Mimi announced the release of the new Mimi TV Hearing Test App. With this new, updated version users can test their hearing at home on their TV, according to the company’s announcement. The Mimi TV App provides sound personalisation based on individual needs and preferences according to the user’s hearing profile and, optionally, year of birth.
Mimi TV Group Mode is a new feature allowing users to create multiple hearing profiles to personalise sound while watching in groups. This helps enable multiple additional users, for example family members and friends, to experience their favorite movies and shows with “the best possible sound according to their personal hearing profile,” the company says.
Personalised audio enables those who have hearing loss to have a better sound experience and give more clarity on sound, based on their individual hearing needs.
With Mimi Sound Personalisation on their TV, users are “completely in control of the sound experience, rather than just controlling the volume.” Now, a group of people with completely different hearing profiles can finally watch TV together without anyone ever missing anything again, Mimi says.
For users that already have their personal Mimi Hearing ID created, they will still be able to apply sound personalisation to their TV by sending their Hearing ID to their device via the Mimi App.
Find out more about the new Mimi TV App. Mimi’s Sales Team is happy to answer questions anytime.
Mimi is building a digital well-being platform that “bridges the gap between hearing well-being and the best personalised listening experience.”
Source: Mimi
Image: Mimi
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As part of their continued customer-focused approach Lucid Hearing announced the launch of fio, its “smallest in-canal, rechargeable hearing aid.”
“Fio is focused on delivering the most comfortable fit and function for the active individual who is looking to maximise every moment of their lives. Hearing health is a right of every individual and our goal at Lucid Hearing is to simply help people hear better” said Jason Kidd, CEO Lucid Hearing. “Part of that responsibility is to make products that are ready for use, discreet in nature, and empower the end user to customize their hearing profile.”
Compatible with LucidShape, fio allows the user to develop custom hearing levels for all types of environments making wearing fio a way to bring the user back into the conversation.
About Lucid Hearing:
Lucid Hearing’s mission is to advance hearing healthcare holistically across its family of brands that encompass hearing enhancement, enjoyment, protection, detection, and wellness. They believe every human should have access to better hearing, and is proud to offer free online and in-store assessments at over 500 Lucid Hearing clinics nationwide.
Hearing Aids Powered by Lucid are “highly sophisticated devices which have the capacity to make a real impact on the overall quality of life for those with hearing loss,” according to the company. They “help deliver natural sound quality that is superior to traditional compression hearing aid technology.” Powered by Lucid hearing aids help you “hear the sounds that are most important to you and ensure they are at the most understandable and comfortable volume.” For a smoother, richer sound, multiple channels create “greater sound quality allowing our Powered by Lucid technology to focus the most important part of the sound signal in a comfortable listening range while minimising distortion.”
Source: Lucid Hearing
Images: Lucid Hearing
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Starkey announced that Evolv AI has won a Red Dot Award: Product Design 2022; this is the sixth year Starkey has won this award. This annual awards program recognises the year’s best products that are aesthetically appealing, functional, innovative, and have outstanding design.
Starkey’s new full line of hearing aids, Evolv AI, sets the stage for an entirely new hearing ecosystem that “not only emphasises hearing’s impact on overall health and wellness, but creates an effortless user experience.” The hearing aids are built on Starkey Sound, “a ground-breaking technology created by years of refining Starkey’s research and science-based algorithms to power high-fidelity audio, which is modled after the human auditory system.” Like the brain, Starkey Sound is designed to automatically suppress background noise and increase speech audibility and intelligibility with machine learning technology, according to the company. The combination of these features creates “an effortless hearing experience for users.” Evolv AI’s “always on and always automatic”approach delivers “realistic and genuine sound quality in every environment, without the need to do anything extra.”
“Congratulations to the entire Starkey family for this impressive, international recognition,” said Starkey President and CEO Brandon Sawalich. “Receiving this honour is a tribute to the amount of research and development we devote to producing high-quality, innovative, and personalised hearing aids.”
Starkey is a privately held, global hearing technology company headquartered in Eden Prairie, Minnesota. Founded by Bill Austin in 1967, Starkey is known for its design, development, and distribution of comprehensive digital hearing systems. Led today by President and CEO Brandon Sawalich, Starkey is the only American-owned provider of hearing technologies. The company has more than 5,000 employees, operates 29 facilities and does business in more than 100 markets worldwide.
Source: Starkey
Image: Red Dot Awards
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Article Suggests Apps and Devices to Help with Tinnitus
Described as a “phantom sound generated by the brain” by audiologist Julie Prutsman, tinnitus is a common condition experienced as ringing or buzzing in the ears, often caused by loud noise exposure. While there is no “cure” for tinnitus, there are methods of coping with the symptoms, according to a recent article in Wired.
Prutsman recommends avoiding silence and exposing yourself to a sound-rich environment. The article’s author suggests the Lofi Work Playlist on Spotify and the Calm or Rainy Mood app at night from the Calm.com website. Additionally, the ReSound Relief App can be helpful, according to the article, because it allows users to create layered soundscapes and customised audio balance for each ear. Other options include sleep headbands, Bose’s SleepBuds II, fans, smart speakers, pillows with built-in audio, and tabletop sound generators.
