What's New in Hearing Aids for 2021


Dr. Erin Wright shares what’s new in hearing aids for 2021 for each of the major hearing aid manufacturers and covers the highlights of their latest technology releases.

You will learn about:

  • The hearing aid features that are considered standard now
  • Research in the field of hearing restoration
  • The newest products from: Signia, ReSound, Phonak, Starkey, and Oticon
  • What's new in Apps & Accessories

This talk was originally presented as part of the Healthy Hearing Online Expo.

Read the video transcript: 

What is hearing restoration?

Okay, so let's start with the technology side of things. So, I'd like to start off with a little bit of research that's being done around the field of hearing restoration. So there's a company called Frequency Therapeutics, and Frequency Therapeutics is a pharmaceutical company that's looking at innovative ways to regenerate cochlear hair cells. So in this image, you can see this beautiful black and white picture of a healthy cochlea. So the cochlea, one of the main structures in the cochlea are these hair cells. And you can see there's four rows of the hair cells. And in 90% of people, it's those hair cells that become damaged and they don't regenerate. So we don't hear at the level of our cochlea. But the cochlea is very important because it's the organ that changes a sound from a physical sound wave into an electrical impulse. And then that electrical impulse travels up the auditory nerve to the auditory cortex, which is where we perceive the sound. But if the hair cells are damaged, that signal doesn't get translated, and the sound doesn't get to the brain, and you don't hear it.

So, Frequency Therapeutics has promising phase one clinical trials that have been shown to help with word recognition. And they are releasing their phase two results in early 2021. So currently, we are not in a stage of generally having this hearing loss be medically correctable. So the current practice for managing hearing loss right now is managing a hearing loss through amplification. So, that's where we're going to go next is what features are available in the market currently to manage people's hearing loss. So, a lot of times people come into the clinic, when we're trying to pick out a hearing aid they say, "You know what, I'm a Luddite. I don't need a hearing aid that's going to connect to my phone. I don't use any of that technology. I don't want to pay for it." And I can understand that. It seems as though it would cost more money to have a hearing aid that had that connectivity than one that doesn't. But now, a lot of these features are standard in every hearing aid by every manufacturer at every price point.

Standard hearing aid features

So, these features like connectivity and rechargeability have been around for a number of years now, and it isn't something that makes a hearing aid more expensive. It's just standard in technology. What makes a hearing aid more expensive, one than the other isn't necessarily features like this, it's the chip, the actual computer chip inside the hearing aid that does a better job or a less a better job of analyzing the sound scene and making decisions about how best to process that signal. So let's talk about each manufacturer specifically or some of the manufacturers that have released something new in the last year. And we can see what their new features look like.

Signia hearing aids

Signia which used to be a company called Siemens launched this particular form factor of hearing aids just recently, just March of 2021. So interesting we've got 55% of the people that are voted. I'll just give people 10 more seconds to give me their opinion about this form factor. This is quite interesting. It's not actually what I thought people would say. I like it. Okay, I'm going to end the polling here. Now, check it out, 50/50 pretty much. Wow, I'm surprised. When I saw this hearing aid I thought people wouldn't like it. That people would maybe think, "Why would I want to be looking like I'm wearing headphones all the time? Doesn't that seem like I'm distracted or maybe not in the moment with somebody because I've got headphones in?" But it looks like 49% of you love them. They look cool like headphones not hearing aids, and 51% of you don't like them.

This is Signia's idea as well is that there is a portion of the population that avoids or delays treating their hearing because of the stigma around being seen as wearing hearing aids and the things that are around that. So Signia launched this hearing aid called The Active Pro, it's what they call it. So there's two levels of this hearing aid. It's a hearing aid primarily that looks like a headphone. Now, Signia has their full line of technology, so all of their hearing aids in all of their different form factors.

So they have all of these different styles of a hearing aid. So the way the hearing aid looks or fits in your ear, whether it's in your ear or behind your ear doesn't really affect the price too much. It's just physically what somebody feels comfortable wearing cosmetically, as well as what's going to be the best acoustical solution for their hearing loss. So, Signia has launched this product, The Active Pro, for people who may feel more comfortable with that particular form factor of a hearing aid. Also, you can see this image here of that, a hearing aid which is called the Styletto, which is another innovative form factor that Signia has launched.

