As promised in a previous blog, I mentioned that I would report on some of my reactions to what I saw and heard while strolling the halls and speaking with attendees and exhibitors of the EUHA (European Union Hearing Association) meeting in Nürenberg, Germany this past month. Many attendees reported that there was nothing really new, but when viewing the exhibits from a technical point of view, I still found some items/issues of interest. Next week’s blog will be a continuation of “An Audiologist in the Wilderness” written by Jim Curran.
Water, Water, Everywhere, But Not for Drinking
The exhibit area had some resemblance to Sea World with fish and hearing aids sharing the same fishbowls/fish tanks – everywhere. One of the technologies shared among many manufacturers involves nano-coating technology, something not entirely new, but expanding as companies invest in the necessary equipment to apply this moisture, scuff, and dirt-resistant feature to their hearing aids. Expect to see numerous ads promoting these features in hearing aids during this next year. Interestingly, I did see a lot of water, but no dirt or scuff displays in the exhibit hall, so resistance to the latter two will have to be accepted as expressed. A later blog will report on this technology.
More RIC, but Now Some With More “RAC”
RIC hearing aids with power speakers seemed to draw more display space and exhibitor promotion, seemingly replacing many of the open fit units as the industry learns that perhaps too many open fit aids were sold when closed may have been a better choice. Additionally, many companies now seem to realize that high fidelity cannot be achieved with an open fit, especially if improved sound quality is to be realized. And, an interesting option that allows various RIC applications up to a very powerful and interesting arrangement was demonstrated at the Widex booth. Would you believe up to 143 dB peak SPL? (By the way, I have no idea what RAC stands for. It is just something I made up in order to have a catchier heading).
Adaptive Directional Everything
There were all kinds of hearing aids with adaptive directional, but now a few comments during discussions with engineers and fitters of hearing aids suggesting that perhaps some real, patient-identifiable front-back directionality may have been overlooked and/or lost as a result of this enthusiasm. The question asked was, has the industry engaged in a case of overkill, especially when many patients cannot hear the adaptable differences in daily listening experiences (as opposed to differences measured in an anechoic chamber)? When combined with adaptive directional, other adaptive features leaves me in a total state of confusion as to the capabilities of the hearing aid or what it is supposed to do. There is always this voice in my head that makes me a little suspicious when I hear the words “trust me” as it relates to hearing aid marketing “advantages.”
Continued Emphasis on Cosmetics
As mentioned in my previous blog, the hearing aid industry has always been driven by cosmetics and I really did not see any change in this direction at the meeting. However, it does appear that the industry has now entered rather fully into the “designer” hearing aid stage, with artwork, signatures, and scrolls imprinted in the plastic coverings – primarily with BTE hearing aids. More surprising however is a return by some manufacturers to CIC instruments that actually fit at the aperture or slightly within it, but with tapering of the tip so as not to make contact with the bony structure. Generating an occlusion effect (OE) with such aids seems to be assured, unless, of course, that the vent can be made large enough (2mm diameter as Lybarger has suggested?) to eliminate the OE, and a feedback system and sufficiently small electronic components that would allow this size vent in an instrument that would fully qualify as a CIC. From IntriCon I saw and listened to a stock, open fit ITC called APT™, intended to physically fit essentially all ears, that incorporates an interesting securing monofilament feature that is shaped to and fits within the concha.
Complexity Versus Simplicity
It is undeniable that hearing aids have become significantly more complex in the amplified signal presented to the consumer, but I did not see or hear any really new “WOW’ performance features. It is possible that I just didn’t recognize them or didn’t talk with the appropriate people. On the other hand, simplicity seems to have been interpreted by most manufacturers as being provided primarily via reduced features and correspondingly reduced cost under the guise of entry-level devices. My impression would be that simplicity (as expressed by KISS) should extend to application by both the consumer and dispenser. A hearing aid by Ear Technology Inc. that appears to move in this direction allows simple self-programming by the consumer using just the volume control (whose functional algorithm automatically manages noise and other features as the VC is adjusted), and also eliminates the need for an external programmer.
Expanded Non-Hearing Aid Offerings by Manufacturers
The continued consolidation of hearing aid manufacturing companies has expanded the variety of equipment available from the largest manufacturers. The suspected expectation by the parent company is that this will draw dispensers more readily because the parent can now provide for essentially all of their equipment needs, and as a result, keep the dollars under a single umbrella. To facilitate this, many of the purchased companies (including those that provide hearing aids) operate as separate subsidiaries and keep their pre-purchased names and marketing directions in order to appeal to a broader base. Most do not identify themselves with the parent company.
Hearing Aid Measurement
The measurement of hearing aids continues to seek methods to evaluate the more complex outputs, and expect to see at least a couple of new options on such equipment.
- 2D/DI. This is a two-dimensional directivity index (ANSI S3.35-2010) to assist in the quantification of the directionality of hearing aids. The measurement, as shown by Frye Electronics on their equipment, captures the values for 11 frequencies, and calculates an average directivity index. Expect to see this from other hearing aid measurement systems as well.
- International Speech Test Signal (ISTS). This test (based on an upcoming but yet unpublished IEC 60118-15 standard) involves third octave analysis performed on the hearing aid response to a standardized speech-like signal (choice of 10, 20, or 45 second presentation times). When the test is complete, results are displayed as the long-term average speech spectrum (LTASS) and the 30th, 65th, and 99th percentiles of the distribution of sound pressure level.
Acoustic Confusion at the Beer Tent
How does the EUHA (European Union of Hearing Aid Acousticians) meeting compare with the large U.S. meeting, that of the American Academy of Audiology (AAA)? The major difference is that food, accompanied by refreshments (especially beer and wine), are part of the daily life of Europeans, and this extends to the EUHA as well. I have never seen anything at this meeting over the years that suggests any misuse by either the exhibitors or attendees. I would not suggest this for the AAA meeting for many reasons, even if it were allowed. A second comparison relates to the use of loud music. At the EUHA, some of the exhibitors have bands playing into the open environment during the show. I personally find this very distracting and unprofessional, especially when I am attempting to listen to a presentation adjacent to the band – or, even when I am hundreds of feet away. While AAA does not allow this, their evening socials are filled with the same din. And, of course, we who dispense hearing aids and counsel our patients to avoid loud noise do not follow our own advice. The situation is made even worse when allowed by the Association conducting the meeting. And, a third major difference relates to the demographics of the attendees. EUHA has a very broad range of attendees by age, and the majority appear to be male. AAA makes it seem as if I have entered someone’s harem. Don’t interpret this as a complaint or as a sexist remark – merely an observation based on the high volume of women. And, my last major comparison is that when I am at the meeting in Germany, I can’t believe how many foreigners there are!