MII SPECIFICATION V1.

4
Rev.: 01 Rev.date: 2020.01.09 Author: EM Prj: MA1 Code: MO49

Maestro Interoperability Interface (MII)

Specification

Version 1.4

Release Date 2020.01.09

Maestro Compatibility 1.12.0

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DOCUMENT REVISIONS
REV. Description of improvements with respect to the previous version or to the substituted document.

1 [EM – 2020.01.09] First official document release

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Purpose and scope

This document describes the native data exchange interface supported by Maestro to allow
interoperation with Third-Party Applications (TPAs), specified as the Maestro Interoperability
Interface (MII).

Protocol version history

MII rev. 1.4

• Supported by Maestro 1.12.0.

• New features: Tympanometry and Acoustic reflexes exams are now supported in XML
export.
• Changes:
o Added <UnitOfMeasure> tag in XML export of Speech audiometry exam.
o Updated Speech Audiometry Element Syntax to revision 2
• Bugfixes: none
• Known bugs: none
• Notes: support for earlier MII versions has been dropped in Maestro 1.12.0. Upgrading
Maestro to 1.12.0 will require TPAs to adopt MII v1.14.

MII rev. 1.3

• Supported by Maestro 1.4.0.

• New features: All exam types are now supported when a PDF report is requested.
• Changes:
o <AllowPureToneAudiometry> and <AllowSpeechAudiometry> tags have been
dropped. Which exam types are allowed during the Maestro session are now
dependant on the value of the <ReportFormat> tag
o Added <dateTime> field to PuretoneAudiometryExam and SpeechAudiometryExam
elements in XML report files
o Added new exam types to enum “Exam” in the Result files.
• Bugfixes: none
• Known bugs: none
• Notes: support for earlier MII versions has been dropped in Maestro 1.4.0. Upgrading
Maestro to 1.4.0 will require TPAs to adopt MII v1.3.

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MII rev. 1.2

• Supported by Maestro 1.3.1 onwards.

• New features: none.
• Bugfixes: arbitrary alphanumeric strings for the Patient ID field are now correctly handled
during the XML report generation.
• Known bugs: none.
• Notes: support for MII v1.1 has been dropped in Maestro 1.3.1. Upgrading Maestro to 1.3.1
will require TPAs to adopt MII v1.2. The only modification required for converting MII v1.1
Request files over to v1.2 is to set “2” as the value for the VersionMinor attribute of the MII
tag. Accordingly, it is good practice for TPAs to check for the VersionMinor value when
parsing Result and Report files.

MII rev. 1.1

• Supported by Maestro 1.0.4 – 1.3.0. Support has been dropped in Maestro 1.3.1.
• First officially supported revision of the protocol.
• Known bugs: due to an error in the MaestroReport_v1.1.xsd file, Maestro only saves the
report when the Patient ID field contains a numeric value. Specifying a generic alphanumeric
string causes Maestro to fail during the report generation.
• Notes: Generic alphanumeric values for the Patient ID field were listed as supported in the
rev1.1 technical specification, but an error in the Maestro Report schema file
(MaestroReport_v1.1.xsd) actually caused Maestro to fail when a non-numeric ID had been
specified in the Request file.

MII Availability
The MII protocol is only supported by Maestro when it is being run in Standalone mode.
Interoperability with third party applications is not available when Maestro is installed in NOAH or
Database mode.

MII workflow
Interaction between Maestro and TPAs is accomplished by passing an MII Request file to Maestro
at start-up time. Maestro then processes the file and configures itself to serve the request. When
the operator closes Maestro, an MII Result file is generated for the TPA to consume, detailing the

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results of the operator actions in the current session. Both MII Request and Result files are xml files
conforming to the MII specification below.

Command line interface

To tell Maestro to open an MII Request file at startup, a single parameter must be passed on the
command line, specifying the name of the Request file to use. The syntax of the command is as
follows:
Maestro.exe /mii filename.mii

where filename.mii specifies the full path to the Request file. The directory containing the Request
file must be writable by the current user.

The operator is then expected to perform an examination on the patient, save the medical report
and close Maestro.

