hearing health foundation
Winter 2018
1958-2018
60 years strong
A Publication of Hearing Health Foundation
hhf.org
The Technology Issue Grounded on Earth by a hearing loss, K. Renee Horton, Ph.D., soars as a NASA engineer
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letter from the ceo
DEAR READERS & SUPPORTERS, happy 201 8! we are thrilled to put this first issue of the new year in your hands, as 2018 is very special for us: We are celebrating 60 years of Hearing Health Foundation (HHF). Our founder, Collette Ramsey Baker, wanted to give back to hearing and balance scientists, because research led to the development of a surgery that restored her hearing. “I can hear the grass grow!” she exclaimed after undergoing fenestration surgery in 1956—and two years later, in 1958, Deafness Research Foundation (now HHF) was born. Dynamic, determined, and energetic, Ramsey Baker harnessed her network of finance and industry chief executives and connected them to leading medical experts in order to launch HHF. On page 19, read about Ramsey Baker and the deep roots HHF shares with the medical community, especially through The Centurions, doctors who pledged to cover HHF’s administrative costs so that all donated funds could go directly to research. Now, in our sixth decade supporting innovative research, HHF is happy to announce two new grants for scientists investigating Ménière’s disease, an inner ear and balance disorder whose symptoms can include debilitating vertigo attacks. Gail Ishiyama, M.D., and Ian Swinburne, Ph.D., are making significant strides in figuring out its causes and, as a result, pathways for treatment. Read about their project plans on page 32, followed by summaries of the latest published research by our Emerging Research Grants scientists (pages 33 to 37) and an update from our Hearing Restoration Project consortium (pages 38 and 39). These eight pages underscore HHF’s continued dedication to fund groundbreaking science, especially at a time when other funding sources for research are becoming scarce. We also want to bid adieu to Laura Friedman, HHF’s communications and programs manager, whose three years of energy and commitment to so many aspects of our operation brings to mind the passion of HHF’s earliest advocates and our mission to prevent and cure hearing loss and related conditions. We wish Laura the
“To each who has joined our crusade to bring new hope to those now deafened and to spare future generations from this isolating affliction, we offer our prayerful thanks on their behalf.” — Collette Ramsey Baker, HHF’s founder, in 1961 absolute best on her new adventure (read about her participation in the Ida Institute’s conference to improve hearing healthcare on page 40). As we embark on our next 60 years, I echo Collette Ramsey Baker, who said in 1961, “To each who has joined our crusade to bring new hope to those now deafened and to spare future generations from this isolating affliction, we offer our prayerful thanks on their behalf.” We look forward to sharing more celebrations and remembrances as 2018 continues. Happy New Year and thank you for your support of our life-changing work!
Nadine Dehgan CEO, Hearing Health Foundation ndehgan@hhf.org
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HEARING HEALTH The Technology Issue Publisher Nadine
A revolution in audio technology plus the need for more affordable, accessible hearing devices suggest a future with greater options—so everyone can treat their hearing loss.
Dehgan CEO, Hearing Health Foundation Editor Yishane
Lee
Art Director Robin Senior Editors
Kidder
Laura Friedman, Amy Gross
Medical Director David
Features 06 Living With Hearing Loss Charting Her Own Flight Plan. Kellie M. Walsh 10 Living With Hearing Loss What Over-the-Counter Hearing Aids Mean to Me and Millions of Others With Hearing Loss. Suzanne Oehler
24 Music Why Does It Always Have to Be So Loud? Thomas Kaufmann Concerts for All. Katelyn Serpe 28 Education It’s (Still) a Noisy Planet. Phalla Messina Pass the HAT. Janice Beetle 32 Research 2018 Funding for Ménière’s Disease Investigators.
14 Managing Hearing Loss Wireless Bluetooth Earphones as Hearing Aids? Richard Einhorn
33 Research Recent Research by Hearing Health Foundation Scientists, Explained.
18 Family Voices The Next Two Million Days. Lauren McGrath My Ears Don’t Work, But My Implants Do. Caroline Oberweger
39 Research The Hearing Restoration Project Stays the Course. Peter Barr-Gillespie, Ph.D.
22 Hearing Aids Small Solution, Big Impact. Apoorva Murarka
40 Hearing Health Person, First. Laura Friedman 41 Research Next Generation. Tsering Shola
Departments
Sponsored
03 Letter From the CEO
45 Advertisement Rechargeable Hearing Aid Batteries: What You Need to Know.
19 Planned Giving 42 Roundup Talking Tech. 50 Meet the Researcher Jennifer Resnik, Ph.D.
46 Advertisement Tech Solutions. 49 Marketplace
S. Haynes, M.D.
Staff Writers
Barbara Jenkins, Au.D.; Emily L. Martinson, Au.D., Ph.D.; Kathi Mestayer; Pranav Parikh; Carol Stoll; Kathleen Wallace Advertising
advertising@hhf.org, 212.257.6141 Editorial Committee
Peter G. Barr-Gillespie, Ph.D.; Robert A. Dobie, M.D.; Judy R. Dubno, Ph.D.; Melissa E. Heche, Au.D.; Anil K. Lalwani, M.D.; Joscelyn R.K. Martin, Au.D. Board of Directors
Elizabeth Keithley, Ph.D., Chair; Sophia Boccard; Robert Boucai; Noel L. Cohen, M.D.; Judy R. Dubno, Ph.D.; Ruth Anne Eatock, Ph.D.; Jason Frank; Roger M. Harris; David S. Haynes, M.D.; Anil K. Lalwani, M.D.; Michael C. Nolan; Paul E. Orlin; Robert V. Shannon, Ph.D. 363 Seventh Avenue, 10th Floor New York, NY 10001-3904 Phone: 212.257.6140 TTY: 888.435.6104 Email: info@hhf.org Web: hhf.org
Hearing Health Foundation and Hearing Health magazine do not endorse any product or service shown as paid advertisements. While we make every effort to publish accurate information, we are not responsible for the correctness of information herein.
Hearing Health Foundation is a tax-exempt, charitable organization and is eligible to receive tax-deductible contributions under the IRS Code 501 (c)(3). Federal Tax ID: 13-1882107
Cover Space Launch System engineer K. Renee Horton, Ph.D.,
Hearing Health magazine (ISSN: 0888-2517) is published four times annually by Hearing Health Foundation. Copyright 2018, Hearing Health Foundation. All rights reserved. Articles may not be reproduced without written permission from Hearing Health Foundation. USPS/Automatable Poly
at NASA’s Michoud Assembly Facility in New Orleans.
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cover photo credit: steven seipel/nasa
Winter 2018, Volume 34, Number 1
Charting Her Own Flight Plan A hearing disability grounded K. Renee Horton, Ph.D., from going into space, but it didn’t stop her from realizing her dream of working at NASA. By Kellie M. Walsh, Folks (folks.pillpack.com)
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for as long as physicist k. renee horton, ph.d., can remember, she has wanted to be a scientist. Every Christmas growing up, in fact, the young Horton taxed both Santa’s wallet and patience with her enthusiasm for STEM (science, technology, engineering, and math). “I would say, ‘I only want a telescope.’ Or, ‘I only want a microscope.’ My dad kept saying, ‘Is there nothing else? You need to give Santa a range here,’” she says. “I’m almost certain when my parents’ egg and sperm met, one of them said, ‘I’m going to be a scientist,’ and the other one said, ‘I’m going to make that happen.’ It was in my core.” Horton is the Lead Metallic and Weld Engineer for the Space Launch System (SLS) at NASA’s Michoud Assembly Facility in New Orleans. Designed to enable deep-space exploration, the SLS will be the largest, most powerful rocket ever built.
living with hearing loss
photo credit: steven seipel/nasa
Horton breaks every fusty mold of the white male scientist stereotype.
“My job is to make sure that the welds and anything metal on the [SLS] rocket are good after we’ve built and put it together,” she says. “I am the person who oversees the requirements that deal with metals and welds.” It’s impossible not to think of the 2016 book and film “Hidden Figures,” about the previously unrecognized group of black women who worked as “human computers” and were essential to NASA’s achievements in the 1960s. As a black woman in STEM and one of the self-described “SLS boots on the ground,” Horton and her work at NASA will be instrumental in sending the first human beings to Mars. Factor in that she’s also a bald, hardof-hearing, former college dropout, and mother of three, and Horton breaks every fusty mold of the white male scientist stereotype. But doing so hasn’t been easy, particularly where her hearing was concerned. “I have a disability that you don’t see,” Horton says. “If somebody’s in a wheelchair, you think, ‘Oh, they need a ramp.’ But if I tell you I need CART services [real-time captioning], you’re looking at me like, ‘Are you privileged or entitled?’ So there were things I just didn’t do for a very long time. Then I woke up one morning, and said, to hell with this. The world is going to give me what’s mine.”
The Right Stuff
A Baton Rouge native, Horton describes her condition as hearing loss in both ears, with the right being more pronounced. She can hear most sounds at high and low frequencies, but has trouble in the speaking range, making conversation and active listening challenging. While representation and access for people with disabilities in STEM fields remains low, Horton says NASA in particular is “very good” about hiring and accommodating people with disabilities. In fact, the level of accommodations NASA provides impressed her so much as an intern that she “knew NASA was the place for me.” Horton completed her dissertation work with NASA and got her first industry job out of grad school there as a mechanical test engineer in 2012. She’s been with the organization ever since. Horton spends much of her workday in office environments, so her personal accommodation needs at NASA are low. She wears digital hearing aids, and most of her colleagues, she says, are “very accommodating” when asked to repeat something or share notes in meetings. When Horton visits remote sites, such arrangements are harder to come by, and she must often remind her colleagues of practical realities. “I can’t be the secretary, guys,” Horton says. “I don’t even make it a
“I have a disability that you don’t see,” Horton says. “If somebody’s in a wheelchair, you think, ‘Oh, they need a ramp.’ But if I tell you I need CART services [real-time captioning], you’re looking at me like, ‘Are you privileged or entitled?’ So there were things I just didn’t do for a very long time. Then I woke up one morning, and said, to hell with this. The world is going to give me what’s mine.” a publication of hearing health foundation
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“Every day we’re doing something that’s moving toward history. It’s really an amazing feeling to be a part of it. That’s my rocket that’s in there.”
hearing health foundati o n
woman issue. You don’t ask the deaf person to be the person to take the notes.” She must also be particularly vigilant when navigating Michoud’s industrial plant (where the SLS is being built), an environment much larger and louder than your average office space. “I have to be more aware of my surroundings in the factory because the noise drowns out voices most times. I do a lot of lip reading when out in the factory,” she says. “Sometimes I have to remind those I work with that I am hearing impaired so that they face me when speaking. I am also very aware of where I sit in certain situations.” Despite these necessities, however, that factory environment—or rather, what it contains—is part of what drew Horton to Michoud in the first place. “I would come down here to visit [Michoud], and I would be sick or crying when it was time to leave. I wanted be with the hardware. I wanted to see it every day,” she says. “I love SLS. Every day we’re doing something that’s moving toward history. It’s really an amazing feeling to be a part of it. That’s my rocket that’s in there.”
Grounded
Horton’s journey to Michoud, however, was very nearly scrubbed before it began. As a young child, Horton’s hearing loss meant she tended to shout when speaking and had trouble following teachers’ instructions. No one thought at the time to test her hearing. Instead she was labeled with the then-common term “retarded” and placed in special education classes. “I was constantly yelling to hear myself, so they taught me how to speak and not to yell,” she says. “They also got rid of my Louisiana drawl accent and taught me not to talk with that clipped sound that people who are hearing impaired end up with.” Horton’s speech therapist recommended she be transferred out of remedial classes and tested for the gifted program instead. The move aligned well with Horton’s strengths: While she had difficulty comprehending and interacting in the traditional classroom, she excelled at the gifted program’s independent study format. Despite this initial hiccup, Horton 8
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Horton is working on NASA’s first deepspace launch project since Apollo.
advanced quickly through her education, finishing high school at age 16. By then she had her cosmic career plan all worked out: join the Air Force, then proceed on the path to becoming an astronaut. “I didn’t know anything else,” she says, “but I wanted to work for NASA.” However, her plans went into free fall when she failed the hearing test of a routine Air Force ROTC physical. Horton had already been struggling in her undergraduate courses at Louisiana State University (LSU) because of her as-yetundiagnosed hearing condition. The results of that hearing test knocked her completely off her trajectory. Because of her hearing, Horton was disqualified from becoming a pilot. And, by extension, an astronaut. “I didn’t know who I was anymore,” she says. “My whole life had crashed in front of my eyes before I turned 18.” Horton says she thought at the time, “Maybe I’m not whole as a person. Maybe God doesn’t love me because He did this to me. Maybe I’m not worthy because I’m defective.” Lost and frustrated by her lot in life, Horton dropped out. She got married, had three children, worked odd jobs. As for her newfound disability, she decided “to ignore it”—a choice, she admits, that affected not only her studies but her marriage as well. But she didn’t give up science forever. In 2000, now divorced and raising three children between the ages of
living with hearing loss
“I wanted what was inside of me fundamentally more than I wanted to allow the hearing impairment to stop me,” she says. “So I looked for ways to be able to be successful.” 1 and 9, Horton returned to LSU. The technology and services existed to support her and accommodate her disability. She just had to ask for them. “I remember walking into the vocational rehabilitation center in Baton Rouge and telling them I wanted to go back to college, but my ears were broken,” Horton says. “I was 27. It took me 10 years to accept my ears were broken and needed help—10 years.”
