The TOP-LLC CST is intended for use by a qualified healthcare professional such as an otolaryngologist, an audiologist, or other qualified professional. It is intended to mask or intermittently mask the patient's tinnitus as part of a tinnitus management program. Patients receive a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) to rule out medically or surgically treatable diseases for which tinnitus is a symptom before proceeding with CST. Initial hearing and tinnitus tests are conducted by a qualified audiologist familiar with the treatment of timitus; subsequent management of the treatment is carried out by an audiologist or other qualified professional.
Device Story
CST is software-based tinnitus management system; operates on standard Windows PC. Clinician uses proprietary GUI and cmusic acoustic compiler to generate sounds matching patient's tinnitus based on verbal feedback. Matching sound file written to PC hard drive; transferred to patient's portable audio device (PAD). Patient uses PAD volume control to adjust sound level to match tinnitus sensation for temporary relief. Used in clinical setting by audiologists/otolaryngologists; patient uses PAD for home therapy. Benefits include temporary masking of tinnitus disturbance.
Clinical Evidence
No clinical data provided. Substantial equivalence based on technological characteristics and intended use compared to predicate devices.
Technological Characteristics
Software-based system; utilizes cmusic acoustic compiler. Runs on Windows XP (SP2) PC (1.2 GHz CPU, 256 MB RAM). Outputs sound files to portable audio devices (PAD). No specialized hardware; uses commercially available computer/audio equipment.
Indications for Use
Indicated for adults (18+) with tinnitus, with or without high-frequency hearing loss, participating in a tinnitus management program. Requires medical evaluation to rule out treatable underlying conditions.
Regulatory Classification
Identification
A tinnitus masker is an electronic device intended to generate noise of sufficient intensity and bandwidth to mask ringing in the ears or internal head noises. Because the device is able to mask internal noises, it is also used as an aid in hearing external noises and speech.
Special Controls
The special control for this device is patient labeling regarding:(1) Hearing health care professional diagnosis, fitting of the device, and followup care, (2) Risks, (3) Benefits, (4) Warnings for safe use, and (5) Specifications.
Long-term reductions in tinnitus severity (Folmer, 2002)
Submission Summary (Full Text)
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Image /page/0/Picture/0 description: The image shows the text "K070599" in a handwritten style. Below this, the text "JUL 13 2007" is printed in a simple, sans-serif font. The text appears to be part of a document or label, possibly indicating a date or identification number.
#### 510K Summary
APPLICANT: ADDRESS:
#### CONTACTS:
Geraldine Crean, Ph.D. Regulatory Liaison, Tinnitus Otosound Products, LLC gerldinecrean@yahoo.com 310-927-6151
Anthony Materna, Ph.D. CEO, Tinnitus Otosound Products, LLC tmaterna@top llc.net
Tinnitus Otosound Products, LLC
880 First Street, Suite 403
Los Angeles, CA 90012
#### DATE OF SUBMISSION:
February 28, 2007
310-273-8217
213-626-0927
#### TRADE OR PROPRIETARY NAME: Customized Sound Therapy
## COMMON OR UNUSUAL NAME(S): CST
#### CLASSIFICATION NAME:
Tinnitus Masker Device (TMD) Described in 21 CFR 874.3400 Class II, product code KLW
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## PREDICATE DEVICE(S)
Petroff Audio Technologies, Inc. Manufacturer: Tradename: Dynamic Tinnitus Mitigation System, DTM-6 510K Number: K974501
Manufacturer: Neuromonics (formerly TiniTech) Tradename: TinniTech ANMP System 510K Number: K030791
## SUBSTANTIAL EQUIVALENCE
Customized Sound Therapy is claiming substantial equivalence to two devices.
1. Equivalence to the Dynamic Timitus Mitigation System, DTM-6, manufactured by Petroff Audio Technologies Inc. 510K number K974501.