SYNCHRONIZATION
When Maestro is launched with the /mii parameter, it immediately creates a lock file in the folder
containing the MII file. The lock file has the same name as the specified MII Request file and ends
with the .lock extension. When Maestro is closed by the operator, it first writes the MII Result file
to disk (along with the reports, if any exams have been performed) and then removes the lock file.
Thus, the calling software should wait on the lock file and only access the Result file after the lock
file has been deleted.

The duty to remove the Result file and the exam report when they are no longer needed is left to
the TPA.

MII file syntax

Valid MII files must conform to the XML document standard. All files begin with a header line as the
first line. After the XML header, there must be one (and only one) <MII>…</MII> root element:
<?xml version="1.0" encoding="ISO-8859-1"?>
<MII versionMajor=”1” versionMinor=”4”>
…
</MII>

The versionMajor and versionMinor attributes must be populated with the revision number of
the MII specification that the MII file is conforming to. The values needed for versionMajor and

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versionMinor to refer to the revision of the specification described in this document are “1” and
“4”, respectively.

Inside the <MII> record, either a <Request> or a <Result> element is allowed, depending on the
MII file type.

Please refer to the following sections for an introduction to the elements allowed inside MII Request
and Result files. For a formal specification of the structure and syntax of MII files please refer to the
MII XSD schema definition attached to this document. Sample Request and Result files are also
available in Appendix A and B.

MII Request files

MII Request files must contain a single <Request> element. The id attribute of the <Request>
element optionally specifies a number representing the Request itself. When specified, Maestro will
quote this value in the corresponding id attribute of the <Result> element in the Result file. This
feature is provided for the convenience of the TPA, which can easily track request/result pairs by
using unique IDs for each request.

Inside a <Request> element, the following elements are allowed:

Element Type Required Default Description

<GUI>
<Layout>
<Left> Short If the <Layout> element is omitted,
<Top> Short Maestro starts up in full-screen mode.
No Full-screen
<Width> Short Otherwise, it resizes its window to the
<Height> Short specified screen coordinates.
</Layout>
<Logo> Path to a custom logo to embed in the
String No None
GUI
Current Language to use for the GUI (language
<Language> String No
Language tag as per ISO 639-1)
</GUI>
<Patient>
Personal information of the current
<Title> String
patient can be specified using the Patient
<FirstName> String
element. If this data is available, Maestro
<MiddleName> String
will include it in the exam report header.
<LastName> String No Empty
The ID element is a free-format string
<ID> String
identifier that TPAs can use to share SSN
<BirthDate> String
or alphanumeric identifiers with no
Enum
<Gender> restrictions.
[M|F|N]

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Element Type Required Default Description

</Patient>
An alphanumeric string representing the
<Operator> string No Empty current operator (the audiologist), to be
quoted on the exam report.
This value specifies if the exam report
must be saved in PDF or XML format. The
Enum
types of exams available during the
<ReportFormat> [PDF|XM No PDF
current Maestro session depends on this
L]
value (see Exams supported by Maestro
1.12 for details).
The folder
containing Specifies the path to the folder where
<OutputFolder> string No the Maestro will save the Result file and the
Request exam report.
file
Specifies the name Maestro will use for
<ResultFile> string No Result.mii
the Result file.
Specifies if Maestro will produce one
report for each exam performed, or a
<AggregateReports> boolean No Yes
single aggregated report containing all
exam findings.

MII Result files

MII Result files contain a single <Result> element. The id attribute of the <Result> element always
corresponds to the id attribute of the <Request> element in the Request file.

Inside a <Result> element, only one or more <Report> elements are allowed. Each of them
describes the location of an exam report file on disk, its format and contents.

