New from Bernafon is the extension to the highly acclaimed and successful Acriva family, now bringing the current collection to 4 technology levels, ranging from the low-end Carista 3, through the mid range Carista 5 and Acriva 7, right through to the top end Acriva 9. The two higher tiered products are called Acriva, whilst the lower two are titled Carista. All four hearing aid families are built on the same platform, using the latest Bernafon chip-sets and software. These latest additions almost complete the new Bernafon family. Still to come are the entry level hearing aid (free for pensioners in Australia), which presently is still the Inizia 1, on an older platform, and a replacement for the long-in-the-tooth Xtreme family of super-powered hearing aids for those with profound hearing losses.
The new Carista hearing aids come very highly featured, and as with all Bernafon products, the most important and integral features are included across the whole product lineup. Taking advantage of the new hardware, both the Carist 3 and 5 incorporate the latest, and highly effective feedback management to ensure they don’t whistle, and the super-quick adaptive noise reduction algorithms to ensure background noise is kept to a minimum without affecting the volume of incoming speech. Also new in both of these hearing aids is transient noise reduction, which works fast enough to detect and supress a loud sound of very short duration before the waerer even hears it. A great example of this technology at work is demostrated when dropping a a glass on a stone floor. Typically, a hearing aid would amplify the crash causing discomfort for the wearer. Transient noise reduction can muffle the crash before it is heard, making it much more comfortable and easy to listen to.
Wireless technology and integration has now been introduced to the Carista 3 (its predecessor was not wireless). This allows adjustments made to be made to one hearing aid, and the other hearing aid will follow suit. It also allows the integration of wireless accessories such as bluetooth streaming for mobile phones and televisions, giving you greater access to sounds you may otherwise struggle to hear.
Although I have not yet fitted either the Carista 3 or 5, the Acrivas I have prescribed have been excellent, with my patients reporting the sound to be the clearest and most natural of and hearing aid they have trialled in the past.
Best value is the Carista 3. Almost as well featured as the 5, but at only $1750 a piece (private buyers), it represents an extraordinarily well equipped and solid unit for the price. Give us a call on 0430 080 274 to find out more information.
Have you ever wondered how hearing aids are made? What makes them so expensive?
The answer to the second question is rather complex, and we will deal with that in a separate post, but today we will have a look at the complex process in making hearing aids, that definitely contributes to the cost.
Behind the ear hearing aids (BTEs), which sit on top of your ears and are then connected to your ear via a wire or tube and mould, are made in a regular production line factory like any other device. All the components are machine soldered and set into the casing. A large number of manufacturers produce these hearing aids in China and other far-Eastern countries, although some production is still done in Europe and the USA.
Custom made units however, such as in-the-ear, in-the-canal and completely-in-the-canal hearing aids are all made individually, according to each patient’s ear. plastic earmoulds that are attached to the BTEs are also made in this way.
Firstly, the audiologist must make an imprezssion of the ear, using a variety of silicone based materials. These are mixed together, rather like the stuff used to make dental impressions, and are injected into the ear using a syringe or special gun. A foam block is placed down the ear canal to esnure the material does not go to far, and to set the end point of the impression.
Once the material has cured (about 2-5 minutes depending on what is used), the impression is removed and sent to a laboratory to be made into a hearing aid or earmould.
When the impression arrives at the lab, it is sent to a technician who will create the hearing aid shell using one of two methods. Traditionally, the impression would be placed in a container of silicon which was cured for several hours and would then be cut out to make a casting mould out of which the hearing aid shell would be cast. This is a very time-consuming method and relies completely on the accuracy of the initial impression.
This method is being replaced with sophisticated scanning and 3-D printing technology that allows for a far more accurate, and adjustable outcome. The impressions are placed in a special box with lasers or cameras that scan the impression and create a 3 dimensional model viewable on a computer screen. Using CAD modelling, the scanned image can now be manipulated and adjusted to fit the electronic components (which are simulated in the software), removing excess material and unnecessary space to make the hearing aid as small as possible, whilst still retaining the key anatomical features necessary to ensure the aid stays securely in the ear without whistling. Once the skilled CAD technician is happy with the model, it is then printed out of a printer that can print plastic layer by layer very precisely to ensure a perfect and individualised fit for your hearing aid.
This process can take several days, and is performed by highly skilled technicians. Hopefully, this will give you some insight in to the way your hearing aids are created.