photo credit: steven seipel/nasa
A New Mission
At LSU Horton got her first pair of hearing aids, early analog devices that she describes as “huge.” “It looked like a big bug was behind my ear,” she says, “so I grew my hair to cover it.” In addition, LSU provided Horton the use of an assisted listening system, in which lecturers wear a special microphone that pipes their speech directly into a pair of earphones. This second time around, Horton also chose to play to her strengths, focusing her studies on programs that emphasized reading-based learning over heavy lectures. “I wanted what was inside of me fundamentally more than I wanted to allow the hearing impairment to stop me,” she says. “So I looked for ways to be able to be successful.” Crediting this newfound combination of adaptability and acceptance—plus the support of her children and a lot of hard work—Horton graduated LSU with a bachelor’s degree in electrical engineering. A few years later, she became the first African American to
earn a Ph.D. in materials science from the University of Alabama. Horton now travels regularly doing speaking engagements and outreach to help others pursue and succeed in STEM, and posts regular affirmations on Twitter. In 2017 she also started a nonprofit organization called Unapologetically Being to help others feel confident about themselves and about requesting accommodations. In that vein, she has since stopped hiding her hearing aids. Three years ago, in solidarity with an aunt with cancer, Horton shaved her head. Leery of the results at first, she caught sight of herself—hearing aids and all—in the mirror one day, glowing, and realized, “I was 40-something, and I was looking at Renee for the first time.” The style has stuck ever since. As for her childhood dreams, Horton never got to become an astronaut, but she did land that dream job at NASA. And she—at least her name—has already traveled to space. Just months after returning to NASA after graduation, she was assigned to Orion Multi-Purpose Crew Vehicle/ Stage Adapter project, the vehicle that will carry the crew via the SLS to Mars, and NASA’s first deep-space launch since Apollo. As part of the project team, Horton was able to write her name—as well as those of her parents, children, and sister— on the Orion vehicle itself. The Orion test-flight launched in December 2014. “I was all giddy like a kid that my Christmas gift had finally come,” she says. “My name got to go into space. It was my way of going into space.”
This story was originally published on Folks, an online magazine dedicated to telling the stories of remarkable people who refuse to be defined by their health issues. Read more at folks.pillpack.com. Follow K. Renee Horton, Ph.D., on Twitter @ reneehortonphd. For references, see hhf.org/winter2018-references. Horton is a part of HHF's Faces of Hearing Loss campaign, a collection of photos featuring individuals with hearing loss, tinnitus, or related conditions. In showing how hearing loss can affect anyone, the portraits promote awareness and education. Learn more at hhf.org/faces.
Share your story: Have you overcome hearing loss obstacles and achieved a dream? Tell us at editor@hearinghealthmag.com. Support our research: hhf.org/donate
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WHAT OVER-THE-COUNTER HEARING AIDS MEAN TO ME AND MILLIONS OF OTHERS WITH HEARING LOSS By Suzanne Oehler
The Consumer Technology Association released its official logo for certified over-thecounter hearing aids (above) in June 2017.
i was in a sound booth. not recording a song or being interviewed on the radio. The kind of sound booth that would jolt my world. The audiologist said to put on the headphones, just like the ones I had donned so many times as a kid to test my hearing. “Press the button when you hear a sound,” she said. I waited and waited, the room closing in on me. I willed the sound to enter my ears, so much so that my mind started playing tricks on me. Finally, I pressed the button, hearing the faintest sound, relieved that I heard something, anything. “I’m sorry, could you repeat that?” “Could you say that again, please?” These were becoming common questions from me, often with a slightly frustrated tone. I have always been challenged by mumblers. Now, I couldn’t make out what my colleague on the other end of the conference table was saying. In the audience of a trade event, I could barely hear the panelists. Nearly everyone became a mumbler to me, even my 8-year-old son. That is, before I realized in the sound booth that day that I was the problem.
The Diagnosis, and Treatment
Otosclerosis was the diagnosis I received to explain my moderate hearing loss at age 38. I was mother of two young kids, a wife, and a professional. My world was turned upside down. I had visions of my 90-year-old grandma with large, puttybeige hearing aids asking me, “What’s that, honey?” and, other times, turning the hearing aids off so she couldn’t hear Grandpa. This “old people’s issue” was now my issue. It affected every aspect of my life. Missing words while chitchatting with 10
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a cashier (as I smiled and pretended), squinting and leaning in trying not to miss important business communication (usually failing), and reading lips (poorly) became my new normal. Instead of feeling frustrated having to ask people to repeat themselves over and over, I now recognized their overt frustration with me over that same request. I’ve learned that ailments and disabilities that can’t be seen aren’t always received with patience. They attract impatience from even your closest friends and family. And I was too scared and embarrassed to tell strangers and friends that I had a hearing problem. I couldn’t come to grips with the surgical option recommended to me by my doctor: Remove the tiny stapes bone in each ear by laser and replace each with titanium prostheses. Fear won over, as I thought: “I could die on the table and leave my children motherless. I could lose my hearing completely. I can live with this.” I tried the backup option, hearing aids. A little smaller and more advanced than those Grandma wore, I gave them my best shot for a week. My hearing improved, but these out-of-pocket, $7,000 devices didn’t fit my lifestyle (I exercise regularly) or my image (I thought they looked obvious when I put my hair up). I constantly fiddled to get the volume right and worried about staying on top of charging them—a simple task I couldn’t even handle for my iPhone. As a result, I overcame my fear and had the surgery. With the support of my husband and kids, I recovered without issue. Next time I found myself in that sound booth, I rocked it. New prognosis: typical hearing, both ears! Now, when my kids claim, “I answered
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you already, Mom!” I remind them that I have bionic hearing. I don’t miss important details in meetings anymore. The TV no longer has to be set on the highest volume. And I have much greater empathy for people challenged with hidden disabilities.
My Story Is Not Unique
Audio is undergoing a significant technological revolution. Headphones are no longer merely passive, allowing you to listen to music and talk on the phone— but active, connecting you to your world.
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Nearly 48 million Americans experience some degree of hearing loss, including young adults. I’ve heard personal stories from many women and men in their 30s and 40s suffering like I did. They are told their options are to get hearing aids—which may not be covered by their insurance plans—or to continue missing key sounds. This is where the “hearables” trend in consumer electronics comes in. Audio is undergoing a significant technological revolution. Headphones are no longer merely passive, allowing you to listen to music and talk on the phone—but active, connecting you to your world. Imagine wireless earbuds able to reduce ambient noise in a crowded restaurant and to zero in on every word, all controlled through adaptive programming and via an app on your smartphone. This is available today for $300 a pair versus $7,000 for two hearing aids. The August 2017 Food and Drug Administration (FDA) Reauthorization Act includes the Over-the-Counter Hearing Aid Bill, giving the green light for the development and launch of OTC hearing aids (also known as personal sound amplification products, or PSAPs). But remember that hearing is not a “onesize-fits-all” proposition. Today’s hearing aids are sophisticated computers that are carefully calibrated to individual hearing needs, requiring that a patient make follow-up visits, in person, to their hearing healthcare professional. Hearing self-diagnosis and selfprescription is a slippery slope, whereby consumer expectations can be set—but missed—without the hands-on care of a hearing provider. If you suspect a hearing loss, ruling out a serious medical cause should always be the first step, with a trip to a medical professional such as an
audiologist or an ear, nose, and throat specialist (ENT or otolaryngologist). Mainstreaming augmented hearing could create new patient challenges. It’s time we enable better hearing for the masses, and with the passage of the bill the FDA will be able to draft rules and regulations to oversee this new category of more affordable hearing options and, most importantly, make sure consumers are fully protected. OTCs have the potential to be big business. The Consumer Technology Association has already announced the official logo for certified OTC hearing aids. The onus is on manufacturers to produce meaningful gateways to hearing, and not just tech gadgets that pump up the volume. The audio world is transforming into something not just of convenience and fashion, but of life-altering value for millions of people suffering through hearing loss, like I did. Here’s hoping that with greater access to hearing technology, we all can have bionic hearing. Based in the San Francisco Bay area, Suzanne Oehler is a business leader and startup adviser with more than 15 years in consumer tech sales and marketing. This article was adapted from an original blog post at suzanneoehler.com. For references, see hhf.org/winter2018-references.
Share your story: What do over-thecounter hearing aids mean to you? Tell us at editor@hearinghealthmag.com.
Support our research: hhf.org/donate
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CAN WIRELESS BLUETOOTH EARPHONES ACT AS HEARING AIDS? Not yet. A longtime user of consumer technology for managing his hearing loss and music career shares his perspective. By Richard Einhorn
The sound delay when using AirPods is not noticeable when streaming music.
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latency and therefore they too can be used for real-time hearing assistance. I find an iPhone, a good hearing app like Jacoti ListenApp or EarMachine, and wired earphones to be a very effective combination, especially when my hearing aids might not work as well as I’d like—in noisy New York City restaurants, for example. (Full disclosure: I consult for Jacoti.) Although the processing within a hearing app does add more delay, the total latency can still be as low as 16 ms., which is still quite an acceptable amount of latency. Bluetooth earphones—which add a lot of delay—are another story. Bluetooth is a specific method used to send and receive information between two devices wirelessly. Bluetooth can be quite flexible and has many applications, but we’ll just focus on one here: transmitting sound between a smartphone and wireless earphones.
When the sound is live— when, say, an electronic device like a hearing aid is being used to hear someone speaking directly in front of you— every fraction of a second of electronic delay counts. Depending on the earphone manufacturer, Bluetooth can add 60 to 80 ms. of delay. Therefore, if you use a pair of standard wireless Bluetooth earphones instead of the wired earphones in the example above, you will get—at the very least—nearly double the acceptable amount of latency. In fact, for AirPods, and for some other Bluetooth earphones with a similar design, it’s actually much worse than that. Unlike in a hearing aid, the AirPods’ mic isn’t connected directly to its miniature speakers. Instead, the AirPods’ mic transmits to the phone over Bluetooth.
photo credit: istockphoto.com
let’s cut to the chase: despite what you may have heard, you can’t use Apple’s AirPods as hearing aids. Nor can you use conventional wireless earphones for realtime hearing assistance. This is due to the limitations of Bluetooth wireless technology and the delay it introduces when transmitting sound wirelessly. Sound takes time to travel through any electronic device. To hear your friend on a smartphone, for example, the call needs to be received by the phone, processed, digitally decoded, and amplified. While all of this happens very quickly, within thousandths of a second, it does still take time. When you can’t see the person who’s making the sound—which is typically the case when using smartphones for phone calls or audio streaming—the sound delay is usually not noticeable. But when the sound is live—when, say, an electronic device like a hearing aid is being used to hear someone speaking directly in front of you—it’s a totally different story. In that case, every fraction of a second of electronic delay counts. Why? If it’s delayed too much, the sound will be out of sync with the lips of the person speaking, significantly reducing speech comprehension. Also, hearing your live voice and the reproduced voice at nearly the same—but not exactly the same—time, can be so disorienting that it becomes all but impossible to communicate. In general, the longest acceptable delay a hearing device can have is about 40 thousandths of a second (milliseconds, or ms.). In fact, most hearing aids have much less than half that amount of “latency,” which is the technical term for this kind of sound delay. With hearing aids, the latency is so low that it’s rarely (if ever) noticed. But some smartphones, specifically iPhones, also have very low
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So, if you’re using a hearing app with AirPods, the AirPods’ mic gets transmitted wirelessly to the smartphone, the sound gets processed on the smartphone’s app, and finally it gets transmitted wirelessly back to the AirPods. This multistep process increases the amount of latency. And when you add it all up, the best case, measured using an app that strongly implied it could “transform” AirPods into hearing aids, was 192 ms.—nearly five times greater than the maximum acceptable latency for real-time listening. In short, AirPods can’t be used as hearing aids. But Bluetooth-based options for hearing assistance can get confusing because there are a lot of product categories on the market. Here is a brief overview of some options. “Made-for-smartphone” hearing aids, like the ReSound LiNX, are standard hearing aids that include Bluetooth, enabling them to connect to your smartphone for phone calls, audio streaming, and basic adjustments (like changing presets on the aids). In this type of hearing aid, standard Bluetooth itself is not used for real-time hearing assistance. (A new cochlear implant processor, the Cochlear Nucleus 7, also uses Bluetooth for audio streaming and programming to an iPhone; as with made-for-smartphone hearing aids, Bluetooth is not used for real-time hearing assistance.) Personal sound amplifier products (PSAPs) that include Bluetooth connectivity, such as the Nuheara IQbuds or the Bose Hearphones, use Bluetooth in a manner similar to made-for-smartphone hearing aids. They can work as hearing devices for some people, but again their Bluetooth functionality provides only lifestyle features (like the audio streaming mentioned above). Consumer Bluetooth earphones such as AirPods provide wireless connectivity for phone calls and music but cannot be used for real-time hearing assistance. There is too much delay. Conventional wired earphones like those made by Apple, Etymotic, and Blue Ever Blue can be used with a smartphone and a good hearing app for effective hearing assistance. If you currently need hearing aids but thought you’d save some money by buying AirPods and using an app, I don’t recommend it. But in the future, it’s possible that Bluetooth latency will be reduced. And given that the Food and Drug Administration is now working on a category of hearing aids to be sold over the counter, it’s quite possible that we’ll see in the market soon AirPod-like devices that are actual hearing aids, without any noticeable sound delay. Richard Einhorn is a composer, record producer, and engineer who, after experiencing a sudden hearing loss in 2010, has used his background in professional audio to become an advocate and consultant for better hearing technology. He is the vice chair on the Hearing Loss Association of America’s Board of Trustees. For references, see hhf.org/winter2018-references.