The elements allowed inside a <Report> element are:

Element Type Description

Enum This value specifies if the exam report
<ReportFormat>
[PDF|XML] has been saved in PDF or XML format.
<FileName> String The name of the exam report file
Enum
[ABLB|ARLT|Bekesy|Decay|DLI|ETFIntact|
A value identifying the type of exam
<Exam> ETFPerforated|HFAudiometry|HIT|MFAudiometr|
contained in the report file.
MHA|MLB|MLD|Questionnaire|QuickSIN|
PureToneAudiometry|Reflex|REMMeasurement|

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SISI|SpeechAudiometry|TENTest|ToneDecay|
Tympanometry|VideoOtoscopy|Video]
(See Support Notes for Maestro 1.12)

In case two or more exams have been performed during a single session, the behavior of Maestro
depends on the value specified for the <AggregateReports> element in the Request file. If
<AggregateReports> is set to true, only one <Report> element will be present in the Result file,
and all exams performed will be listed in its <Exam> elements. Accordingly, a single report file will
be written to disk, containing the findings of the whole exam session.

If <AggregateReports> is set to false, and two or more exams have been performed in the current
session, more <Report> elements will be present in the Result file, each containing a single <Exam>
element, and corresponding to a separate report file containing the findings of that single exam.

Support Notes for Maestro 1.12

Maestro 1.12 has dropped support for previous MII versions and only supports MII rev. 1.4.

Exams supported by Maestro 1.12

All exam types are supported during a Maestro session when the requested report type is PDF, but
there are some limitations when the requested report type is XML, depending on the release of
Maestro.

Maestro 1.12 only supports exporting pure tone and speech audiometries, tympanometries and
acoustic reflexes in XML format. All other exam types are disabled and cannot be performed if an
XML export has been requested via MII.

Languages supported by Maestro 1.12

Values recognized by Maestro 1.12 for the <Language> tag are: en, it, de, fr, es, tr, pl, zh, ja, ko, pt,
ru, nl.

APPENDIX A: Sample MII Request file

<?xml version="1.0" encoding="ISO-8859-1"?>

<MII versionMajor="1" versionMinor="4">

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<Request id="42">
<GUI>
<Layout>
<Left>0</Left>
<Top>0</Top>
<Width>1600</Width>
<Height>1200</Height>
</Layout>
<Logo>D:\logo.png</Logo>
<Language>en</Language>
</GUI>
<Patient>
<Title>Mr.</Title>
<FirstName>John</FirstName>
<MiddleName></MiddleName>
<LastName>Doe</LastName>
<ID>AA0123456789</ID>
<BirthDate>2015-01-01</BirthDate>
<Gender>N</Gender>
</Patient>
<Operator>Dr. Smith</Operator>
<ReportFormat>XML</ReportFormat>
<OutputFolder>C:\Temp</OutputFolder>
<ResultFile>Result.mii</ResultFile>
<AggregateReports>false</AggregateReports>
</Request>
</MII>

APPENDIX B: Sample MII Result files

Example of a result file corresponding to the request above, where AggregateReport is set to false:
<?xml version="1.0" encoding="ISO-8859-1"?>
<MII versionMajor="1" versionMinor="4">
<Result id="42">
<Report>
<ReportFormat>XML</ReportFormat>
<FileName>C:\Temp\Report001.xml</FileName>
<Exam>PureToneAudiometry</Exam>
</Report>
<Report>
<ReportFormat>XML</ReportFormat>
<FileName>C:\Temp\Report002.xml</FileName>
<Exam>SpeechAudiometry</Exam>
</Report>
<Report>
<ReportFormat>XML</ReportFormat>
<FileName>C:\Temp\Report003.xml</FileName>
<Exam>Tympanometry</Exam>
</Report>
<Report>
<ReportFormat>XML</ReportFormat>
<FileName>C:\Temp\Report004.xml</FileName>
<Exam>Reflex</Exam>
</Report>
</Result>
</MII>

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Example of a result file corresponding to a request with AggregateReport set to true:

<?xml version="1.0"?>
<MII versionMajor="1" versionMinor="4">
<Result id="88">
<Report>
<ReportFormat>XML</ReportFormat>
<FileName>d:\Report.xml</FileName>
<Exam>PureToneAudiometry</Exam>
<Exam>SpeechAudiometry</Exam>
<Exam>Tympanometry</Exam>
<Exam>Reflex</Exam>
</Report>
</Result>
</MII>

APPENDIX C: Pure tone audiometry element syntax Rev 1

The pure tone audiometry exam is composed of traces. Each trace is described by trace parameters
and is composed of points. The following table specifies the trace parameters and the point
elements:

