Maico MA 53 Operating Instructions Manual

MAICO Diagnostic GmbH

Operating Instructions

MAICO MA 53

MAICO Diagnostic GmbH, Salzufer 13/14, D 10587 BERLIN, Tel. ++49 30/70714650, Fax ++49 30/70714699

Operating Instructions MA 53

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Table of Contents Page

1 Introduction ............................................................................................. 4

2 Description ............................................................................................... 5

3 Getting started ......................................................................................... 7

3.1 Unpacking your instrument .................................................................... 7

3.2 Preparing the MA 53 for use .................................................................. 8

3.3 Getting familiar with the MA 53 ............................................................ 9

3.3.1 Using the keyboard of the MA 53.................................................. 10

3.3.2 The display of the MA 53 .............................................................. 12

4 Pure tone audiometry ............................................................................. 13

4.1 Air Conduction (AC) Testing ................................................................ 13

4.2 Uncomfortable Hearing Level (UCL) Testing .......................................... 14

4.3 Bone Conduction (BC) Testing ............................................................. 15

4.4 Masking of the opposite ear .............................................................. 16

4.4.1 Crossover: .................................................................................... 16

4.4.2 Masking theory: ............................................................................ 16

4.4.3 Manual masking: .......................................................................... 16

4.4.4 Automatic masking: ...................................................................... 17

4.5 Diagnostic tests ................................................................................... 18

4.5.1 Suprathreshold tests ...................................................................... 18

4.5.2 The Stenger Test ........................................................................... 22

4.5.3 The Threshold Decay (Carhart) Test ................................................ 22

4.6 Dual Frequency Mode .......................................................................... 23

4.7 Free tunable frequencies in 1 Hz Steps (FTF) ......................................... 24

4.8 High Frequency Audiometry (optional) ................................................. 24

5 Speech audiometry ................................................................................. 25

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5.1 Connecting the speech source ............................................................. 25

5.1.1 Connecting a CD-player ................................................................ 25

5.1.2 Connecting a Microphone ............................................................. 25

5.2 Speech calibration ............................................................................... 26

5.2.1 Calibration of the CD with speech test material ............................. 26

5.2.2 Calibration of the microphone for live speech test .......................... 26

5.3 Connection and calibration of the monitor phone ................................ 27

5.3.1 Connection of the monitor phone ................................................. 27

5.3.2 Adjustment of the monitor phone ................................................. 27

5.4 Speech Audiometry ............................................................................. 28

5.6 Masking .............................................................................................. 29

6 Quick reference guide ............................................................................ 30

6.1 Startup settings ................................................................................... 30

6.2 Receiver selection ................................................................................ 30

6.3 Signal selection.................................................................................... 30

6.4 Select tone or speech audiometry mode ............................................... 30

6.5 Frequency selection ............................................................................. 31

6.6 Warble tone (FM) ................................................................................ 31

6.7 Pulse tone ........................................................................................... 31

6.8 Suprathreshold tests ............................................................................ 31

6.8.1 SISI Test ........................................................................................ 31

6.8.2 Decay test (Carhart) ...................................................................... 32

6.9 Swap function ..................................................................................... 32

6.10 Tracking function .............................................................................. 32

6.11 STIM Mode selection ......................................................................... 32

6.12 Interlock function .............................................................................. 33

6.13 Talk over microphone ........................................................................ 33

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6.14 Talkback microphone and Monitor volume control ............................. 33

6.15 Speech audiometry ............................................................................ 33

6.16 Speech calibration ............................................................................. 33

6.17 User menu ........................................................................................ 34

7 Advanced features .................................................................................. 36

7.1 Complex mixing .................................................................................. 36

7.2 Advanced Noise Selection .................................................................... 37

7.3 Talk-back microphone ......................................................................... 37

7.3.1 Connection of the talk-back microphone ....................................... 37

7.3.2 Adjustment of the talk-back microphone ....................................... 37

7.4 Assistant phone ............................................................................... 38

7.4.1 Connection of the assistant phone ................................................ 38

7.4.2 Adjustment of the assistant phone ............................................... 38

8 Recommended literature ......................................................................... 39

9 Computer interface ................................................................................ 40

10 Care and maintenance of the instrument .............................................. 41

11 Trouble shooting .................................................................................. 42

12 Technical Data ...................................................................................... 43

13 Warranty, Maintenance and After-Sales Service ..................................... 51

14 Safety Regulations ................................................................................ 52

14.2 Measuring security: ........................................................................... 52

14.3 Device control: .................................................................................. 52

14.4 Operation: ......................................................................................... 52

14.5 Patient Safety: ................................................................................... 52

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1 Introduction

Thank you very much for purchasing a quality product from the MAICO
family. This MA 53 audiometer is manufactured to meet all quality and safety
requirements, and has been certified with the CE-symbol according to
Medical Directive 93/42/EEC.

In designing the MA 53 we placed particular importance in making it a user­friendly device, meaning its operation is simple and easy to understand. All
built-in test signals are generated by a digital signal processor (DSP) which
allows implementing new test signals just with a software upgrade. And
because MA 53 functions are software controlled, upgrading later to new,
extended measurement functions will be simple and inexpensive. That means
that you have invested in a device that will adjust to your future needs.

This user manual should make it as easy as possible for you to become
familiar with the functions of the MA 53. Please open out the flap of

illustrations on the last page. The description of the position (e.g. ➄) of
controls, displays and connections, found again in the text, will make it easier

for you to learn how to operate the MA 53.

If you have problems or have ideas for further improvements, please get in
touch with us. Simply call.

Your MAICO-team

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2 Description

The MA 53 is a two-channel audiometer for pure tone and speech
audiometric tests. It can be used for ENT diagnostics and hearing aid fittings
in the office, and for mobile audiometry in clinics, homes and abroad.

Tests can be performed using the DD45 headphones (AC), the optional high
frequency headphones HDA 200, B 71 bone conduction receiver (BC) or
optional insert phones and loudspeakers (FF). Built-in test signals are pure
tone, pulse tone, warble tone, narrow band and broadband noise. The MA 53
has stereophonic microphone inputs for live speech audiometry, an input for
an optional tape/CD player with speech test material and an additional input
for a second tape/CD player (i.e. for external masking signals).

The MA 53 audiometer with the standard DD 45 delivers 11 air conduction
(AC) test frequencies from 125 Hz to 8 kHz, with levels from -10 dBHL to 120
dBHL.

With the optional high frequency HDA 200 it delivers 17 air conduction (AC­HF) test frequencies from 125 Hz to 16 kHz, with levels from -20 dBHL to 120
dBHL.

Bone conduction (BC) can be tested with 11 test frequencies from 125 Hz to
8 kHz with levels from -10 dBHL to 70 dB HL (with the standard bone
conductor B 71 the frequency range is limited from 250 Hz to 6 kHz).

The optional insert phones EAR 3A submit levels from -10 dBHL to 120 dBHL
with 11 test frequencies from 125 Hz to 8 kHz.

Optional loudspeakers are available for free sound field measurements (FF).
The new, portable loudspeakers MAICO SBC have a dynamic range from -10
dBHL to 80 dBHL at 1m distance, for nine test frequencies from 500 Hz to 8
kHz. The frequency range for speech is 500 Hz to 8 kHz with levels up to 80
dBSPL.

The Canton loudspeakers (not available in the USA), deliver levels up to 90
dBHL at 1m distance over the entire frequency range from 125 Hz to 8 kHz.

The MA 53 has also separate line level outputs for an external amplifier.

The hearing level is controlled independently for each channel by two
detented dials on the left and right of the instrument which can be operated
from the side or the top. The level steps are 5 dB and can be changed to 2 dB
or 1 dB. The signal STIM bar and the frequency up/down keys are just beside
the level control knobs for easy one handed control of level, frequency and
signal presentation.

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The large backlighted LCD-display shows level, frequency, transducer, signal
and other information for each channel.

As a result of modern microprocessor technology, the MA 53 is easy to use
and is extremely reliable.

The audiometer is designed to be extremely service friendly. Automatic test
programs make trouble shooting and the yearly calibration as easy as possible.

PC-Interface:

A serial RS 232C interface for data transfer to a connected computer is built
in. The optional MAICO-audiometry module for NOAH enables the automatic
data transfer of all test results of the MA 53, like speech audiogram and
ABLB, DLI, SISI, tone decay etc.

For more information see chapter 9.

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3 Getting started

3.1 Unpacking your instrument

Your MA 53 was carefully inspected and packed for shipping. However, it is a
good practice to thoroughly inspect the outside of the shipping box for signs
of damage. If any damage is noted, please notify the carrier immediately.

Carefully remove the instrument from the shipping box. Remove the plastic
bag from the instrument and inspect the case for any damage.

Notify the carrier immediately if any mechanical damage is noted. This will
assure that a proper claim is made. Save all packing material so the claim
adjuster can inspect it as well. Notify your dealer or MAICO when the adjuster
has completed the inspection.

SAVE ALL THE ORIGINAL PACKING MATERIAL AND THE SHIPPING
CONTAINER SO THE INSTRUMENT CAN BE PROPERLY PACKED IF IT NEEDS TO
BE RETURNED FOR SERVICE OR CALIBRATION.

All accessories are already packaged in the compartment connected with the
MA 53. Please check that all accessories listed below are received in good
condition. If any accessories are missing or damaged, immediately notify your
dealer or MAICO.

