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R&D Blog
The R&D Blog is a forum for manufacturers to share their latest research and news, but more importantly is a place for readers to comment and discuss new developments with them. Above all, it is a forum for opinions, questions, and discussions about hearing aid technology between manufacturers and hearing healthcare professionals. Submit an article for the R&D Blog by sending it to the editor at HJ@wolterskluwer.com. Articles should be no more than 1,500 words, and will be reviewed and edited before posting. Readers may submit comments, which will be moderated, by clicking the link below.
Tuesday, October 08, 2013
By Lindsay Prusick, AuD
Education & Training Audiologist, Starkey Hearing Technologies
 
It affects 10 percent of Americans, no one has the same experience, and it does not discriminate. Can you guess what I am talking about? Tinnitus! The topic of tinnitus has become all the buzz.
 
Tinnitus is the perception of sound in one or both ears, or in the head, when no external sound is present. The sound is real, but no one except the patient hears it. 
 
Researchers and clinicians have worked for decades to figure out the treatment or combination of treatments that can provide relief to patients with tinnitus. However, to date, no one specific treatment has been shown to work for every patient. Fortunately, there are a number of treatment options that have consistently been shown to help. 
 
When Starkey Hearing Technologies set out to develop a tinnitus management technology, we made it a priority to take into consideration clinical research evidence, current tinnitus management protocols, and the needs of tinnitus patients and hearing healthcare professionals.
 
We recently released Multiflex Tinnitus Technology in Xino Tinnitus, a discreet receiver-in-canal (RIC) 10 device that is the smallest standard hearing aid Starkey currently offers. It provides 12 channels for programming the hearing aid response and 16 bands for shaping the tinnitus stimulus. 
 
Xino Tinnitus is available in up to a 70-gain receiver and comes packed with our reliable and robust advanced features, including Spectral iQ, InVision Directionality, Voice iQ2, and, most notably, Multiflex Tinnitus Technology, which incorporates the elements of sound therapy, amplification, education, and personalization to provide patients with tinnitus relief.
     
Sound Therapy
Sound therapy has been shown to provide relief to many who have tinnitus. Sound therapy refers to the use of sound, such as noise, music, and relaxation sounds, to decrease the prominence of tinnitus. The sound can be set to a level that partially or fully masks tinnitus. 
 
Multiflex Tinnitus Technology offers a white noise stimulus that can be enabled on a per memory basis. The stimulus can either be steady state or modulated, which provides a breeze or wavelike sound quality to the tinnitus stimulus.
 
Amplification
Hearing aids have been shown in many studies to provide relief from tinnitus to individuals who have both tinnitus and hearing loss. This relief may occur for a number of reasons but is most commonly attributed to the fact that hearing aids amplify ambient background sounds, which, in turn, may partially or fully mask the ringing sounds of tinnitus. 
 
It’s important to note that while Xino Tinnitus is a fully functioning hearing aid, it has been cleared by the Food and Drug Administration for use with tinnitus patients who have normal hearing, as it can be programmed to function as a sound generator only. 
 
Education
Simply educating patients about tinnitus, such as its prevalence, known triggers, and treatment options, can provide initial relief. Individualized counseling personalizes treatment and can help individuals better manage their tinnitus, setting them up for long-term success. 
 
Starkey Hearing Technologies provides a number of AudiologyOnline courses to teach professionals about the counseling and educational aspects of working with patients who have tinnitus. We also provide a number of online resources at starkeypro.com/tinnitus.
 
Personalization
A very important part of tinnitus treatment is personalization. Since every patient has different needs and a different tinnitus experience, it is extremely important that professionals personalize treatment to yield patient-perceived benefit and relief. 
 
Multiflex Tinnitus Technology offers a “Best Fit” tinnitus stimulus algorithm that shapes the stimulus based on the patient’s audiometric configuration, providing immediate personalization in the fitting of the device as well as an excellent starting point for professionals.
 
One of most singular features of Multiflex Tinnitus Technology is SoundPoint Tinnitus, which provides the tinnitus patient the ability to work with the professional during the fitting process to fine-tune and individualize relief to their exact specifications. 
 