Both the Cochlear Nucleus 7 (above) and the ReSound LiNX (below) can be connected to smartphones.
Share your story: Tell us about your experiences using apps, earphones, and other over-thecounter technology at editor@ hearinghealthmag.com.
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When your hearing aids connect directly to movie night,
life is on
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Ask your Hearing Care Provider for details. Discover more at www.phonak-us.com/audeo-b-direct or call 877-841-6510
*with Bluetooth® 4.2 wireless technology and most older Bluetooth phones © 2017 Phonak, LLC. All rights reserved.
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family voices
h earing health foundation
The Next Two Million Days A hearing aid manufacturer’s life-changing donation to a 6-year-old boy is priceless. By Lauren McGrath the future sounds clearer and looks brighter for Ethan, age 6, who recently began wearing ReSound LiNX 3D hearing aids recommended by his audiologist. His new hearing aids were very generously donated to him by ReSound. Ethan was born with mild-to-moderate hearing loss in his right ear and moderate hearing loss in his left. Thanks to universal newborn hearing screening legislation, an initiative promoted by Hearing Health Foundation and other organizations, Ethan was diagnosed at birth and able to receive immediate intervention. In 1993, only 5 percent of newborns were tested at birth for hearing loss; today 97 percent of babies are screened before they leave the hospital. Since age 6 weeks, Ethan has worn hearing aids and received speech therapy. He is now a happy first grader at a New Jersey school with many on-site services for students with hearing loss. Ethan is an older brother to twin girls, an avid selftaught reader, a math enthusiast, a soccer player, and a
Planned Giving for Hearing Research
martial arts student. He is ecstatic that his new hearing aids have already improved his life; from the moment he put them on, he noted how much more easily he could hear with them compared with his previous pair. He especially appreciates their small size; the devices do not impede his favorite activities and don’t fall out. As Ethan is easily overwhelmed by noise, he also likes that he can seamlessly adjust the volume on his hearing aids through the ReSound Smart 3D smartphone app. He’s so proud of their style and features that he brags about them to his soccer teammates. “Ethan asked me, ‘Can I wear my new hearing aids for the next two million days?’” says Jason, Ethan’s dad. It speaks volumes to Ethan’s experience that he is ready to make a 5,500-year commitment to his new hearing aids. At a young age, he is already on track to overcome the challenges associated with hearing loss. Ethan is confident about his hearing loss, and he and his family are thankful he was graciously provided with hearing devices that make him happy. Lauren McGrath is the marketing manager for Hearing Health Foundation.
“Through the generosity of planned gifts, Hearing Health Foundation (HHF) has been able to fund much of our research and education programs,” says Nadine Dehgan, HHF’s CEO. “We are grateful for those who give to create a meaningful, long-term impact on the future.”
If you wish to leave a planned gift, this can be done by designating “Hearing Health Foundation” as the beneficiary of your life insurance policy, or you can simply remember HHF in your will.
To learn more, visit hhf.org/how-to-help. Thank you for your ongoing support.
Those who may have already remembered us in their
Please let us know if you have remembered HHF in your estate plan so we may thank you and designate the gift in a manner you wish. Email us at development@hhf.org or call 212.257.6140.
estate plans through our former name, Deafness Research Foundation, should know that their gift will still go to Hearing Health Foundation.
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planned giving
In gratitude after a successful otosclerosis surgery, Collette Ramsey Baker created the Deafness Research Foundation, now known as Hearing Health Foundation.
HEARING HEALTH FOUNDATION CELEBRATES
60 YEARS
The legacies of Collette Ramsey Baker and Wesley H. Bradley, M.D., underscore the shared mission of Hearing Health Foundation and the medical community to support and fund groundbreaking scientific research. sixty years ago, collette ramsey baker founded Deafness Research Foundation, now known as Hearing Health Foundation (HHF). After living with a hearing loss for decades, she found relief through fenestration surgery, an early otosclerosis treatment. In gratitude, Ramsey Baker wanted to give back. Her daughter, Collette Wynn, says, “My mother made a promise that, if the operation worked, she would do something to support research to find the causes of deafness and develop better treatments.” HHF was launched in 1958. Ramsey Baker introduced her surgeon, Julius Lempert, M.D., who pioneered the fenestration surgery, and Walter Petryshyn, M.D., her otolaryngologist (ear, nose, and throat specialist), to finance and industry leaders, and from this talented group came HHF’s first Board of Directors, with Ramsey Baker becoming HHF’s president. In 2006, this magazine ran a profile of Ramsey Baker featuring the recollections of HHF’s early years from Wesley H. Bradley, M.D., a skilled surgeon who went on to lead what became the National Institute on Deafness and Other Communication Disorders (NIDCD). Bradley passed away in 2012, two years after Ramsey Baker. In the article, Bradley recounts how HHF’s mission so impressed Lempert that he spoke about the organization to leading otologists. “These individuals quickly saw the advantage of supporting a group that was firmly established to promote otological research,” Bradley said.
One early effort was the creation, in 1960, of a program to encourage people to donate their temporal bones to hearing science upon death. The National Temporal Bone Registry, now overseen by the NIDCD, has led to countless research breakthroughs. In 1963, physician support of HHF was formalized with the creation of The Centurions, a group of doctors who covered HHF’s administrative costs so all funds raised went directly to hearing research. Physicians also joined the board and launched the Emerging Research Grants program, which remains HHF’s flagship along with the Hearing Restoration Project research consortium. Bradley’s three-decade involvement with HHF, including as a founding Centurions member and medical director, was recognized with the Wesley H. Bradley, M.D., Memorial Grant, awarded to a promising ERG scientist in 2014. “I had the idea of honoring Wes’s work,” says Bradley’s wife, Barbara. “The many years he spent working at Deafness Research Foundation, it really was a labor of love. He believed very strongly in its mission.” Says Elizabeth Keithley, Ph.D., the chair of HHF’s Board of Directors, “Planned giving is a major component of HHF’s success today and into the future. It is with these achievements and many more in mind that we celebrate 60 years and look toward more groundbreaking discoveries in hearing and balance science.” Read more about Bradley in “A Family Gift” in the Fall 2014 issue and “A Tribute to Wesley H. Bradley, M.D.” in the Winter 2013 issue, both at hhf.org/magazine. Support our research: hhf.org/donate
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family voices
h earing health foundation
MY EARS DON’T WORK, BUT MY IMPLANTS DO
Caroline Oberweger with her family.
By Caroline Oberweger
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While the technology is a marvel of science, cochlear implants are also, for me, just pure magic. understand how my cochlear implants work. The very day my first implant got activated, a friend texted, “So, do you hear perfectly now?” I had to explain that, in fact, that first day I heard very poorly; it would take time, patience, and months of listening practice with a good speech-language pathologist before my brain would learn to process what initially sounded artificial and electronic as the normal, everyday sound of objects and voices. Is my hearing perfect today, five years postimplantation? No, but it’s pretty darn good. Especially considering that, after decades of moderate to severe hearing loss, today I have no natural hearing left at all. My ears don’t work. But my implants do, splendidly. And I couldn’t be happier. New York City resident Caroline Oberweger is Hearing Health Foundation’s development consultant. For references, see hhf.org/winter2018-references.
Share your story: Tell us how you explain your listening technology at editor@hearinghealthmag.com.
Support our research: hhf.org/donate
photo credit: carly jara
“no walkman in the water, ma’am.” I’m in my neighborhood park, about to go swimming in a New York City public pool. “Oh sorry,“ I stammer to the City Parks employee addressing me. “It’s not a Walkman. It’s a waterproof cochlear implant processor.” She looks at me like I’m speaking Greek. “No electronics in the water,” she repeats. “But it’s to help me hear,” I explain. She doesn’t budge. She doesn’t understand. I have to try another tactic. Deep breath. “I’m deaf. I cannot hear without this, so I need to wear it while I swim. It’s not a Walkman, see? It’s a magnet that goes on my head.” The word deaf gets her attention. Now she gets it. Here in front of her is a person with a disability. Here is a person using an accommodation. She knows she cannot stop me from using it. Looking embarrassed, she waves me through. I thank her and smile. In the five years since I’ve gotten my cochlear implants, one of the biggest challenges—or at least, one of the most unexpected ones—has been the need to explain the technology to others. Thanks to my long, thick hair, most of the time no one can see my implant processors at all. But when they can, the reaction is often one of bemusement or blankness. My experience with the City Parks employee was not the first one like that, or the last. Once, on vacation, someone asked me why I needed an MP3 player in the ocean. He thought I was listening to music. He didn’t understand that I was listening to the whole world. On a planet where only about a half million individuals out of 7.5 billion use a cochlear implant, ignorance of the technology is to be expected. And I’m proud to speak on its behalf, to explain why I need them and what they do, and to proclaim that while the technology is a marvel of science, for me it’s also just pure magic. I love making people smile when I tell them about the first time I heard the swish-swish that applying body lotion makes (a sound I never knew existed!), or how I learned that you don’t have to actually stand in front of the oven waiting for it to reach the desired temperature, because… Did you know there’s a beep? (They knew. I did not.) But it’s also frustrating at times. “I’m not tuning out my children,” I want to shout to those shooting a disapproving glance at that wire sticking out of my head. “I’m tuning in!” Even relatives and close friends did not, initially, quite
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1. Cochlear Limited. D1190805. CP1000 Processor Size Comparison. 2017, Mar; Data on file. 2. Cochlear Limited. D1182081. CLTD 5620 Clinical Evaluation of Nucleus 7 Cochlear Implant System. 2017, Mar; Data on file. ©Cochlear Limited 2017. All rights reserved. Trademarks and registered trademarks are the property of Cochlear Limited. The names of actual companies and products mentioned herein may be the trademarks of their respective owners. ©2017. Apple, the Apple logo, iPhone, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. The Nucleus Smart App is compatible with iPhone 5 (or later) and iPod 6th generation devices (or later) running iOS 10.0 or later. CAM-MK-PR-336 ISS1 NOV17
of users reported that listening to music via direct streaming to the Nucleus 7 Sound Processor was the most convenient way to listen to music. 2
The Nucleus 7 Sound Processor is compatible with iPhone 8 Plus, iPhone 8, iPhone 7 Plus, iPhone 7, iPhone 6s Plus, iPhone 6s, iPhone 6 Plus, iPhone 6, iPhone SE, iPhone 5s, iPhone 5c, iPhone 5, iPad Pro (12.9-inch), iPad Pro (9.7-inch), iPad Air 2, iPad Air, iPad mini 4, iPad mini 3, iPad mini 2, iPad mini, iPad (4th generation) and iPod touch (6th generation) using iOS 10.0 or later. Apple, the Apple logo, FaceTime, Made for iPad logo, Made for iPhone logo, Made for iPod logo, iPhone, iPad Pro, iPad Air, iPad mini, iPad and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc., registered in the U.S. and other countries. Information accurate as of November, 2017
hearing aids
h e ar ing health foundation
Small Solution,
BIG IMPACT
A doctoral student’s award-winning invention has the potential to revolutionize hearing aid technology. By Apoorva Murarka for many people, the sound quality and battery life of their electronic devices are no more than a second thought. But for hearing aid users, these are pivotal factors in being able to interact with the world around them. One possible way to update existing technology—which has gone unchanged for decades—is small in size but monumental in impact. As a Ph.D. candidate in electrical engineering at MIT, I developed a microspeaker to improve the functions of devices that emit sound. I see hearing aids as one of the most important applications of this new technology.
Feeling the Heat
Most hearing aids have long used a system of coils and magnets to produce sound within the ear canal. These microspeakers use battery power to operate, and lots of it. Valuable battery life is wasted in the form of heat as an electric current works hard to travel through the coil to eventually help produce sound. The more limited a user’s hearing, the more the speaker must work to produce sound, and ultimately much more battery is used up. As a result, research has shown that many hearing aid users in the United States use about 80 to 120 batteries a year or have to recharge batteries daily. Aside from the anxiety that can accompany the varying dependability of this old technology, the cost of constantly replacing these
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batteries can quickly add up. But battery life is not the only factor to consider. Because the coil and magnet system has not been updated in decades, the quality of sound produced by hearing aid speakers (without additional signal processing) has been just as limited. Even small upgrades in sound quality could make a world of difference for users.
energy-efficient hearing aids to significantly improve the quality of life for users. This invention is being developed further, and I hope to work with those with hearing loss, relevant organizations, and hearing aid companies to fully understand the needs of users as well as explore all of its applications.