2. Equivalence is also claimed to the TinniTech ANMP System, manufactured by Neuromonics (formerly TiniTech). 510K number K030791
## DEVICE DESCRIPTION
The Tinnitus Otosound Products LLC (TOP-LLC), Customized Sound Therapy (CST), falls under devices described in 21 CFR 874.3400 Class II, product code KLW. The device is a CD comprised of software with two components: a graphic user interface and cmusic program. The software can be used on a notebook or desktop computer with at least Windows XP (SP2) having at least a 1.2 GHz Pentium III CPU (or equivalent), 256 MB of RAM, 1 GB of free disk space, a CD drive, and an available USB port.
The Customized Sound Therapy software produces, and transfers sounds to a sound wave file. This sound file can be stored on any commercially available computer hard drive or portable audio device (PAD) like an iPod.
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## DESCRIPTION OF DEVICE DESIGN
The CST software consists of specialized programs for creating the CST sounds, which are matched as closely as possible to the tinnitus sensation experienced by the patient. The CST software is based on the cmusic acoustic compiler and a proprietary graphic user interface developed specifically for use during sound matching with CST [1; Chapter 3, pp. 150-214; Appendix D, pp. 490-546]. - Under control of a qualified audiologist or other qualified professional, the CST software writes the matching sound on the hard drive of the computer. A copy of this sound is transferred to a commercially available portable audio device for use by the patient during therapy. The volume control on the PAD is used to match that apparent level of the CST sound to the patient's tinnitus sensation as subjectively judged by the patient.
The system is intended to provide relief from the disturbance of tinnitus in an attempt to provide temporary relief of the effect of tinnitus
#### INTENDED USE
The TOP-LLC CST is intended for use by a qualified healthcare professional such as an otolaryngologist, an audiologist, or other qualified professional. It is intended to mask or intermittently mask the patient's tinnitus as part of a tinnitus management program.
Patients receive a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) to rule out medically or surgically treatable diseases for which tinnitus is a symptom before proceeding with CST. Initial hearing and tinnitus tests are conducted by a qualified audiologist familiar with the treatment of timitus; subsequent management of the treatment is carried out by an audiologist or other qualified professional.
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## INDICATIONS FOR USE
The CST system is a CD with software that enables qualified professional to identify, with the patient's verbal input, the sounds that most closely match the patient's tinnitus. The device is indicated to mask and intermittently mask tinnitus as part of a tinnitus management program. The target population for the device is adults (18 years and over) who present with tinnitus, that may or may not be accompanied with hearing loss at the higher frequencies, and who are participating in a tinnitus management program.
#### RISKS AND WARNINGS FOR SAFE USE
The software packaging and the CD are clearly marked with two warnings: 1) the sounds on the discs should not be played at uncomfortable levels, and 2) the CST system should not be used if such use prevents the user from hearing sounds warning of danger (like the beeping of oncoming vehicles).
The following caution statement is also on the software packaging and the CD:
Caution: Federal law restricts this device to sale by or on the order of a practitioner licensed by the law of the State in which he/she practices to use or order the use of this device.
## DEVICE CHARACTERISTICS
The CST device consists of computer software, which identifies, produces and transfers custom sounds, CST, from a desktop or laptop to a PAD. The CST software is based on the cmusic acoustic compiler (standard in generating computer music) that includes a proprietary graphic user interface developed specifically for use during sound matching with CST [1]. CST software will be use with standard computer and audio equipment that is commercially available. The standard commercially available components are intended for use as designated by the manufacturer.
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# CONCLUSIONS
CST is equivalent to tinnitus masking devices already approved for marketing.
## REFERENCES
[1] Moore, F. R. Elements of Computer Music (Prentice-Hall, 1990)
[2} Folmer, R.L. Long-term reductions in tinnitus severity. BMC Ear, Nose, and Throat Disorders, 2002, 2(3): 1-9.
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Image /page/5/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is a stylized symbol that resembles three human profiles facing to the right, stacked on top of each other.
Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850
JUL 1 3 2007
Tinnitus Otosound Products, LLC c/o Geraldine Crean, Ph.D. 880 First Street, Suite 403 Los Angeles, CA 90012
Re: K070599
Trade/Device Name: Customized Sound Therapy (CST) Regulation Number: 21 CFR 874.3400 Regulation Name: Tinnitus masker Regulatory Class: Class II Product Code: KLW Dated: May 22, 2007 Received: May 24, 2007
Dear Dr. Crean:
We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.