Millions of Americans have tinnitus, and Starkey Hearing Technologies now offers a tinnitus management option for professionals. For more information and to get the Multiflex Tinnitus Technology experience, including a SoundPoint Tinnitus demo, please go to starkeypro.com/tinnitus.

Wednesday, August 28, 2013
By Caitlin E. Veri
Communications Coordinator, EarQ
 
One of Colleen Van Rooy’s earliest memories is touching her family’s television/stereo cabinet to feel the sound moving through it. As a child born with hearing loss, that was the only way the Appleton, WI, native could experience sound.
 
But things soon changed when Colleen received her first pair of hearing devices at the age of 4. From that moment on, Colleen was unstoppable. From academics to community service, Colleen has never missed a step. Today, as she raises three children who also have hearing loss, Colleen continues to exemplify determination as she tackles any obstacle that stands in her way.
 
Colleen is just one of the many individuals in our society who overcame hearing loss to live a well-rounded and successful life. In a society that wrongly equates hearing loss with weakness, a revolutionary foundation is primed to shatter stereotypes and empower the millions of people with untreated hearing loss to take action.
 
The HearStrong Foundation will radically challenge the general perception of hearing loss in our society today by celebrating individuals worldwide who have not only faced hearing loss but conquered it with a determined spirit, a focused mind, and an unwavering heart. Known as HearStrong Champions, these men, women, and children are the cornerstone of the foundation, which is funded through the generosity of EarQ providers. People will nominate friends, coworkers, and family members who have refused to let hearing loss deter them from their goals to be named an official HearStrong Champion.
 
Once selected by the foundation, each champion is awarded a gold medal and certificate. Many will receive a ceremony at their local provider’s office that will possibly be attended by local dignitaries and celebrities to help signify the event and give champions a powerful vehicle to share their story. By publicizing champions in local and national press, the foundation can reach the 80 percent of people with hearing loss who have yet to seek assistance and motivate them to take control of their hearing health.
 
“People need to know about the businesswoman who wears invisible hearing aids so she can discreetly hear her clients better, or the nine Olympic athletes who competed in the 2012 London games while wearing their athletically designed hearing devices, or the 4-year-old who loves to show off her pink hearing aids,” said Ed Keller, president of The HearStrong Foundation. “HearStrong will break down stereotypes and show the humanity of hearing better.”
 
The foundation will also facilitate hearing device donations to those who need proper hearing devices but cannot afford to buy them on their own.
 
Roughly 36 million Americans have hearing loss, and that number is on the rise. Recent studies have shown that one in five teenagers has hearing loss, as well as 60 percent of veterans returning from Iraq and Afghanistan. However, due to lack of education and negative connotations, many people choose to suffer in silence. The HearStrong Foundation will change that view once and for all.
 
For more information, visit www.hearstrong.org.

Tuesday, June 04, 2013
By Mary Rapaport
ReSound

The joy of hearing is all about small moments—the sound of bicycle bells on a spring day, an intimate whisper in a crowded restaurant, a granddaughter’s first words. Restoring these moments is what inspires us every day. Every time hearing is restored, another magical moment is created. Hearing is so fundamental that professionals who restore it help their patients start brand new lives. 
 
It is in these moments that audiologists remember why they chose hearing healthcare. It is not surprising that CareerCast recently rated audiology as a top five profession.
 
ReSound has launched the Moments Movement as a way to recognize hearing healthcare professionals and elevate the patient moments that inspire and motivate them daily. Here are some of the most inspiring moments that have been shared.
 
Getting to Know Your Wife All Over Again
Adriana Rodriguez-Miciak of Baylor College of Medicine had her "why I chose this career" moment with a young man who has congenital hearing loss. At the fitting, his eyes lit up. He could hear the birds for the first time in probably many, many years. When his wife spoke, he was floored by how natural and clear her voice sounded. It was as if he was getting to know her all over again.
 