Smaller and Smarter
I invented an alternative to the old coil and magnet system, removing those components completely from the picture. In their stead, I developed an electrostatic transducer that relies on electrostatic force instead of magnetic force to vibrate the sound-producing diaphragm. This way of producing sound wastes much less energy, translating into significantly longer battery life in hearing aids. This work won the $15,000 Lemelson-MIT Student Prize for its groundbreaking nanotechnology innovation. The biggest difference? Size. You would need to look closely to even see this microspeaker’s membrane—its thickness is about 1/1,000 the width of a human hair. Additionally, the microspeaker’s ultrathin membrane and microstructured design enhance the quality of sound reproduced in the ear. Power savings due to the microspeaker’s electrostatic drive can be used to optimize other existing features in hearing aids such as noise filtration, directionality, and wireless streaming. This could pave the way for “smart,”
Apoorva Murarka is a Ph.D. candidate in electrical engineering at MIT, where he also received bachelor’s and master’s degrees in the same field. Originally from India and Singapore, he holds more than a dozen granted and pending patents and has published research in peer-reviewed and refereed journals. You can learn more about Murarka, his invention, and his recent award at lemelson.mit. edu/winners/apoorva-murarka.
Share your story: Tell us your battery mishap stories at editor@ hearinghealthmag.com. Support our research: hhf.org/donate
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music
h ear i n g h ealth foundation
WHY
DOES IT ALWAYS HAVE TO BE SO
LOUD?
Assistive listening technology can keep everyone’s ears safe at concerts. By Thomas Kaufmann
caption
why does it always have to be so loud? That’s the question I’ve been asking myself for more than two decades. And I think I’ve finally found the answer. I wonder if you’ll agree. The first time I deeply thought about this question was back in Germany, where I grew up. At the age of 18 I had started my first business, a booking agency for DJs and musicians, and was playing a wedding gig. One of the guests walked up to me and yelled—since he was standing right in front of the loudspeaker—“Hey! Can you turn it up louder?” I was puzzled. Wasn’t it already loud enough? I was standing behind the loudspeakers and considering putting my earplugs in. Yet, somehow, he wanted the music to be louder. Didn’t he know that he was risking noise-induced hearing loss? Why did it need to be louder? I couldn’t make sense of it. Little did I know the journey I would embark on to find the answer.
Keeping Your Ears Safe
In my early 20s, I started going to more and more concerts and nightclubs to listen to other DJs and find inspiration 24
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for my own work. Almost every time, the first thing I did after walking through the door was to put in my custom-fit earplugs. These comfortable silicone pieces, equipped with a special filter invented by Mead Killion in the late 1980s, are known as musician’s earplugs. They preserve the clarity of sound while essentially turning down the volume of everything around you. Whenever I forgot to bring my earplugs, I would leave the venue mentally exhausted. My ears would be ringing and everyone’s speech sounded muffled. Again, I would ask myself, why does it always have to be so loud? Why do people like to listen to music at volume levels that are literally painful to my ears? One morning in early 2012, now living as a graduate student in California, I found myself asking similar questions. I was out having breakfast with some friends. One of them, a professional photographer, was complaining about his ears still ringing from the concert he had been shooting the night before at the Santa Barbara Bowl, a 4,500-seat amphitheater. He was standing right in front of the loudspeakers to catch the best shots of the band.
music
With hearing loop technology, we dramatically improve the signal-to-noise ratio, similar to what noise-canceling headphones do. It takes out the distance from the sound source and the reverberation in the room as well as distracting environmental noises. Instead of trying to cancel out noise, it doesn’t let it in to begin with. I asked him, “Well, don’t you use earplugs?” When he responded, “No, they muffle the sound,” I said, “You have to wear the right ones.” I got out my custom earplugs and showed them around; no one was even aware this product existed. Our breakfast ended with another friend asking, “Why don’t you start a business with that?” Challenge accepted! Two months later, OTOjOY was born.
photo credits: julian bajsel (left); a. arthur fisher (right)
From Hearing Protection to Hearing Better
While OTOjOY started out as a simple discussion among friends about hearing protection, I was soon introduced to the Santa Barbara Chapter of the Hearing Loss Association of America (HLAA), where I learned about hearing loop systems. This form of assistive listening technology takes sound from a venue’s sound system and sends it directly and wirelessly to a listener’s hearing aid or cochlear implant without any distortion, echo, or background noise. All the listener hears is crystal-clear sound directly from the sound system. Although this technology has been in use for decades in Scandinavia and the U.K., only a few places in the United States had adopted hearing loops. At the time I was starting OTOjOY, not a single venue in the Santa Barbara area had been equipped with a system. I knew intuitively that this technology could have a significant impact in this community. Together with the local HLAA chapter and another nonprofit organization, we decided to raise awareness about the challenges associated with hearing loss and to start installing the technology in venues around Santa Barbara. Within a few years, Santa Barbara became the most hearing-friendly city in the state of California, which
earned OTOjOY the Santa Barbara Mayor’s Award for Outstanding Effort in 2014. Still, what does all of this have to do with the big question—why does it always have to be so loud? A key phrase that kept coming up in both my scientific research and in my work with OTOjOY was “signal-tonoise ratio.” In essence, this term describes the relation between the volume of the things that you want to hear and the things that you don’t. With hearing loop technology, we dramatically improve the signal-to-noise ratio, similar to what noise-canceling headphones do. It takes out the distance from the sound source and the reverberation in the room as well as distracting noises, such as the people talking behind you and the clinking of their glasses. However, instead of trying to cancel out noise, it doesn’t let it in to begin with. As I thought about this concept, it dawned on me. Why does it always have to be so loud? Because we want to hear the music, and only the music. And since we can’t turn down the noise, our only option is to turn up the music. But—is it, really? I thought otherwise.
Changing the Way We Access Live Music
Our mission to provide better hearing accessibility at concerts and events brought a few new ideas to light. We have provided hearing loop technology at some of America’s largest music festivals, including Coachella and Stagecoach. Things started shifting during the 4th International Hearing Loop Conference in Berlin, in October 2017, when we invited a few attendees to see the band ODESZA in concert and to try out our newest product, OTOjOY LoopBuds. These earbuds allow people to access the sound from a hearing loop with a smartphone app, with a much better signal-to-noise ratio compared with using loudspeakers in a large room. When people in the audience at these shows experienced their favorite band with enhanced clarity while also being able to control the volume, their jaws
ODESZA in concert (opposite page), and (this page) the duo’s Clayton Knight (far left) and Harrison Mills (far right) experience sound with OTOjOY’s Thomas Kaufmann (center right) and Micah Thomas.
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dropped. As it turned out, most of them chose to listen to the concert at a much lower volume than was playing over the loudspeakers. After being introduced to ODESZA’s management and to the musicians themselves, we learned that they not only want to make their shows more accessible to all of their fans, allowing them to be fully immersed in the music, but are also open to promoting “smart” and safe music listening. The main question that came up in our discussion was “what other options are there other than earplugs?” We believe that the answer is “assistive listening for everyone.” By bringing clear, high-fidelity music directly to people’s ears and simultaneously blocking out other noises, we can lower the volume level on the loudspeakers, make the show more enjoyable for everyone, and protect people’s hearing at the same time. Innovating in the realm of hearing loop technology for the past five years helped me find the answer to the question that had been bugging me for decades: Why does it always have to be so loud? The answer is: It doesn’t.
Phoenix-based OTOjOY founder and CEO Thomas Kaufmann studied physics in Germany and has a master’s degree in chemistry from the University of California, Santa Barbara. For more, see www.otojoy.com and “Tech Solutions,” page 46.
Seattle-based Harrison Mills and Clayton Knight are ODESZA, who have earned three GRAMMY nominations and Gold singles in the U.S. and Australia. For more, see odesza.com.
Concerts for All A young music promoter who has a hearing loss proves that enjoying concerts isn’t just about hearing the sounds. By Katelyn Serpe when talking about concerts and hearing loss, the focus is often on the risk of noise-induced hearing loss. But what is a concert like for people who already have a hearing loss? Maclain Drake, a 23-year-old from Utah, is changing the concert experience so that live music can be enjoyed by all. At age 2, Drake was diagnosed with mild to moderate sensorineural hearing loss and has used hearing aids ever since. While growing up, Drake was told that his hearing loss meant he was unlikely to be able to sing or play musical instruments. But through dedication and encouragement from his family,
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photo credits: robert redfield (kaufmann), tonje thilesen (odesza)
music
he proved the naysayers wrong and learned to do both— not only performing in musical theater but also playing percussion beginning in his teens. Today, Drake is making the concert experience accessible to those with hearing loss. “I was inspired to create Vibe after a friend mentioned that they thought EDM [electronic dance music] concerts were the best concerts ever,” he says. Launched in January 2017, Vibe enhances concerts by making them about more than just audio, notably through lights. Drake works with musicians to make sure the visuals match the feeling of the music, so guests connect with the music through videos, lights, and LED screens that show the music’s soundwaves. Beyond visual effects and assistive listening technology, Vibe also utilizes four-by-four vibrating platforms to allow guests to “hear” music through their feet. Drake has also added tastes and scents to the live concert experience. “People who are deaf-blind go to concerts too, so adding tastes and smells seemed like the next logical step to make the concerts better,” he says. Like the visuals, the scents match the music, such as using a pineapple scent if the music is meant to give a tropical feeling. Eventually Drake hopes to expand Vibe to other music genres and locations beyond Utah’s Salt Lake City area. And while earplugs are available to protect hearing, he admits that he doesn’t see them much in use despite the risk of hearing loss. “Everyone deserves to enjoy live concerts, and music venues should be more accommodating to people with hearing loss,” says Drake, who hopes that Vibe concerts will help break the stigma surrounding hearing loss, while also promoting hearing protection. Meanwhile, he continues to think of new ways to enhance the concert experience for everyone, such as performers using special gloves that shoot laser lights off the fingers. “All we’re doing is making the music come more to life.”
Past HHF intern Katelyn Serpe is a senior at Rutgers University in New Jersey, studying political science and economics. For more, see vibemusicevents.com and follow Vibe Music Events on Twitter, Facebook, or Instagram.
Diagnosed with a hearing loss at age 2, Vibe’s Maclain Drake wants to make the concert experience accessible to all.
Vibe enhances concerts by making them about more than just audio, notably through lights. Maclain Drake works with musicians to make sure the visuals match the feeling of the music, so guests connect with the music through videos, lights, and LED screens that show the music’s soundwaves.
Share your story: Tell us about steps you take to enjoy concerts at editor@hearinghealthmag.com.
Support our research: hhf.org/donate
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education
h ear i n g health foundation
IT’S (STILL) A
NOISY PLANET
Ten years on, the National Institute on Deafness and Other Communication Disorders continues to spread awareness of the dangers of noise-induced hearing loss to children ages 8 to 12 and their parents. By Phalla Messina for many people, noise is a feature of their daily environment, but they don’t always realize the damage noise can do to their hearing. To raise awareness about hearing loss that noise can cause, in 2008 the National Institute on Deafness and Other Communications Disorders (NIDCD), part of the National Institutes of Health, launched the public health campaign It’s a Noisy Planet. Protect Their Hearing‰. A decade later, the campaign’s message remains the same: People can protect themselves from noise-induced hearing loss (NIHL) by lowering the volume, moving away from the noise, or wearing hearing protection such as earplugs or earmuffs. NIHL occurs when hair cells in the inner ear are damaged by sounds that are too loud. Hearing loss from exposure to noise at or above 85 decibels (the sound level of heavy city traffic) can put a person at risk to lose their hearing. The louder the sound, the shorter the amount of time it takes for hearing loss to occur. A person’s distance from the source of the sound, and the length of time they’re exposed to the sound, are also key factors on whether a sound can damage hearing. Children often participate in common activities that can reach a potentially damaging noise level, such as listening to music at high volume; attending concerts,
sporting events, or movies; and playing band instruments. The good news is that NIHL is preventable, and research shows that parents and caregivers are the primary influence on preteens. With Noisy Planet’s tools and information, parents and other adults can encourage children to start healthy hearing habits—and keep up those habits as they get older. A key component is school presentations. The campaign conducts school presentations at elementary and middle schools across the Washington, D.C., metro area. So far, the 45-minute presentation has been given to more than 20,000 students. Students in 2nd through 7th grades learn the parts of the ear, how loud noise can affect their hearing, and how they can protect their hearing while still enjoying their favorite activities. Popular interactive activities include students acting out the parts of the ear, and using pipe cleaners to show what happens when hair cells are exposed to loud sounds. To expand the use of the presentations, the campaign staff have trained youth leaders, school nurses, audiologists, and teachers, and now the 10-year-old campaign has a Teacher Toolkit on the Noisy Planet website to help educators present hearing loss prevention messages in their communities: » The presentation and script provide a step-by-step framework for leading an educational session. » Short demonstration videos show how to conduct four hands-on activities as part of the presentation. The instructions outline the materials needed, the number of student volunteers required, and the estimated time for each activity. » Free materials can be downloaded, printed, or ordered. These additional teaching tools can be referenced during presentations, or handed out to students to take home and share with their families and friends. The Noisy Planet website also has a variety of free, science-based information on NIHL resources including educational fact sheets, hearing-related news stories, an e-newsletter, pop quizzes and interactive games,
The NIDCD’s Phalla Messina demonstrates sound vibrations using a tuning fork and pingpong ball on a string.
education
and shareable images for social media and websites. There is also an interactive infographic where users can pick a sound to see how loud it is and then get tips for keeping their ears safe. Hearing Health Foundation is proud to help the NIDCD spread the message that noise can irreversibly harm young ears, and that parents and teachers can play a crucial role in establishing healthy hearing habits that last a lifetime.