Section Field Type Notes Admissible values

DateTime string Date and time of
exam acquisition
General
Revision int Data structure
revision
HACondition string When defined, it “NOT_DEFINED”
indicates if the “UNAIDED”
exam has been “AIDED”
performed in aided
or unaided
condition
StimulusOutput string Output of the “NOT_DEFINED”
stimulus channel “AC”: air conduction
“BC”: bone conduction
Trace
“FF”: free field
parameters
StimulusTransducer string Transducer of the “NOT_DEFINED”
stimulus channel “TDH39”: TDH-39
“BONE_BC71”: BC – 71
“FREE_FIELD”: free field
“EARTONE_ER3”: ER-3
“EARTONE_ER5”: ER-5
“SENNHEISER_HDA300”: HDA300
“SENNHEISER_HDA200”: HDA200
“SENNHEISER_HDA280”: HDA280

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“DD45”: DD45
StimulusSide string Side of the stimulus “NOT_DEFINED”
channel “Left”
“Right”
“Bilateral”
StimulusInput string Input of the “NOT_DEFINED”
stimulus channel “TONE”
“WARBLE”
“NARROWBANDNOISE”
“WHITENOISE”
MaskingOutput string Output of the “NOT_DEFINED”
masking channel “AC”: air conduction
“BC”: bone conduction
“FF”: free field
“INS_MASK”: insert mask
MaskingTransducer string Transducer of the “NOT_DEFINED”
masking channel “TDH39”: TDH-39
“BONE_BC71”: BC – 71
“FREE_FIELD”: free field
“EARTONE_ER3”: ER-3
“EARTONE_ER5”: ER-5
“SENNHEISER_HDA300”: HDA300
“SENNHEISER_HDA200”: HDA200
“SENNHEISER_HDA280”: HDA280
“IME100”: IME100
“DD45”: DD45
MaskingSide string Side of the masking “NOT_DEFINED”
channel “Left”
“Right”
“Bilateral”
MaskingInput string Input of the “NOT_DEFINED”
masking channel “TONE”
“WARBLE”
“NARROWBANDNOISE”
“WHITENOISE”
IsUCL string True if the type of True, false
threshold
examined is UCL,
false if it is HL.
StimulusDBLevel int Intensity level of [-10, 120]
the stimulus
StimulusFrequency int Frequency of the [125, …, 8000, 12500]
Point
stimulus
Masked string True if the point is True, false
masked

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MaskingDBLevel int Intensity level of [-10, 120]

the masking
NoResponse string True if the point is a True, false
not response point

APPENDIX D: Speech audiometry element syntax

Rev 2
The speech audiometry exam is composed of traces. Each trace is described by trace parameters
and is composed of points. The following table specifies the trace parameters and the point
elements:

Section Field Type Notes Admissible values

DateTime string Date and time of
exam acquisition
Material string Name of the speech
material
General Revision int Data structure
revision
UnitOfMeasure string Unit of measure “dBHL”
used during the “dBSPL”
exam
HACondition string When defined, it “NOT_DEFINED”
indicates if the “UNAIDED”
exam has been “AIDED”
performed in aided
or unaided
condition
ExamMode string It indicates the type “NOT_DEFINED”
of speech “WRS1”
Trace audiometry “WRS2”
parameters “WRS3”
“WRS_BINAURAL1”
“WRS_BINAURAL2”
“WRS_BINAURAL3”
“SRT”
“MCL”
“MCL_BINAURAL”
“UCL”
“UCL_BINAURAL”