Standard accessories:

- 1 Headphone DD 45

- 1 Bone conduction receiver B 71 with headband

- 1 Patient response switch

- 1 power cable

- 1 microphone with stand (only for export outside USA)

- 1 audiogram form (50 sheets)

- 1 monitor headset with microphone (USA only)

- 5 sound room cords (USA only)

Calibration of the device:

The instrument, headphones, bone conduction receiver as well as the optional
insert phone and loudspeaker match one another and have the same serial
number (e.g. 6631520). Because they have been calibrated with this
particular instrument, use of other transducers is not allowed. If one of the
acoustic transducers is replaced, the instrument must be recalibrated.

The use of non-calibrated audiometers leads to incorrect
measurements!

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3.2 Preparing the MA 53 for use
The MA 53 with its integrated compartment for
the accessories is perfect for portable use. The
rugged housing, light weight and the
comfortable handle make it easy and convenient
to transport the instrument. Carry it, as shown,
with the bottom away from the leg. That helps
protect the front cover from damage, and due
to the asymmetrical handle position it provides
more space for your leg.

To get started first move the handle under the
housing. Unlatch the cover by pressing in the
two black locks located on the left and right
sides near the front of the instrument. Open the
front cover and rest it on the back cover of the
accessory compartment. To open the
compartment, press the two black locks in the
upper middle of the instrument. Open the
compartment cover as seen in picture 2. Take
the headphone, the bone conduction receiver,
the patient response switch and the microphone
out of the compartment and connect the power
cable to power. The MA 53 operates with
voltages from 100 to 240 V~ AC, 50/60 Hz. To
avoid pinching the cables when closing the
cover, lay the cables in the slots provided. Close
the back cover and latch it with slight pressure.
You can place the microphone or a tape or CD­player on top of the cover (see picture 3).

The MA 53 should be operated in a quiet room,
so that the audiometric examinations are not
influenced by outside noises. For use in noisier
environments headphones with optional sound
insulation muffs are available.

Electro-medical instruments, which emit strong
electromagnetic fields (e.g. microwaves ­radiotherapy devices), can influence the function of the audiometer. Therefore
the use of these instruments is not allowed in close proximity to the
audiometer.

Picture 1 Transport of MA 53
Picture 2 MA 53 with open cover

Picture 3 MA 53 in operation

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The test room must be at normal temperature, usually 15 C / 59 F to 35 C /
95 F, and the instrument should be switched on about 10 minutes before the
first measurement to guarantee precise measuring results. If the device has
been cooled down (e.g. during transport), please wait until it has warmed up
to room temperature.

3.3 Getting familiar with the MA 53

Turn on the instrument with the power
switch  which is located at the right side
of the MA 53. The device performs its
initial test and autocalibration. If an error
is detected the test is stopped and a
description of the error is shown on the
LCD-display . In this case please contact
your local dealer or service.

If the

s above the

receiver selectors  and  and the signal
selectors  and  are lighted. The
frequency is set to 1 kHz and the level to
30 dBHL for the left channel,

-10 dBHL noise for the right. All these
settings are also shown on the display 
(see picture 5).

The hearing level can be easily adjusted
independently for each channel with a
knob  and ↕ on each side of the
instrument. For optimal convenience
these level control knobs are usable from
the top or the side of the instrument.
They are detented in 5 dB steps
(adjustable to 2 dB or 1 dB). The signal
STIM bars  and ↔ are located beside
the level control knobs , ↕. The signal
LEDs  and  light up when the signal is
presented. You can change from
presenter to interrupter function with the
STIM MODE button . The corresponding
LED lights when the interrupter is

Picture 4 MA 53 power switch, display and
selection buttons for left and right channel

Picture 5 MA 53 display with initial settings

Picture 6 MA 53 level and frequency control

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selected. The frequency is changed with up , → and down ,  buttons
for both channels together. The design of the MA 53 makes it easy to control
level, signal presentation and frequency with one hand.

3.3.1 Using the keyboard of the MA 53

All main functions of the MA 53 are
directly accessable by pressing a single
button. Not frequently used procedures
like the calibration of the speech source
or the level step selection are hidden as a
“second level function”. To select this
function just press the addressed button
more than two seconds. A user menu for
the customization of the MA 53 is
available for advanced users (see chapter

8).

Following is the description of the main
and

second level

functions of each

button:

 left (blue) channel frequency up: change to next higher frequency
 left (blue) channel frequency down: change to next lower frequency
 left (blue) talk over microphone: switches on the talk over microphone

as long as the button is pressed. The level can be adjusted with the
knobs  or ↕. The actual value is displayed in dB

HL

at the lower center

of the LCD-display .

 left (blue) channel receiver selector: changes the receiver from AC to

BC or FF or INSERT (if option assembled). The lighted LED above shows
the current selection.

2nd level: selects test mode HL, UCL, MCL for selected receiver

 FM - modulation (warble tone): changes test signal from pure tone to
warble tone.

2nd. Level: to enter the user menu press button during power on.

 left (blue) channel signal selector: changes the test signal from pure

tone to tape/CD or microphone or noise or switches the channel off.

2nd. Level: Calibration of tape/CD or live voice microphone

 pulse tone: enables pulsing of pure tone or warble tone.

2nd. Level: enter pulse tone menu: ABLB, DLI and SISI Test

 stim mode: changes the signal presentation from presenter to
interrupter mode.

2nd. Level: enables interlock function. Pressing left  or right ↔ signal
presentation bar affects both channels.

Picture 7 MA 53 keyboard

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 swap function:

exchanges the outputs for both ears (i.e. the right controls now affect
the left ear).

 tracking function:

enables the automatic tracking
(see chapter 4.4 masking).

2nd. Level: enters level step
selection menu. The actual
level step is displayed at the
lower center of the LCD­display

. Choose the level

steps with the frequency
up/down buttons

and 

 right (red) channel signal

selector key:
changes the test signal from
pure tone to tape/CD or
microphone or noise or
switches the channel off.

2nd. Level: adjustment of talkback microphone and monitor phone

 right (red) channel receiver selector:

changes the receiver from AC to BC or FF or INSERT (if option
assembled). The lighted LED above shows the current selection.

2nd level: selects test mode HL, UCL, MCL for selected receiver

 right (red) channel talk over microphone:

switches on talk over microphone as long as the button is pressed. The
level can be adjusted with the knobs  or ↕. The actual value is
displayed in dBHL at the lower center of the LCD-display .

 right (red) frequency down:
change to next lower frequency
 right (red) frequency up:
change to next higher frequency

Picture 8 MA 53 keyboard

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3.3.2 The display of the MA 53

The large backlighted graphical LCD­Display  of the MA 53 shows all actual
settings and test results. The display area is
split with a line into an upper or main area
and a lower or advanced area (see picture

9). The main area shows the individual
settings for the left channel on the left and the right channel on the right.
General settings which affect both channels are displayed in the middle. The
example picture 9 shows a typical setting for a BC- threshold test. The left
channel is bone conduction with 70 dB

HL

, tone and tracking function

enabled. The right channel is set to 90 dB

HL

narrow band noise with air
conduction for masking. The test frequency is 1500 Hz and the test signal is
a warble tone. The lower section of the display shows that the talk over
microphone button  or  is pressed and the audiologist talks to the patient
with 70 dBHL. The HL in the upper row before 1500 Hz indicates that the
current measurement is stored as Hearing Level (threshold) test.

Picture 10 shows the display for a speech
test with speech test material from tape
or CD of the left ear and masking of the
opposite ear. The left part of the LCD-
display  shows the settings for the left
channel:

level = 60 dBHL, receiver = AC, signal = tape/CD.
The middle of the LCD-display  shows the actual test and the result:

MS stands for multi syllable speech test,

speech discrimination = 60%, correct words = 6, wrong words = 4.
The right part of the LCD-display shows the setting for the right channel:

level = 60 dBHL, receiver = AC, signal = speech-noise (masking).

The LCD-display  has an energy saver function: the backlight of the display is
automatically switched out after approximately three minutes. Any action
with the MA 53 such as pressing a button or turning the knobs switches the
backlight immediately on again.

Picture 9 MA 53 display for BC-test

Picture 10 MA 53 display for speech - test

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4 Pure tone audiometry

4.1 Air Conduction (AC) Testing

In the hearing threshold test, the hearing threshold of the
patient is measured in comparison with the normal
hearing threshold for air conduction. The test is started on
the ear with better hearing.

The patient should sit at a distance of at least 1 m from
the device.

Eliminate any obstructions which will interfere with the
placement of the earphone cushions on the ear (i.e. hair,
eyeglasses).

Ensure the headphones are put on correctly: Red side on the right, blue side
on the left. Adjust the headband of the headphones so that the receivers are
at the correct height (the sound output grid exactly facing the ear canal).

Start with the “better” indicated ear at 1 kHz. (After switching on, the
frequency is automatically set to 1 kHz.) In the following example we assume
that the left is the “better” ear.

Set the receiver selector  to AC and the signal selector  to TONE.
Set the left level control knob  to a value just below expected hearing loss.

Explain to the patient that he should press the button of the patient response
switch if he just hears the test tone.

Press the STIM bar  for a certain
time to present the test tone. The
STIM LED  should light on.

If the patient hears the test tone,
the patient response display lights
red. In this case decrease the level
with the level control knob .
Proceed with presenting the test
signal as described before.

If the patient doesn’t hear the test
tone, increase the level with the
level control knob . Proceed with
presenting the test signal as
described before.

Picture 11 Headphone

Picture 12 MA 53 controls and display for air conduction
threshold test of the left ear

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When you find a stable threshold value, note the level and frequency. If the
MA 53 is connected to a PC, the value was stored with your last STIM
presentation.