Phalla Messina is a public affairs specialist at the NIDCD. For more information, see nidcd.nih.gov and noisyplanet.nidcd.nih.gov, and “like” the Noisy Planet page on Facebook. See Hearing Health’s Summer 2009 cover story about the Noisy Planet launch at hhf.org/magazine.
Share your story: How do you handle noisy environments, for you or for your children? Tell us at editor@hearinghealthmag.com.
Support our research: hhf.org/donate
Pass the HAT
Heather Stinson, an itinerant teacher of the deaf, works with a student using a HAT system.
Classrooms get an upgrade with digital technology. By Janice Beetle as an itinerant teacher of the deaf, heather Stinson educates students and staff about how to get the most out of classroom hearing technology. Sometimes, students do the teaching, as when a seventh grader explained the microphone she uses to her classmates. “She named her microphone ‘Mikee’ and did the presentation from the mic’s perspective—on how he likes to be used,” Stinson says, adding that her student made it clear that she can’t hear her classmates without Mikee, and she can hear best when they speak directly into him. “She explained the situation with humor. She really improved how other students were using the microphone. They now remember to ask ‘Where’s Mikee?’ before they speak.” Microphones are a key piece of the assistive equipment used by students who have a hearing loss, says Joni Skinner, Au.D., a board-certified audiologist who works at Clarke Hearing Center, part of Clarke Schools for Hearing and Speech in Northampton, Massachusetts. They are used by a student’s peers, as well as by the teacher. Microphones like “Mikee” are passed around the classroom when individual children are speaking, and the sound is transmitted directly to the student with hearing loss as part of what’s called Remote Microphone Hearing Assistance Technology—or HAT systems. The classroom teacher also wears a microphone, called a transmitter, and their voice is transmitted wirelessly to a device on the student’s hearing aid or cochlear implant, called a receiver. “No matter where the student is relative to the teacher in the classroom, and what kind of noise is going on around them, they have good and consistent access to their teacher’s voice,” Skinner says.
Formerly Known as FM
Once called “FM equipment” because it relied on a frequency modulation signal, the HAT technology, manufactured by companies such as Oticon and Phonak, is not actually new but, rather, improved. The Roger system, a HAT technology by Phonak, functions like the older technology but relies on a digital signal “so it has better sound quality, and it’s less likely to get interference,” Skinner says. “HAT touchscreens bring smartphone-like technology into the classroom.” The teacher wears the device around their neck, and the mic picks up the teacher’s voice, which is transmitted to the student through either a hearing aid or cochlear implant. If the student with hearing loss is working in a small group, the teacher can take off the device, lay it on the table, and use the touchscreen to instruct it to pick up voices around the table. The transmitters can also connect to computers and audio-visual equipment, so students with hearing loss have direct access to media presented. “We get reports from parents of students with hearing loss that their child has better behavior or is less fatigued when they get home at the end of the day after using the HAT equipment, as opposed to before they got it,” Skinner says. “The goal is better access to sound but also for the child to have the energy to participate in extracurricular activities they might enjoy.” a publication of hearing health foundation
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Talk to Teachers Heather Stinson, itinerant teacher of the deaf, and Joni Skinner, Au.D., share classroom advice for parents to discuss with their school’s teachers and staff.
Use technology all day. Make sure that a passed microphone and HAT system are used throughout the school day—at meetings, school assemblies, and beforeor after-school programs—not just in the classroom.
Acoustics matter. Be aware of the acoustics in a room and ask whether teachers can make simple modifications to reduce noise. This helps all students hear better. Use carpet or area rugs and dividers to block sounds from, for example, a fish tank or a heating or air conditioning system.
Repetition, repetition. When a classroom discussion is ongoing, ask that teachers repeat what each student has said so that a student with a hearing loss will hear it twice—once through the passed microphone, and once directly through the HAT system.
HAT is not just for students with hearing loss, Skinner says. Children with mild hearing loss as well as students with central auditory processing disorders or attention deficit disorder also benefit from using this technology.
The Importance of Training
In addition to fitting children with hearing aids, Stinson also works with school districts to recommend and support their use of HAT systems and other technology in the classroom. She visits her 17 students in six public and private schools in Massachusetts to work on auditory development, listening skills, and self-advocacy. She partners with teachers and staff, helping them understand the equipment as well as maintain it, repair it, and use it to students’ best advantage. “It’s not going to solve the problem just to have the equipment in the classroom,” Stinson says. “Teachers need a point person they can seek out with their questions.” Stinson can do a fair amount of troubleshooting over the phone, through a call or text message. At the beginning of each new school year, Stinson asks her students to acknowledge and explain their equipment to their classmates to “remove the stigma.” Generally, she is present with them to help in the conversation. And sometimes, students get creative—like the seventh grader who did the presentation on “Mikee.” Stinson was happy to see a sixth grader and second grader partner together. “They connected and decided the sixth grader would help mentor the second grader with her presentation,” Stinson says. “Everyone was excited about it. The two students read a book they had written together and passed around a hearing aid. My little second grader was a rock star for quite a long time afterward!” 30
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Proof Positive
Removing the stigma of assistive equipment is a particular battle when students become teenagers, Skinner says. One student who has had a hearing loss her whole life turned 14 and recently started ninth grade. The student was pushing back on using the HAT system as she “didn’t want to be different,” Skinner says. But after using the same equipment she’d had since kindergarten, the student was ready to be introduced to the latest technology. Her ability to understand words in an atmosphere with some background noise improved dramatically, from 28 percent comprehension to 96 percent, which was even better than the 76 percent she heard with her hearing aids alone in a quiet test booth. The student was convinced about the new system’s value. “She was so excited,” Skinner says. “The goal is to get them to do equally as well as their peers with typical hearing and to not have to struggle to hear so much.”
Massachusetts-based writer Janice Beetle is a communications consultant for Clarke Schools for Hearing and Speech. For more, see clarkeschools.org.
Share your story: Tell us classroom strategies that have worked for your child at editor@ hearinghealthmag.com. Support our research: hhf.org/donate
photo credit: david fried (headshot)
Trainings are important. At the beginning of a school year, or if your child is newly diagnosed as deaf or hard of hearing, request that all staff be trained in how to use the microphone and HAT system.
Check comprehension. Teachers should strive to ask students (with or without a hearing loss) open-ended questions to ensure comprehension because they may nod in agreement to a yes/no question—even if they do not understand. —J.B.
Regain Your Lost Hearing On Each and Every Phone Call. A
Discover the Life’s Work of a Hollywood Legend Who Finally Decided to Do Something About His Severe Hearing Loss
t the height of his career, Larry took a break from show biz with a mission to give himself and the world perfect, personalized phone calls. He and his former Harvard roommate assembled a team of the world’s-foremost experts in hearing, auditory neuroscience, and digital signal processing to create SonicCloud: a breakthrough app that automatically adjusts every phone call to the way you hear.
Here’s how it works: You take a free hearing test. Then, SonicCloud intelligently personalizes your hearing based on the results. Every call will sound so crisp and clear you may actually weep for joy! Trouble Hearing on Your Phone? Not Anymore...
88% of people surveyed said they could hear ‘clearly better’ on phone calls with SonicCloud than Already, SonicCloud has been downloaded hundreds with their expensive hearing aids – including those of thousands of times, and has been praised by both which can cost upwards of $7,000! By comparison, Apple and Google for its novel approach to hearing SonicCloud only costs $9.99/month, and you can try enhancement. They recognize the innovative way the it free for 30 days before ever paying a dime. app harnesses the processing power of the cloud – far beyond that of a conventional hearing aid. Go to SonicCloud.com to learn more about this next-generation technology.
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We tune the cloud to personalize your hearing
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2018 Funding for Ménière’s Disease Investigators Hearing Health Foundation is thrilled to announce two new grants awarded for innovative research that will increase the understanding of Ménière’s disease, the inner ear and balance disorder characterized by fluctuating hearing loss, recurrent vertigo, a feeling of fullness in the ear, and tinnitus. These grants, earned by two prior Emerging Research Grants scientists, are generously supported by a family committed to finding treatments and cures for Ménière’s disease, a condition that completely disables nearly a third of those who have it. Gail Ishiyama, M.D.
University of California, Los Angeles, David Geffen School of Medicine Project: Cellular and molecular biology of the microvasculature in the macula utricle of patients diagnosed with Ménière’s disease Goal: To investigate the microscopic structure of the vasculature (blood vessel system) of balance organs from patients with intractable Ménière’s disease. Ishiyama’s hypothesis is that altered biochemical pathways affecting the vasculature of the blood labyrinthine barrier—which protects the inner ear from toxins and infections—may cause a dysfunction of the inner ear, leading to hearing loss and vertigo. Ishiyama’s recent research revealed structural cellular changes in the blood labyrinthine barrier of the utricle, a balance organ, in Ménière’s patients (see opposite page). This project continues the work by detailing the cells and biochemical pathways that are altered in Ménière’s disease. It will provide greater information on the blood labyrinthine barrier and allow for the development of interventions that prevent the progression of hearing loss and stop the disabling vertigo in Ménière’s disease patients.
Ian Swinburne, Ph.D.
Harvard Medical School Project: Classifying the endolymphatic duct and sac’s cell types and their gene sets using high-throughput single-cell transcriptomics Goal: To understand how the inner ear endolymphatic duct and sac stabilize the inner ear’s environment and to identify ways to restore or elevate this function to mitigate or cure Ménière's disease. The endolymphatic duct and sac play important roles in stabilizing a fluid composition necessary for sensing sound and balance. The recurrent vertigo in Ménière's is likely caused by a malfunction of the endolymphatic sac, causing volume or pressure changes in the inner ear. Swinburne recently found that the typical-functioning endolymphatic sac periodically inflates and deflates like a balloon, and that specialized cell structures in the sac appear to transiently open, causing the deflation of the endolymphatic sac. The sac, then, appears to act like a relief valve to maintain a consistent volume and pressure within the inner ear. This project will generate a list of endolymphatic sac cell types and the genes governing their function, which will aid in Ménière's diagnosis (which can be delayed due to the range of fluctuating symptoms) and the development of a targeted drug or gene therapy.
A 2016 Emerging Research Grants (ERG) scientist funded by The Estate of Howard F. Schum, Gail Ishiyama, M.D., is an associate professor of neurology at UCLA’s David Geffen School of Medicine. A 2013 ERG scientist, Ian Swinburne, Ph.D., is a research fellow in systems biology at Harvard Medical School.
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EMERGING RESEARCH GRANTS
Recent accomplishments by ERG recipients underscore the importance of supporting scientists who bring fresh approaches to hearing and balance studies.
Recent Research by Hearing Health Foundation Scientists, Explained The First Documentation of Ménière’s Disease Cellular Changes ménière’s disease is characterized by fluctuating hearing loss, vertigo, tinnitus, and ear fullness, but the causes of these symptoms are not well understood. Past research has suggested that a damaged blood labyrinthine barrier (BLB) in the inner ear may be involved in the pathophysiology of inner ear disorders. Gail Ishiyama, M.D., a 2016 Emerging Research Grants (ERG) recipient, was the first to test this proposition by using electron microscopy to analyze the BLB in both typical and Ménière’s disease patients. A report by Ishiyama and colleagues appeared in Scientific Reports (part of the Nature Publishing Group). The BLB is composed of a network of vascular endothelial cells (VECs) that line all capillaries in the inner ear organs to separate the vasculature (blood vessels) from the inner ear fluids. A critical function of the BLB is to maintain proper composition and levels of inner ear fluid via selective permeability. However, the inner ear fluid space in patients with Ménière’s has been shown to be ballooned out due to excess fluid. Additionally, Ishiyama and team had identified permeability changes in magnetic resonance imaging studies of Ménière’s patients, which may be an indication of BLB malfunction. The group used transmission electron microscopy (TEM) to investigate the fine cellular structure of the BLB in the utricle, a balance-regulating organ of the inner ear. Two utricles were taken by autopsy from individuals with no vestibular or auditory disease. Five utricles were surgically extracted from patients with severe, stage IV Ménière’s disease (with profound hearing loss and intractable recurrent vertigo spells) who were undergoing surgery to treat it. Microscopic examination revealed significant structural differences of the BLB within the utricle between individuals with and without Ménière’s disease. In the typical utricle samples, the VECs of the BLB contained numerous mitochondria and very few fluid-containing
organelles called vesicles and vacuoles. The cells were connected by “tight junctions” to form a smooth, continuous lining, and they were surrounded by a uniform membrane. However, the Ménière’s utricles showed varying degrees of structural changes within the VECs. While the VECs remained connected by tight junctions, a higher number of vesicles and vacuoles was found compared with typical utricles, and this may cause the swelling and degeneration of other organelles. In the most severe case, there was complete VEC necrosis, or cell death, and a severe thickening of the basal membrane surrounding the VECs. The documentation of the cellular changes in the utricle of Ménière’s patients was the first of its kind and has important implications for future treatments. The study concluded that the alteration and degeneration of the BLB likely contributes to fluid changes in the inner ear organs that regulate hearing and balance, thus causing the Ménière’s symptoms. Additional understanding of the specific cellular and molecular components affected by Ménière’s may lead to the development of new drug therapies that target the BLB to decrease vascular damage in the inner ear. —Carol Stoll A 2016 ERG scientist funded by The Estate of Howard F. Schum, Gail Ishiyama, M.D., is an associate professor of neurology at UCLA’s David Geffen School of Medicine. Read about Ishiyama’s newly funded Ménière’s disease research on the opposite page.