The Cries of Your Newborn Son
Lynda Wayne of Cadence Hearing says her favorite moment was when a young man brought his newborn baby into the office. Prior to hearing aids, he had never heard his child cry or make noises at all. As soon as Dr. Wayne programmed the instruments, his wife brought the baby into the office. The patient's eyes widened and then started to tear up upon hearing his new baby boy. This man, who had a severe hearing loss, had emigrated from Russia and was never fit previously. "This was his first experience with hearing aids, and it certainly was a memorable one," Dr. Wayne said.
 
Helping a Child with Cancer
Caroline Bjarnason of Integrity Hearing & Balance experienced one of the most profound moments of her career while working as a pediatric audiologist in Southern California. She had been performing routine hearing exams on a child who was undergoing chemotherapy. At one of the exams, she diagnosed a hearing loss. As she explained the results, the patient's mother cried. A few weeks later, the patient came into her office for a hearing aid fitting. During the fitting, the mother realized her child could hear again, and she cried once more. She then turned and said something the audiologist has never forgotten: the mother thanked Ms. Bjarnason for returning her child to her. Of all the things her child had lost to cancer, hearing was the most tragic, she said. "In that moment I realized, more than ever, what an integral part I play in the lives of my patients," Ms. Bjarnason said.
 
The Sounds of Spring
For Eliza Floyd of Audio Hearing Center, her moment occurred when seeing a patient for a follow-up visit. As the two of them chatted, the patient mentioned that her daughter, who always visits in the spring, had been in town recently. The patient and her daughter were enjoying some conversation one night in the kitchen when, all of a sudden, the patient heard a sound that she recognized but hadn't heard in many years—peepers! "It's a sound that is very unique to spring," Dr. Floyd said. "She was so happy that she could hear them again after so many years and delighted that her daughter could be there to witness the moment."
 
Emerging from the Silence
Bonny Kuhfal of Bay Area Hearing Services saw an older gentleman from the Philippines who had not heard for many, many years. His daughter told Ms. Kuhfal that he never spoke to anyone and no one ever talked to him; he had withdrawn into total silence. When Ms. Kuhfal turned on the hearing aids, his face lit up with a smile from ear to ear. He said, "I don't want to leave this room. I want to stay and talk to you all day." He was teary eyed, and so was everyone else in the room.
 
ReSound is collecting moments like these online at  www.gnresound.com/moments and awarding monthly grants to the hearing healthcare professionals who help make these moments possible.

Friday, May 03, 2013
By Thomas Tedeschi, AuD
Vice President, Franchise Development
Sonus

It usually starts with the small things. You may not notice them, but chances are people around you do. The TV volume is just a few notches louder than usual. The coworker two cubicles down calls your name, and you miss it. Your cell phone shows missed calls even though the ringer's on. The alarm doesn't wake you, but it woke your spouse.
 
At some point, someone -- a friend, a family member, maybe even a coworker or your boss -- might point out that you may need to get your hearing checked. If you've found yourself in that situation, or maybe you've even started to notice the symptoms yourself, don't fret. You're not alone, and there are solutions available.
 
Hearing loss is faced by 37 million Americans and reaches across demographic lines, such as age, race, and gender. While the diminishment of a key sense clearly creates physical limitations, hearing loss can also exact an emotional toll. Frustration, depression, anger --  all of these feelings and more are common responses to hearing loss. There’s no simple path in hearing loss, but learning about and recognizing the signs and symptoms opens the door to a wide range of treatment options. Taking the first steps toward proper treatment is one of the smartest, most straightforward things you can do to affect your quality of life.
 
Physical Symptoms
When we were teens or young adults, there’s a good chance that many of us walked out of a club or concert and found the world to be a little muffled by the time we got home, as if our ears were suddenly packed with a wall of mud. Then we went to bed, woke up in the morning, and went about the next day with hearing back to normal.
 
The primary, and most obvious, symptom of hearing loss is just that: the loss of clear hearing. In general, this symptom comes across as a muffled feeling, similar to the sensation of trying to listen to TV while wearing earplugs. When hearing loss occurs sharply and suddenly, such as in the concert example above (which would be a temporary threshold shift due to the trauma of the intensity of the sound), it’s easy to distinguish -- you suddenly can’t hear well. For many people dealing with chronic hearing loss, this muffling occurs gradually over months or years, such that the change is often too subtle to notice in day-to-day life.
 