As an an adjunct, this scanning process is slowly being rolled out in clinics to replace the traditional ear impression described above. Currently, Siemens market a device for scanning impressions in the clinic, which can then be emailed direct to the lab for CAD design. An ear impression is still required, but it cuts out one step in the process at the lab. Soon to come, and developed by Lantos technologies (http://www.lantostechnologies.com) and Otometrics (http://earscanning.com) amongst others, is a device that scans the ear directly, before sending the scan to the lab to be made up into a hearing aid.
Eliminating the need for messy and time consuming silicon impressions and cutting out the time needed to ship the impressions, this technology should greatly improve the accuracy and lead time for custom made hearing aids. Watch this space in early 2014!!!
We have long understood that listening to excessive volumes of music through headphones will cause ear damage and hearing loss but an alarming survey from New York has shown how prevalent this problem really is.
Although not a formal scientific study, with the results gleaned from a New York City survey (The National Health Interview Survey), the results nonetheless speak for themselves.
The survey shows that 58% of people aged 18-44 listen to music through headphones 5-7 days per week, with more than half of those listening daily. Of those that listen daily, 16% classified their listening as heavy usage (more than 4 hours per day), which is about 6% of the total population aged 18-44.
The study also measured subjective hearing loss levels by asking respondents if they thought they experienced any hearing problems. Whilst 22% of those over 45 years old thought they had a hearing problem, which is what could be expected from a normal population in that age group, 23% of heavy users under 44 years of age reported hearing problems, far above the average response of 9-10% reported by normal headphone users.
Let’s break down this research into meaningful figures for Australia, assuming it mimics New York for headphone use.
There are approximately 8 million people in Australia aged 18-44, of which about 3 million would be listening to music daily through headphones, if we use the statistics from the New York study. 16% of those would be heavy users, which equates to about 500 000 people. If 23 % report subjective hearing loss, we are looking at over 100 000 people in this age group alone, who are deliberately damaging their ears and long term hearing. This figure excludes those under 18 and over 45, many of whom would be exposing themselves to similar levels of noise exposure and experiencing similar problems. Bear in mind too, that the survey was done up until 2006. In the 7 years since, with the proliferation of mp3 players and smart phones, the figures are likely to be considerably higher.
Do you want to be one of the 100 000?
Obviously, the best way to avoid damaging your ears is to reduce your exposure to loud music. However, this is not always a fair option. Given that many people listen to music whilst in the street, whether walking, cycling or on public transport, the tendency is to turn up the volume of the music above the background noise level, which in itself can be loud enough to cause hearing damage. A good pair of headphones, preferably over the ear, or even in the ear, with noise cancellation and a good seal to outside noise will make all the difference. If you are not having to compete with background noise, you can safely listen to music at about 75dB (subjectively around the volume of very loud speech – not shouting), without the risk of causing damage to your ears or hearing loss! A good set with noise cancellation technology will typically cost around $50-100, although you can get some truly excellent units for about $150. The better the sound quality, the less likely you are to need the volume boosting to compensate. It’s a good and pleasurable investment that could save you from a lot of problems in the future.
For more information and to find out about suitable headphones, call Jack on 0430 080 274.
Recent studies published in The Laryngoscope, an ENT journal from the USA show indications of links between obesity in Adolescents and hearing loss, particularly in the low frequencies.
Almost 1500 people aged between 12 and 19 were included in a study over the duration of 2005-2006. The study found that hearing levels were consistently lower among the obese group relative to their peers, with the most marked difference occurring below 2000Hz, critically important frequencies for speech understanding. Almost twice the number of obese participants showed reduced hearing compared to the non-obese group, with 15.16% of participants showing reduced hearing levels. The hearing loss was also registered as sensorineural – commonly called nerve deafness, which is an alarming thought as most sensorineural hearing loss can not currently be restored.
Possible theories presented to explain this outcome include increased internal inflammation associated with obesity that may encroach on the inner ear and it’s delicate parts, causing irreversible damage. Also suggested were reduced levels of particular anti-inflammatory proteins in obese people, that have been associated elsewhere with sensorineural hearing loss.
A more indirect but likely link may be found through the higher prevalence of associated conditions affecting obese people such as diabetes, cardiovascular difficulties and high cholesterol levels, all of which have long been known to contribute to hearing loss.
Given that over 25% of Australians are classified as obese, including a large number of people under the age of 18, these studies highlight the incredible importance of healthy eating and exercise regimes, particularly in children. Sensorineural or nerve deafness is typically associated with those aged over 55, and is a degenerative condition. If our children are showing such tendencies at such a young age, the outlook is quite bleak!
The silver lining is that current research (mostly in early stages) is quickly pointing to the possibilities of stemming the tide of degenerative sensorineural hearing loss and perhaps even its reversal. However, this does not excuse poor habits and as we know prevention is always better than a cure.