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Diagnosing Ménière’s Disease
Only 69 percent of those with Ménière’s disease are correctly diagnosed, while 31 percent of those with the disease show typical diagnostic results.
electrocochleography is a commonly used assessment of the auditory system, specifically the inner ear and the hearing nerve. It most often uses a brief acoustic stimulus, known as a “click,” at a relatively low repetition rate, and it measures two key responses: summating potential (SP) and action potential (AP). Both responses assist in the diagnosis of Ménière’s disease, an inner ear and balance disorder. Previous research has established that individuals with Ménière’s disease are likely to have abnormally large SPs and a large SP/AP ratio. Though click electrocochleography (ECochG) has great potential to detect Ménière’s, it lacks sensitivity, or the ability to correctly identify those with the disease. Only 69 percent of those with Ménière’s disease are correctly diagnosed, while 31 percent of those with the disease show typical ECochG results. This lack of accuracy prevents its use as a definitive diagnostic tool. Wafaa Kaf, Ph.D., a 2015 Emerging Research Grants (ERG) recipient, is researching the use of a novel analysis technique called continuous loop averaging deconvolution (CLAD) to improve the sensitivity of ECochG for diagnosing Ménière’s disease. In a paper published in Frontiers in Neuroscience, Kaf and colleagues share findings on the effects of altering the parameters of the acoustic stimulus on ECochG responses in order to quantify the effect of stimulus rate and duration of the elicited stimuli. The team obtained SP measurements for 500 hertz (Hz) and 2,000 Hz tone bursts that varied in duration and repetition rate from 20 women with typical hearing. CLAD was used to interpret the tracings elicited by the differing stimuli of tone bursts. They found that SP amplitude was significantly larger when using the highest stimulus repetition rate. It is believed that the high stimulus repetition rates minimize the neural contributions and mostly reflect hair cell responses, the target of ECochG. In addition, longer duration stimuli is believed to better reflect hair cell involvement, while shorter stimuli may be useful in eliciting responses reflective of neural contributions. Also, the 2,000 Hz tone bursts produced a larger SP amplitude compared with 500 Hz tone bursts. As a result, the team says the 2,000 Hz tone bursts at a high repetition rate and a long duration can be used as parameters to minimize neural contributions to SP measures, whereas short duration stimuli can be used to assess neural activity. The data that Kaf’s team published is a critical initial advancement toward ultimately understanding the SP measurement in diseased ears. Their findings not only provide normative data for tone burst ECochG measurements across stimulus frequencies, stimulus rates, and stimulus durations, but also help improve the use of ECochG for early diagnosis of Ménière’s disease. —Wafaa Kaf, Ph.D., and C.S.
A 2015 ERG scientist funded by The Estate of Howard F. Schum, Wafaa Kaf, Ph.D., is a professor of audiology at Missouri State University.
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The Gap Between Self-Reported Hearing Loss and Treatment Patterns hearing loss is one of the most prevalent chronic conditions in the u.s. and has been associated with negative physical, social, cognitive, economic, and emotional consequences. Despite the high prevalence of hearing loss, substantial gaps in the utilization of amplification options, including hearing aids and cochlear implants (CI), have been identified. Harrison W. Lin, M.D., a 2016 Emerging Research Grants (ERG) recipient, and colleagues recently published a paper in JAMA Otolaryngology–Head & Neck Surgery that investigates the contemporary prevalence, characteristics, and patterns of specialty referral, evaluation, and treatment of hearing difficulty among adults in the United States. The researchers did a cross-sectional analysis of responses from a nationwide representative sample of adults who participated in the 2014 National Health Interview Survey and responded to hearing health questions. The data collected included demographics information as well as self-reported hearing status, functional hearing, laterality (hearing ability in each ear), onset, and primary cause (if known) of the hearing loss. In addition, the team analyzed specific data regarding hearing-related clinician visits, hearing tests, referrals to hearing specialist, and utilization of hearing aids and CIs. Here are the results by the numbers:
36,690
Records were analyzed, representative of about 240 million U.S. adults
Average age of respondents
Of respondents said their hearing was less than “excellent/good,” ranging from “a little trouble hearing” to “deaf”
Men were more likely to report hearing issues than women
Of those who saw their doctor for their hearing: Of those who said they had hearing problems: » 1⁄3 were referred to an otolaryngologist » Nearly 1⁄3 never saw a doctor (an ear, nose, and throat specialist, or ENT) » Nearly 1⁄3 never had their hearing tested » 27 percent were referred to an audiologist » Only 1 in 5 said they visited a doctor for hearing problems in the past five years » 21 percent of respondents noted difficulty hearing speech in noise at least half the time The study shows that there are considerable gaps between self-reported hearing loss and patients receiving medical evaluation and recommended treatments for hearing loss. Increased awareness among clinicians regarding the burden of hearing loss, the importance of early detection and medically evaluating hearing loss, and available amplification options can contribute to improved care for individuals with hearing difficulty. —C.S.
A 2016 ERG recipient funded by funded by The Barbara Epstein Foundation Inc., Harrison W. Lin, M.D., is an assistant professor in the department of otolaryngology–head & neck surgery at the University of California, Irvine, Medical Center. Support our research: hhf.org/donate
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Prenatal Intervention May Be Necessary for Usher Syndrome Treatment usher syndrome is a hereditary disorder that affects 1 in 20,000 people worldwide and causes concurrent hearing and vision loss. Although today there is no cure, scientists have begun to understand the molecular mechanisms of hearing loss in Usher syndrome by identifying the specific mutations in genes associated with auditory hair cell malfunction. Gene-specific targeting has been used on Usher mutations to restore hearing, but the efficacy and best timing of the treatment is still being investigated in mouse models. Research published in JARO (Journal of the Association for Research in Otolaryngology) by 2009 and 2011 Emerging Research Grants (ERG) recipient Michelle Hastings, Ph.D., and colleagues shows that early administration of a gene-specific targeting treatment is critical for repairing outer hair cells to preserve hearing in those with genetic disorders like Usher syndrome. Hastings’ research focuses on Usher type 1, which is the most severe of three subtypes and is associated with six genes. One gene, USH1C, contains the instructions to create a protein that localizes to auditory hair cells and helps to maintain their bundle structure and ability to detect sound waves. A mutation in USH1C causes this protein to be cut short and malfunction, leading to Usher type 1C in humans. Adding, or “knocking-in,” the mutation to mouse DNA causes symptoms similar to those of human patients with Usher type 1C. These Usher mice exhibit hearing and vision loss as well as deficits in balance, little or no auditory-evoked brainstem response (ABR), and abnormal results in eye tests called electroretinograms. The hearing loss is linked to defective or missing inner and outer hair cells in the cochlea of the inner ear. Antisense oligonucleotide (ASO) therapy is a genespecific targeting therapy previously used by Hastings and her team to preserve hearing in Usher knock-in mice. ASOs are small strands of nucleotides (the building blocks of DNA and RNA) that are specifically synthesized to bind to the disease-causing mutation site of RNA and block it from creating defective RNA and proteins. The ASO therapy targeting the USH1C mutation was administered to the Usher mice a few days after birth. Both hearing and ABR test results improved, showing preserved inner hair cell function. However, the function of the outer hair cells, which
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surround the inner hair cells and are responsible for amplifying sounds, was not tested in that study. Hastings’ most recent research, with Jennifer Lentz, Ph.D., and team, investigated whether the timing of ASO treatment can protect outer hair cells in addition to inner hair cells for full hearing preservation. When two tones are presented in the ear canal, outer hair cells that function normally respond by producing amplified sounds known as distortion product otoacoustic emissions (DPOAEs). In Usher mice, DPOAEs are not detected, which indicates loss of outer hair cell function. For the study, ASO therapy was administered to knockin Usher mice of varying ages, and then outer hair cell function was tested by measuring DPOAEs in 1-, 3-, and 6-month-old mice. ASO treatment was able to recover outer hair cell function, as measured by DPOAEs, when it was administered one day after birth. However, the treatment was not effective if first administered on or after postnatal day five. The results suggest that early genetic treatment will be essential for hearing preservation for people with Usher syndrome, since there is a developmental window of time when USH1 gene expression is needed to properly develop auditory hair cells. In humans, hair cell development occurs early in pregnancy, so ASO treatment would likely require very early prenatal intervention. ASOs have been approved for clinical use for a number of different diseases in humans, but more animal research is necessary before moving to clinical trials for ASO therapy for Usher syndrome. Hastings has also published research on testing ASO therapy on prenatal mice, and found that injecting ASOs in the amniotic cavity of pregnant mice can in fact access the cochlea. Her research has improved the understanding of the functions of inner and outer hair cells, bringing scientists closer to developing a cure for Usher syndrome. —C.S.
A 2009 and 2011 ERG scientist, Michelle Hastings, Ph.D., is an associate professor in the department of cell biology and anatomy at Chicago Medical School, Rosalind Franklin University of Medicine and Science.
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Gaining Better Clarity of Neural Networks the ear, just like any other organ in the human body, uses nerves to function properly. One of the most vital nerves that the ear uses is the cochlear nerve, which connects the inner ear to the brain—or, more specifically, to the tonotopically based regions of the cochlear nuclear complex located in the brainstem. This nerve shares the same shape and design of most nerves in the body, with dendrites absorbing information from various sources, sending the signal down the axon of the nerve through action potentials, and terminating the signal in a synapse so the message can Using differential interference be spread. contrast microscopy and In order to allow for immunofluorescence, 2010 and this process to occur 2011 ERG scientist Zhengqing expediently, the nerve Hu, M.D., Ph.D., and team encounters a process tracked the myelination known as myelination, (formation of a protective or providing a protective sheath) of the mouse myelin sheath to propagate cochlear nerve immediately a signal faster. This is done following birth. They found through a glial cell known that oligodendrocyte cells as an oligodendrocyte. important for myelination are Oligodendrocytes form a found to migrate along with layer of lipid (fat) and protein the transition zone between around the axon to provide the central and peripheral insulation, thereby allowing nervous systems. signals to be sent to the brain more efficiently. A team of scientists led by 2010 and 2011 Emerging Research Grants (ERG) recipient Zhengqing Hu, M.D., Ph.D., was able to analyze oligodendrocyte protein expression in the cochlear nerve of postnatal mice. Through the use of differential interference contrast (DIC) microscopy, they were able to investigate the cochlear nerve at staggered postnatal days (the period following birth). Their findings indicate oligodendrocytes are found to migrate along with the transition zone between the central
and peripheral nervous systems. As the fetus develops after birth, and myelination occurs in nerves connecting to the brain, the oligodendrocyte protein marker Oligo2 was observed. There are many other neurodegenerative autoimmune diseases, such as multiple sclerosis, caused by demyelination, and hearing loss could potentially be added to that list. Hu’s work improves clarity of the neural network connecting the inner ear and the brain. —Pranav Parikh
A 2010 and 2011 ERG scientist and General Grand Chapter Royal Arch Masons International award recipient, Zhengqing Hu, M.D., Ph.D., is an associate professor in the department of otolaryngology– head and neck surgery at the Wayne State University School of Medicine in Detroit.
Staff writer Carol Stoll has a master’s degree in science education from Harvard University and a bachelor’s degree in biology from Washington University in St. Louis. She taught high school science in Newark, New Jersey, and Riverdale, New York. Past HHF intern Pranav Parikh is studying biochemistry and philosophy at Boston College. For references, see hhf.org/winter2018-references.
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NEW METHOD ENABLES THE SYSTEMATIC STUDY OF HAIR CELL LOSS AND REGENERATION IN CHICKENS
These images show the undamaged (top) and damaged utricle, an inner ear balance organ, in a chicken. HRP researchers have devised a new method to study the precise timing of hair cell regeneration in chickens using a single surgical application of an ototoxic drug.
when auditory hair cells in the mammalian inner ear are damaged or die, they do not regenerate, causing permanent hearing loss. Hair cells in birds do regenerate, restoring structure and function to inner ear hearing and vestibular (balance) organs. Understanding how this occurs may lead to hearing loss treatments for humans. Past experiments investigating hair cell regeneration in live chickens required multiple injections of a drug to induce hair cell loss, making it difficult to determine the exact timing of the regenerative response. A promising solution to this problem—using a single ototoxic drug, surgically administered—was recently published by Hearing Restoration Project researchers Stefan Heller, Ph.D., and Jennifer Stone, Ph.D., along with postdoctoral fellows from their laboratories, in the Journal of the Association for Research in Otolaryngology. Mirko Scheibinger, Ph.D., the leading postdoctoral fellow of the study, performed surgery on chickens to eliminate hair cells in the inner ear organs. During the surgery, he administered streptomycin (an antibiotic harmful to the ear, or ototoxic) to the chicken’s inner ear. At various times after the surgery, the team dissected and analyzed two sensory organs—the utricle, a vestibular organ, and the basilar papilla, the hearing organ—and counted and observed hair cells and their surrounding supporting cells. The results show that the surgical application of a single streptomycin dose is a feasible approach to elicit hair cell loss and regeneration in the chicken utricle and basilar papilla. Just hours after streptomycin delivery, hair cell numbers significantly declined and DNA replication was activated. The researchers were then able to record specific events of the regeneration process, which start around 12 hours after streptomycin-induced hair cell loss and continue over the course of several days. The team found that avian supporting cells produce new hair cells two ways: either by converting into a hair cell (direct transdifferentiation); or by dividing, usually asymmetrically, into a supporting cell and a hair cell. Throughout this process, supporting cell numbers and density in the utricle remain relatively constant, so there may be a mechanism that responds to specific levels of damage and coordinates individual regeneration events. This single-dose streptomycin method allows for the detailed, timed study of hair cell regeneration in live chickens, and may lead to future treatments of hearing and balance issues in humans. —Carol Stoll Stefan Heller, Ph.D., is a professor in the department of otolaryngology–head and neck surgery at Stanford University, California. Jennifer Stone, Ph.D., is a research professor at the Virginia Merrill Bloedel Hearing Research Center, University of Washington. For more, see hhf.org/hrp. For references, see hhf.org/winter2018-references.
