VetWave

Instrumental test

• What are the differences between VET-WAVE^®  and the classical impedance measurement known in human audiometry? Impedance measurement is a diagnostic technique that studies the transmission of sound vibrations through the middle ear. It allows to study the functionality of the middle ear and the possible presence of pathologies in order to determine the various degrees of deafness. There are two main types of impedenzometry: the pressure-free technology used by Vet-Wave and the technology based on pressure variations used in tympanometry.The classic technology measures the variation of an impedance component by using a continuous tone at a single frequency 226 Hz while changing the pressure inside the external ear canal. Vet-Wave, on the other hand, is based on the direct measurement of the acoustic impedance by generating a multi-frequency acoustic signal ranging from 100 to 3 000 Hz sent inside the ear canal. The portion of the signal that is reflected is measured with a newly designed intensimetric PP probe which allows to define the portion of acoustic energy absorbed with precision for each frequency without having to use pressure variations to the eardrum.  The NEURANIX P-P sensors can measure the synchronicity of the pressure wave through the sound velocity wave using a specific P-V (Pressure- Velocity) algorithm calculation. This calculation allows to obtain the resonance volume of the system measured together with the value of the admittance value for each Hz without having to apply pressure to the eardrum.
• Is VET-WAVE^® invasive for the patient?   One of the various advantages of VET-WAVE^®  is the absence of pressure variations to the eardrum and the middle ear, making the exam more tolerated by the patient, without generating pain or particular discomfort.
• What are the clinical indications that VET-WAVE^® studies?  The test is particularly useful in the characterization of pathological conditions of the external and middle ear due to:
  - External and internal ear infections;
  - Foreign body trauma;
  - Middle ear degenerations or neoformations such as perforation or tympanic laceration;
  - Excessive stiffness (otosclerosis) or tympanic flaccidity;
  - Cholesteatoma;
  - Middle ear cancer;
  - Tympanum sclerosis;
  - Optical polyps;
  - Dislocated ossicles.
  To complement / integrate the aforementioned functional study, visual inspection of the external duct and tympanum can be carried out thanks to the integrated video otoscope. For further information on the parameter values resulting from the test, please refer to the document on our website www.vet-wave.com "Suggestions interpretation parameters VET-WAVE ® ".
• What does the Q factor (fQ) mean? It is defined as resonance/band frequency calculation and indicates the amount of energy that is NOT absorbed by the eardrum. A high value of Q means that a lot of acoustic energy is reflected back by the eardrum and vice versa if Q is small. The normal Q value expresses the correct functioning of the middle ear if combined with the normal volume of the ear duct.
• What does the value Vr mean? It is the Resonance Volume that allows to indirectly recalculate, based on the value of the recorded resonance peak, the volume that is present between the probe and the resonant membrane. It indicates the volume of the external auditory canal, and is associated with the size of the skull. If the eardrum is torn, it increases because the volume measurement also includes the volume of the tympanic bubble (middle ear), however during chronic external proliferative otitis it decreases. The value increases or decreases if inside the duct there is material capable of absorbing or reflecting certain frequencies. For example: the value decreases due to the presence of ear wax or masses that invade the lumen.
• What does P mean? The resonance peak (P) indicates the amount of acoustic energy that returns to the probe. This is the maximum value of Acoustic Admittance.
• What does the Resonance Frequency indicate?  It indicates the frequency at which the resonance peak occurs.
• Do the parameters of Vr, f Q and P change between adults, puppies or sex?        Yes, they vary according to the age and size of the subject, however gender does not influence the parameters. The values fQ and P are closely related to the resonance volume. To limit this variability linked to the volume, and ensure that the values fQ and P give information exclusively related to the functionality of the tympanic membrane and middle ear, an automatic correction algorithm normalizes the P and fQ values and VET-WAVE^®  indicates this output as normalized values as “P**, fQ**”.
• What is the difference between the automatic or manual use of the VET-WAVE^®? In mode Manual it is the operator who chooses the graphic and values to be included in the report, while in the Automatic mode it is the VET-WAVE^®  software that selects the tympanogram to be considered and inserted in the report.
• What kind of diagnostic indications can VET-WAVE^® give?  It is possible to get certain indications on the diagnosis. By pressing the "Diagnosis" key, the software indicates probable pathologies related to the type of tympanogram selected, excluding others. These indications always need to be confirmed by the veterinarian and he or she will insert them accordingly in the final report.
• How can I identify and confirm a torn eardrum?   VET-WAVE^®  simultaneously measures the volume of the ear canal and the amount of energy absorbed. A torn eardrum has a larger than normal volume and absorbs more energy.
• How can I identify the presence of fluid in the middle ear?   In the case of fluid in the middle ear, the eardrum becomes stiffer than normal and therefore the energy is reflected, bringing the Q value above the norm.