“Nothing works for everyone, which is why seeking help can be maddeningly frustrating,” Joy Onozuka, a tinnitus research and communications officer for the American Tinnitus Association(ATA), was quoted as saying in the article. “We advise people to start with and explore inexpensive technologies, with free trials or good return policies.”
When searching for a treatment, the article stresses the importance of finding things approved by the FDA and/or with clinical data to support its claims. Prutsman says that the Neosensory Duo and Lenire devices have solid science behind them, and utilise bimodal stimulation, both touch and sound, to help “rewire the brain.”
Other options include features to monitor noise levels on Apple iOS devices and watches, apps like the NIOSH Sound Level Meter, or the SoundPrint app which lists noise levels at different venues.
“Hearing protection is really important for someone that has tinnitus and doesn’t want it to get worse,” Prutsman is quoted as saying in the article. “Unfortunately, a lot of people will go to the opposite extreme and overprotect their hearing at safe levels. This can create a worse situation called hyperacusis or hyper-sensitivity to sound.”
To read the article in its entirety, please click here.
Source: Wired
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Signia Launches Insio Charge&Go AX Custom Hearing Aids
Signia announced the general availability of its Insio Charge&Go AX custom hearing aids, the newest device built upon Signia’s Augmented Xperience (AX) platform.
The AX platform utilizes Signia’s Augmented Focus technology, which helps process speech and background noise separately—using two dedicated processors—and combines them to deliver “outstanding speech clarity in a fully immersive soundscape,” according to the company.
Signia Insio Charge&Go AX and Signia AX were recently named CES 2022 Innovation Awards Honorees in the Wearables and Accessibility categories.[1]
The Insio Charge&Go AX is the second family of Signia hearing aids built upon the AX platform, following the Spring 2021 launch of the Pure Charge&Go T AX RIC hearing aids. The Insio Charge&Go AX is the “industry’s first family of custom-fitted in-the-canal (ITC) and in-the-ear (ITE) hearing aids to feature contactless charging, Bluetooth connectivity, and the ability to stream from Android and Apple iOS devices.”
“By taking the Augmented Xperience platform and adapting it for use in our newest custom hearing aids, Signia continues to combine world-class audiology and world’s- first technologies to enhance human performance,” said Dr Brian Taylor, senior director of audiology for Signia. “The Insio Charge&Go AX hearing aids join the widely- acclaimed, groundbreaking Pure Charge&Go T AX rechargeable RIC hearing aids in giving hearing care professionals a wider range of solutions to fit patients’ needs, wants, and styles.”
Designed For All Patients’ Needs
Both the ITC and ITE Insio Charge&Go AX custom hearing aids are fully rechargeable and designed to support a broad range of patients’ needs. They come with a contactless charger for “easy operation, meaning wearers don’t have to worry about charging positions when ensuring maximum battery life.” And they connect to iPhones and ASHA-compatible Android devices and feature push-button control of smartphone functions.
All Insio Charge&Go AX custom hearing aids are “designed for a high fitting rate.” They are “uniquely small and customized to the wearer’s ear canal for all-day comfort and higher patient satisfaction.” They also come in a range of colors including Black, Dark Brown, Brown, Mocha, Tan, and Beige.
“As with all our hearing aids, we’re not just looking to help correct a loss,” said Taylor. “Through iconic innovation and a consumer-centric approach, Signia also aims to give patients an edge. Our new custom, AX-based hearing aids are the first custom hearing aid with contactless charging that can be tailored to both the patient’s hearing loss and ear anatomy.”
According to studies, Signia AX results in greater than 25% better speech understanding in noise compared to users’ own hearing aids.[2] And 95% of study participants reported exceptional speech understanding in their home environment.[3]
Backed by the Power of the Signia app
Like other Signia hearing aids, the new Insio Charge&Go AX hearing aids come with the Signia app, providing “on-the-go support and intuitive access to hearing aid controls.”
The Signia App provides wearers with streaming capabilities; tinnitus therapy; the AI-based Signia Assistant for a more personalized listening experience and 24/7 digital support; Signia Telecare for remote care support; and much more. It also allows wearers to activate Signia’s “first-of-its-kind Face Mask Mode, which dramatically improves audibility for wearers communicating with someone in a face mask.”
For more information on the Signia Insio Charge&Go AX hearing aids, visit here.
[1] The CES Innovation Awards are based upon descriptive materials submitted to the judges. CTA did not verify the accuracy of any submission of any claims made and did not test the item to which the award was given.
[2] Signia White Paper. Based on transformation of the 1.8 dB SNR improvement using a value of the slope of the psychometric function (Wagener & Brand, 2005).
[3] Signia White Paper. 18/19 participants had a mean rating of speech intelligibility-related questions of more than 8.0 and 9.0, respectively.
Source: Signia
Images: Signia
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By Nicky Chong-White, PhD, Jorge Mejia, PhD, James Galloway, MDesSc, and Brent Edwards, PhD
The recently released Headphone Accommodations feature of Apple AirPods Pro has the potential to help people with hearing loss. When activated with Transparency mode, Headphone Accommodations applies customizable frequency-dependent gain to help the wearer better hear the sounds around them. In this article, objective measures that characterize the acoustic performance of AirPods Pro are presented. The results suggest that, while differences to traditional hearing aids exist, Headphone Accommodations provides amplification to help people with mild-to-moderate hearing loss hear sounds more easily and allow them to experience the benefits of amplification.