Signia has a new chip that they call Xperience, or X, the X chip and The Active Pro has been launched in this X chip. And one of the things that the X chip is doing is it includes motion sensors. So hearing aids, obviously have microphones and have acoustic sensors where the sound comes into those microphones and the acoustic sensors of the two microphones on the hearing aid are constantly making decisions about what to do with that information. So, an example of that would be that you're at a restaurant. And the acoustic sensors realize that this is a noisy place, and that you want to hear the person that presumably you're looking at. So the hearing aids put the microphones in a directive sort of narrow beam bandwidth, so that it's focusing more on what you're looking at.

The addition of motion sensors just adds to the functionality of these hearing aids because let's say you leave that table. You get up and walk out of the restaurant. Now, the hearing aids if they only have acoustic sensors are going to still be in that narrow band of directionality. But presumably you want to hear the person that's walking next to you. So after six steps, the motion sensors realize that you're no longer sitting but now you're moving. And the movement makes the motion sensors and the acoustic sensors work together to relax that directionality so that you can hear the person that is walking next to you. So, that is a great new feature that Signia has launched in their X platform.

The other thing that they have unique to their manufacturer is called their Own Voice Processor. So, the Own Voice Processor is a technology from Signia that tries to recognize the person's voice. And we train it to learn that voice in the clinic when they first get fit with their hearing aids. And then it doesn't amplify their voice in the same way that it amplifies speech around them. So historically, with hearing aids, there's always been complaints about people hearing their own voice too loud or feeling like their own voice is echoing. There's a number of factors that are involved in that, but this particular proprietary way of managing that by Signia has definitely been helpful.

ReSound hearing aids

Okay, so let's move to ReSound. ReSound is another of the manufacturers and ReSound has always been an innovative technological company. They were the first company to introduce Bluetooth into a hearing aid in 2012. They were also the first company to launch a receiver in the ear hearing aid, which is now about 80% of hearing aids that are out there. So, ReSound is always coming up with ways to innovate. Sometimes they're good, and sometimes they don't work. But they're courageous at introducing new technology into the market. So what they've done with their new hearing aid, called ONE is introduced a microphone into the receiver. So, can you see on this picture, there's a little hole, and the little hole is right here next to the... Whoops, that didn't work. Wow. The little hole is right by that wire that's feeding into the hearing aid. And that's an actual microphone.

So now this hearing aid has two microphones that are on the back of the ear, which is what every hearing aid has, an additional third microphone in the ear canal that is communicating with the three microphones on the other ear through a near field magnetic transmission. So, you've got a six microphone system that is working to enhance the natural sound quality of the room around you. So when you have normal hearing and you're not wearing a hearing aid, we rely on what's called the pinna effect. So the pinna is the technical name for your outer ear, all these folds that collect sound and direct it into the ear canal. So the pinna effect is important. It enhances sound at the very frequency where most of the speech sounds occur.

When you have hearing aids with microphones behind the ear, you lose that pinna effect. So the manufacturers employ correction factors to account for this, but the correction factors are never good as the real thing. So ReSound is trying to fix that problem by adding this third microphone. Now, this has never really been able to be done before because when you have a microphone that's that close to the speaker at the end of the hearing aid where the amplified sound is coming out. It's a recipe for feedback. So feedback is when a hearing squeals. And that happens because amplified sound leaks out of the hearing aid and leaks back into the microphone and gets re-amplified. So when amplified sound is re-amplified, we get feedback. When you have a microphone and a speaker that close to each other, you can see how that would be possible.

ReSound has launched a pretty sophisticated feedback cancellation algorithm into their hearing aid so that they can accommodate this microphone in the ear. One of the benefits of this is wind. It really does a much better job at being able to hear outside on a windy day, if you're going for a walk with a friend and it's particularly windy, this third microphone can reduce wind by up to 19 decibels. So, it's pretty effective. So this receiver they call it a Murray receiver, mic and receiver in the ear, and it's brand new as of November 2020.