• Is VET-WAVE^® capable of measuring the stapedial reflex?   VET-WAVE^®  has the ability to measure the stapedial reflex, however this function is being developed. The algorithm is based on the measurement of the pressure variation of one or more probe tones, generated at the resonance frequency of the auditory canal of each subject, this allows to obtain the maximum sensitivity of the stapedial response for each individual subject.
• Why does the device not find the resonance peak (P)? There could be an error during the measurement due to problems with the probe, for example: the probe is not connected to the device, the probe is not correctly positioned inside the ear canal of the animal, the probe terminal is blocked by earwax.
  NB: during the pre - test, the device automatically identifies the correct positioning of the probe and automatically starts the measurement and subsequently the data processing.
• Do I have to fill in all patient data every time I take a measurement?  
 No, you can reuse the data you filled in the last time, just select the "RETRIEVE DATA" button on the right of the patient data entry pages and related to the operator and the site where the test is performed.
• Can measurement data and reports be exported?  
 Yes, by selecting the "EXPORT REPORT" button it is possible to export the measurements to the USB memory stick provided by Neuranix by connecting it to the device. A report will automatically be generated that will present the measurement taken, the otoscope images (if available), the patient data entered and (if required) the indications on the pathology provided by VET-WAVE^®.
• What happens if the USB is not recognized by the device? It may happen that the system takes a few seconds to recognize the USB memory stick. If after a few seconds (maximum 15-20 seconds) the USB is not recognized, turn off the system and insert the USB before turning it on again. It is however suggested to insert the USB in the system port before turning on the device.
• Are the values fQ , P and Vr parameters that can give different diagnostic indications if interpreted individually?   No, these parameters must be considered and interpreted together. It is possible to obtain useful diagnostic information from their interpolation and from the morphological indications of the values and graphic provided. For further information on the correct interpretation of the parameters consult the manual.
• What is the diagnostic added value for the veterinarian using VET-WAVE^®?   This tool allows to increase the professionalism and diagnostic potential of the general practitioner and specialist as currently being the only tool available for veterinary medicine capable of assessing the functionality of the external and middle ear.
• Can the presence of earwax, liquids or anything else in the dog's ear canal affect the measurement? Yes, the presence of material in the duct can condition and in extreme cases prevent the measurement. For these reasons it is important and strongly recommended to perform a thorough cleaning of the ear before taking measurements with the VET-WAVE^®, just as you would do with a normal otoscope exam.
• Can the presence of excessive hair in the duct compromise the measurement?   It is always possible to perform the measurement with the VET-WAVE^®  if the animal and the ear canal to be investigated are adequately prepared. The practice and precautions to be implemented before using the instrument are the same as using a classic otoscope. So, in extreme cases it is necessary to sedate the animal, carry out thorough washing of the ear and remove as much excess hair from the duct as possible.
• Are there scientific studies on the use of VET-WAVE^® in exotic animals and in horses?   Currently they are not yet available but there are numerous projects to implement the study and use of VET-WAVE^®  on all small (pet) animals of veterinary interest.
• How complex and long is the training period of the veterinary surgeon to correctly carry out a measurement with the VET-WAVE^®? The correct handling and use of the probe is very similar to that of the use of the classic otoscope already used by most Veterinary Doctors. In the software there is a function called "Pre-test" which helps the operator to find the correct position of the probe during the measurement.
• Have scientific publications been made on the use of VET-WAVE^® in dogs?   Yes, pilot studies have been published and other scientific reports on the most important international journals are imminent.
• What are the symptoms attributable to an otological problem in dogs? The clinical picture can vary depending on the type of problem. If the problem is in the external ear, the dog may present itching, pain, presence of material/fluids coming out of the ear, rotating its head etc. These symptoms may be present in whole or in part depending on the severity of the condition. If the damage involves the middle ear, the dog shows pain, rotated head, labyrinthitis and balance disorders. If the damage is in the inner ear, the total or partial loss of hearing capacity will probably the most common clinical sign.
• What are the advantages of having a Firefly otoscope supplied with the machine if you already have another type of otoscope?  The most important advantage is practicality. VET-WAVE ®  associated with FireFly is able to perform an impedance test and in the same session it allows to directly visualize the eardrum straight on the display of the device. Moreover, thanks to the presence of specific cones equipped with an operating channel and thanks to the equipment of a professional veterinary otological forceps, it is possible to operate easily in the duct and on the eardrum e.g. to take out foreign bodies. It is also possible to take photos of the eardrum and have them automatically inserted in the diagnostic report.
• Can I connect any brand and type of digital otoscope equipped with a USB cable? No, the software recognizes only the Firefly otoscope supplied with the VET-WAVE ® instrument.