Many technology offerings by Apple demonstrate their growing commitment towards health and accessibility. Apple provides a number of accessibility features to benefit people who are deaf or hard of hearing. With Made for iPhone (MFi) hearing aids, users can stream audio from their iPhone directly to their hearing aids and control their hearing aid settings. The Live Listen feature helps users hear conversations more clearly by using their iPhone as a remote microphone which sends amplified sounds to their AirPods or compatible hearing aids.
Figure 1. Apple AirPods Pro with recharging case.
Recent iOS releases have added capabilities to AirPods Pro that have the potential to help people with hearing loss. While earbuds that seal the ear canal typically block external sounds, the AirPods Pro Transparency mode uses microphones on the outside of the devices to let wearers hear the world around them (Figure 1). With the release of Headphone Accommodations in 2020, the sound picked up by these microphones is amplified with both frequency-dependency gain and compression, giving AirPods Pro hearing aid-like capability. While different gain presets can be selected from a connected iPhone, the user’s audiogram can also be entered which is then used to “fit” the gain in the AirPods Pro to their hearing loss.
With audio processing features that seem comparable to those in traditional hearing aids, there have been suggestions that AirPods Pro can be alternatives to hearing aids to help people with hearing loss hear better or, more generally, provide benefit to hearing and communication in difficult listening situations.
To determine how similar the amplification in AirPods Pro is to hearing aid amplification, we used standard hearing aid characterization methods to measure the performance of AirPods Pro. In this article, we present the findings from our objective evaluation of Headphone Accommodations with Transparency mode in AirPods Pro and provide insights into how Headphone Accommodations may benefit people with hearing loss.
Study Methods
In order to understand how AirPods Pro can help people with hearing difficulties, acoustic measurements were performed to investigate:
Gain provided by Headphone Accommodations for a given audiogram or preset profile, and
Other acoustic characteristics commonly used to characterize hearing aids.
Figures 2a-b. iPhone screenshots of interfaces to control Headphone Accommodations.
Devices. For this study we used Apple AirPods Pro earbuds (with firmware version 3E751, released April 2021) paired with an iPhone running iOS 14. Settings for Headphone Accommodations were adjusted on the iPhone to tune the headphone audio to different configurations (Figure 2).
Figure 3. Acoustic room test configuration with GRAS Coupler.
Equipment and set-up. Gain measurements were conducted in an acoustic test room as shown in Figure 3. Measures were performed using a GRAS RA0045 Ear simulator (standard IEC 60318-4 (711)) and B&K type 4190 reference free-field microphone positioned 1 meter from the loudspeaker. The RA0045 ear simulator has acoustic impedance closely resembling that of an average human ear and is widely used in verification of frequency response of consumer audio products and hearing aids.
Other acoustic measurements commonly used to determine the specifications of hearing aid characteristics according to IEC and ANSI test standards were carried out using the Aurical Hearing Instrument Test (HIT) box with 2cc coupler (Figure 4).
A) Measurements of Headphone Accommodations Gain
Figure 4. Aurical HIT test configuration.
To determine the amount of gain provided by Headphone Accommodations, the output sound level of the AirPods Pro was measured across the range of audible frequencies. The input sound stimulus was the International Speech Test Signal (ISTS),1 presented from the loudspeaker at 50, 65, and 80 dB SPL.
Transparency Mode. As a baseline, the gain of the AirPods Pro in Transparency mode with Headphone Accommodations turned off was measured. This is the default setting for users who do not wish to apply any audio tuning profiles to the sounds around them and, according to the Apple website, “lets outside sound in, so you can hear what’s going on around you” while wearing the AirPods Pro.2
Figure 5. Gain for Transparency mode with Headphone Accommodations turned off relative to the unaided condition for different input speech levels.
For the AirPods Pro to be acoustically transparent while being worn, the gain relative to the unaided (or unworn) condition should be 0 dB. As can be seen in Figure 5, the gain is close to 0 dB except in the 1-2 kHz and 4-6 kHz regions where resonances are present. These deviations may be transducer resonances that vary in frequency and amplitude across manufacturing batches.
Transparency Mode with Headphone Accommodations. The frequency response of the AirPods Pro can be customized by the user in three ways: 1) Using preset profiles; 2) Manually adjusting settings, and 3) Using audiogram data.
1) Using preset profiles.Headphone Accommodations comes with three preset profiles for users to select, each providing different frequency-varying gain. Figure 6 depicts the gain measured for each profile. For a 65 dB input speech level, the Balanced Tone profile provides a gain boost of around 12 dB gain between 2-5 kHz, Vocal Range has a peakier shape with around 15 dB gain between 2-5 kHz, and Brightness has a more gradually sloping gain to 4 kHz that peaks at 15 dB. Gain compression is also noted, with a compression ratio of approximately 1.5:1 at 4kHz in all profiles.
Figures 6a-c. Headphone Accommodations gain for Transparency mode with preset profiles, a) Balanced Tone, b) Vocal Range and c) Brightness, all at moderate strength, for different input levels.