Test through the frequencies. Starting at 1 kHz set the higher frequencies first
then the lower frequencies.

Use the frequency up key  or → to select the higher frequencies and use
the frequency down  or  to select the lower frequencies.

Select the next frequency, increase the level again and proceed with
presenting the test signal as described before.

Once all frequencies are tested choose the poorer ear and repeat the hearing
threshold test. You can do this with the corresponding controls on the other
side or just by pressing the SWAP button
. The SWAP function enabled means
that you measure the right ear using the
controls on the left side. The ouput to the
left and right earphones are changed.
Also, the left and right display text is
changed (see picture 13).

The correct marks in an audiogram are: O (red) = right and X (blue) = left

Pulse tone: If required, the test can also be performed with a pulsed tone.
Press the PULSE button  and the pure tone will be switched 0.25s on and

0.25s off.

Warble tone: If required, the test can also be performed with a warble tone.
Press the FM button  and the pure tone will frequency modulate. The
warble tone can also be pulsed as described before.

For hygienic reasons it is important to clean the ear cushions of the
headphone (see chapter 11).

4.2 Uncomfortable Hearing Level (UCL) Testing

Testing of UCL can be measured using pure tone stimuli or speech (live voice
or tape/CD). The purpose is to determine the dB level at which the stimuli
becomes uncomfortable to the patient. This information is valuable f

s upper dynamic range limit for proper hearing aid

fittings and for determining symptoms of recruitment.

Warning! Because this test uses high sound pressure levels, it is
extremly important to perform this test using the utmost c

Picture 13 MA 53 display for AC-test with
enabled SWAP function, Pulse and Warble tone

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s MCL (Most Comfortable Level).

The UCL level is described as the level between very loud and loud perception
of the test signal.

Press the receiver selector button  or
 longer than 2 seconds. The LCD­display in the upper row changes from
HL to UL (see picture 14).

Start as described in chapter 4.1 with a
test level of 60 dB

HL

.

Present the tone briefly (max. 1s)

If the signal was recognized by the patient as not uncomfortable increase the
level and proceed as described before.

If the signal was uncomfortable for the patient note the values.

Proceed accordingly with other test frequencies.

For hygienic reasons it is important to clean the ear cushions of the
headphone (see chapter 10).

4.3 Bone Conduction (BC) Testing

Bone conduction, i.e. the transmission of sound waves through the skull
directly to the inner ear conways information about the function of the inner
ear. For a neural hearing loss the values of air conduction (chapter 4.1) and
bone conduction are the same. In this case a hearing loss of the middle ear
can be eliminated.

Place the bone conduction receiver so that the flat, circular side of the
transducer Y is placed on the mastoid, at the noticeable ledge of the cranial
bone behind the auricle). The other side of the headband is placed in front of
the opposite ear.

Set the receiver selector  or  to BC and the signal selector  or  to TONE.

Perform the test the same way as for air conduction (see 4.1). Enter the
measurements for all frequencies on the form, connect all points with dotted
lines marked on the audiogram form as follows: > = right and < = left

For hygienic reasons it is important to clean the bone conductor (see chapter

10).

Picture 14 MA 53 display for UCL-test left

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4.4 Masking of the opposite ear

The basics of masking are explained below. To begin testing immediately,
please go directly to 4.4.3 Manual masking.

4.4.1 Crossover:

When measuring a pure tone audiogram you assume that the measured
hearing threshold is correct. But if you recognize that sound is also
transmitted through bone conduction over the entire skull it is probable that
the opposite ear has also received sound. This is called “crossover”.

Crossover can also occur when measuring air conduction because a small
amount of air conducted sound is received by the skull and transmitted by
bone. Whether the crossover signal can heard by the opposite ear depends on
its inner ear function.

Relevant to crossover is the sound level which is received by the opposite ear.
The difference between the original test signal at the test ear and the received
signal at the opposite ear is called “interaural attenuation”.

For bone conduction measurement the interaural attenuation is 0 to 15 dB.
Bone conduction crossover is therefore possible even with a slight difference
in hearing loss between ears.

Important: Please advise the patient to tell you in which ear he hears the test
signal. It is thereby easier to detect crossover.

4.4.2 Masking theory:

To ensure that the patient will not experience crossover you must mask the
opposite ear. Masking increases the hearing threshold of the opposite ear.

The masking is done with a noise signal which is transmitted by the
headphone. For pure tone audiometry a narrowband noise is used. This noise
changes its center frequency according to the frequency of the test signal.

4.4.3 Manual masking:

If you have to mask use the common masking rules. See chapter 7 for
recommend literature.

Masking is an important part of practical audiometry. It is necessary to be
familiar with this topic to avoid errors which would lead to a wrong diagnosis.

For the opposite ear set the receiver selector  or  to AC and the signal
selector  or  to NOISE.

Adjust the required masking level with the level control knob  or ↕.

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Notice that the masking sound is continuously presented for effective
masking. You can interrupt the masking signal by pressing the corresponding
interrupter key  or ↔.

To mask when performing bone conduction testing, place the headphone on
the opposite ear so that the receiver is at the correct height (the sound output
grid  exactly faces the ear canal). Adjust the headband of the headphones.
The receiver on the side where the bone conductor is placed should sit directly
on the cheek bone.

The marking for air conduction with masking should be done with the
symbols  = the right side and ■ = the left side on the audiogram form. The
marking for bone conduction with masking should be done with the symbols
[ = the right side and ] = the left side on the audiogram form.

4.4.4 Automatic masking:

With the manual masking, as described before, you have to readjust the
masking level every time you change the test signal level. The MA 53 has a
tracking feature for easy masking.

Adjust for the test signal using the level control knob or ↕, then with the
opposite level control knob  or  adjust for the corresponding masking
level.

Now press the TRACK button . The
masking level is automatically changed if
you adjust the test signal level. (e.g. if the
test level was 30 dB and the masking level
50 dB and you change the test level to 45
dB the masking level is automatically
adjusted to 65 dB).

Picture 15 MA 53 display for bone
conduction with masking and enabled
tracking function

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4.5 Diagnostic tests

4.5.1 Suprathreshold tests

The MA 53 offers additional suprathreshold tests which can offer more
information about the kind of the hearing loss.

To access suprathreshold tests press the
PULSE button  longer than two seconds.
The suprathreshold test menu is now
displayed on the lower part of the LCD­display  (see picture 16). The actual
choice is displayed inversely. You can
toggle through the different options by briefly pressing the PULSE button .
Start the chosen option by pressing the STIM bar  or ↔.To exit the
Supratreshold test menu briefly press the FM button .

4.5.1.1 The ABLB (Fowler) Test

The Alternate Binaural Loudness Balance test is a recruitment test which uses
the presentation of alternating tones between the two ears with headphones.
The intensity of the tone in the hearing-impaired ear is varied until the
loudness of the tone is judged by the patient to be equivalent to a tone at a
constant intensity in the normal ear. This is called loudness balance. The test is
done for various intensity levels in the normal ear.

To start the test select 0.5 sec. or 1 sec. modulation time in the
suprathreshold menu (as described before under 4.5) and press the STIM bar
 or  ↔.

On the LCD-display  is ABL with the chosen modulation time shown (see
picture 17).

Adjust the desired hearing levels for both
the normal ear and the impaired ear using
the level control knobs  and ↕.

Press the STIM MODE button  to present
the signal continuously.

Now change the level for the hearing-impaired ear with the level control knob
↕ or  until the patient indicates that the loudness in both ears is equal.

Note the levels and proceed with other levels and frequencies as required.
To exit the test, briefly press the PULSE button .

Picture 16 MA 53 display with
suprathreshold menu

Picture 17 MA 53 display with ABLB test

Operating Instructions MA 53

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4.5.1.2 The DLI (Lüscher) Test
The Intensity Difference LImen for loudness test (or Just Noticeable

Difference, JND) is another recruitment test. A pure tone is amplitude

modulated at a rate of 2/second. The patient has to determine whether this
signal was steady or undulating (beating).

To start the test select a modulation
amplitude from 0.5 dB to 4.0 dB in the
suprathreshold menu (as decribed before
under 4.5.1) and press the STIM bar  or
↔.

The LCD-display  shows DLI, along with the chosen modulation amplitude
(see picture 18).

Now adjust the required test level with the level control knob  or ↕ and
present the test signal by pressing the STIM bar  or ↔.

To exit the test press the PULSE buttom  longer than 2 seconds. The
suprathreshold tests menu is now displayed. To exit the suprathreshold test
menu briefly press the FM button .

Picture 18 MA 53 display with DLI test

Operating Instructions MA 53

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4.5.1.3 The SISI Test

The SISI (Short Increment Sensitivity Index) is guided by the principle that
patients with cochlear impairment are hypersensitive to small intensity
increments. The continuous test tone is increased by 1 dB for a period of 0.2
seconds every 4.8 seconds. Whenever the patient hears the increment, he/she
presses the patient response switch. The SISI test information and the test
score are shown on the LCD-display . The test will end automatically after
20 presented increments. The score is expressed as a percentage of ratio of
the increments heard to the delivered increments (all increments heard =
100% - no increments heard = 0%). A high score indicates a cochlear
impairment. A low score is related to normal hearing or conductive or
retrocochlear pathology.

4.5.1.3.1 Preparation of the SISI Test

To start the test select SISI in the
suprathreshold menu (as decribed before
under 4.5) and press the STIM bar  or
↔. The display  changes to the SISI
conditioning screen (as shown in picture

19).

