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Lyric2 sizing instruction
Sizing for Lyric2 is a 2-step process
In the first step, the maximum depth of insertion is determined
using a length sizer.
In the second step, the Lyric2 device sizers are used to determine
the correct device size.
Complete both measurements on one ear before continuing with
the other ear. After successful sizing, Lyric2 can be immediately fit.
Step 1 Determine device insertion depth
Inform the patient what you are doing and show that the tip of
the length sizer is very soft (e.g. touch back of hands with it).
Instruct patient to tell you when TM is touched (usually indicated
by scratching noise or tickling sensation).
Locate the posterior meatus. This will be your reference point for
the sizing process. Hold length sizer between your index and
middle finger and insert it into the ear canal by gently tapping
with your thumb, taking care to keep the tip at the bottom of
the canal.
To ensure the sizer is laying on the bottom of the ear canal, it
helps to use the inter-tragal notch as the entry point.
Lift index finger and gently tap the length sizer into the canal
with your thumb. The length sizer is balanced on your middle
finger and the floor of the ear canal.
Insert length sizer until the soft tip touches the tympanic
membrane, at which point you will feel or see the length sizer
bend or bounce back against your thumb.
Always release pinna before reading maximum device insertion
depth at posterior meatus.
Refer to color band markings to determine maximum device
insertion depth (see diagram above: length sizer diagram).
Repeat the measurement 2 times to avoid false measurements
(e.g. because length sizer hits the wall, etc.).
Release the sizer/device by pulling back the moving tension ring
completely. Remove the insertion tool.
Removal
To remove a sizer or a device from the ear, use the removal notch
on the top part of the tip of the insertion tool. Enter the canal with
the removal notch up and thread the removal loops into the
removal notch. Once engaged, slowly and gently pull the sizer/
device out of the ear canal using a circular hand motion. As an
alternative, a forceps (Lyric slider forceps or similar) or a blunt-
nose tweezer can be used for removal. Therefore grasp the sizer /
device at the handle. As with the insertion tool, pull slowly and
gently using a circular hand motion.
Cleaning and maintenance
For cleaning instruction, please refer to the “Equipment cleaning
and maintenance instruction” on page 22.
Thread the removal loops into the loading notch. To do so, position
the sizer/device face down and guide the loops into the notch.
Once both loops are in place, slowly release the moving tension
ring to retract the loading hook and place the sizer/device on the
tip of the tool. Make sure that the handle is completely engaged in
the tip notch.
Once the insertion tool is properly loaded, use the depth collar to
set the maximum depth of insertion on the insertion tool. Turn the
sliding depth ring to the left side for the right ear and to the right
side for the left ear so that the ring faces the
posterior meatus.
Sizer/device insertion
Prior to insertion, gently apply lubricant.
Use the moving tension ring to adjust the
tension of the sizer/device. Squeezing the rings
releases tension, spreading the rings apart
increases tension.
Ear canals vary in shape, however most have a slight S shape with
a gentle rise. Again, diligent otoscopy is important for successful
placements.
Insert the sizer according to the shape of the canal as observed
during otoscopy.
Be mindful of the need for variable tension while steering through
the canal. Each ear is different, however for most ears, more
tension will be required to maintain the appropriate device angle
when navigating the bends of the canal. Once past the posterior
meatus, tension should be relieved so as not to apply undue
pressure to the canal walls.
The maximum insertion depth should be treated as a not-to-
exceed value and is reached when the sliding depth ring lines up
with the posterior meatus.
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