2) Manually adjusting settings.Headphone Accommodations for the preset profiles can also be manually fine-tuned. The user can adjust the amount of amplification from 0 to 100%, and the tonal balance from 0% (darker) to 100% (brighter). Additionally, the user can select the degree that soft sounds will be boosted by choosing the strength as slight, moderate, or strong.
Figure 7 shows the effects on gain for an input sound level of 65 dB SPL for the Vocal Range preset profile at slight strength when settings are adjusted. The amplification control varies gain over a 12 dB range. Tone adjustment increases the gain by up to 8 dB above 1.5 kHz while decreasing gain down to -4 dB below 1.5 kHz. Increasing the strength setting can add up to 8 dB gain per level.
Figures 7a-c. Effect of adjusting a) Amplification b) Tone and c) Strength for the Vocal Range preset on Headphone Accommodations gain.
Figure 8. Custom audiogram profiles applied to Headphone Accommodations.
3) Using audiogram data. A final way to adjust the gain in Headphone Accommodations is by using audiogram data. At the time of testing, the only way to enter an audiogram was by completing a hearing sensitivity test on the iPhone that writes the results to the Apple Health app. To allow us to enter a specific audiogram without doing a hearing test, we developed an app that allowed us to manually input an audiogram to tune Headphone Accommodations. (Note: Since this work was done, iOS 15 now allows one to enter an audiogram manually.) We created 3 custom audiograms, as shown in Figure 8, and measured the gain provided by Headphone Accommodations for each of these hearing losses (Figure 9). For comparison to what an audiologist-fit hearing aid would provide for people with these audiograms, real-ear insertion gains specified by NAL-NL2 are also shown.
As can be seen, NAL-NL2 generally prescribes a steeper gain curve than what Headphone Accommodations provides. Note also that NAL-NL2 also prescribes a higher compression ratio than what Headphone Accommodations provides, as demonstrated by the wide spread between gain curves for different input levels. Headphone Accommodations is most closely matched with NAL-NL2 at normal conversational levels (65 dB SPL), but generally provides greater amplification at loud input levels (80 dB SPL) and lower amplification at soft sound levels (50 dB SPL).
Figures 9a-c. Headphone Accommodations gain with custom audiograms for (a) mild sloping (b) mild-moderate sloping and (c) flat 40 dB hearing loss for input levels of 50, 65, 80 dB SPL. The dashed lines show the prescribed NAL-NL2 Real Ear Insertion Gain (REIG) for the same audiograms.
B) Other Measurements
Industry standards ANSI S3.22:2014 and IEC 60118-7:2005 specify methods for characterizing the acoustic performance of hearing aid devices. Therefore, AirPods Pro performance was measured in adherence to these standards, where appropriate, allowing for comparisons to be made with traditional hearing aids (Table 1).
Table 1. Measurements on AirPods Pro as per ANSI S3.22-2014. 1Mid-range hearing aid from a major hearing aid manufacturer.
A brief description of the measures performed:
Output SPL for 90-dB input SPL (OSPL90) is used to approximate the maximum output level performance of the device.
Total Harmonic Distortion is a measure of distortion caused by nonlinearities in the audio throughput. Lower numbers indicate better sound quality.
Equivalent Input Noise is a measure of the device’s internal noise, typically caused by the microphone. Lower numbers indicate better sound quality.
Attack and release times measure the speed of the compressor.
The OSPL90 for AirPods Pro is less than 100 dB, more than 10 dB lower than typical hearing aids. Whereas hearing aids are designed specifically to amplify sound for people with mild to severe hearing loss, the max output level of AirPods Pro suggests they are more suited to provide amplification for mild-moderate losses. As very high audio levels can cause hearing damage, consumer devices such as headphones and earbuds often limit maximum output levels for hearing safety.
Total harmonic distortion is very low for the AirPods Pro. The attack time is fast, indicating the compression responds quickly to reduce the gain of high-level sounds. The release time is slower than some hearing aids but faster than others.
However, the measured equivalent input noise for the AirPods Pro in Transparency mode was higher than typical hearing aids, which suggests that users with near-normal hearing thresholds may perceive some audible sound, such as a faint background hiss, when using Transparency mode in very quiet environments.
Final Observations
AirPods Pro with Headphone Accommodations in Transparency mode enable people with hearing loss to hear quiet sounds more easily by providing frequency-dependent gain amplification and compression. The preset profiles are suitable for those with mild-to-moderate sloping hearing loss and can allow them to experience the benefit of amplification. Sound preferences can be fine-tuned to adjust the strength, tone, and overall amount of amplification.
The gain provided by Headphone Accommodations for a given audiogram does not compensate for the reduced audibility and reduced loudness across the range of input sound levels in the same way that traditional hearing aids fit to NAL-NL2 do. In particular, loud sound levels are generally over-amplified in the AirPods Pro compared to NAL-NL2, while soft sound levels are under-amplified.