Next to muffled hearing, tinnitus (a persistent ringing, buzzing, or whining sound in the ears) is one of the most common symptoms of hearing loss. Tinnitus can vary in length, frequency, intensity, and even tone, with some people experiencing a high-pitched tone and others experiencing buzzing, whooshing, clicking, or chirping. Many different factors can cause tinnitus, from loud-level trauma to infection.
 
Another symptom of hearing loss can be vertigo (dizziness). The vestibular system, which controls balance, is also housed in the inner ear, and diseases such as Meniere’s disease not only affect hearing ability, but also impair the balance system.
 
In addition, there are a number of diseases and illnesses that can cause hearing loss, including measles, meningitis, and mumps.
 
Emotional Symptoms
Physical symptoms are one thing, but studies have shown that hearing loss can have an emotional impact as well. Perhaps you’ve gradually felt like you’re avoiding friends and family because of their frustration when you can’t understand what they say. Or maybe you’ve begun declining invitations to go to restaurants or public places because you’ve developed a more difficult time keeping track of what’s being said. If you find yourself withdrawing socially, becoming frustrated with the simple act of conversation, or feeling like talking leads to misunderstanding -- in addition to having the physical symptoms, however slight, listed above -- it’s a good idea to get your hearing checked.
 
In addition to inhibiting social interactions, hearing loss can indirectly create stress in your life by affecting your work, relationships, or finances. If you have hearing loss, communication can become difficult, leading to mixed messages and missed details. Hearing loss can also take a toll on personal relationships, and, in worst-case scenarios, a vicious cycle is created where people on both sides feel misunderstood and frustrated, all while potentially overlooking a medical root cause.
 
The thought of approaching potentially difficult situations may leave you feeling anxious, frustrated, angry, or depressed. When compounded by the interpersonal strain resulting from miscommunication in various relationships, it becomes clear that hearing loss can create an emotional fallout that ripples negatively through many aspects of your life.
 
The goal, then, is to recognize the emotional and physical symptoms of hearing loss and move forward with appropriate diagnosis and treatment.
 
What Comes Next
At Sonus, we always advise patients to take advantage of the many resources available online to research possible conditions underlying their symptoms. Following this advice will help you engage in an informed dialogue with your audiologist and arm you with the appropriate questions to ask to help expedite the most accurate possible diagnosis and facilitate the best rehabilitative strategy.
 
Millions of people suffer from hearing loss, and a significant number can experience improvement and assistance through modern medicine and technology. With a thorough examination and diagnosis, the nature of your hearing loss symptoms will be clear, as will the options for treatment and moving forward.

 
Dr. Tedeschi, who has over 30 years of experience in the hearing healthcare field, has been vice president of franchise development at Sonus since September 2009.

Thursday, April 11, 2013

By Jennifer Groth

ReSound Global Audiology

 

My teenage daughter and I were visiting my father, who lives in rural Iowa. We decided to check out a new restaurant for dinner, and Dad drove, with me in the passenger seat and my daughter in the back. There are four miles of gravel road to get to the highway from his house, and, apart from kicking up a lot of dust, it’s pretty noisy. And you’ll usually meet a tractor or two on the road, not to mention cows and deer. So it’s pretty important to keep your eyes on the road if you want to stay out of the ditch.

 

“What have you been doing this summer?” Dad yells over his shoulder to my daughter.

 

“Hanging,” is her eloquent reply.

 

“What?” he says, straining to see her in the rearview mirror.

 

“She’s been hanging out with her friends,” I shout at the same time she repeats her answer.

 

“What?” he yells back at my daughter.

 

“Oh yeah, and Shannon and I went to see Oklahoma!” she says.

 

“Who has glaucoma?” he says, and cranes his neck around, swerving a little.

 

And so it goes the rest of the trip, and we manage to arrive in one piece. However, the challenge continues during dinner, as the restaurant turns out to be a huge, reverberant space. Even though there aren’t that many other guests, carrying on a conversation with Dad is tough. He wears hearing instruments with the latest technology, including directionality, and is a fervent advocate for the benefits of amplification. Even so, there are some situations that continue to be a struggle. Either the speech-to-noise ratio is so poor that directional hearing instrument processing cannot improve matters sufficiently, or it is not possible to look at the speaker to take advantage of visual and contextual cues, or some combination of these factors.