Phonak hearing aids

Our next manufacturer that I'm going to talk about is Phonak. So Phonak launched their new product called Paradise in August of 2020. So it's been launched with a new and faster chip that is called Prism. So this chip, the faster they can process the signal, the better the hearing aid does it correctly analyzing that sound signal. So one of the best features about this is they've added the motion sensors just like the Signia product. So, the Signia product and the Paradise product both have those acoustic sensors and the motion sensors working together. In addition, this Phonak Paradise product is one of the best hearing aids for connectivity. So they can connect to eight different Bluetooth devices and two devices at the same time.

Hearing aids have always been able to pair to Apple iPhones or iPads for quite a long time. Phonak was holding out to launch a product that could be connected to any Bluetooth device which they have done with this Paradise product. So we can connect it to any Android, any technology that has Bluetooth can be effectively paired to a hearing aid. So even things like an amplify stethoscope or a Bluetooth stethoscope can be paired to a hearing aid. So, things that have Bluetooth can be paired to these hearing aids so it opens up a few more options for people who have difficulty with certain types of sounds.

The other thing that this hearing aid in addition to its faster chip and better sound quality. It's a truly hands-free phone call. So, with other hearing aids that connect to phones, you have to answer that call on the phone and speak into the phone for the other person to hear you. What Phonak has done is made the microphones on the hearing aid pick up the speaker's voice. So when you get a call, you can answer the call by double tapping the hearing aid, that answers the call, and then the microphone on the hearing aid picks up your voice, sends it back to the phone for the other caller. So you can effectively leave your phone in your purse, and you would get a call and say call from Broadmead Hearing Clinic, and then I would tap my hearing aids, answer the call, take that call and then tap it to hang up. So, it's truly hands free, which is fantastic.

In addition to phone calls, you can stream any audio, so music or audio books, and you can do the same thing. You can tap to stop the streaming and tap to start the streaming. I'm just making a little bit easier for people with dexterity issues where it's hard to find a physical button to push the button to answer the call. They're just slowly introducing features that make things easier for people.

The other thing Phonak has is a prescriptive algorithm that they use in calculating their sound for people who have more severe hearing losses. So, people with more severe hearing losses have different challenges with amplification than people who have mild hearing losses. With severe hearing losses, sometimes, one time I heard somebody describe it where it's not just a matter of making things louder because louder can be too loud. So imagine that with normal hearing, imagine you have a volume dial. And you can hear when the volume dial is at one, and it's painful when the volume dial is at 10. When you have severe hearing loss, what happens is maybe you can hear when the volume dial is at seven, and that at eight and a half, it's too painful.

So, your dynamic range of hearing shrinks on both sides where instead of having this range where we can fit all of the sound into, now the range shrinks not only on the soft sounds, but also the loud sounds. So, Phonak has come up with a way to compress sound without affecting the overall clarity. So, it's genuinely a really good product for people who are in that category of hearing loss that's considered more severe. For that particular population as well, Phonak has developed an app called myCall-to-Text, which I really love because historically, phones have understandably been challenging for people with hearing loss. When they put a phone to one ear, they don't have any of their speech reading capability. They just have to rely on the hearing in that one ear on top of a hearing aid.

Now with Bluetooth connectivity, you can stream that phone call into both hearing aids. And simultaneously, you can look at your phone and read real time captions. Just like you're looking at these real time captions right now. That's what it would be like when you're on a phone call. So if you're on a phone call to something important where you need to get information of phone numbers or different things where you feel maybe less confident with your hearing. A lot of times people will say, "I'll just pass the phone to my partner and they'll take that call." Well, hopefully people can become independent with taking those calls. Look at that transcript on the real time caption which can be saved on your phone for reference later. So you can go back to the conversation and reread the conversation using those real time captions.