References
Holube I, Fredelake S, Vlaming M, Kollmeier B. Development and analysis of an International Speech Test Signal (ISTS). Int J Audiol. 2010;49(12):891-903. doi:10.3109/14992027.2010.506889
Apple Inc. AirPods Pro and AirPods Max Active Noise Cancellation and Transparency mode. Available at: https://support.apple.com/en-us/HT210643
Keidser G, Dillon H, Flax M, Ching T, Brewer S. The NAL-NL2 prescription procedure. Audiol Res. 2011;1(1):e24. doi:10.4081/audiores.2011.e24
Citation for this article: Chong-White N, Mejia J, Galloway J, Edwards B. Evaluating Apple AirPods Pro with Headphone Accommodations as hearing devices. Hearing Review. 2021;28(12)8-11.
About the authors:Nicky Chong-White, PhD, is a Senior Research Engineer at the National Acoustic Laboratories (NAL) in Sydney, Australia. Since joining NAL in 2004, she has applied her background in speech and audio signal processing, acoustics, machine learning and software development to investigate hearing. Jorge Mejia, PhD, is Head of Signal Processing at NAL. His current research is focused on developing technology to improve speech understanding in noise for people with hearing impairments, understanding the real-world benefit of established and emerging hearing technologies, and developing artificial intelligence solutions. James Galloway, MDesSc (Audio & Acoustics), is a Research Engineer at NAL responsible for facilitating research experiments and conducting electroacoustic analysis. Brent Edwards, PhD, is Director at NAL. For over 22 years he has led R&D teams at major hearing aid companies and Silicon Valley startups that have developed innovative signal processing algorithms, fitting procedures, diagnostics and outcome measures, wireless technologies, transducers, and other technologies that have benefited hearing aid wearers and hearing care professionals worldwide.
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Here’s a quick audiological reference to the potential effects of the COVID-19 virus
By Robert M. DiSogra, AuD
It is still too early in the pandemic to make definitive statements about the full impact of the COVID-19 virus on the auditory/vestibular and central auditory systems. Certainly, hearing care professionals should revise their Case History forms and consider adding tests for auditory processing disorders and a cognitive screening in order to make the appropriate referral(s) for patients. Counseling will continue to be a major part of the patient’s experience with hearing care clinicians.
This article presents a brief summary of what is already reported about COVID-19 and the impact it has had on the patients of hearing care professionals and our practices since the pandemic was first declared in 2020. Until more evidence-based research is published, this summary is designed to serve as a “first-look” at the recent literature for audiological understanding, management, and counseling of COVID-19 survivors.
As noted by Kelley and Bhattacharjee in this edition of Hearing Review (see p 14), there currently are no definitive links to auditory/vestibular complaints due to this specific coronavirus (SARS-CoV-2), although many hearing-related issues have presented in these patients. As with anything related to COVID-19, reliable updated information should be monitored, with a particular focus on data from the Centers for Disease Control and Prevention (CDC) at www.cdc.org. Additional COVID-19 information for audiologists can be found on the American Academy of Audiology’s Coronavirus Resource page at: www.audiology.org/practice-management/covid-19-resources.
General Definitions and Information
Long-hauler. This is a term used to describe a person whose COVID-19 symptoms linger 8 weeks to 6 months post-diagnosis. There is no formal diagnostic label for a long-hauler. However, several published papers have offered more than 10 possible labels including “COVID-19 Syndrome” and “Post-COVID-19 Syndrome.”1 Numerous long hauler Facebook support groups exist on social media and LinkedIn, including: Long Haul COVID Fighters, Long COVID Support, COVID-19 Information Center, and COVID-19 Long Haulers Outreach.
Brain fog is a non-medical term that describes the symptoms comparable to mild cognitive impairment (MCI) and/or an auditory processing disorder.2 Auditory processing testing is strongly recommended when such a patient is in your office. A cognitive screening is also recommended in order to make an appropriate referral. There are many overlapping behaviors of mild cognitive impairment, auditory processing disorder, and “brain fog” (see sidebar).
A new set of questions that detail the COVID-19 experiences of the patient should be developed. This includes the specific dates of any hospitalization and medications prescribed related to the diagnosis of COVID-19, as well as the onset of any auditory/vestibular/cognitive complaints.
Be aware that comorbidities and prior COVID-19 medical management must be further evaluated because they can exacerbate a pre-existing condition.
The patient’s pharmacist is a valuable resource to learn more about the patient’s pharmaceutical history.
To obtain information on a particular drug’s side effects the following resources are recommended:
Contact the patient’s pharmacist.The patient may report significant communication complaints but have a normal pure-tone audiogram.
Presently, there appears to be no published information about the drugs used for COVID-19 intervention and any drug interactions with a patient’s pre-COVID diagnosis drug regimen.
Outer Ear
Personal Protective Equipment (PPE) should be worn by the clinician at all times when removing cerumen (any procedure), and infection control protocols should always be followed.3
Otoscopy should still be part of the initial workup and all subsequent visits. Video otoscopy is strongly recommended to maintain a visual record of the status of the ear canal and tympanic membrane.
The COVID-19 virus can be transmitted in an airborne way through the secretions of the ear canal epithelium.4,5
Cerumen can be disposed of in the trash, drain, or toilet without any need for a biohazard bag; there is no risk of transmission of the virus to someone else.6
Middle Ear
The COVID-19 virus can colonize in the middle-ear and mastoid region.7
Middle-ear muscle reflexes may be absent because of peripheral hearing loss or brainstem involvement, although there is no published research on this test with COVID-19 patients.