 

Hearing instrument fitters have long had to counsel their patients to manage expectations to the many and commonly encountered situations where hearing instruments don’t provide sufficient benefit. Happily, new technologies based on digital wireless transmission are changing that. As the name indicates, digital wireless is distinguished from analog wireless transmission by the digital encoding and decoding of the transmitted signal. The modes of transmission are similar to those of analog wireless in that current digital wireless hearing aids use either magnetic induction or radio frequencies to send and receive the signals. However, the fact that the transmitted information is in a digital format is attractive in that it opens up new possibilities for reducing interference, ensuring privacy of transmission, and enhancing audio quality, such as with stereo transmission.

 

One way digital wireless transmission is enhancing the usefulness of hearing aids in challenging listening environments is by means of a small companion microphone that can be placed near the sound source of interest. The microphone picks up the desired sound and streams it directly to the wearers’ hearing instruments, vastly improving the signal-to-noise ratio. The ReSound Unite Mini Microphone is an example of such as device. The ReSound digital wireless hearing instrument system is based on a robust and secure proprietary transmission protocol at 2.4 GHz, the same frequency band as the ubiquitous Bluetooth wireless technology.

 

The ReSound Unite Mini Microphone picks up sound at the source and transmits directly to the hearing instruments in the 2.4-GHz frequency band.

 

How much of a difference can a remotely placed microphone really make? It is well-established that dual microphone hearing instrument directionality can boost the signal-to-noise ratio compared with omnidirectionality by approximately 4 dB. It is also well-established that this benefit decreases with increasing distance and that it is based on spatial separation of the desired and competing sounds.

 

To illustrate the potential benefit of the Unite Mini Microphone in noisy situations where distance to the desired sound may not be ideal, the microphone was evaluated against adaptive directionality in a laboratory investigation with twenty hearing-impaired participants. Testing was performed in a setup with noise surrounding the listener, not just from the rear plane. Speech materials were presented via the artificial mouth of a head-and-torso simulator to which the Unite Mini Microphone was attached as a conversational partner to the hearing instrument user. Testing was carried out at distances of 1.5 meters, 3 meters, and 6 meters between the head-and-torso simulator and the listener.

 

The graph below shows the average signal-to-noise ratios at which 50 percent of the speech material could be correctly identified by listeners. Three findings were striking:

1.     Streaming the speech via the Unite Mini Microphone resulted in a signal-to-noise ratio boost of more than 10 dB at the shortest distance compared with adaptive directionality.

2.     The signal-to-noise ratio benefit was maintained with distance from the Mini Microphone, whereas benefit with adaptive directionality decreased as distance from the talker increased.

3.     The signal-to-noise ratio benefit attained when the hearing instrument microphones were active during streaming from the Mini Microphone was equivalent to the benefit attained from the Mini Microphone alone.

 

Signal-to-noise ratio for 50-percent speech recognition with adaptive directionality versus the ReSound Unite Mini Microphone. Note how the benefit of the Mini Microphone remains constant with distance, while the benefit of directionality decreases markedly as the distance between the listener and the signal of interest is increased.

 

While directional microphone systems in hearing instruments are inarguably beneficial for users, the comparative benefit of a companion microphone that streams directly from the source of the desired sound to the hearing instruments is staggering. Furthermore, this benefit is achieved even if the hearing instrument microphones are on, meaning that the user can still hear other sounds in the environment while using the Mini Microphone. These results indicate how the ReSound Unite Mini Microphone can supplement conventional amplification and directional processing to overcome their limitations in particularly challenging situations. As illustrated at the beginning of this article, cars and noisy restaurants are examples of common and notoriously difficult listening situations. The Mini Microphone provides an easy and convenient solution to increase the number of environments in which hearing instruments are useful for wearers, which is a proven correlate of consumer satisfaction.

About the Author

Michelle Hogan, Editor
Editor, The Hearing Journal

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