If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.
Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.
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This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.
If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Center for Devices and Radiological Health's (CDRH's) Office of Compliance at (240) 276-0115. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.
Sincerely yours,
M.B. Egleston, MD
Malvina B. Eydelman, M.D. Director Division of Ophthalmic and Ear. Nose and Throat Devices Office of Device Evaluation Center for Devices and Radiological Health
Enclosure
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# Indications for Use
KOZOS 510(k) Number: "
Device Name: Customized Sound Therapy (CST)
Indicaitons For Use:
The CST system is a CD with software that enables a qualified healthcare professional to identify, with the patient's verbal input, the sounds that most closely match the patient's tinnitus. The device is indicated to mask and intermittently mask tinnitus as part of a tinnitus management program. The target population for the device is adults (18 years and over) who present with timitus, that may or may not be accompanied with hearing loss at the higher frequencies, and who are participating in a tinnitus management program.
Perscription Use: X (Part 21 CFR 801 Subpart D) AND/OR
Over-The Counter Use
(Part 21 CFR 801 Subpart D)
(12 CFR 801 Subpart C)
(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)
Concurrence of CDRH, Office of Drug Evaluation (ODE)
\$\checkmark\$
Prescription rescription of CFR 801.109) Page 1 of
Elm Chen Peng
(Division Sign-Off)
Division of Ophthalmic Ear,
Division of Ophthalmic Ear,
Nose and Throat Devises
510(k) Number K01054
Two short videos show you everything — or skip straight to the written tutorial if you'd rather read. You can reopen this any time from the Tutorial button in the top bar.
Part 1 — Search, results, and everyday workflows 16 min
Part 2 — Embeddings: the galaxy map 3 min
1. Search: exact and fuzzy
Type a phrase like "coronary artery calcification" into the search box. You get two kinds of results. Exact results match the literal phrase — prefix searches work ("coronary artery calcificati") but suffix searches do not. Fuzzy results match on the meaning and intent of your phrase rather than the exact words, and are sorted by relevance score. Hover over the Exact or Fuzzy badge on any row to see exactly why it matched.
Use the checkboxes above the results to narrow: SaMD keeps only software-only devices, AI / ML keeps only devices with AI.
Exact vs. fuzzy search: what's the difference?
Exact matches on the literal phrase (prefix search works, suffix does not). Fuzzy matches on the meaning and intent of the phrase rather than the exact words. Hover over the badge on any row to see why it matched.
You search "coronary artery calcification" and want only software devices with AI. What two filters do you apply?
Narrow by SaMD (software-only devices), then narrow by AI/ML (devices with AI).
2. The results table
Scroll right in the results table. The intended use is extracted for you — no need to open the PDF. The device story gives a high-level snapshot of what the device does and how it's used. The AI Performance sub-table shows each output name, acceptance criteria, observed values, and development/test dataset descriptions — the same format Innolitics uses for regulatory strategy outputs, and the fastest high-level fingerprint of an AI device. It is AI-generated but has been very reliable in practice.
Where do you find a device's intended use without opening the PDF?
Scroll right in the search results table. The intended use column is extracted for you; no need to dig into the 510(k) summary PDF.
What does the AI Performance sub-table show, and why is it useful?
Output name, acceptance criteria, observed values, development dataset description, and test dataset description. It's the same format we use for regulatory strategy output and Fast 510(k) input, and the fastest high-level fingerprint of an AI device. AI-generated but reliable in practice.
3. Judging fuzzy relevance
Fuzzy results trail off in relevance as you scroll. Use three signals to decide how far down to go: the fuzzy badge explanations, the intended use column, and whether your target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, you're past the relevant zone. A top hit with a low score (~0.4) and a stretched explanation is a hint the closest predicates are far away — the project may be headed for De Novo. Note the fuzzy search is a pattern match: it doesn't handle negation ("not") well, and hardware devices can appear — filter by SaMD/AI ML to cut them.
How do you judge how far down fuzzy search results to go?