Siemens, the highly respected German industrial giant and Hearing Aid pioneer has now released new additions to its highly acclaimed Micon family.
Building on the success of the Pure and Ace Receiver in Canal models, the small Life micro BTE and waterproof Aquaris series, Micon has been extended to the full size Motion BTE range as well as a new range of handcrafted custom made in-the-ear products dubbed Insio.
The original models have also benefited from a new, budget version called 3mi, that brings the same exceptional sound quality associated with the Micon chip but at a lower price point and minus some of the features of the higher end versions.
With Siemens Micon, the hearing aid is capable of 250 million calculations per second, yet manages to still last as long as a traditional hearing aid on its batteries. This exceptionally powerful and fast processor allows the hearing aid to analyse incoming sound in 48 channels, ensuring precise and very natural sound quality. A new compression system also ensures that the hearing aids are able to immediately suppress loud noises such as a clap or something dropping on the floor, without affecting the clarity of ongoing speech. Traditionally, this has been very difficult, with most hearing aids either proving too loud for transient sounds, or missing out on the ongoing speech.
48 channels also allows for greater background noise reduction, as it ensures the directional microphones are able to prove fully effective, even when taking onto account the “head-shadow” effect (the effect one’s head has on the sound reaching a hearing aid when it is sitting on an ear, as opposed to a hearing aid sitting on its own in a laboratory where most development tests are done). These hearing aids also feature a special directional mode, whereby they can actually focus behind the wearer. This feature proves especially effective in a car, when the wearer is the driver and struggles to hear back-seat passengers.
With a full suite of Bluetooth compatible accessories, allowing connectivity to phones, televisions and other music devices, Siemens Micon presents the latest drive for improved sound comfort and clarity from one of the leading manufacturers in the world.
The icing on the cake is that anecdotal evidence from audiologists in the field has shown them to be a truly exceptional hearing aid with almost immediate acceptance by clients as the most comfortable hearing aid they have ever worn. Just last week, I fitted a gentleman with a pair of Pure 7mi hearing aids as an alternative to the top of the range hearing aid he had been wearing from an other maufacturer, and his surprised response was telling: “I can actually distinguish everything you are saying”.
To give Siemens Micon a try, call 0430 080 274 to book an appointment. You will not be disappointed!
We are all well aware that exposure to loud noise, such as a music concert, can leave one feeling slightly muffled, or ‘deaf’ for a day or two after the exposure.
This post presents a short (depending on your perspective) overview of some of the possible causes behind this phenomenon.
We hear through a complex chain of mechanical vibrations (sound waves) that originate at the sound source, pass through our outer and middle ear through the eardrum and associated bones (ossicles) into the inner ear. In the inner ear, these sound waves are converted into electrical signals through specialized receptors called hair cells, which are then transmitted via our auditory nerve (VIIIth Cranial Nerve) to our brain for processing. In most people the mechanical pathway through the outer, middle and inner ear remains intact throughout their lifetime. Sensorineural or ‘nerve’ deafness is normally related to the junction between the mechanical and electrical (nervous) pathway – the hair cells.
The hair cells are so called because they have tiny hair-like projections called stereocilia on top of them. The cells themselves are embedded in the basilar membrane, which moves up and down with the mechanical vibrations of the sound waves. The stereocilia are connected at the top to a static membrane called the tectorial membrane. As the cells vibrate, the hairs (which cannot move at their tips due to the tectorial membrane) are caught in a shearing motion which opens up a channel beneath them allowing positively charged Potassium and Calcium ions to enter. These charged particles set off the electrical impulse that travels the nerve into the brain. Hearing loss is generally thought to be caused by a malfunctioning of the stereocilia which stops them moving and allowing the charged particles to enter the nerve channel.
The debate is what causes this malfunctioning in noise induced hearing loss.
Early theories suggest that the stereocilia being subject to extraordinary forces through the loud noise become shorter or lose their connection to the tectorial membrane. Thus, although they continue to vibrate effectively, they do not experience the shearing effect and so cannot open the nerve channels.
In addition to the passive vibrations of the mechanical sound waves, there is an active tuning process within the inner ear that encourages stronger vibrations at the frequency (pitch) of the incoming sound. Recent theories suggest that in response to excessive noise levels, the active process becomes fatigued, so to speak and can no longer effectively tune the signal with increased vibrations at the appropriate frequency. This lack of extra tuning is what we experience when our hearing becomes muffled. As our ears rest up following the noise exposure, the active process regains its energy, once again allowing for the extra tuning we need for the full hearing experience.