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THE HEARING RESTORATION PROJECT STAYS THE COURSE
photo credits: jane g photography (bio photos) and amanda janesick, ph.d.
By Peter Barr-Gillespie, Ph.D.
The use of bioinformatics not only has uncovered genes that may play roles in hair cell regeneration but also provides an easier way to visualize and analyze large, disparate data sets.
why can chickens and fish regenerate their hair cells, and mammals cannot, leading to permanent hearing loss in humans? This has been the central question for the Hearing Restoration Project (HRP) consortium, which gathered for its annual meeting in Seattle in October 2017 to review recent results, discuss data, and plan for the next year. In 2016, Hearing Health Foundation (HHF) and the HRP made a significant decision to focus on two major research strategies we believe are critically important for understanding hair cell regeneration—and for potentially restoring hearing in humans. These main efforts are: (1) to use "single-cell sequencing" experiments to reveal the molecular processes of hair cell regeneration in the chicken, fish, and mouse with unprecedented resolution; and (2) to examine whether epigenetic DNA modification (the inactivation of genes through chemical changes to the DNA) is why mouse (and human) supporting cells are unable to transform into hair cells after damage to the ear. We want to know whether those epigenetic changes or molecular processes are why fish and chick hair cells can regenerate but mammalian hair cells cannot. There was significant progress in both major efforts and we recommended they continue for another year. We also reviewed other HRP research, such as a project by HRP scientist Ronna Hertzano, M.D., and her University of Maryland colleague Seth Ament, Ph.D., who has extensive training in bioinformatics. This emerging discipline uses information management and analysis tools to uncover relationships between large, disparate sets of data—like what has been generated by the HRP. Ament has uncovered several interesting genes that may play roles in hair cell regeneration, and with Hertzano he is working to ensure the HRP data is both easily visualized and analyzed. The collaborative approach of the HRP is unique in the landscape of hearing research. The combined efforts of 14 outstanding hearing investigators will lead to results far more quickly than the traditional approach, which relies on many single investigators carrying out their research in isolation. I am grateful HHF was able to raise funding for our 2017 projects above the level it had been for the past several years. We were able to devote needed resources to our two major efforts as well as to related research. Nevertheless, a further increase in funding would allow us to accelerate all nine of these collaborative projects to optimal levels. On behalf of myself and the scientists who make up the HRP, I sincerely thank you for your investment and interest in our work and look forward to giving you further updates. HRP scientific director Peter Barr-Gillespie, Ph.D., is the interim senior vice president for research, a professor of otolaryngology at the Oregon Hearing Research Center, and a senior scientist at the Vollum Institute, all at Oregon Health & Science University. For more, see hhf.org/hrp. Support our research: hhf.org/donate
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Person,
t s r i F
An international seminar in Denmark tackles how to make the hearing healthcare experience better for all. By Laura Friedman how can we improve the patient experience when receiving audiological care? This was the question posed to a small international symposium with representatives who fell into one or more categories: individuals with hearing loss, leaders in prominent patient associations, audiologists, and hearing health opinion makers. I was honored to represent Hearing Health Foundation (HHF) as one of the 31 attendees at this two-day “innovation seminar” in Skodsborg, Denmark, sponsored by the Ida Institute, a Denmark-based nonprofit that aims to better understand human dynamics associated with hearing loss. Titled “The Hearing Journey: What Matters to You?”, the October 2017 seminar focused on person-centered care, a treatment model that focuses on the whole person, rather than just the ailment or condition experienced by the patient. The peer-reviewed Permanente Journal says person-centered care “provides the basis for better recognition of health problems and needs over time and facilitates appropriate care for these needs in the context of other needs.” Similarly, the World Health Organization identifies empowerment, participation, the central role of the family, and an end to discrimination as the core values of person-centered care. One of the most eye-opening takeaways was recognizing that all those who are part of the care cycle feel shared sentiments of frustration, poor communication, lack of access, and high costs. Addressing these challenges from a variety of vantage points is critical to improving personcentered care and may be applied to medical care as whole. The exercises and projects we worked on resulted in meaningful insights related to person-focused hearing healthcare. We spoke about stigma, barriers to rehabilitation, and the need for creating “a new narrative” for how we speak about hearing loss—such as how current nomenclature addresses it as a loss or deficit. Altering the language can play a role in changing the experience for those who are hard of hearing, like myself. 40
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All parties stressed the importance of including caregivers and family members in process of managing hearing, and the need for a multidimensional model of care to address the psychological and emotional aspects of hearing care. This included developing a framework to discuss diagnoses and their subsequent treatment options in terms that empower rather than discourage the patient. We also discussed how clinicians should be more cognizant that a diagnosis can be difficult for the patient to come to terms with, and to remember that even though the most successful patients want treatment it may take time for them to feel motivated to take the next step. Follow-up appointments, rather than immediate discussion of treatment options, was a suggestion we agreed would serve the patient and clinician well.
One of the most eye-opening takeaways was recognizing that all those who are part of the care cycle feel shared sentiments of frustration, poor communication, lack of access, and high costs. Addressing these challenges will improve person-centered care. I look forward to working with Ida and fellow attendees to develop and employ tangible tools and solutions to better a patient’s hearing journey both in and out of the audiologist's office. Laura Friedman is the communications and programs manager for HHF. For references, see hhf.org/winter2018references. Read her story, “Leaping Over Hurdles,” in the Spring 2016 issue of Hearing Health at hhf.org/magazine.
Share your story: Tell us your suggestions for hearing healthcare changes at editor@hearinghealthmag.com.
photo credit: liza chrust photography
hearing health
research
Next Generation For this high school student, a hearing loss sparked an interest in scientific research, leading to international recognition.
Passionate about science, high school student Tsering Shola worked in the lab of HHF Council of Scientific Trustees member Peter Steyger, Ph.D.
By Tsering Shola my hearing loss is due to nerve damage, but the cause of damage has not been determined. It led me to become more interested in the field of audiology, specifically drug-induced hearing loss. Aminoglycosides are antibiotics that treat bacterial infections such as sepsis, but when these drugs enter the inner ear they cause permanent damage to hair cells and hearing ability. In order to understand why and how this happens, researchers segment images of the ear by using a manual process that can take up to several hours per image. When I began working at Oregon Health & Science University with Peter Steyger, Ph.D. (who is a member of Hearing Health Foundation’s Council of Scientific Trustees), I segmented these images by hand.
Meeting people from all over the world has shown me the true potential of my generation and makes me want to be a part of the scientific community in the fullest way possible. I realized how tedious the process was and began to test the efficiency of the segmentation performed by a machine. A lab member created an algorithm that allowed a machine to perform the segmentation in a matter of minutes, compared with the hours it took manually. Over the next couple of months, I compared the results of the machine with that of manual segmentation and was able to validate the process. Thus, researchers are able to save hours of work on image segmentation. For this project (“Ototoxic Drug Levels in Cochlear Tissues: Validating Machine Segmentation of Drug Uptake in Individual Cells Types of the Cochlea in Confocal Images”) I was honored, at age 16, to be a finalist
at the 2017 Intel International Science and Engineering Fair (ISEF). I really cannot stress enough how ISEF has impacted me profoundly and has changed my perspective on the next generation of innovators. Nobel laureates, ISEF alumni, and professors gave advice and insight into the world of STEM (science, technology, engineering, and math) careers. Meeting people from all over the world has shown me the true potential of my generation and makes me want to be a part of the scientific community in the fullest way possible. Within a week at ISEF in May 2017, people who were once complete strangers became some of the closet friends I’ve ever made; I’ve met so many incredible individuals through our shared passion for science. With Team Washington (a group of 17 students who represented Washington State), doing common things such as getting breakfast, exploring Los Angeles and Universal Studios, and practicing our presentations made ISEF the best week of my life—I seriously mean it! Outside of school, I advocate for human rights through my school’s International Human Rights Club, where I’ve served as an officer for the past two years. I am also a part of Girls Learn International as a National Student Advisory Board member and a guest blog writer for Feminist Focus. As a junior, I’m not exactly sure what discipline of science I want to major in—it seems like I change my mind every day!—but I know that I want to pursue a degree and then a career in STEM. Tsering Shola is a high school student in Washington State whose family is originally from Tibet.
Share your story: Has having a hearing loss affected your interests and career choice? Tell us at editor@ hearinghealthmag.com. Support our research: hhf.org/donate
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technology roundup
hearing health foundation
TalkingTech These voices speak to the technology driving innovation in hearing and hearing healthcare. Genome Editing “I think it’s pretty exciting. I think it’s doing real gene therapy with CRISPR editing in the mouse but also in a context that you can see the future for doing the same type of thing in humans.” —Peter Barr-Gillespie, Ph.D., the Hearing Restoration Project’s scientific director, speaking about research by Daniel B. Polley, Ph.D., who assists Hearing Health Foundation with reviewing Emerging Research Grants applications. An associate professor of otolaryngology at Harvard Medical School, Polley and colleagues in the U.S. and China published a report in Nature in December 2017 detailing their successful effort to disable a genetic mutation causing progessive hearing loss. A single treatment using CRISPR genome editing technology partially preserved hearing in mice bred with a mutation of the Tmc1 gene (and which are called Beethoven mice in a nod to the composer’s progressive hearing loss).
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Auditory Training and Hearing Devices “This work combines the state of the art from two disciplines: speech engineering and auditory attention decoding. We were able to develop this system once we made the breakthrough in using deep neural network models to separate speech.” —Nima Mesgarani, Ph.D., an associate professor of electrical engineering at Columbia University, who published a study in the August 2017 Journal of Neural Engineering describing a breakthrough toward cognitively controlled hearing aids.
“Words come quickly, and we must process them quickly. Auditory training helps you adjust to new sounds faster and takes you to a new level of performance.” —Nancy Tye-Murray, Ph.D., a Washington University in St. Louis professor of otolaryngology, audiology, and communication sciences, whose testing and development of clEAR (customized learning: Exercises for Aural Rehabilitation) was supported by the National Institutes of Health. The software can use actual voices of loved ones in games to improve word memory, focus, and speed for better understanding of speech in noise.
“Telehealth utilizes communications technologies like smartphone apps to provide virtual healthcare and education services to patients. Your hearing care professional can interact with you via apps to access and adjust hearing aid settings, provide and monitor auditory training exercises, and receive feedback about your hearing aids.” —Carol Meyers, Au.D., an educational specialist for Signia with more than 25 years of clinical practice working extensively in diagnostics, hearing aid technology, and how to address communication needs.
“Down the road, let’s say the hearing aid market is completely disrupted three to five years from now. It’s so important that Doppler is remembered as the company that opened that door. That’s really important not only to me, but the employees of the company.” —K.R. Liu, Doppler Labs’ vice president of advocacy and accessibility, who has a hearing loss. After a promising start and the launch of its Here One earbuds that allowed users to manipulate ambient sound, Doppler shut its doors in October 2017, mainly due to the cost of hardware.
technology roundup
Apps to Help With Hearing
Captions Where You Need Them...
the increasingly sophisticated digital signal processing that smartphones provide continues to spur tech entrepreneurs to develop apps for a range of hearing issues, including hearing testing, protection, amplification, education, captioning, and tinnitus relief. There are simply too many to list here, so we point you to two in-depth resources online: “70+ Best Hearing Loss and Tinnitus Apps for Your Ears,” from Everyday Hearing; and “The Best Apps for Phone Captioning,” from Healthy Hearing. (For links to the stories, see hhf.org/winter2018-references.) Here is a selection of noise-fighting technology that did catch our attention: A project called Sounds of New York City (SONYC), led by New York University and Ohio State University scientists, aims to help prevent noise-induced hearing loss (NIHL) by monitoring the sounds of the city. SONYC helps to create a constant, large-scale, data set of acoustics in the city by gathering sound information from a network of smart sensors that can be trained to recognize sounds, such as a jackhammer, and citizen reports, mainly through the city’s 311 non-emergency hotline and app. Funded by the National Science Foundation, the project will help city officials better identify areas of excessive noise pollution and strategically employ resources to mitigate noise. Also leveraging crowdsourced information, the SoundPrint app uses decibel readings sent in by users to provide color-coded, numerical noise rankings of public places such as restaurants and coffee shops, presented on a map and as a list, so you can find a quiet spot. The lessersound app records decibel measurements, mapping them as data points and providing color coding to show danger levels at a glance. For an engineering project, Harvard students created the Sweetspot app that helps people find collaborative workspaces on campus that have lower levels of noise. Unlike the crowdsourced decibel readings, acoustic data for the app was collected by Wi-Fi–enabled microphones set up around campus. The Warfighter’s Hearing Health Instructional Primer (WHHIP) app is designed to help prevent hearing loss and tinnitus, the top health issues for military service members. Developed by the Office of Naval Research, WHHIP teaches about hearing conservation through videos, photos, and text, including the ability to send closeup selfies to see if earplugs are being worn correctly. —Carol Stoll
google-owned youtube introduced auto-captioning (with mixed transcription results) back in 2009, and now other tech giants are following suit, making posted video content more inclusive. In June 2017, Facebook Live enabled closed captions, helping Facebook’s roughly 65 million active daily visitors who have a hearing loss (as estimated by Business Insider) to experience live video. Apple Clips, launched in April 2017, is a social video–editing app that allows users to combine videos, photos, and animated captioning and effects, including auto-captioning, through a feature called Live Titles. The University of Michigan’s Scribe software utilizes machine intelligence to algorithmically combine the notes of multiple non-expert (and less expensive) transcribers to catch errors and reduce costs, producing real-time captions in less than four seconds.