This is a subscription service. So there's an annual cost to having it. If you call somebody else who has the app. So, if you're frequently talking to your sister... It's a free app to download if you talk to somebody else who's downloaded that app that call is free. But maybe your doctor's office is calling you and they won't have the app and then that would be more of when you would want to have the subscription service. So Phonak has come up with that app as well called myCall-to-Text.

Starkey hearing aids

The next hearing aid manufacturer we're going to look at is Starkey. So, Starkey is an American company and what they have new in 2021, they have a full line of products as well. But what's new in their particular product line is a rechargeable in the ear hearing aid. So rechargeable hearing aids have been fantastic, game changing for a lot of people to not have to deal with batteries anymore, but you have to have had it sit behind your ear in order to take advantage of the rechargeable feature. Starkey is the first and only manufacturer that creates a product that fits in your ear, and is also rechargeable.

So, in this past year of mask wearing, people have... I mean six or seven people a day say, "I've got so much going on behind my ears. I've got the masks, my glasses, my sunglasses, my hearing aids, it's too much." So it's understandable, it is too much. It's valuable real estate behind the ear. And sometimes people say, "Well, if I'm going out, I'm not going to wear my hearing aids because I'm going to have to wear my mask," and they feel like they need to choose between those things. Starkey has this technology in the ear rechargeable where it's just fitting in the ear canal leaving the space behind your ear free for those other things like masks and glasses.

Starkey has some pretty innovative artificial intelligence that they're using. They have a feature called Edge Mode. And what Edge Mode is Starkey is utilizing artificial intelligence. And Edge Mode is a feature in the hearing you that you have to activate. So when you would do that is if you were in a restaurant and it was quite noisy, you would double tap the hearing aid signaling to the hearing aid that you want it to go into Edge Mode. And what Edge Mode does is it takes a momentary scan of the environment to determine... It's basically you're telling the hearing aid, "I'm struggling in this environment, help." Double tap the hearing aid, it scans the environment and tries to apply noise management to help pull that signal out of the background noise. So, that's Starkey.

Oticon hearing aids

The next manufacturer that I want to talk about is Oticon. So, Oticon released their new chip called More in January of 2021. Now, every once in a while we encountered technology that moves the hearing aid industry forward in a big way. So in 1996, Widex came out with the first digital hearing aid. Now there's nothing other than digital hearing aids. In 2012, ReSound came out with Bluetooth hearing aids. Now every hearing aid has Bluetooth. And now Oticon has come up with a hearing aid that employs a different type of artificial intelligence than we've seen in the past. So for the last few years hearing aids have employed artificial intelligence in their hearing aid technology.

What that means is that the engineers feed hearing aids millions of sound samples and by millions in this specific case, specifically 12 million sound samples. So when we're relying on engineers to do this, we're relying on their ability to describe the sound. So Oticon is taking this a little bit further, one step further with a product, with a process called deep learning. Deep learning is sort of a next level of artificial intelligence. And it's the process that is used in computer chess games, that's used in Apple's face ID, facial recognition, as well as Tesla's self-driving cars. So, the chess game for example. People have fed or engineers have fed computers specific chess moves, but it's impossible to feed a computer every infinite possible chess move. So what happens is that the computer uses this deep neural deep learning to execute moves that it hasn't specifically been taught. So it allows the computer to make its own decisions in any given moment.

So, if we're asked to describe the difference between a cat and a dog, for example, we obviously intuitively know the difference. But when we're describing them, we might say that they're both animals, they both have four legs, they both have fur, they both have tails. And we might know what the difference is, but it might be a little bit hard to describe to a computer chip what these differences are. So when we rely on human engineers, we rely on their limited experiences and their descriptions of sounds. And when we can rely on a computer's ability to learn, we just get more specific, more sensitive classification of sound, which results in an overall better clearer sound quality.

My experience, I've been an audiologist for 25 years this year. And in my experience, so far, I've had a similar reaction when I'm fitting people with this hearing aid for the first time, which is this sounds clear. So, if you were listening to Christine's talk this morning, she was talking about a feature in hearing aids called, where we can gradually increase the sound over time. So rather than giving people all of the sound that they need on the first day, which can be overwhelming and harsh, what we've done is gradually up that sound over time. What I'm finding with this particular product is that at the full prescription, people's perception is that it sounds clear, including my own parents, who I've been fitting hearing aids with several number of years. Their impression right off the bat was clarity. And I had them write to the prescription right off the bat.