Another approach is based on the production of ‘free-radicals’ within the inner ear on exposure to loud noise. Free-radicals exist in many parts of science and biology and are rogue, highly reactive molecules that are not attached to an existing structure. They have been blamed for all sorts of diseases including cancer, although they do play a vital part within our bodies’ immune system and other systems. Essentially, being in an unstable, charged state, they will react with any molecule they can to balance their electrical charge. If they react with a critical cell or structure within the body, they may damage the cell. They are thought to have damaging effects on stereocilia within the inner ear. Antioxidants are the most common combatant for dealing with free-radicals, as they provide a safe molecule for the free-radical to latch onto, thereby minimizing the harmful possibilities of a bad reaction. Studies have shown that administering antioxidants to a person both prior to and up to three days following excessive noise exposure can reduce the effects of TTS and temporary hearing loss.
Newer research is based on evidence showing that the stereocilia are actually connected to each other via microscopic lateral projections called ‘tip-links’. These link the top of a shorter hair to the side of the next, taller hair. With all the stereocilia being linked to each other in this way, they move much more efficiently. Loud noise causes these tip-links to break meaning there is less synchronization between the hairs and correspondingly less effective transmission of chemicals through the nerve channels. Research demonstrates that although damaged stereocilia don’t heal on their own in humans, broken tip-links can regenerate within a few hours. This may be another contributing factor in temporary hearing loss and how it naturally resolves. For further information on tip-links and how they regenerate, take a look at this recent study http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.1001583.
Newly launched from Bernafon, a Swiss hearing aid manufacturer and part of the largest hearing aid group in the world, William Demant, is the Acriva family of hearing aids.
Built on an entirely new platform, analyzing the acoustic signal 20,000 times per second, the hearing aids are capable of adjusting each phoneme independently using the proprietary ChannelFree processing strategy. Unlike most hearing aids, which only adjust the signal based on syllables, ChannelFree allows for an exceptionally clear and natural sound.
Bernafon have launched their new features under the umbrella of Audio Efficiency 2.0, which incorporates a number of advanced features to make sounds clearer and more comfortable in the presence of background noise.
First up is a Frequency Composition strategy which copies and relocates sounds high up in the frequency range that may be too difficult for some people to hear, down to a lower frequency region that has better hearing levels. This then allows access to sounds such as “S” and “T” etc that would otherwise be difficult to pick out. Unlike other systems, the system does not replace the original signal; it simply provides an extra copy, whilst leaving the original intact for a more natural sound.
Additionally, Bernafon have introduced a new noise reduction system which is so quick, it is even able to suppress background noise that occurs between individual speech phonemes.
My favourite feature is called REMfit. Integrating with the MedRx Avant REM system that Optimal Hearing uses, the hearing aids are able to adjust the sound levels to your individual hearing loss perfectly. A microphone is inserted into your ear which measures the amplification of the hearing aid at your eardrum. The hearing aid then tunes its amplification to match your prescription exactly.
Come in and talk to us about what the new Bernafon hearing aids can do for your hearing. Call us on 0430 080 274.
Coming very soon to Australia are the latest Phonak hearing aids to benefit from the new Quest platform.
Following the late 2012 release of the BTE Bolero Q series and the custom Virto Q series come the Receiver in Canal Audeo Q hearing aids.
Now available in 4 levels of technology from the top spec Q90 down to a new entry level Q30, they represent the pinnacle of RIC technology available from the Sonova brand.
Alongside the rest of the Quest family (also to include Naida – Super Power), all of these models have a significantly improved feature set over the older Spice + platform. This is particularly evident in the lower spec Q30 and Q50, which now offer exceptional features and flexibility for their price point.
New for all models too is a special tinnitus mode, which produces a masking sound to reduce the annoyance of tinnitus.
As well as the technology upgrades, there are new cases too. The familiar look of the Audeo S (now 312) and Audeo Mini (now 10) models is retained, with improvements to the wind and microphone protection, but more importantly, the Audeo Yes shape has finally been updated with a more organic and modern profile as the 312T with telecoil.
New compact and angled receivers round out the changes. Available from mid May.
Just had a client with particularly waxy ears and had a go using the latest device – a disposable suction tip.
Just look at how much wax we removed from only one ear!
It’s a great unit that simply clips onto the suction hose and is very comfortable as it is made of plastic rather than steel. Plus, you get to see exactly how much wax you pulled out.
Suction takes about 5-10 minutes for a normal ear and can be quite a relaxing experience. It is a little loud as the suction tip can get very close to the eardrum, but it should never be painful. It is a good idea to soften the ear wax with a couple of drops of baby oil or even bicarbonate of soda solution a few minutes before suction.