Select the test frequency with the
frequency keys / or /. For the test you should choose the frequency
where the maximum bone conduction hearing loss is measured as described
in chapter 4.3.

Adjust test level with the level control knob  or ↕. The level should be set
to a value 20 dB above the individual hearing threshold (measured under
chapter 4.1). It must reach at least 60 dB

HL

.

Recognize that in the SISI mode the test signal is presented continuously. You
can interrupt the test by pressing the STIM bar  or ↔ for however long you
hold it down.

The patient must be instructed: "You will now hear a continuous tone. Every
time it becomes louder, immediately push the switch”.

4.5.1.3.2 Training of the Patient

Only with careful training during the following conditioning phase can a valid
test result be achieved.

The training starts with a modulation level of 5 dB. That means a continuous
tone, e.g. 65 dB

HL

, is briefly increased every 4.8 seconds for 0.2 seconds by 5

dB, e.g. to 70 dB

HL

. During the increment time the text “Tone Now” is shown

Picture 19 MA 53 display with
SISI conditioning 5dB

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Picture 20 MA 53 display with SISI
conditioning 5dB and presented increment

on the lower area of the LCD display  (see picture 20). The text “Answer
now” appears for approx. 1.5 seconds. During this period the patient may
respond. If he/she answers too early or too late the answer will not be
accepted by the MA 53.

The number of detected increments is
counted and shown on lower right area
of the display. Furthermore, the number
of presented increments is shown (see
picture 20).

When you are sure that the patient has understood the object of the test,
press the PULSE button . The modulation level will be changed to 3 dB.

If the patient has understood this part of the test also, press the PULSE button
 again. The modulation level will be reduced to 2 dB.

4.5.1.3.3 SISI Test

If the patient has understood the test up to
here, press the PULSE button  again to
start the SISI test.

The LCD-display indicates SISI test (see
picture 21) and the modulation level is
adjusted to 1 dB. Now 20 increments will
be presented to the patient.

You can delay the test for the time you press STIM bar  or ↔. This could be
helpful in determining if the patient
malingers.

The test will end automatically after 20
presented increments. The number of
detected increments is counted and indicated
as percentage of the presented increments
(see picture 22).

If you are sure that the result of the test is
consistent you can abort the test at any time
by pressing the PULSE button . The result is
then indicated accordingly (picture 23).

Retrocochlear hearing impairment is
represented by low scores (< 25 %), cochlear defects by high scores (> 70 %).

Press any button leave the SISI test.

Picture 21 MA 53 display with SISI test
Picture 22 MA 53 display with SISI result

Picture 23 MA 53 display with aborted SISI
test

Operating Instructions MA 53

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4.5.2 The Stenger Test

The Stenger test is conducted as a malingering test in cases of alleged hearing
loss or unilateral deafness. It is based on the premise that when two tones of
the same frequency are presented simultaneously into both ears, only the
louder tone will be perceived.

The patient with a feigned hearing loss will not be able to hear the quiet tone,
but will also not admit being able to hear the loud tone.

Select the desired frequency with the frequency keys / or / and adjust
the sound intensities with the level control knobs  and ↕.

Present the tone with the STIM bars  and ↔.

The easiest procedure is to present the desired frequency into the better ear
at a level of 10 dB above the threshold. At the same time present the signal
into the poorer ear (the one with the possible feigned loss) at a level 10 dB
below the admitted threshold. If the loss in the poorer ear is real, the patient
will be unaware of the signal in that ear and will respond only to the tone in
the good ear. If the patient does not respond at all it is likely the admitted
threshold is incorrect and you have a “positive” Stenger.

4.5.3 The Threshold Decay (Carhart) Test

This examination is conducted as a fatigue test in cases of sensitivity loss.
Select the desired frequency with the frequency keys / or /.

Adjust the sound level to a value about 5 dB above their hearing threshold
with the level control knob  or ↕.

Instruct the patient to start pressing the patient response switch when he
hears a tone and to release the switch when he doesn’t hear the tone
anymore.

Enter continuous tone presentation by pressing the STIM MODE button  to
present the test signal or press the
corresponding STIM bar  or ↔.

The PAT response LED  lights and after
two seconds a bar stop watch with a scale
from 0 to 60 seconds appears on the lower
area of the LCD-display  (see picture 24).

Picture 24 MA 53 display with
initial tone decay test

Operating Instructions MA 53

Geba_MA53_e_13a.doc 23 851 430/3 11/11

When the patient releases the switch the
bar of the stop watch stops and you can
see the time the patient heard the tone (see
example picture 25).

If the time was less than 60 seconds
increase the level with the level control
knob  or ↕ by 5 dB.

Press any button to erase the stop watch on the display  and start the test
again.

Continue this procedure until the patient can hear the tone at least for 60
seconds.

The threshold shift can be entered on the tone audiogram pad by drawing a
wavy line under the selected frequency.

4.6 Dual Frequency Mode

The MA 53 offers the dual frequency mode to the right and the left ear with
different frequencies. This “true two channel” feature can be used to detect
frequency disorders.

To enable the dual frequency mode press the left frequency up key  and
frequency down key  simultaneously.

The LCD-display  shows the test
frequency of the left channel on the left
(1000 Hz) and the test frequency of the
right channel on the right (2000 Hz) of the
center. (Picture 26)

Use the frequency up key  to select the higher frequencies and the
frequency down key  to select the lower frequencies for the left channel.

The frequencies of the right channel could be selected independent from the
left with the frequency up key → and the frequency down key .

To exit the dual frequency mode press the left frequency up key  and
frequency down key  simultaneously again.

The LCD-display  now shows the test
frequency (example 1500 Hz) for both
channels in the center (picture 27).

Picture 25 MA 53 display with
example tone decay test

Picture 26 MA 53 display with dual
frequency mode

Picture 27 MA 53 display with single
frequency mode

Operating Instructions MA 53

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4.7 Free tunable frequencies in 1 Hz Steps (FTF)

This feature is activated by pressing the right frequency button
simultaneously. This feature is just a gimmick to show the possibilities of the
instruments.

4.8 High Frequency Audiometry (optional)

The optional High Frequency Audiometry offers tone audiometry with the
additional test frequencies 9000 Hz, 10000 Hz, 11200 Hz, 12500 Hz, 14000
Hz and 16000 Hz. Tests using this advanced frequencies give additional
information of the individual hearing performance. They are especially useful
for the early detection of hearing damages of younger persons.

The headphone Sennheiser HDA 200 is
designed for high frequency audiometry.
The HDA 200 works over the full
frequency range from 125 Hz to 16000
Hz.

It is possible to use the HDA 200 as
standard AC receivers for all AC tests or to
use two AC-receivers with the MA 53. In this case the normal AC receiver
(DD45) goes up to 8000 Hz. The HDA 200 is selected with the receiver
selector key  or  as “insert phone”.

The tests with high frequencies are done as described before in chapter 4.

The minimum hearing level starts for frequencies from 9000 Hz to 16000 Hz
at -20 dB

HL

.

Picture 28 MA 53 display for
high frequency audiometry

Operating Instructions MA 53

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5 Speech audiometry

5.1 Connecting the speech source

5.1.1 Connecting a CD-player

To conduct speech tests using speech test
material you can connect a CD-player to the
MA 53. Use a standard phono plug cable to
connect the right and left outputs of the
device with the corresponding inputs  and
 on the rear panel of the MA 53. To avoid
pinching the cables when closing the cover,
lay the cables in the slots provided.

If you are using a small portable CD-player
or tape you can place it on top of the cover
of the MA 53. This saves space and makes the usage of the CD-player or tape
very convenient.

Caution: If you are using a CD- or tape-player powered by electrical current,
the player must meet electrical safety requirements, such as IEC 601-1 or UL.
This is to avoid electrical shock of either the patient or you. If you are not sure
if your player meets these requirements it is safer to use battery power.

5.1.2 Connecting a Microphone

Connect the microphone to the SPEECH
MIC connector  on the rear panel of the
MA 53 (see picture 30). To avoid pinching
the cables when closing the cover, lay the
cables in the slots provided. Place the
microphone on top of the cover of the MA

53. The microphone can be used for live
speech audiometry and communication
with the patient. If your instrument is
supplied with a monitor/mic headset,
connect the phone plug labeled M with the
SPEECH MIC connector .

Picture 29 MA 53 rear panel
with TAPE/CD input

Picture 30 MA 53 rear panel
with SPEECH MIC input

Operating Instructions MA 53

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5.2 Speech calibration

5.2.1 Calibration of the CD with speech test material

The MA 53 must be calibrated to the
particular speech test material in use to
ensure valid test levels. That means every
time you change the CD or tape you must
recalibrate the instrument.

To calibrate the Tape/CD speech input
select TAPE/CD with the left SIGNAL
selector key .

Press the left SIGNAL key  longer than 2
seconds.

In the lower area of the display  the text
Calibration appears. You also see the
actual settings in % of the maximum
calibration for both channels (see picture

32).

On every CD or tape with speech test
material you have a reference signal, such
as a reference tone or speech simulating
noise.

Perform the reference signal with CD.
Use the left knob  for the left channel and the right knob ↕ for the right

channel and adjust the levels until both VU-meters  and  show all yellow
and one green light.

If one or more red lights are on, reduce the level using the corresponding
knobs  or ↕.

Store the calibration by pressing the STIM bar  or ↔.