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WRSType string It indicates the type “NOT_DEFINED”

of the WRS exam “WRS_STANDARD”
mode “WRS_SINGLE_POINT”
StimulusOutput string Output of the “NOT_DEFINED”
stimulus channel “AC”: air conduction
“BC”: bone conduction
“FF”: free field
StimulusTransducer string Transducer of the “NOT_DEFINED”
stimulus channel “TDH39”: TDH-39
“BONE_BC71”: BC – 71
“FREE_FIELD”: free field
“EARTONE_ER3”: ER-3
“EARTONE_ER5”: ER-5
“SENNHEISER_HDA300”: HDA300
“SENNHEISER_HDA200”: HDA200
“SENNHEISER_HDA280”: HDA280
“DD45”: DD45
StimulusSide string Side of the stimulus “NOT_DEFINED”
channel “Left”
“Right”
“Bilateral”
StimulusInput string Input of the “NOT_DEFINED”
stimulus channel “INT1”: internal source
“INT2”: internal source
“LINE1”: external source
“LINE2”: external source
“MIC”: microphone
“MIC_USB”: microphone
“USB1”: external source
“USB2”: external source
MaskingOutput string Output of the “NOT_DEFINED”
masking channel “AC”: air conduction
“BC”: bone conduction
“FF”: free field
“INS_MASK”: insert mask
MaskingTransducer string Transducer of the “NOT_DEFINED”
masking channel “TDH39”: TDH-39
“BONE_BC71”: BC – 71
“FREE_FIELD”: free field
“EARTONE_ER3”: ER-3
“EARTONE_ER5”: ER-5
“SENNHEISER_HDA300”: HDA300
“SENNHEISER_HDA200”: HDA200
“SENNHEISER_HDA280”: HDA280
“IME100”: IME100
“DD45”: DD45

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MaskingSide string Side of the masking “NOT_DEFINED”

channel “Left”
“Right”
“Bilateral”
MaskingInput string Input of the “NOT_DEFINED”
masking channel “INT1”: internal source
“INT2”: internal source
“LINE1”: external source
“LINE2”: external source
“MIC”: microphone
“MIC_USB”: microphone
“USB1”: external source
“USB2”: external source
“WHITENOISE”
“SPEECHNOISE”
StimulusDBLevel int Intensity level of [-10, 100] if UnitOfMeasure is dB HL
the stimulus [10, 120] if UnitOfMeasure is dB SPL
Percent int Score [0, 100]
Point Masked string True if the point is True, false
masked
MaskingDBLevel int Intensity level of [-10, 100] if UnitOfMeasure is dB HL
the masking [10, 120] if UnitOfMeasure is dB SPL

APPENDIX E: Tympanometry element syntax Rev 1

The tympanometry exam is composed of traces. Each trace is described by trace parameters and is
composed of points. The following table specifies the trace parameters and the point elements:

Section Field Type Notes Admissible values

DateTime DateTime Date and time of exam
General acquisition
Revision int Data structure revision
Side string Test side “NOT_DEFINED”
“LEFT”
“RIGHT”
“BILATERAL”
ProbeFrequency short Probe tone frequency 226, 678, 800, 1000
Trace
(Hz)
parameters
PressureRateMode Enum Pressure rate set mode “MANUAL”
“FIXEDRATE”
“AUTORATE”
PressureFixedRate Unsigned Pressure rate value [15, 600]
short (different from 0 only if

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PressureRateMode is
FIXEDRATE) (daPa/s)
PressureAutoRateMaxValu Unsigned Pressure rate maximum [15, 600]
e short value (different from 0
only if
PressureRateMode is
AUTORATE) (daPa/s)
PressureAutoRateMinValu Unsigned Pressure rate minimum [15, 600]
e short value (different from 0
only if
PressureRateMode is
AUTORATE) (daPa/s)
PressureSweep Enum Pressure sweep “INCREASING”
direction “DECREASING”
DisplayedPressureMaxValu short Pressure scale [-600, + 400]
e maximum displayed
value (daPa)
DisplayedPressureMinValu short Pressure scale [-600, + 400]
e minimum displayed
value (daPa)
DisplayedAdmittanceMode Enum If compensated, the “COMPENSATED”
contribution of the ear “ABSOLUTE”
canal volume is
removed
DisplayedAdmittanceComp string Admittance component “NOT_DEFINED”
onent (Y, B, G) “MODULE”
“SUSCEPTANCE”
“CONDUCTANCE”
“CONDUCTANCEANDSUSCEP
TANCE”
DisplayedAdmittanceMaxV short Admittance scale
alue maximum displayed
value (multiplied by
1000)
DisplayedAdmittanceMinV short Admittance scale
alue minimum displayed
value (multiplied by
1000)
AdmittanceUnitOfMeasure string Unit of measure of “NOT_DEFINED”
admittance “ML”
“CM3”
“MMHO”
AdmittanceConversionFact float Conversion factor
or between mmho and ml
measurement units

