your specifications click OK To print without pre viewing click Print To see a preview of the report before printing click Create Pre view To scale the preview for viewing change the Zoom pe...

Page 84: ...changes to the template as described in the procedures that follow 5 4 1 Customize report items Select tests to include Customize item size and position Click on the name of the item The name is highlighted The corresponding item in the preview changes is highlighted Select items to include Click on item name Item corresponding to selection is highlighted ...

Page 85: ...ion the cursor along the right edge Once the left right arrow appears drag to the desired width Alternatively to change the position and size of the items you can enter new values in the Report Items tab Change item position Change item dimensions Settings for item position and size Left mm Distance from either the left margin or the right edge of the item appearing at the left of this item Top mm...

Page 86: ... a text file created in another application The file must be saved as an RTF rich text format file Click Import RTF file to insert the file Change item starting position Settings for start position New page Places the item at the top of a new page The item is positioned slightly below the top margin unless Skip Top property on new page has been selected See Changes to document settings 86 New line...

Page 87: ... Creating a new multi test report template Note The cover page is included in the report only when selected from the list of items on the Report items tab Edit existing text Add delete tags Import file created in another application ...

Page 88: ... the Report items tab to start on a New page or New Line header items and font name and size Document settings Papersize Select the paper size from the drop down list Portrait Landscape Click on the icon for the preferred orientation Top mm Set the height of the top margin Right mm Set the width of the right margin Left mm Set the width of the left margin Bottom mm Set the height of the bottom mar...

Page 89: ...e between the bottom of the header and the top edge of all items set to New Page Standard header Select to insert the standard header Standard header is defined in Settings Program Printout Header bitmap Select to insert the desired bitmap in the header of the new template Press to locate the bitmap Select the bitmap image and click Open to insert Note When creating the bitmap it is recommended to...

Page 90: ...patient data 4 Highlight the patient file and click OK to view the file Note If the file is saved in Vestlab the data will never be able to be accessed with the CNG analyzer software To save the file in the Vestlab database use the Save As icon ...

Page 91: ...ent wears mas cara The patient has to remove the mascara The camera is set up for the wrong eye Select the correct button Right or Left in the Vestlab Software The infrared mirrors in the video goggle mists up Use anti misting agent and a soft cloth to clean the mirrors The eye position is too far from the center of the video cameras Adjust the horizontal eye posi tion of the VG 40 Video Gog gles ...

Page 92: ...90 Otometrics Troubleshooting Vestlab Software ...

Page 93: ... error message dialogs if program fails See the detailed information in the dia log box HortmannVestlab 100 Symbols Hortmann Vestlab 100 is marked with this symbol to indi cate compliance with Type BF of the safety standard EN 60601 1 Hortmann Vestlab 100 is marked with this symbol when it is important that the user refers to associated informa tion given in this manual Hortmann Vestlab 100 is CE ...

Page 94: ... this symbol to indicate that it is electronic equipment covered by the Directive 200296 EC on waste electrical and electronic equipment WEEE Hortmann Vestlab 100 is marked with this symbol to indi cate it is suitable for direct current Symbols on the Hortmann Vestlab 100 back panel see Device setup and software installation 6 HortmannVestlab 100 Symbols Hortmann Vestlab 100 Warning Notes Equipmen...

Page 95: ...ied with the system Note 8 To comply with EN 60601 1 1 the computer printer etc must be connected to the isolation transformer Note 9 Conductive parts with patient connection must not be in contact with other conduc tive parts at any time No defibrillators or HF surgical equipment should be applied to the patient when connected to Hortmann Vestlab 100 at any time Note 10 Connection to network or m...

Page 96: ...he equipment ONLY IF All assembly operations extensions re adjustments modifications or repairs are carried out by the equipment manufacturer or personnel authorized by the man ufacturer The electrical installation to which the equipment is connected complies with EN IEC requirements The equipment is used in accordance with the instructions for use The manufacturer reserves the right to disclaim a...

Page 97: ...N Otometrics A S System Capabilities Inputs 1 Eye 2 Channels Full Monocular Testing Simultane ous Collection of both Left and Right Eye Signals Coupling DC Response Resolution 0 1 Typical Horizontal and Vertical Linearity 1 Full Scale Horizontal 1 2 Full Scale Vertical Sampling Rate Full 60 Hz for All Tests Software Windows Graphical User Interface High Performance Analysis Software Database Stora...

Page 98: ...n Continuous Operating Environment Temperature 15 C to 35 C 59 F to 95 F Rel Humidity 0 to 90 non condensing Warm up time 2 min Air Pressure 600 hPa to 1060 hPa Operations at temperatures below 20 C 4 F or above 60 C 140 F may cause permanent damage Storing and Handling Temperature 20 C to 60 C 4 F to 140 F Rel Humidity 90 non condensing Air Pressure 500 hPa to 1060 hPa System Capabilities ...

Page 99: ... x 13 6 x 11 3 Weight 2 7 kg 5 lbs 7 oz Calibration None Required Standards Safety EN 60601 1 UL2601 1 CAN CSA C22 2 NO 601 1 90 Hortmann Vest lab 100 EN 60601 1 Class II Type BF IPXO Power Supply EN 60601 1 Class II IPXO System EN 60601 1 1 EMC EN 60601 1 2 Accessories VNG optical cleaning cloth 7590527 Audiowipes 8 62 43002 ...

Page 100: ...98 Otometrics Technical Specifications Hortmann Vestlab 100 ...

Page 101: ...ixation Index Calculation 69 Further tests 75 G Gaze 54 H History 45 I Input devices 26 M Measurement windows 32 Multi test report 80 N Nystagmus analysis 29 Nystagmus Editor 37 P Patient consideration 21 Patient data Existing 23 Importing 87 New 21 Peak Frequency Calibration 69 Position 58 Positioning 61 Printing report 77 Program settings 23 R Report Multi test 80 Single test 77 Romberg 47 S Saf...

Page 102: ...tion 82 Test Battery Calibration 50 Calorics 65 Clinics 47 50 Further tests 75 Gaze 54 History 45 Position 58 Positioning 61 Troubleshooting Vestlab software 89 U Unterberger 48 V Vestlab software Icons and menus 16 Main window 15 Menu bar 18 System startup 15 Test icons 17 Video goggles Cleaning 35 Video playback 40 ...

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