5.2.2 Calibration of the microphone for live speech test

To calibrate the SPEECH MIC input select
MIC with the left SIGNAL selector key .

Press the left SIGNAL key  longer than 2
seconds.

In the lower area of the display  the text
Calibration appears. You also see the actual

Picture 31 MA 53 controls and displays
for speech calibration

Picture 32 MA 53 display with
speech calibration of CD-player or tape

Picture 33 MA 53 display with
speech calibration of the microphone

Operating Instructions MA 53

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settings in % of the maximum calibration for both channels.

Position yourself the customary distance from the microphone and speak test
words.

Use the left knob  to adjust the level until both VU-meters  and  show all
yellow and one green light.

If one or more red lights are on, reduce the level using the knob .
Store the calibration by pressing the STIM bar  or ↔.

5.3 Connection and calibration of the monitor phone

5.3.1 Connection of the monitor phone

Connect the monitor phone plug E to the
MONITOR connector  at the rear panel of
the MA 53 (see picture 34).To avoid
pinching the cables when closing the cover,
lay the cables in the slots provided. The
monitor phone allows you and the patient
to hear the speech test material
simultaneously. This helps in determining if
the test word was understood by the
patient. If the talk back option of the MA
53 is installed, the communication from the
patient to audiologist will be heard with the
monitor phone.

5.3.2 Adjustment of the monitor phone

To adjust the output level of the monitor
phone press the right SIGNAL key  longer
than 2 seconds.

In the lower right area of the display  the
text Monitor appears. Below that you see
the actual settings in % of the maximum
output level (see picture 35).

Perform a test signal with Tape, CD or the talk back microphone (if installed).
Use the right knob ↕ and adjust the output level that is comfortable for you.
Store the adjustment by pressing the STIM bar  or ↔.

Picture 34 MA 53 rear panel
with MONITOR phone output

Picture 35 MA 53 display with
adjustment of the monitor phone

Operating Instructions MA 53

Geba_MA53_e_13a.doc 28 851 430/3 11/11

5.4 Speech Audiometry

The speech-recognition threshold SRT is the hearing threshold for speech. It is
the lowest level at which the patient correctly recognizes the stimuli 50% of
the time. Usually, recognition is indicated by repetition of the speech-stimulus
item. The speech test can be done with recorded speech test material from
CD or tape or with the microphone and live voice using standardized word
lists. Different methods for speech tests are standardized worldwide such as
the ASHA guidelines for determining the threshold level for speech (Asha 21,
page 353-356).

Explain to the patient that he should repeat each word he hears.

The patient should sit at a distance of at least 1 m from the device.

Eliminate any obstructions which will interfere with the placement of the
earphone cushions on the ear (i.e. hair, eyeglasses).

Ensure the headphones are put on correctly: Red side on the right, blue side
on the left. Adjust the headband of the headphones so that the receivers are
at the correct height (the sound output grid exactly facing the ear canal)

Set the receiver selectors  and  to AC and the signal selectors  and 
both to TAPE/CD (if you are using recorded speech test material) or to MIC (if
you wish to perform a speech test with live
speech).

On the LCD-display  the initial setting for
speech audiometry (see picture 36)
appears. The percent speech discrimination
score is displayed in the middle. Below this,
the number of correct and incorrect words
is shown.

If you are using CD or tape, put the monitor phone on to hear the test words.
Depending on your test method, use the level control knob  or ↔ to set the

start level.

Perform the test words.

Tally the correct words by pressing the
frequency up key  or →.

Tally the incorrect words by pressing the
frequency down key  or .

When you finish a word list, note the
percentage of the speech discrimination score.

Picture 36 MA 53 display with
initial settings for speech audiometry

Picture 37 MA 53 display with
typical result for speech audiometry

Operating Instructions MA 53

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If you are working online with a PC press the STIM bar  or ↔ to transfer the
test result to the PC (see also chapter 9).

To clear the counter for the next test, press the FM key .

It is also possible to perform the speech test with loudspeakers (e.g. for the
verification of hearing aid fitting) or bone conduction.

Select the required transducer with the RECEIVER selection button  or  and
proceed as described before.

5.6 Masking

Speech audiometry has similar masking rules to those described in chapter 4.4
for pure tone audiometry.

When TAPE/CD or MIC is selected on one channel, and NOISE masking on the
opposite channel, the MA 53 automatically performs speech masking noise.

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6 Quick reference guide

6.1 Startup settings

Air conduction on both channels
Pure tone on both channels
30dBHL on both channels
Presenter mode

6.2 Receiver selection

Press either the right  or left  RECEIVER key to select the receiver (AC, BC,
FF, INSERT). The display  shows the selected receiver below the levels.

Not available receivers will be skipped. It is not possible to select bone on both
channels simultaneously.

After a new selection the level will be reset to 30dB

HL

.

6.3 Signal selection

Press either the right  or left  SIGNAL key to select the signal. The kind of
NOISE signal depends on the signal of the opposite channel. Speech masking
noise is used if on the opposite channel the speech signal is selected. (see 6.4
below). The display  shows the selected signal below the receiver text.

The 5. Position is signal off. The light at the signal key  or  and the STIM
LED  or  is off and the level in the display  is erased.

6.4 Select tone or speech audiometry mode

Tone audiometry: shows level and frequency on the display 
Speech audiometry: shows level, correct and incorrect words and speech

discrimination in percentage on the display

Signal left

Signal right

Mode

Tone Tone Tone

Tone Noise (NBN) Tone

Tone Tape/CD or LV Tone

Noise (NBN) Tone Tone

Tape/CD or LV Tone Tone

Tape/CD or LV Tape/CD or LV Speech

Tape/CD or LV Noise (Speech) Speech

Noise (Speech) Tape/CD or LV Speech

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6.5 Frequency selection

Use one of the two sets of frequency keys / or / to select the
frequency. The maximum and minimum frequency depends on the receiver
you have selected.

6.6 Warble tone (FM)

Press the FM key  to activate the warble tone. Warble is shown in the
display .

Press the FM key  again to switch back to pure tone.

6.7 Pulse tone

Press the PULSE key  to activate the pulse tone. Pulse is shown in the display
 and the light above the PULSE key  is on.

Press the PULSE key  again to deactivate pulsing.

6.8 Suprathreshold tests

Press the PULSE key  longer than 2 seconds. In the lower area of the display
 the parameters of the ABLB, DLI and SISI test are shown.

Using the PULSE key, select the test and parameter.
Press one of the STIM bars  or ↔ to select your choice. The lower area of

the display  is cleared and the selected test is shown on the display . The
light above the PULSE key  is on.

To change to another parameter press the PULSE key  again and hold longer
than 2 seconds.

To end the selected test, press the PULSE key  briefly.

6.8.1 SISI Test

Once SISI is selected, the test begins immediately by conditioning in 5dB
increments. Press the PULSE key again to enter the next levels of SISI
conditioning (3 dB, then 2 dB) and to start the SISI test (1dB). During the test
the display  shows the increment level, the number of presented increments
and the number of correct answers given by the patient. In addition, “Tone
Now“is displayed when an increment is presented and “Answer Now“is
displayed during the answer acceptance time.

During SISI-conditioning it is possible to clear the counters by pressing the FM
key .

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To cancel the conditioning and the SISI test and to return to standard
operation press the SWAP key .

After 20 increments the SISI test is finished. The text SISI Result with the result
in percentage is shown.

You can stop the SISI test with the PULSE key . The text SISI aborted and the
actual result in percentage is shown.

Press the PULSE key  to quit the SISI test.

6.8.2 Decay test (Carhart)

If the patient presses the patient response switch longer than 3 seconds, in
the lower area of the display  a decay bar appears and shows the counted
time until the patient releases the patient response switch.

To clear the display  and reset the decay function press one of the STIM
bars  or ↔.

6.9 Swap function

Press the SWAP key  to exchange the left and right channel. The big letters
R and L will be swapped in the display  and the light above the SWAP key 
is on.

Press the SWAP key  again to deactivate swapping.

6.10 Tracking function

Press the TRACK key  to activate tracking. Both the left and right sides of
the display  will say TRACKED, meaning that both channels are tracking
each other. If NOISE is selected on one channel, the text TRACKED is erased,
because a noise channel is not allowed to track a signal channel.

Press the TRACK key  again to deactivate tracking.

6.11 STIM Mode selection

Press STIM MODE  key to switch between continuous presentation and
presentation by pressing the STIM bar  or ↔. When in continuous
presentation mode the STIM bars and ↔ function as interrupters. The light
above the STIM MODE key  is on if continuous presentation is selected.

Speech and noise are always in continuous presentation, except when both
channels are selected as noise.

Press the STIM MODE key  again to deactivate continuous presentation.

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6.12 Interlock function

Press the STIM MODE key  longer than 2 seconds to activate the interlock
function. The display  shows the text Interlock.

Interlock works only if both channels have the same kind of signal (Speech,
tone or noise). In modes where no interlock is available the display  shows
No Interlock.

Press the STIM MODE key  longer than 2 seconds to deactivate the interlock
function.

6.13 Talk over microphone

Press one of the TALK OVER keys  and . In the lower area of the display 
the volume level of the talk over microphone is shown.

Adjust the talk forward volume with the left  or right ↕ knob.
Release the TALK OVER key  or  if you have finished talking to the patient.

6.14 Talkback microphone and Monitor volume control
Press the right SIGNAL key  longer than 2 seconds and the volume control
bars for TB and monitor are shown.

Adjust the monitor volume with the right knob ↕.
Adjust the talkback microphone volume with the left knob .
To store the actual settings press one of the STIM bars  or ↔.