Often, I hear just words like this sounds tinny, or this is echoing. And that's understandable when the brain hasn't heard those high frequency sounds in a long time. But this is a new description for me in clinic. So each one of these iterations of technology, each time the computer chip gets a little bit faster, we're only improving the experience of the person who's wearing the hearing aids. So this is an exciting new technology for us to try in the clinic.


And finally, I just want to review apps and accessories. So, apps are actually a big thing now with hearing aids. We always have had the remote control, which has been very basic volume up and down or change your programs type of thing. Remote controls often come along with hearing aids, and they've been around forever. Now, with apps, the person using the app has so much more control over their overall sound quality than ever before. So in previous sessions, today, we talked a little bit about Mask Mode. But these apps allow people to change bass and treble. They allow them to lock in the directionality of their microphones. They allow them to prioritize different signals in the environment. Sometimes I find people can be nervous about, well, I don't really need that. I don't want to fuss with them. And that's fine, 90% of the time hopefully the hearing aids will be automatic. But it's nice to have that control on your phone with you where if you are struggling, you have an avenue that you can deal with that.

The apps are only getting better. And as well with the apps, they have functions like find my hearing aids. So if you lose your hearing aids, you can go to the app and find them. You can also look at other data about your hearing aid like what your battery life is or what your average wearing time is. Some of those types of things. Some of them like Starkey, are even trying to combine things like fitness trackers with hearing aids, so it will actually track your steps. So you don't need an additional fitness tracker. So they're moving into a technology of hearables as opposed to just hearing aids.


And finally, with accessories, every manufacturer has their array of accessories that are devices separate from the hearing aids that connect to the hearing aids. So the best of those devices are going to be the TV adapter, which for many people is fantastic. One of the things about these new TV adapters is that it's better able to separate the background music from the actual speech. And oftentimes, people will come into the clinic and complain that the mixing of this signal is not good. And they can't hear the person talking, the actor talking because all they can hear is the background noise. These TV adapters do a good job at separating out that signal from the noise.

The other great accessory is a remote microphone. So a remote microphone is almost like a third hearing aid and fantastic for when you're with somebody who's at a distance from you. When you're in a car where there's other road noise, or especially if you're one on one in a restaurant. The partner could wear the microphone, it picks up their voice, and wirelessly sends their voice to your hearing aids so you could be in another room. For example, I was with my mom and we were at a museum that had a ton of people in the museum. And I lost her in the moment and I was wearing a microphone and I said, "Mom, I lost you. Put up your hand." And I could see her, in the sea of people I could all of a sudden I saw her hand come up because she could hear me from that distance. It's a fantastic technology.

What’s best for me?

Finally, I just want to conclude by just wrapping up and addressing the question of okay, there's all these new things and all these new features and all these new hearing aids, which one is the best one for me? The best one for you is, you can't say. It's such a unique individual decision, but the best thing for you is to see an independent audiologist and describe to them as best you can your environments, and your needs, and your budget, and your lifestyle. And that audiologist will listen to those things and go through their bank of information and try to match you with the technology that's going to best suit your particular needs.

Using caution when researching online

I would just caution you, and just be aware of what you're looking online, what you see online, because online can be confusing. Particularly, Signia has a branch of their business called hear.com. And hear.com is a marketing machine that if you ever type the word hearing into your computer, you're going to get advertisements from hear.com saying that there's some sort of German engineering hearing aid that's better than anything else. It makes it seem like it's something incredible and new. So just be aware of the advertising that you're seeing online. Also, be aware that some of these websites that seem neutral or consumer report types are actually owned by manufacturers. So they will do a consumer report type review on the hearing aids, but it's owned by that manufacturer. So, it's obviously going to make that hearing aid seem better than the rest.

