Clinical Practice Patterns of Fitting Advanced Device Features in Children With Cochlear Implants

Purpose: The purpose of this study was to identify common clinical practice patterns for providing advanced noise management features in children with cochlear implants (CIs) and evaluate trends in consideration of clinician experience and comfort with CI manufacturer-specific technology. Method: A mixed-model survey including quantitative and qualitative questions regarding providing advanced noise management features in the pediatric CI population was collected electronically via research electronic data capture. Survey questions spanned approach/philosophy toward provision of features, age of provision, and demographics of respondents. Descriptive statistics were completed to define common clinical practice patterns and demographic information. Results: A total of 160 pediatric audiologists from 35 U.S. States and five Canadian provinces completed the survey. Most audiologists (73.8%) reported enabling automatic directional microphones, and a vast majority (91%) reported enabling advanced noise processing features such as automatic noise cancellers, wind noise cancellers, and impulse noise cancellers in recipients' main programs. Audiologists ranked features in terms of importance for a school-age child with the top three ranked as automatic noise reduction, automatic directional microphones, and concha-level microphones. Importance of child-specific factors varied depending upon the specific feature of interest. Conclusions: Variability exists among providers in enabling advanced noise management features for pediatric CI recipients. Multiple factors, including patient characteristics, provider characteristics, and limited evidence-based guidance, could account for much of the variation. Overall, there is a trend toward automaticity for noise management. Additional studies are warranted to provide the evidence base for confidently programming advanced features for children using CIs.

Hearing Aid Selection: Closed- versus Open-canal Fitting Hearing Aids

To select hearing aid is an essential process for successful hearing rehabilitation. The purpose of this study is to review hearing aid selection considerations between receiver in-the-canal (RIC) and custom hearing aid (CHA) in order to guide appropriate selection of the hearing aid. This study discussed three key factors in the hearing aid selection including physical, acoustic and electroacoustic characteristics and other aspects. Advantages of RIC types are comfort to wear, reduction of the occlusion effect, presence of directional microphones, on-site fit, easy connectivity with other devices, and use of rechargeable batteries. On the other hand, the CHA types have their advantage in terms of being comfort to wear with masks, proper insertion and placement, reduction of the acoustic feedback, good approximation of frequency response curve, improvement of speech in noise perception, expanded hearing aid candidacy with varying hearing thresholds, and easy telephone use. We concluded that appropriate selection of the hearing aid would contribute to successful hearing rehabilitation, if considering physical, psycho-social, and acoustical characteristics.

Cochlear Implant Research and Development in the Twenty-first Century: A Critical Update

Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The review focuses on the processing, stimulation, and audiological methods that have been used to try to improve speech perception by human CI listeners, and on fundamental new insights in the response of the auditory system to electrical stimulation. The introduction of directional microphones and of new noise reduction and pre-processing algorithms has produced robust and sometimes substantial improvements. Novel speech-processing algorithms, the use of current-focusing methods, and individualised (patient-by-patient) deactivation of subsets of electrodes have produced more modest improvements. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of promising technologies that are currently being developed in animal models, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.

Hearing Aid Technology to Improve Speech Intelligibility in Noise

Understanding speech in noise is difficult for individuals with normal hearing and is even more so for individuals with hearing loss. Difficulty understanding speech in noise is one of the primary reasons people seek hearing assistance. Despite amplification, many hearing aid users still struggle to understand speech in noise. In response to this persistent problem, hearing aid manufacturers have invested significantly in developing new solutions. Any solution is not without its tradeoffs, and decisions must be made when optimizing and implementing them. Much of this happens behind the scenes, and casual observers fail to appreciate the nuances of developing new hearing aid technologies. The difficulty of communicating this information to clinicians may hinder the use or the fine-tuning of the various technologies available today. The purpose of this issue of Seminars in Hearing is to educate professionals and students in audiology, hearing science, and engineering about different approaches to combat problems related to environmental and wind noise using technologies that include classification, directional microphones, binaural signal processing, beamformers, motion sensors, and machine learning. To accomplish this purpose, some of the top researchers and engineers from the world's largest hearing aid manufacturers agreed to share their unique insights.