6.15 Speech audiometry

To select speech audiometry switch both channels to TAPE/CD or MIC by
using the SIGNAL selector keys  and . In speech mode the display  shows
the percentage of correct repeated words. Below this percentage the number
of correct and wrong receipted words is shown.

To count the correct words press one of the frequency up keys  or →.
To count the wrong words press one of the frequency down keys  or .
To clear the counter press the FM key .

6.16 Speech calibration

To calibrate the speech inputs Tape/CD or MIC select the signal you’d like to
calibrate with the left SIGNAL selector key .

Press the left SIGNAL key  longer than 2 seconds. In the lower area of the
display  the text Calibration appears. Perform the reference signal with
Tape, CD or microphone. Use the left knob  for the left channel and the

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right knob ↕ for the right channel and adjust the levels until both VU-meters
 and  show all yellow and one green light. If one or more red lights are on,
reduce the level using the corresponding knobs  or ↕.

Store the calibration by pressing the STIM bar  or ↔.

6.17 User menu

To enter the User Menu you have to press the FM key  during instrument
switch-on.

To choose an item from the menu use the FREQUENCY keys / or /.
To select the chosen item press one of the STIM bars  or ↔.
Change the actual setting with the FREQUENCY keys / or /.
To confirm the changed setting press one of the STIM bars  or ↔.
To return without change press the FM key .
To return to the standard operation press the FM key  at the user menu.

Following menu items are available:
FF Set 1/2* Select the calibration for the first or the second

loudspeaker set

Bin Monaural Select the signal source channel for CD/TAPE

(Bin/Left/Right)

User Setup Setup of special functions
User Preference Customization of the instrument

* = only accessable if option is purchased

The User Setup Menu has the following selections:
Frequence Roll Setting of frequency control function (stop at highest

and lowest frequency or continuous change)

Default Levelset Initial level (signal or receiver change) is 30 dBHL or

not altered

Return to 1 kHz After the transducer has been changed the test

frequency of 1 kHz is automatically selected

Monitor with STIM Monitor phone active only with speech or

presentation of actual test signal

SRT Test Enable/disable Speech Reception Threshhold test
Adv. Noise Select. Enable/disable additional masking / test signals ( NB-

noise, speech-noise, white noise)

el. Output FF Electric output off or active when FF selected
Decay Enable/disable decay test

Operating Instructions MA 53

Geba_MA53_e_13a.doc 35 851 430/3 11/11

The User Preference Menu has the following selections:
Off Signal Enable/disable switch off position of signal selector

key  and 

Start with IP* Default setting of INSERT instead of AC
Start Tone / NBN Initial masking setting of right channel on/off
Language Select Submenu to select language
Presenter 1.5s The signal will only 1.5 s presented when the STIM

bar is pressed

Invers Dials Changes direction of level control dials  and ↕
Interru./Present Default setting of STIM MODE (Presenter or

Interrupter)
Bone-Mask-System* Activates the special MAICO Bone Masking headset
(not available in the USA)

* = only accessible if option is purchased

Operating Instructions MA 53

Geba_MA53_e_13a.doc 36 851 430/3 11/11

7 Advanced features

7.1 Complex mixing

The complex mixing feature of the MA 53 allows the operator to route two
different test signals to the same ear. The test signals and the test levels are
independently adjustable but will be presented to one ear (ipsilateral). This
feature could be used to test with speech in noise, competing message tests,
tone on noise or several other
combinations.

- To enter the complex mixing press the
swap key  longer than 2 seconds.

- The LCD-display  shows the mixing
selections (see picture 38).

- Use the left frequency up key  to switch on the mixing for the left ear and
the right frequency up key → for the right ear.

- Picture 39 shows i.e. the LCD-display for
enabled mixing on the left ear.

- Store the selection by pressing the STIM
bar  or ↔.

- The LCD-display  now shows the actual
setting for mixing. In the example picture
40 is a pure tone with a level of 30 dBHL
and a narrow band noise with a level of 30
dBHL, both with a frequency of 1000 Hz,
presented to the left ear.

Adjust hearing level and the test signal
independently for both channels. Both
signals will be mixed and presented to the left ear.

You can also select other receivers like BC, FF or insert phone for the left ear
with the left receiver selector key .

Other possible selections are mixing with presentation to the right ear or to
both ears.

To exit the complex mixing press the swap key  longer than 2 seconds and
switch the mixing for the left and the right ear to the off position.

Picture 38 MA 53 display with
mixing selection screen

Picture 39 MA 53 display with
mixing selection for the left ear

Picture 40 MA 53 display with
selected mixing for the left ear

Operating Instructions MA 53

Geba_MA53_e_13a.doc 37 851 430/3 11/11

7.2 Advanced Noise Selection

The MA 53 offers for advanced masking or testing the selection of narrow
band noise, speech masking noise and white noise as test signal.

Enable this feature from the user setup menu

The additional signals are now available as test signals. Select the required
signal by pressing the signal selector key  for the left channel and key  for
the right channel.

If the noise-LED is illuminated, you can choose between NB-Noise, Speech­Noise and White Noise by pressing the signal selector key.

7.3 Talk-back microphone

The optional talk-back microphone allows the patient to speak to the
operator. This feature is used if the patient sits in a sound excluding booth.
The communication from the patient to the operator will be heard with the
monitor phone.

7.3.1 Connection of the talk-back
microphone

Connect the talk-back microphone plug
to the TB MIC connector  at the rear
panel of the MA 53 (see picture 41).To
avoid pinching the cables when closing
the cover; lays the cables in the slots
provided.

7.3.2 Adjustment of the talk-back
microphone

To adjust the level of the talk-back
microphone press the right SIGNAL key 
longer than 2 seconds.

In the lower left area of the display  the
text Talk Back Level appears. Below that
you see the actual settings in % of the
maximum output level (see picture 42).

Let the patient say some test words with the talk-back microphone.
Use the right knob ↕ and adjust the output level that is comfortable for you.
Store the adjustment by pressing the STIM bar  or .

Picture 41 MA 53 rear panel : TALK-BACK
MICROPHONE and ASSISTANT-PHONE
connector

Picture 42 MA 53 display with
adjustment of the talk-back microphone

Operating Instructions MA 53

Geba_MA53_e_13a.doc 38 851 430/3 11/11

7.4 Assistant phone

The optional assistant phone allows the operator to speak directly to an
assistant person in the sound excluding booth. This could be a parent when
measuring children. The operator speaks to the assistant person via the talk
forward microphone and the assistant phone. This communication cannot be
heard by the patient.

To talk to the patient press the left TALK OVER button .

To talk to the assistant person press the right
TALK OVER button .

7.4.1 Connection of the assistant phone

Connect the assistant phone with the
attached connecting cable together with the
talk-back microphone to the TB MIC
connector  at the rear panel of the MA 53
(see picture 43).To avoid pinching the cables
when closing the cover, lay the cables in the
slots provided.

7.4.2 Adjustment of the assistant phone

Press the right TALK OVER key . In the lower area of the display  the
volume level of the assistant phone is
shown (see picture 44).

Adjust the assistant volume with the left
 or right  knob.

Release the TALK OVER key  if you have
finished talking to the patient.

Picture 43 MA 53 rear panelwith TALK­BACK MICROPHONE and ASSISTANT-PHONE
connector

Picture 44 MA 53 display with
adjustment of the assistant phone

Operating Instructions MA 53

Geba_MA53_e_13a.doc 39 851 430/3 11/11

8 Recommended literature

Audiometric Interpretation: A Manual of Basic Audiometry
Lloyd, Lyle L., and Harriet Kaplan
Baltimore: University Park Press, 1980

Auditory Disorders: A Manual for Clinical Evaluation
Jerger, Susan, and James Jerger
Boston: College Hill Press, 1981

Handbook of Clinical Audiology
Katz, Jack
Baltimore: William & Wilkins, 1994

s Audiology Desk Reference
Roeser, Ross J.
New York / Stuttgart: Thieme, 1996

Auditory Diagnosis
Silam, Shlomo and Carol A. Silvermann
San Diego / London: Singular Publishing Group,

1997

Operating Instructions MA 53

Geba_MA53_e_13a.doc 40 851 430/3 11/11

9 Computer interface

The MA 53 can be connected for data transfer to a PC.

Caution: The computer you are using must meet electrical safety
requirements, such as IEC 601-1 or UL. This is to avoid electrical shock
of either the patient or you.

All test results are online transferred to the PC and stored in the database.

In pure tone audiometry initially all
measured data is transferred as hearing
threshold data. You can see the letters HL
meaning threshold measurement in the
upper middle of the LCD-display  (see
picture 45).

To test the uncomfortable level (UCL) press the receiver selector button  or
 longer than 2 seconds and the LCD-display  in the upper row changes
from HL to UL. All measured data is now transferred as UCL data.

To test the most comfortable level (MCL) press the receiver selector button 
or  longer than 2 seconds and the LCD-display  in the upper row changes
from UL to ML. All measured data is now transferred as MCL data.

In speech audiometry initially all measured
data is transferred as multisyllable test data.
You can see the indication MS in the upper
middle of the LCD-display  (see picture

46).

To test with single syllables press the
receiver selector button  or  longer than
2 seconds and the LCD-display  in the upper row changes from MS to SS.
All measured data is now transferred as single syllable test data.

To test the uncomfortable level (UCL) for speech press the receiver selector
button  or  longer than 2 seconds and the LCD-display  in the upper row
changes from SS to UL. All measured data is now transferred as UCL speech
data.