Inner Ear/Cochlea
Hearing loss is likely to occur at the peak of the infection, possibly due to the blood-labyrinth barrier being damaged/destroyed at this period. Sensorineural hearing loss (SNHL) usually occurs after the peak of the infection (downward slope of infection), but hearing loss could occur within four weeks of infection. It is not known if any fever associated with the virus could also contribute to the hearing loss. The hearing loss might not be immediately obvious to the patient if it is in the mild loss category.8
At least two studies9,10 involving COVID-19 patients suggest otoacoustic emission (OAE) test results (Distortion Product and Transient Evoked) may be abnormal with or without hearing loss on a pure-tone audiogram.
The most common type of COVID-19 hearing loss is bilateral SNHL in the high frequencies.9
If extended high-frequency audiometry is available, it should be added to the test battery. Although there is no published research about the use of high-frequency audiometry relative to COVID-19, like any virus, the loss might be more deleterious to the higher frequencies first—similar to drug ototoxicity.
Although there is no published data about word recognition scores (WRS) being affected by the virus, if the WRS is abnormal in the presence of normal pure-tone audiogram, then an auditory processing evaluation is strongly recommended.
Sudden Sensorineural Hearing Loss (SSNHL) has been reported after the vaccine, but the incidence was no different than for the general population.11 The researchers noted that there were only 40 reports of SSNHL in the VAERS during a 3-month period during which time more than 86.5 million dosages were administered. Onset (mean): 4 days (range: 0-21 days).
Auditory symptoms can fluctuate.12
There continues to be a need for research in this area.
Brainstem/Auditory Cortex
ABRs can be abnormal with no measurable waves after Wave I if the virus has affected the brainstem.13
Eight terms have been used to describe auditory pathway/primary auditory cortex dysfunctions which could also involve the virus:
Mild Cognitive Impairment (MCI). This term has been used interchangeably with “brain fog.”14,15
Brain fog. Used interchangeably with MCI.16
Central Auditory Processing Disorder (CAPD) or Auditory Processing Disorder (APD).17
Obscure auditory dysfunction.18,19
Hidden hearing loss.20
Cochlear synaptopathy.21
Adverse drug reactions.12,22-24
There is also a possibility of an undiagnosed learning disability.
Tinnitus
Tinnitus is usually secondary to SNHL. However, if there is no pure-tone loss, then OAE data should confirm cochlear involvement.25
Comorbidities must be identified in the case history along with the patient’s current medications.26
Tinnitus self-assessments are an effective counseling tool with tinnitus patients (ie, Tinnitus Handicap Inventory, Tinnitus Functional Index).
There continues to be a need for research in this area.
Vestibular System
There is no evidence-based research about auditory/vestibular-related symptom recovery, therefore recovery cannot be predicted.
Some reports suggest there is an approximate 20% risk of vestibular involvement.27
Again, there continues to be a need for research.
Considerations for Special Patient Populations Regarding COVID-19
Pediatric referrals. Over the next year, there could be more referrals by pediatricians for families of babies and toddlers who did not keep their initial follow-up appointment and/or where audiological services were limited or not available during the pandemic’s peak.28 Re-establish yourself with all pediatricians in your area about your facility’s pediatric services.
Diabetes (Types I and II). There is an increased risk of hearing loss, or an exacerbation of pre-existing hearing loss, in patients with diabetes according to the American Diabetes Association (www.diabetes.org).
Low vision/blindness. Patients who are blind or have low vision are more at risk for anxiety-related problems (ie, less independent).29
Adults with Down syndrome and/or developmental disabilities. Patients with Down syndrome are more at risk for anxiety-related problems (ie, confusion/altered consciousness).30 Patients with developmental disabilities also have higher risk of contracting COVID-19 because of their need for close contact from their caregivers.31
Dietary Supplements
There are no FDA-approved, over-the-counter (OTC) supplements or nutraceuticals for COVID-19 management (including supplements for other auditory/vestibular problems and tinnitus).32
Audiometric Testing Guidelines
No audiometric testing guidelines exist for COVID-19 management. Until specific testing and management guidelines are developed by the major hearing care associations for COVID-19 survivors with communication complaints, it is recommended that audiologists use the following two guidelines from the American Academy of Audiology: Position Statement and Clinical Practice Guidelines33 and Audiologist’s Role in the Diagnosis and Treatment of Vestibular Disorders.34 As noted earlier, the AAA Coronavirus Resource webpage is also a good resource.
Communication strategies should be reviewed as needed for patients and their families whether hearing loss has been identified or an auditory processing disorder has been identified (see: https://drbobdisogra.com/communication-strategies). The use of Hearing Assistive Technologies (HAT) and/or hearing aids should also be addressed as needed.
In terms of special billing procedures for this patient population, there is only one new insurance billing code for COVID-19. The billing code 77902 is used for COVID-19-related supplies. (Note: There is no guarantee of payment. Covered expenses and reimbursement depend on the patient’s contract.)
Conclusion
Obviously, more audiology evidence-based research is needed as we continue to study the virus and its impact on the auditory system and patient management for hearing care professionals. Certainly, a new Case History form needs to be developed because of the unusual circumstances around the pandemic and the emergence of patients who are still experiencing lingering medical issues.