The best thing you can do for your hearing loss is to trust that the audiologist that you're with is independent and that they are going to provide you with all of the options and narrowing those options down to figuring out what is the best thing for your particular lifestyle. Okay, thank you so much for attending. I'm impressed with how many people showed up today. I'm honored that you'd spend your afternoon listening to me talk. So, I'm opening the floor to any questions.

Questions & Answers

Doran:  That's great. As usual, Erin, that's fascinating. And you can see there is a lot of information packed into just what's new this year. So, Erin's advice of see an independent audiologist is a good one. It's different than consumer electronics, or a car like I keep saying where you can just go online and figure out which Honda Civic is the best for you. It's frustrating for us to see how much misinformation is there, how much people with alternative motives are reviewing hearing aids and putting those reviews out there. So, you're best to see your independent audiologist. Erin, just a couple of questions for you coming through. First one is a popular one. Why are hearing aids so expensive? And people are always comparing them to consumer electronics again, to IMAX or TVs? Why are hearing it so expensive?

Dr. Erin Wright: That's a good question, and it's a popular question. And there's a lot that goes into them. I mean, namely the research and development. So you've got teams of PhD level people and engineers trying to create these tiny little chips to fit into hearing aids that can process sound. So you've got these big manufacturers with a lot of research and development costs. And the problem as compared to companies like Apple where everybody buys an iPhone, there's less people out there to recuperate the cost of their research and development. That's one of the factors.

The other factor is that you are paying for the professional services for the life of your hearing aid from an audiologist. So if you were to add up how much you pay your accountant, imagine over five years, what are you paying that professional person to manage your finances, your financial planner, or your accountant. You have a professional service on top of an electronic device. So it's not like Best Buy where you can just walk in and buy a TV and you never have to go back there. It's a combination. And currently, it's a bundled combination where you're not really seeing what you're paying for the hearing aid versus the professional services. So, that in combination with the research and development is what goes into the cost of them.

Doran:  Yeah, for sure. And if I could just add, you talked a lot about the chip. A lot of that is the programming. Those are proprietary programs that are running and it's very complex, like you mentioned. It's sound compression. It's its connectivity. These are supercomputers that fit behind your ears. Let's not talk about the battery technology involved. So, I would say, yeah, there's a lot that goes into putting these things behind your ears for sure. Erin, can you just talk about Signia for a second? A couple questions about that. That's a newer name in the market. What's their history?

Dr. Erin Wright: Signia is a private equity firm that purchased the hearing aid division from Siemens about four years ago. And Siemens agreed to let this private equity firm use their name for about three years. And then they had to switch to Signia. So, it's just been basically a Siemens hearing aid that's been purchased by a different company.

Doran:  Okay, a couple questions about what hearing aid is good for music or what hearing aid is good for tinnitus. That's where your audiologist is going to come in where they know the entire range, what your specific listening situation is. So they're going to do a good job of picking that make and model out for you. But maybe just speak to who does a good job often is for music lovers.

Dr. Erin Wright: Well, for me, I want to answer the tinnitus one. We use Widex a lot for tinnitus because they have those fractal tones like Martina was talking about. And that has been shown to be less cognitive load than some of the white noise maskers out there on the market. For music, there was a time about four years ago where certain manufacturers had better microphone technology that was really making a difference for music processing. Now it's leveled out a little bit. There isn't, I don't think, I wouldn't necessarily rule out a certain manufacturer with music anymore. That used to definitely, definitely be the case. But now with a lot of their new chips, they're all employing some of these microphones with better ways to tolerate loud sounds.

Doran: For sure. Now, what about refreshing your hearing aids? Linda's asking her hearing aids are five years old? Should she look at new ones? Or what do you usually recommend for the age of what you're wearing?

Dr. Erin Wright: Well, that's a good question. I mean, the average age of people replacing their hearing aids would be five years old. But that would be an average. So I would say to anybody in that situation to look at how they're doing with their hearing aids. If their hearing aids are five years old, and they're not feeling like they're having any trouble. They've seen their audiologist. They've had those hearing aids checked and programmed to make sure that they're fitting their hearing loss. And if they're doing well with their hearing aids, that's great, then their problems are solved. If they're struggling with their hearing aids and finding they're asking for repetition, or finding the sound quality is tinny or harsh or annoying in any way, then there's definitely room for improvement and they could try different technology.