Increasing the Effectiveness of Hearing Aid Directional Microphones

Directionality is the only hearing aid technology — in addition to amplification — proven to help hearing aid users hear better in noise. Hearing aid directionality has been documented to improve speech intelligibility in multiple laboratory studies. In contrast, real-world studies have shown a disconnect between the potential of the technology and what hearing aid users experience in their daily life. This article describes the real-world studies that inspired ReSound to take a different approach to applying directional microphone technology. This approach is based on the idea that hearing aid directionality can leverage natural binaural hearing and inherent listening strategies. The directional strategy includes three listening modes that will be explained. These are the Spatial Cue Preservation mode, the Binaural Listening mode, and the Speech Intelligibility mode. The strategy and the advantages it provides in terms of sound quality, spatial hearing, and improved signal-to-noise ratio with maintained awareness of surroundings are explained.

Cochlear implant research and development in the 21st century: A critical update

Cochlear implants (CIs) are the world’s most successful sensory prosthesis and have been the subject of intense research and development in recent decades. We critically review the progress in CI research, and its success in improving patient outcomes, from the turn of the century to the present day. The introduction of directional microphones and of new noise-reduction and pre-processing algorithms have produced robust and sometimes substantial improvements. Improvements from novel speech-processing algorithms, the use of current-focussing methods, and individualised (patient-by-patient) de-activation of subsets of electrodes have been identified but have been more modest. We argue that incremental advances have and will continue to be made, that collectively these may substantially improve patient outcomes, but that the modest size of each individual advance will require greater attention to experimental design and power. We also briefly discuss the potential and limitations of revolutionary technologies, and suggest strategies for researchers to collectively maximise the potential of CIs to improve hearing in a wide range of listening situations.

METHODS OF COUNTERING INTELLIGENCE USING SMALL-SIZED UNMANNED AERIAL VEHICLES

Small-sized aircrafts are increasingly used for espionage or intelligence. This is due to their small size, which gives them the advantage of being unnoticed. Easily carried in a backpack or bag, they can be launched almost anywhere in the world. Drones easily provide the collection of useful information with the help of technical means installed on them, it can be both cameras that have high resolution, and directional microphones that collect the recording of confidential information for tens of meters from the object of intelligence. All this poses a threat to the inhabitants of all countries of the world. In this article, a study is conducted on possible methods for detecting small-sized aircrafts, general effectiveness of these methods is evaluated, and it’s concluded that passive radar is a promising method of countering and detecting unmanned aerial vehicles.

Coupled D33 Mode-Based High Performing Bio-Inspired Piezoelectric MEMS Directional Microphone

Microelectromechanical system (MEMS) directional microphones have been identified as having use in multi-projected virtual reality applications such as virtual meetings for projecting cameras. In these applications, the acoustic sensitivity plays a vital role as it biases the directional sensing, signal-to-noise ratio (SNR) and self-noise. The acoustic sensitivity is the multiplied outcome of the mechanical sensitivity and the electrical sensitivity. As the dimensions are limited in MEMS technology, the improvement of the acoustic sensitivity by reflecting the mechanical as well as electrical domains is a challenge. This paper reports on a new formation of the D33 mode, the coupled D33 mode, based on piezoelectric sensing to improve the acoustic functionalities. The unique advancement of the proposed D33 mode is that it allows multiple spans of the regular D33 mode to perform together, despite this increasing the diaphragm’s dimensions. At a reduced diaphragm size, the orientation of the coupled D33 mode realizes the maximum conversion of the mechanical deflection into electrical sensitivity. The significance of the proposed D33 mode in comparison to the regular D33 mode is simulated using COMSOL Multiphysics. Then, for a proof–of–concept, the experimental validation is carried out using a piezoelectric MEMS directional microphone inspired by the ears of the fly Ormia ochracea. In both ways, the results are found to be substantially improved in comparison with the regular approach of the D33 mode, showing the novelty of this work.