Picture 45 MA 53 display with
pure tone threshold setting

Picture 46 MA 53 display with speech setting

Operating Instructions MA 53

Geba_MA53_e_13a.doc 41 851 430/3 11/11

10 Care and maintenance of the instrument
Disconnect the power plug before cleaning!

To clean the instrument, headphones, bone conduction receiver, loudspeaker
and other accessories use a soft cloth dampened with a little warm soapy
water or washing-up liquid; no alcohol or spirits should be used.

The ear cushions of the headphone can be detached for cleaning. To remove
the ear cushion pull it gently from the earphone. To assemble the cleaned or
changed ear cushion press it on the earphone and make sure that it sits
properly. The sound outlet hole must be exactly in the middle of the
earphone.

During cleaning, please ensure that no liquid runs into the switches, level
control, headphone capsules or loudspeaker openings.

Operating Instructions MA 53

Geba_MA53_e_13a.doc 42 851 430/3 11/11

11 Trouble shooting

If you should find that your instrument is no longer
working properly during a test run, please check
the following points:

Diodes in the buttons do not light up and
there is nothing to see on the LCD-display :

Is the power cord plugged in correctly?
Check the power fuses ♦.
Disconnect the power plug, unscrew the fuses 

alongside the power cord socket and check the
fuses. If the wire in the glass vial is broken, please
insert new fuses (1 A slow blow).

Diodes light up, but test tone is absent:

- Green STIM LED  or  does not glow:

- Press STIM bar  or  (When the diode illuminate and the tone is

available, the device works in presenter mode).

- Green STIM LED  or  does glow:

- Is level control  or ↕ set to an audible level position?

- Are the acoustic receivers connected to the correct socket?

- Is the required receiver with button  or  selected - is the correct LED

illuminated?

- Is the lead connecting the headphones, bone conductor or loudspeaker

loose or defective?

If your instrument still does not work properly after this short check, please
consult your dealer or service center.

Picture 47 power socket and fuses

Operating Instructions MA 53

Geba_MA53_e_13a.doc 43 851 430/3 11/11

12 Technical Data

The MA 53 audiometer is an active, diagnostic medical
product according to the class IIa of the EU medical directive
93/42/EEC.

Standards:

IEC 601-1class II, protection class BF

IEC 645-1/ EN 60 645-1: Type 2

IEC 645-2: Type A

ANSI S3.6-1996: Type 1 HF A

Test-Frequencies:

(individual selectable for
each channel)

125 Hz, 250 Hz, 500 Hz, 750 Hz, 1 kHz, 1.5

kHz, 2 kHz, 3 kHz, 4 kHz, 6 kHz, 8 kHz,
9 kHz*, 10kHz*, 11.2 kHz*, 12.5 kHz*, 14

kHz*, 16 kHz*

*= with optional HDA 200

Level step:

5 dB, 2 dB or 1 dB level steps (user selectable)

Sound Pressure Level:

AC with earphone DD45

- 10 dBHL ... 120 dBHL

(500 Hz, 4 kHz -10 dBHL ... 115 dBHL)

(250 Hz, 8 kHz -10 dBHL ... 100 dBHL)

(6 kHz -10 dBHL ... 110 dBHL)

(125 Hz -10 dBHL ... 80 dBHL)

BC with bone conduction

receiver Radioear B 71:

- 10 dBHL ... 80 dBHL

(1000 Hz: –10 dBHL.... 75 dBHL)

(500 Hz, 750 Hz)
(4 kHz, 6 kHz: -10 dBHL ... 60 dBHL)

(250 Hz: -10 dBHL ... 45 dBHL)

(125 Hz, 8 kHz no output)

(speech: -10 dBHL ... 80 dBHL)

Insert earphone with

optional EAR 3A:

- 10 dBHL ... 115 dBHL

( 500 Hz, 4 kHz -10 dBHL ... 110 dBHL)
( 250 Hz -10 dBHL ... 105 dBHL)
( 6 kHz -10 dBHL ... 95 dBHL)
( 125 Hz -10 dBHL ... 90 dBHL)

( 8 kHz -10 dBHL ... 85 dBHL)

Operating Instructions MA 53

Geba_MA53_e_13a.doc 44 851 430/3 11/11

FF with optional

loudspeaker type

Canton:

- 10 dBHL... 90 dBHL

(measurement in 1m distance)

( 1 kHz, 1.5 kHz -10 dBHL ... 85 dBHL)

( 500 Hz, 750 Hz -10 dBHL ... 80 dBHL)

( 250 Hz, 6 kHz, 8 kHz -10 dBHL ... 75
dBHL)

( 125 Hz -10 dBHL ... 60 dBHL)

( speech -10 dBHL ... 85 dBHL)

FF with optional portable
loudspeaker MAICO SBC:

- 10 dBHL... 85 dBHL (measurement in 1m
distance)

( 750 Hz, 2 kHz, 8 kHz -10 dBHL ... 80
dBHL)

( 500 Hz, 6 kHz -10 dBHL ... 75 dBHL)

(125 Hz, 250 Hz no output )

(2 kHz, 6 kHz -10 dBHL ... 90 dBHL)

(3 kHz, 4 kHz -10 dBHL ... 100 dBHL)

Test Signal:

Pure tone, pulse tone, warble tone,

narrowband noise, broadband noise (speech

masking noise)

Modulation:

Pulse tone: 0.5 s on/off

Warble tone: triangular, freq. deviation
5%, repetition rate 5 Hz

Tests:

ABLB (Fowler): 0.5 s and 1 s

DLI (Lüscher): 4; 3; 2; 1.5; 1 and 0.5 dB

SISI test: 5 dB, 3 dB, 2 dB
conditioning;

1 dB test; Modulation time 4.8/0.2s

Carhart decay test (built-in stop watch)

Stenger test

Functions:

Tone presenter / interrupter

Interlock (tone presentation of both channels
simultaneously)

Channel swap

Tracking (fixed level difference between both
channels)

Mixing (ipsilateral presentation of both

channels) Talk forward, Talk back, Monitor

phone, Assistant phone

Warm up time:

less than 10 min after power on

Mode of operation:

Continuous

Operating Instructions MA 53

Geba_MA53_e_13a.doc 45 851 430/3 11/11

Environment conditions:

+ 15 ... + 35 C / + 59 ... + 95 °F (operation)

+ 5 ... + 50 C / + 41 ... + 122 °F (storage)

Maximum humidity 90 % (storage and

operation)
According to water: ordinary equipment

According to sterilization: not applicable

Dimensions:

W x D x H: 36 x 46 x 15 cm /

14.2” x 18.1” x 5.9”

Weight:

4.6 kg / 10.1 lbs
(with accessories 5.8 kg / 12.8 lbs)

Power Supply:

100 - 240 V~ 50/60 Hz ±10 %

Power Consumption:

app. 25 VA

Device Fuses:

2x 1A slow blow

Operating Instructions MA 53

Geba_MA53_e_13a.doc 46 851 430/3 11/11

Connection plugs:

Connection

Specification

A power socket

left/right=power,
middle=prot.GND

(100 ... 240 V~ 50/60 Hz)
B power fuses

1 A slow blow

C serial PC-interface

1=GND, 2=RX, 3=TX, 5= GND,
6=DTR

RS 232 C
D patient response switch

sleeve=GND, tip=in

RI= 500 

E signal output right

sleeve=GND, tip=out

ZA= 47 k , UA= 8 Vef f

F signal output left

sleeve=GND, tip=out

ZA= 47 k , UA= 8 Vef f

G Loudspeaker FF right channel

sleeve=GND, tip=out

ZA= 4 , UA= 8 Vef f

H tape/CD input right channel

sleeve=GND, tip=in

ZI= 47 k , UI= 0.04 - 5 Veff

I Loudspeaker FF left channel

sleeve=GND, tip=out

ZA= 4 , UA= 8 Vef f

J tape/CD input left channel

sleeve=GND, tip=in

ZI= 47 k , UI= 0.04 - 5 Veff

K masking phone for BC (option)

sleeve=GND, tip=out

ZA=10 , UA = 1 Vef f

L tape/CD input right channel

sleeve=GND, tip=in

ZI= 47 k , UI= 0.04 - 5 Veff

M tape/CD input left channel

sleeve=GND, tip=in

ZI= 47 k , UI= 0.04 - 5 Veff

N BC (bone conduction receiver)

sleeve=GND, tip=out

ZZA= 4 , UA= 8 Vef f

O monitor phone

sleeve=GND, tip=out

ZA= 250 , UA = 8 Vef f

P insert phone right channel

sleeve=GND, tip=out

ZA=10 , UA = 1 Vef f

Q talkback microphone

sleeve=GND, tip=in

ZI= 1 k , UI= 0.38 - 500 mVeff

R insert phone left channel

sleeve=GND, tip=out

ZA=10 , UA = 1 Vef f

S right live voice microphone

sleeve=GND, tip=in

ZI= 1 k , UI= 0.38 - 500 mVeff

T AC (headphone) right channel

sleeve=GND, tip=out

ZA=10 , UA = 1 Vef f

U live voice microphone

sleeve=GND, tip=in

ZI= 1 k , UI= 0.38 - 500 mVeff

V AC (headphone) left channel

sleeve=GND, tip=out

ZA=10 , UA = 1 Vef f

Picture 55 rear of MA 53 with connection plugs

Operating Instructions MA 53

Geba_MA53_e_13a.doc 47 851 430/3 11/11

Calibration values: AC-Receiver DD 45 Force: 4 ... 5 N

Frequency [Hz]