Doran: Yeah, so again, people are curious about the price. Can you give us a quick range about what hearing aids cost for a very entry level to the latest technology of bells and whistles?

Dr. Erin Wright: Sure, that's a good question. The very basic entry level technology is going to cost around $1,750 per hearing aid. And most people need them in both ears. So you're looking at $3,500. There's no tax on hearing aids. But that would be generally the price, and there's a lot that goes into those hearing aids. Those hearing aids are connected to Bluetooth, they're rechargeable, they're excellent. They've got excellent quality hearing aids with some features like impulse noise management. So, at $3,500 you're still getting a good product. The very premium, the most expensive hearing that we have is going to be about $2,850 each. Those would be some of the newer technology like that Oticon More hearing aid with that deep learning deep neural network that is employing some new features to help the hearing aid better analyze the environment around them, and make decisions about how to process a signal in noise.

So, the difference between any level of hearing aid really boils down to one feature, which is how does the hearing aid deal with a complex environment. And I hate using the word noise because a lot of people interpret that word to mean something annoying like traffic or a blender or a vacuum or people say to me concerts, that kind of thing. It's not noise as much as competing signals. So you might be in an environment where you're talking on the phone and you've got a TV, you've got a competing signal here. How does the hearing aid know you want to hear this and not that. And especially when that competing signal is also speech. So a classic environment would be like a cocktail party where there's a lot of noise, but that noise is people talking speech. So there's this speech that you want to hear and that speech that you don't want to hear. And that's a complex task that our brain does. And so some of the hearing aid technology is better than others at helping somebody focus in that particular environment.

Doran: Yeah, for sure. Now, that's a good time to set people's expectations, right? People want to put hearing aids in and have the hearing of an 18 year old normal hearing. We both know that shouldn't be the expectation. So, you're dealing with auditory processing, as much as what's going on just right inside the ear. It's the whole systems.

Dr. Erin Wright: Yeah, that's right. So, I mean, hearing aids are addressing one third of the problem. And that third is damage to those cochlear hair cells. And so, hearing aids are addressing one third of the problem. The other third is listening, and the other third is processing. So all of those things have to be firing in order for somebody to understand a message. So, a lot of people have the most difficulty hearing their primary communication partner because they might be at home reading the newspaper, and their spouse walks in and says, "Do you want to go for a walk?" And then the person with hearing loss will turn on, realize they're talking, know there's something about going for a walk, but maybe just missed out one word. And say, "Are you asking me to go with you? Or are you just telling me that you're going for a walk?" And then it just turns into a what?

So, the listening aspect of that is that the partner says, "Honey, yes." Allows that person to focus their attention, and get that listening aspect of the piece in order, then they say, "Do you want to go for a walk?" Now we're dealing with the hearing aids and the actual amplification of that person's voice, and getting that full signal to the brain. Maximizing your hearing is what we're dealing with as audiology with hearing aids. We're maximizing that third of the issue. The other third is about processing. So, processing is how well does your brain fill in the blanks.

So my best analogy around processing is looking at the TV show Wheel of Fortune, where sometimes you can see people who get the word when they only have two letters. And you think, "How on Earth did that person know that that word was banana when there was only one and in there?" And it wasn't that they saw it any better. It's that their visual cortex can fill in the blanks. And the auditory cortex is the same structure. So when you're not hearing the whole signal as you don't when you have hearing loss, we rely on the brain or the auditory cortex's ability to fill in the blanks. And so, for people who've had untreated hearing loss for a long time or degenerative auditory processing issues, there is more issues around filling in the blanks, so they might need 90% of that signal in order to understand the message.

If you have questions about this presentation, or want to speak with an Audiologist about about tinnitus treatment programs, please call: Broadmead Hearing Clinic: 250-479-2969 or Oak Bay Hearing Clinic: 250-479-2921. Or request an appointment online.