Brain fog appears to be the trending term for mild cognitive impairment or possibly an auditory processing disorder. Diagnostic tests—supported by evidence-based research—can help quantify the impact that the virus has on the central auditory pathways. In my opinion, the term “brain fog” should be dropped from all future research papers when cognitive impairments are suspected with COVID-19 patients. Physicians and other healthcare professionals need to be educated on what an auditory processing disorder is and how the audiologist can quantify their test results with evidence-based research.
It is still too early in the pandemic to make definitive statements about the full impact of the COVID-19 virus on the auditory/vestibular and central auditory systems. Audiologists should consider adding a cognitive screening test to their practices in order to make the appropriate referral(s) for those patients whose auditory processing test results do not indicate that any processing issues are present. Counseling will continue to be a major part of the patient’s experience with hearing care clinicians.
CORRESPONDENCE can be addressed to HR or Dr DiSogra at: bobd1030@aol.com.
Citation for this article: DiSogra R. COVID-19 and the hearing care professional: What we know so far. Hearing Review. 2021;28(9):18-21.
Celik S, Kalcioglu MT, Esen F, Hanege FM, Cag Y, Kocoglu E. SARS-CoV-2 presence in cerumen. ENT Jour. 2020;100(2):158S-159S.
Hanege FM, Kocoglu E, Kalcioglu MT, et al. SARS-CoV-2 presence in the saliva, tears, and cerumen of COVID-19 patients. Laryngoscope. 2020;131(5):E1677-E1682.
https://honiton-hearing.co.uk/wp-content/uploads/2021/07/Signia2021-Honiton-hearing.jpeg6401280adminhttps://honitonnew.leecurran.co.uk/wp-content/uploads/2018/03/honitonhearinglogo.pngadmin2021-12-07 12:53:462022-01-02 15:41:07COVID-19 and the Hearing Care Professional: What We Know So Far
Widex announced its “first-ever rechargeable behind-the-ear hearing aid offering PureSound, LED indicator, telecoil, and direct streaming to iPhone and Android.” With the new Widex MOMENT BTE R D, patients with “hearing loss from minimal up to severe-to-profound can now benefit from Widex’s unique natural sound processing.”
“With 91% of users reporting satisfaction with Widex MOMENT sound quality[1], we’ve applied this patented technology to our first rechargeable BTE solution,” said Dana Helmink, senior director of audiology and clinical education at Widex. “Featuring sound like no other, the Widex MOMENT BTE R D is designed to give patients greater control over their hearing experience while offering direct streaming across popular devices like iPhone and Android. Hearing care professionals now have even more options for fitting patients with natural sound and convenient, flexible lifestyle features that enhance the use of their hearing aids.”
The rechargeable Widex MOMENT BTE R D hearing aid is fully compatible with the Android Audio Streaming for Hearing Aids (ASHA) standard, which allows wearers to stream music and calls directly to their hearing aids without requiring a separate accessory, according to the company. It also supports direct wireless connections to iPhones, Widex TV Play, and WidexLink devices. Developed to meet the needs of even the most demanding hearing aid wearers, Widex MOMENT BTE R D runs for up to 37 hours on a single charge and 24 hours total when used for roughly 8 hours of streaming — more than enough battery life for those who spend much of their day streaming, Widex says.
The Widex MOMENT BTE R D has the option of using a standard ear hook and two thin tubes for a better fit regardless of ear size and shape. Either can be used to take full advantage of PureSound with ZeroDelay processing, which helps “eliminate delay-based distortion in Widex MOMENT hearing aids and improves sound perception.” Recent Widex studies have shown that “90% of users found the sound of their own voice to be natural when wearing Widex hearing aids featuring PureSound, compared to their current hearing aids.” Widex also says that a “full 95% said the overall sound of PureSound was natural.”
“Delay impacts many levels of sound perception,” Helmink said. “With PureSound, we’re finding patients overwhelmingly prefer the naturalness, clarity, and localisation of the sound they experience from Widex MOMENT hearing aids to what they get from other devices.”
Widex MOMENT BTE R D hearing aids come standard with telecoil and feature a new HCP-programmable LED indicator and, unique to this model, a separate preference control switch to help patients use their hearing aids more easily. HCPs can enable the LED indicator to flash different colours and patterns to communicate status to the wearer, such as on/off, low battery, or a successful Bluetooth connection or accessory pairing. As a result, the hearing aid wearer – or their caregiver – can more easily understand the status of the hearing aids through a visual indicator.
The Widex MOMENT BTE R D is available in a range of colours, similar to other Widex MOMENT hearing aids. It comes with a standard charger and will soon be available with the Widex Charge n Clean charger, featuring a UV-C LED treatment to help eliminate bacteria and viruses and temperature stabilisation to help ensure optimal battery performance, Widex says.
HCPs will be able to perform fittings of the Widex MOMENT BTE R D via the new Compass GPS 4.3 fitting software.