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[mmho] =
AdmittanceConversion
Factor * [ml]
ECVModule Unsigned Ear Canal Volume (ECV)
short module (multiplied by
1000):
65535 = not valid
ECVPhase short Ear Canal Volume (ECV)
phase (multiplied by
1000):
32767 = not valid
ECVRange Enum ECV value can be inside, “INSIDE”
below or above the “BELOW”
measurement range “ABOVE”
AdmittancePeak Unsigned Admittance value of the
short tympanogram’s peak
(multiplied by 1000):
65534 = not found
65535 = not valid
AdmittancePeakRange Enum Admittance peak value “INSIDE”
can be inside, below or “BELOW”
above the “ABOVE”
measurement range
AdmittancePeakPressure short Pressure value of the
tympanogram’s peak:
4094 = not found
4095 = not valid
DisplayedTympanogramFac Enum Tympanogram factor “NOT_DEFINED”
tor currently displayed on “TYMPANOGRAMWIDTH”
Maestro software “TYMPANOGRAMGRADIENT”
TympanometryGradient Unsigned Tympanogram gradient
short (multiplied by 100):
65535 = not valid
TympanometryWidth Unsigned Tympanogram width
short (daPa):
65535 = not valid
AdmittanceModule Unsigned Module of the
short admittance value
(multiplied by 1000): to
obtain compensated
value subtract the
Point
ECVModule
AdmittancePhase short Phase of the
admittance value
(multiplied by 1000)
Pressure short Pressure value (daPa)

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APPENDIX F: Acoustic reflexes element syntax Rev 1

The acoustic reflexes exam is composed of traces. Each trace is described by trace parameters and
is composed of points. The following table specifies the trace parameters and the point elements:

Section Field Type Notes Admissible values

Date and time of exam
DateTime DateTime
General acquisition
Revision int Data structure revision
Side string Test side “NOT_DEFINED”
“LEFT”
“RIGHT”
“BILATERAL”
ProbeFrequency Short Probe tone frequency 226, 1000
(Hz)
ExamMode String It indicates the type of “NOT_DEFINED”
acoustic reflex search “MANUAL_REFLEX”
“FIXED_INTENSITY”
“SEEK_THRESHOLD”
“GROWING_INTENSITY”
AdmittanceUnitOfMeasure String Unit of measure of “NOT_DEFINED”
admittance “ML”
“CM3”
“MMHO”
DisplayedAdmittanceMaxValue Short Admittance scale
maximum displayed
Trace
value (multiplied by
parameters
1000)
DisplayedAdmittanceMinValue Short Admittance scale
minimum displayed
value (multiplied by
1000)
DisplayedPolarity Enum Reflex polarity displayed “POSITIVE”
on Maestro software “NEGATIVE”
Pressure Short Pressure at which the [-600, + 400]
acoustic reflex exam is
performed (daPa)
TotalDuration Unsigned Duration of the data
short acquisition (ms)
PrestimulusDuration short Acquisition time before
sending the stimulus
(ms)
StimulusDuration Unsigned Duration of the stimulus
short (ms)

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 MII SPECIFICATION V1.4
Rev.: 01 Rev.date: 2020.01.09 Author: EM Prj: MA1 Code: MO49

StimulusFrequency Short Frequency of the

stimulus channel (Hz)
StimulusInput String Input of the stimulus
channel
StimulusIntensity Short Intensity level of the
stimulus (dB)
StimulusPresentation Enum It indicates where the “NOT_DEFINED”
stimulus is sent in “CONTRALATERAL”
relation to the “IPSILATERAL”
stimulation side
ReflexFound Boolean True if the reflex is found True, False
ReflexRecognitionSensitivity Unsigned Admittance change
short amplitude for reflex
detection (multiplied by
1000)
Admittance int Admittance change
Point (multiplied by 1000)
Time int Sampling time (ms)

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