Reference equivalent threshold
sound pressure level sound damping

ISO 389 - 1
with Coupler IEC 318-2

[dB] (re 20 Pa)

ANSI S3.6-1
with Coupler NBS 9A

[dB] (re 20 Pa)

[dB]

125 47.5 47.5 3
250 27.0 27.0 5
500 13.0 13.0 7
750 6.5 6.5 -
1000 6.0 6.0 15
1500 8.0 8.0 -
2000 8.0 8.0 26
3000 7.5 7.5 -
4000 9.5 9.5 32
6000 20.5 20.5 -
8000 12.0 12.0 24

Calibration values: BC-Receiver Radioear B 71 Force: 4.9 ... 5.9 N

Frequency [Hz]

Reference equivalent threshold
force level

air radiation

ISO 389 - 3

[dB] (re 1N)

ANSI S3.6-1996

[dB] (re 1N)

mean / maximum

[dB]

250

67 67 - 500

58

58 - 750

48.5

48.5

-

1000

42.5

42.5

-

1500

36.5

36.5

-

2000

31

31

-

3000

30

30

4 / 18

4000

35.5

35.5

-

6000

40

-

10.5 / 31

Operating Instructions MA 53

Geba_MA53_e_13a.doc 48 851 430/3 11/11

Calibration values: AC-High Frequency Receiver Sennheiser HDA 200
Force: 9 ... 10N

Frequency [Hz]

Reference equivalent threshold

sound pressure level

Sound damping

ISO 389 - 5
with Coupler IEC 318
and Type 1 Adapter

[dB] (re 20 Pa)

ANSI S3.6-1
with Coupler IEC 318
and Type 1 Adapter

[dB] (re 20 Pa)

[dB]

125

29.5 14.5

250

18.0 16.0

500

9.5 22.5

750

6.5 -

1000

6.5 28.5

1500

5.5 -

2000

3.0 32.0

3000

3.0 -

4000

8.5 45.5

6000

9.5 -
8000 17.0 16.0 44.0
9000 18.0 17.0 -
10000 22.0 21.5 -
11200 22.5 21.0 -
12500 27.5 27.5 -
14000 36.0 37.5 -
16000 58.0 58.0 -

Operating Instructions MA 53

Geba_MA53_e_13a.doc 49 851 430/3 11/11

Calibration values: FF : Free sound field (0 degree incidence)

Frequency [Hz]

Reference equivalent threshold
sound pressure level

ISO 389 - 7

[dB] (re 20 Pa)

ANSI S3.6-1996

[dB] (re 20 Pa)

125

22

22

250

11

11

500

4 4 750

2

2

1000

2

2

1500

0.5

0.5

2000

-1.5

-1.5

3000

- 6

- 6

4000

- 6.5

- 6.5

6000

2.5

2.5

8000

11.5

11.5

Calibration values: Insert phone Eartone 3A

Frequency [Hz]

Reference equivalent threshold
sound pressure level

sound damping

ISO 389 - 2

with Coupler IEC 126

[dB] (re 20 Pa)

ANSI S3.6-1

with Coupler HA-2

[dB] (re 20 Pa)

[dB]

125

26

26

32.5

250

14

14

36

500

5.5

5.5

37.5

750

2 2 -

1000

0 0 36.5

1500

2 2 -

2000

3 3 33 3000

3.5 3.5 - 4000

5.5

5.5

39.5

6000

2 2 -

8000

0 0 42.5

Operating Instructions MA 53

Geba_MA53_e_13a.doc 50 851 430/3 11/11

Standard accessories: 1 air conduction receiver DD 45
1 bone conduction receiver Radio Ear B 71
1 microphone (for live speech)
1 patient response switch
1 power cord
1 pad of audiogram paper (50 sheets)

Optional accessories:
Loudspeaker Canton (single unit) Part No. 801165

Portable Loudspeaker SBC (pair) Part No. 802092
(not available in the USA)
Insert phone Part No. 4790
Talk back microphone Part No. 6619
Monitor phone Part No. 705209
Audiogram paper (50 sheets) Part No. 1162-417

Options: High Frequency Audiometry with

HDA 200 Headphone Part No. 801110-1

Operating Instructions MA 53

Geba_MA53_e_13a.doc 51 851 430/3 11/11

13 Warranty, Maintenance and After-Sales Service

The MAICO MA 53 is guaranteed for 1 year.

This warranty is extended to the original purchaser of the instrument by
MAICO through the distributor from whom it was purchased and covers
defects in material and workmanship for a period of one year from date of
delivery of the instrument to the original purchaser.

The MA 53 may be repaired and serviced only by your dealer or by a service
center recommended by your dealer. We urgently advise you against
attempting to rectify any faults yourself or commissioning non-experts to do
so.

In the event of repair during the guarantee period, please enclose evidence of
purchase with the instrument.

In order to ensure that your instrument works properly, the MA 53 should be
checked and calibrated at least once a year. This check has to be carried out
by your dealer.

When returning the instrument for repairs it is essential to send the
headphones, as well. Send the device to your dealer or to a service center
authorized by your dealer. Please include a detailed description of faults. In
order to prevent damage in transit, please use the original packing if possible
when returning the instrument.

Within the European Union it is illegal to dispose electric and
electronic waste as unsorted municipal waste. According to
this, all MAICO products sold after August 13, 2005, are
marked with a crossed-out wheeled bin. Within the limits of
Article (9) of DIRECTIVE 2002/96/EC on waste electrical and
electronic equipment (WEEE), MAICO has changed their
sales policy. To avoid additional distribution costs we assign
the responsibility for the proper collection and treatment
according legal regulations to our customers.

Operating Instructions MA 53

Geba_MA53_e_13a.doc 52 851 430/3 11/11

14 Safety Regulations

14.1 Electrical Safety:

The MA 52 audiometer is constructed to comply with protection
class II of the international standard IEC 601-1 (EN 60601-1).
Protection from an electric shock is ensured even without the
system earth connection. The instruments are not intended for

operation in areas with an explosion hazard.

14.2 Measuring security:
To guarantee that the audiometer works properly, the instrument has to be
checked and calibrated at least once a year.

The service and calibration must be performed by an authorized service
center. In accordance with the regulations of the EU medical directive we will
drop our liability if these checks are not done.

The use of non-calibrated audiometers is not allowed.

14.3 Device control:
The user of the instrument should perform a subjective instrument check once
a week. This check can be done following the list for subjective instrument
check (see next page). For your own security, you should copy the enclosed
list, fill it in once a week and store it in your files.

14.4 Operation:

Only skilled personnel (Audiologists, ENT professionals or other with
equivalent knowledge) should operate the instrument.

14.5 Patient Safety:

Please note that if connection is made to standard equipment like printers and
network, special precautions must be taken in order to maintain medical
safety. Connecting this device to other devices in order to make a system may
cause the safety specifications to be invalid. It is therefore recommended to
insert a galvanic separation between the device and the host computer, unless
the computer is battery operated or supplied by a medical approved power
supply. Galvanic separation must fulfill the EN 60 601-1.

Operating Instructions MA 53

Geba_MA53_e_13a.doc 53 851 430/3 11/11

Checklist for Subjective Audiometer Testing

- Clean the ear and head cushion!

- Untangle all lines when necessary

- Are the headphone cushions in good condition?
If not  replace

- Are plugs and leads in good condition / undamaged?

- Are all controls working properly?

- Is the Patient Response Key working properly (if available)?

- Check batteries and renew if necessary?

Instrument:........................................

Manufacturer:…................................

Serial No.:....

.....................................

Examiner:........................................

Test Signal Quality

All the test frequencies in the below table indicate typical hearing level and can be changed when necessary:
Test these frequencies and enter the following abbreviations, if necessary: “B” for Buzz tone, “G” for Noise, “V” for signal
distortion, “S” for switching masking noise.

Right Ear

Level
Left Ear

kHz

0.25

0.5 1 2 3 4 6 8

0.25

0.5 1 2 3 4 6 8

kHz

AC

30dB HL

50dB HL

70dB HL

BC
30dB HL

50dB HL

* When noise “B”, “G”, “V” or “S” has been checked, please inform your service center!
* If conduction test signals are also audible in the non-test ear, please inform your service center!

Air Conduction Audiogram with test person

Right Ear

Level
Left Ear

kHz

0,25

0,5 1 2 3 4 6 8

0,25

0,5 1 2 3 4 6 8

kHz

Target
dBHL

*

Left
Earpiece

Actual
dBHL

Left
Earpiece

Right
Earpiece

Is
dBHL
**

Right
Earpiece

* Target value is the value measured in the last audiogram of the test person
**Repeat the measurement with headphones the wrong way around
If the difference between target and actual value at a particular frequency or between right and left headphones is more than 10 dB,
please inform your service center!

Bone Conduction Audiogram

Right Ear

Level
Left Ear

kHz

0,25

0,5 1 2 3 4 6 8

0,25

0,5 1 2 3 4 6 8

kHz

Target
dBHL*

Is
dBHL

If the difference between target and actual value at a particular frequency or between right and left headphones is more than 10 dB,
please inform your service center!

Tested.............................................................................................

Date:...............................................................................................

Operating Instructions MA 53

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Specifications are subject to change

MAICO Diagnostic GmbH

Salzufer 13/14
1058 Berlin
Telefon [phone]
Telefax [phone]
Email: [e-mail]
Internet: www.maico.biz