Use the relevancy signals: the fuzzy badge explanations, the intended use column, and whether the target output (e.g., Cobb angle) still appears in the AI Performance sub-table. Once it stops appearing, results are trailing off in relevancy.
4. Device detail page: chat and citations
Click a device name to open its detail page: device facts on the left, a chat window on the right. Ask something like "Describe the training data". The answer carries little citation bubbles — click one to jump to the highlighted passage in the source PDF, so you can verify every AI answer against the document. There's also a Download PDF button for sharing.
How do you verify an AI chat answer on the device detail page?
Click the citation bubbles to jump to the relevant highlight in the source document.
Reading rule for every project: how many summaries do you read in full?
At least the three most relevant 510(k) or De Novo summaries, in full. After that, use targeted chat questions to confirm your memory quickly. The tool supports this professional habit — it doesn't replace it.
5. Side-by-side comparison
Select multiple rows in the results table (aim for under ~10), then open the PDF Viewer tab. Ask one question — it goes to all selected devices in parallel, each with citations. This is the fastest way to compare and contrast devices: training data, PCCP scope, how they handled adding new scanners, and so on.
What does the side-by-side PDF viewer mode do?
Select multiple devices, open the PDF viewer tab, and ask one question (e.g., "Describe the training data"). It queries all selected devices simultaneously with citations, so you can compare and contrast quickly.
6. Collections
With rows selected, go to the Collections tab and create a labeled collection (e.g., "Cobb Angle Project"). Reload that selection any time — before a client call, pull up the collection and ask questions across all of its devices at once.
How do you save a set of selected devices for later use?
Select the rows, go to the Collections tab, and create a labeled collection (e.g., "Cobb Angle Project"). You can reload the selection anytime and carry it into the PDF viewer and other tabs that support selections.
7. Product codes and the regulations tree
Click a product code in the results to jump to it in the regulations tree — identification text, sibling product codes, and devices you can open in a PDF viewer on the right. Click a regulation number to see its identification, special controls, and related product codes. You can also search by product code or regulation number at the top of the tree. Always read the special controls if any exist for your device — it broadens your search and sharpens pre-kickoff research.
What can you do from the regulations tree view?
Browse product codes and regulation numbers, read the identification text and special controls, browse sibling product codes, open device PDFs on the right, and search by product code or regulation number at the top of the tree.
8. Chart view
Click Show Chart and segment by regulation number (or product code) to see which regulations dominate your result set. Clicking a regulation takes you into the regulations tree. Great for spotting that most matches are, say, hardware laparoscopic devices — a cue to go back and filter.
How do you see which regulations dominate a search result set?
Click "Show Chart" and segment by Regulation Number. Clicking a regulation takes you to the regulations tree.
9. The predicate graph
Open the Predicates tab for a family-tree view of predicate relationships. Click a node to trace its parents and children; selections from search carry over pre-selected. Commonly predicated devices are worth reading — a lot of people predicated them for a reason. The visual lineage is also handy on client calls, e.g. to show how a predicate family evolved and justify why your predicate still holds.
In the predicate graph, why are commonly predicated devices worth reading?
A lot of people predicated them for a reason. Clicking a node traces parents and children, and selections from search carry over pre-selected.
10. Embeddings: the galaxy map
The Embeddings tab plots every matching document in a 2-D "galaxy map" where semantically similar devices cluster together. Hover or click clusters to explore, and let AI label the clusters for you. Embeddings beat product codes for grouping: two devices can carry different product codes (LLZ vs. QIH) yet do the same thing — the embedding captures the meaning of the intended use and device story. This is also exactly how retrieval-augmented generation (RAG) works under the hood, and it makes a great visual on client calls.
Try it yourself
Head to the search page and work through a few of these AI/ML fuzzy searches to build intuition: perivascular fat on CT · aortic valve calcification opportunistic screening on noncontrast CT · breast cancer prediction on digital pathology slides · autism detection · gestational age prediction · a hearing aid that can also detect a pulse · foundation model based analysis of ECG · large language models · penetration test. Watch how the relevance scores, intended use, and AI Performance tables tell you when results stop being meaningful.