For more information about Widex MOMENT, click here.
https://honiton-hearing.co.uk/wp-content/uploads/2021/11/Widex-Moment-BTE-R-D_pair-with-charger-1280x640-1.jpeg6401280adminhttps://honitonnew.leecurran.co.uk/wp-content/uploads/2018/03/honitonhearinglogo.pngadmin2021-11-30 17:39:232021-11-30 17:39:23Widex Launches Moment BTE R D Hearing Aid
Extending the Blu line of hearing devices, Unitron announced the official launch of its Stride Blu BTE (Behind-The-Ear) hearing aids.
Offering “comfort combined with powerful hearing technology,” the new Stride B-PR and Stride B-UP BTE form factors are said to “provide easy personalisation and performance to support everyday life.” A smaller, sleeker design than its predecessor, the Stride B-UP features “an easy-to-find multifunction button for easier control and is Unitron’s first Ultra Power device to offer Made For All direct connectivity,” according to the company. The rechargeable Stride B-PR offers tap control and provides a full day of listening on a single charge, so wearers can remain engaged in their daily activities without pausing to recharge.
Connecting clients directly to their hearing care professionals (HCPs), Unitron introduces new enhancements to their distance support solution, remote adjust. In addition to gain and compression adjustments, remote adjust now helps allow HCPs to make adjustments to directionality, feedback cancellation, speech enhancement, and noise reduction.
“Now, more than ever before, hearing aid users are looking to take control over their hearing journey. Life changes quickly and hearing aids should never be an obstacle in experiencing the moments that matter the most to all of us,” said Unitron Product Manager Samson Berhane. “Stride Blu BTEs allow wearers to capitalise on the design that best fits their hearing needs and physical characteristics, while also benefiting from the ability to make the adjustments they need to live life to the fullest.”
“Automatically optimising sound across a wide variety of sound experiences, including both complex and quiet environments, Blu hearing aids transition seamlessly from one situation to another.” In situations where the automatic features don’t match the wearer’s listening intentions, they can select “convenient pre-set sound profiles, and make adjustments in the moment to boost speech or listening comfort, via the Remote Plus app.”
“Everyone deserves to enjoy all hearing experiences. Unitron recognises that to make this possible our technology and design has to fit seamlessly into their lives,” said Berhane. “Products such as Stride Blu BTEs are an excellent example of our commitment to offering hearing aids that can offer a listening experience that is effortless and empowering.”
Starkey announced the Evolv AI, its newest full line of hearing aids. According to the company, the Evolv AI “is setting the stage for an entirely new hearing ecosystem that not only emphasizes hearing’s impact on overall health and wellness but creates an effortless user experience.”
“In 2018, we reinvented the hearing aid with Livio AI,” said Starkey Chief Technology Officer Achin Bhowmik, PhD. “Today, the smartest hearing aid just got smarter. For example, every single hour, an Evolv AI hearing device will make 55 million adjustments – automatically. And we aren’t done yet. The next 18 months from Starkey will redefine hearing healthcare for the decade ahead.”
Evolv AI is built on Starkey Sound, a technology created by “years of refining Starkey’s research and science-based algorithms to power high-fidelity audio, which is modeled after the human auditory system.” Like the brain, Starkey Sound is designed to automatically suppress background noise and designed to increase speech audibility and intelligibility with machine learning technology, according to the company’s announcement.
Starkey also introduces the industry’s “smallest 2.4 GHz CIC,” as part of the Evolv AI line of hearing aids.
“Craftsmanship is something of a lost art,” said Chief Audiology Officer Sara Burdak, AuD. “At Starkey, Chairman Bill Austin pioneered the concept that designing and manufacturing hearing aids requires excellence. Our researchers, engineers, and manufacturing teams have continued that long-standing tradition of handcrafted excellence by dedicating themselves to create smaller, more powerful, and longer-lasting devices every single day.”
Additional features of the Evolv AI product family include:
“40% reduction in noise energy compared to Starkey’s previous technology,”
Additional refinement of Edge Mode,
Fall Alert and Voice Reminders at all technology tiers,
Thrive usability enhancements,
TeleHear first and follow-up fit additions.
Evolv AI’s always-on and always automatic approach helps “deliver realistic and genuine sound quality in every environment, without the need to do anything extra.”
“The connection between better hearing and improved overall health outcomes is indisputable,” said Starkey Chief Health Officer Archelle Georgiou, MD. “However, we know that if the technology inside a device isn’t easy to use, patients won’t reap the benefits. Evolv AI certainly leads the way in sound quality, but its ease of use is truly game changing.”
“We know better hearing is best served through you, the hearing professional,” said Starkey President and CEO Brandon Sawalich. “At Starkey, Hear Better, Live Better is much more than a tagline. It’s our commitment to you to help your patients live better through better hearing. We can’t wait for you to see how Evolv AI does that, in a way that is effortless out in the real world.”
The company also announces that Starkey Expo 2022, the hearing industry’s biennial event, will be held May 11– 15, 2022, in Las Vegas, Nevada. Stay tuned!
https://honiton-hearing.co.uk/wp-content/uploads/2021/11/Starkey-Hearing-aids-Honiton.jpeg6401280adminhttps://honitonnew.leecurran.co.uk/wp-content/uploads/2018/03/honitonhearinglogo.pngadmin2021-11-03 17:47:262021-11-03 17:47:26Starkey Launches Evolv AI Hearing Aids
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