...and Muting, Too Good news for anyone who has ever been jolted by a loud ad that suddenly plays when you (or someone near you) opens a link on their phone or laptop: Starting in January 2018, the default setting on the Google Chrome browser will block autoplay videos. —C.S.
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Soundhawk also ceased production for similar reasons, after being highly rated in a July 2017 JAMA research letter as an effective personal sound amplification product comparable to a hearing aid.
Noise Protection and Education “Instead of using electronics to try and synthesize something artificial, we’re taking the actual sound waves that come into your ear, and modifying them. So, what you hear is the actual, physical pressure wave, as it is already arriving into your ear.” —Knops founder Arjen De Jong, Ph.D., whose doctorate is in acoustics. The Dutch-based company ran a successful Kickstarter campaign to fund volume-adjustable, analog earplugs that are scheduled to ship in early 2018.
“A custom-designed and built ‘Jolene’ will be the heart of the exhibit, allowing museum patrons to measure the sound level at which they typically listen to music. The sound level [in decibels] will be displayed on a large computer monitor along with a dynamic display of associated safe listening time per day based on that specific sound level.” —University of Northern Colorado audiology and speech-language sciences professor Don Finan, Ph.D. Finan helped create a 3-D–molded “interactive ear” that is part of a green-haired mannequin called Jolene to teach about noise-induced hearing loss in Phoenix’s Musical Instrument Museum.
Share your story: What is your favorite hearing-related technology? Tell us at editor@hearinghealthmag.com. Support our research: hhf.org/donate
For references, see hhf.org/winter2018-references.
Download on the
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TINNITUS TECHNOLOGY
The best Tinnitus Masking solution is the one you don’t even have to think about. The Aurio App offers a solution to mask the personal negative effects of Tinnitus whilst listening to music or other media.
and customise their personal balance of white, pink, brown and purple noise to mask their individual Tinnitus condition. Personalised levels can be set for each ear and individually
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RECHARGEABLE HEARING AID BATTERIES: What You Need to Know hearing aid users have long made it clear they would prefer rechargeable hearing aids over their disposable battery counterparts. A recent survey by The Hearing Tracker revealed that 70 percent of hearing aid wearers want rechargeable batteries, but interestingly only 11 percent have them. One of the primary reasons for this discrepancy is disappointment with past rechargeable battery performance. Traditional rechargeable hearing aids use nickel-metal hydride (NiMH) batteries, which often fail to operate hearing aids for a full day on a single charge. Rechargeable battery technology has made significant strides in recent years in power, capacity, and duration, making it a more practical solution, even for today’s most sophisticated hearing aids. There are two new battery options available for rechargeable hearing aids: silverzinc (AgZn) and lithium-ion (Li-ion). Both options offer a full day of power on a single charge, but they have distinct differences to consider when evaluating which rechargeable battery option is right for you.
Silver-Zinc (AgZn)
Silver-zinc batteries provide all-day power on a single charge—even with Bluetooth streaming. And now, nearly every major hearing aid manufacturer offers select products with silver-zinc rechargeable batteries. Silver-zinc batteries are small, which enable them to be used in many of today’s most popular size 312 hearing aids. The charging process is easy: Each night the hearing aids are placed in the
Rechargeable battery technology has made significant strides in recent years in power, capacity, and duration, making it a more practical solution, even for today’s most sophisticated hearing aids. charger and are fully charged in the morning; charging time can take up to seven hours. If you forget to charge, the batteries are removable and can be used with zinc-air disposables. This gives you the confidence of having a fast-acting backup plan. Silver-zinc batteries last a whole year and should be replaced annually. Additionally, silver-zinc batteries are nontoxic, nonflammable, and recyclable.
Lithium-Ion (Li-ion)
Lithium-ion batteries also provide all-day power on a single charge, with streaming. Currently there are two manufacturers that offer Li-ion rechargeable hearing aids. Li-ion batteries are larger than silver-zinc; the smallest Li-ion battery is about the same as a size 13 battery. The charging process is easy and fast; Li-ion hearing aids can be fully charged in about three hours. If you forget to charge you can rely on a 30-minute charge to give you up to six hours of wear time. For safety reasons, the battery compartment is sealed, so Li-ion batteries are not interchangeable with disposable
batteries. Li-ion batteries last longer than a year, and potentially can last the life of the hearing aid. A hearing care professional can provide additional information and help you make the right battery and hearing aid choice to best meet your individual hearing and lifestyle needs. With all-day power from a rechargeable battery, you do not need to worry about a battery dying at an inconvenient time, plus they eliminate the hassle of frequently changing small batteries. With new rechargeable options available, more people can benefit from the convenience that reliable rechargeable hearing aids provide. For more about ZPower silverzinc rechargeable batteries, visit zpowerhearing.com.
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Tech Solutions
This sponsored collection represents current trends in hearing technology.
Aurio
Hearing Amplifier
Aurio gives you the means to control your Tinnitus and simultaneously improves your quality of life. Aurio masks the personal negative effects of your Tinnitus whilst you are listening to music or other media and can be individually customized to offset any personal Tinnitus condition. Used anywhere, in any location, Aurio provides a full spectrum of masking sounds which can be customised to suit your profile, volume controls for each masker, and adjustments for either ear. Save a specific Soundscape for every change to your Tinnitus during the course of your day. Visit aurio.life.
CapTel
Ideal for people with hearing loss, the CapTelÂŽ Captioned Telephone works like any other telephone with one important addition: It displays captions of every word the caller says throughout the conversation. CapTel phone users can listen to the caller,
and can also read the written captions in CapTel's bright display window. You hear what you can and read what you need to, letting you enjoy phone calls with confidence. Different models to fit your lifestyle. Visit captel.com.
CaptionCall
CaptionCall is a revolutionary phone for hearing loss. It displays smoothscrolling captions of what callers say on a large, easy-to-read screen while simultaneously providing powerful amplification and superb audio quality. CaptionCall is an ambassador for hearing health and an advocate for people with hearing loss, encouraging people everywhere to actively manage their hearing health through regular evaluations and early treatment. CaptionCall is committed to helping people with hearing loss stay socially engaged for a happier, healthier life. Visit captioncall.com.
These featured products are paid advertisements. To advertise in Hearing Health magazine, please email advertising@hhf.org or call 212.257.6141. 46
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Changing lives and gaining popularity! The Britzgo BHA-220 is an affordable Hearing Amplifier that’s equipped with 4 modes and is suitable for all lifestyles. It comes with a 5th generation digital chip, soft adjustable tubes for both ears, and over 500 hours of use per battery! Britzgo offers an unbeatable price of only $54.95. We also promise the best in customer care, a 90-day money-back guarantee, and a one-year warranty. Visit hearingamplifier.com.
InnoCaption
Funded by the Federal Communications Commission, InnoCaption is a smartphone app (for iPhone and Android) that provides realtime captioning on incoming and outgoing calls. Our patented technology uses stenographers to provide captions within a couple of seconds with at least 95 percent accuracy. Our features include captioned voicemail, access to 911, caller ID, speed dial, and favorite contacts! The app is free to download and use for those with hearing loss. Visit innocaption.com.
Innovative Real-Time Captioning for Your Smartphone Calls
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OTOjOY LoopBuds
OTOjOY LoopBuds are telecoilenabled earbuds that allow you to access the sound from any hearing loop with your smartphone. Simply download the LoopBuds app, walk into a looped venue, and receive crystal-clear audio directly into your ears without the need for a hearing aid. Visit www.loopbuds.com and use coupon code “HHF2018” for a $5 discount. Retail Price: $75
Rayovac’s NEW Pro Line Advanced Hearing Aid Batteries
In a recent Rayovac study, hearing aid wearers ranked battery life as the most important factor when choosing a hearing aid battery. Rayovac’s NEW Pro Line Advanced line addresses this with a new design and formulation that deliver more power to ensure that no hearing aid battery lasts longer (based on ANSI/ IEC performance tests for size 10, 13, 312)! In addition, Rayovac’s NEW easy to use package and tab make handling the battery easier than before. For more information on this new product contact your hearing professional today!
Panasonic KX-TGM450S Amplified Phone
Hear and be heard, loud and clear. Panasonic’s easy-to-use KX-TGM450S amplified phone system is ideal for everyone affected by hearing loss. Bright LEDs signal incoming calls and one-touch features boost caller volume up to 50 decibels (dB) and ringer volume up to 112 dB. Slow down fast talkers while conversing/ checking messages by using the slow talk feature. Enlarged dial and function pads, speakerphone, English and Spanish Talking Caller ID, and 250-number call block are included. Expandable up to six handsets for whole-house convenience. Visit shop.panasonic.com/amplified.
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Sennheiser Set 880 and Set 860
Sennheiser’s Set 880 and Set 860 assistive listening devices let you enjoy your favorite movies to the fullest. The wireless headphones deliver crystal-clear, enhanced sound. To optimize speech and music, the Set 860 features three hearing profiles, while the Set 880 model offers five profiles to tailor the sound to your preferences. A unique Speech Intelligibility feature helps to boost speech clarity dynamically, reducing TV background noise that may interfere with the dialog. Visit sennheiser.com/set880.
SonicCloud: This App Makes Every Call Sound Perfect! Try It Free
Give yourself the gift of hearing so you won’t miss a word when talking on the phone with loved ones! If you've been struggling to hear on your smartphone, simply download this breakthrough app and take your free hearing test. You'll experience perfect calls in no time! SonicCloud is based on the latest science in audio processing and neuro-acoustics, and is available for Apple iOS and Android smartphones. Visit soniccloud.com.
These featured products are paid advertisements. To advertise in Hearing Health magazine, please email advertising@hhf.org or call 212.257.6141.
SUPPORTERS OF HEARING HEALTH
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meet the researcher
hearing health foundation
Emerging Research Grants (ERG) As one of the only funding sources available for innovative research, HHF’s ERG program is critical. Without our support, scientists would not have the needed resources for cutting-edge approaches toward understanding, preventing, and treating hearing and balance disorders.
EMERGING RESEARCH GRANTS
Meet the Researcher Jennifer Resnik, Ph.D.
Massachusetts Eye and Ear, Harvard Medical School
Resnik received a doctorate in neuroscience from the Weizmann Institute of Science in Israel and is currently a postdoctoral research fellow at Massachusetts Eye and Ear, Harvard Medical School. Resnik’s 2017 Emerging Research Grant is funded by Hyperacusis Research Ltd.
In Her Words sensorineural hearing loss due to noise exposure, aging, or certain drugs or diseases reduces the neural activity transmitted from the cochlea to the central auditory system. These types of hearing loss often give rise to hyperacusis, an auditory hypersensitivity disorder in which low- to moderate-intensity sounds are perceived as intolerably loud or even painful. previously thought as originating in the damaged ear, hyperacusis is emerging as a complex disorder. While it can be triggered by a peripheral (external) injury, it develops from a maladaptation of the central auditory system to the peripheral dysfunction. In other words, the brain, in trying to fix one thing, damages another. the recovery of sound detection and speech comprehension accompanied by an increase in sound sensitivity may reflect an “overcompensation” that drives the recovery of basic signal representations but also pushes central networks toward unstable states of heightened excitability and gain. we want to better understand the paradoxical role of central auditory system plasticity as both the cause of— and treatment for—the perceptual consequences of hearing loss. To do this we are studying the brain’s compensatory mechanisms, after cochlear damage, that allow for basic sound recovery but also introduce chronic hypersensitivity, such as hyperacusis. Then we need to figure out how to use these mechanisms to our advantage, in order to improve how the brain processes sound after hearing loss. as a child curious about how things work, I remember wondering, Can animals understand speech? How do they communicate with one another? Now I wonder, how does the brain modify its own circuits and functions in order 50
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to navigate through dynamic environments and evolving sensory needs? By this I mean changes in the environment, like the lack of light or a lot of noise, or changes in the signal, such as talking to someone who has an accent. All of these affect how our brain interprets sound. my audiogram shows typical hearing, but I know I have problems understanding speech in noisy environments, unless the person is standing right next to me. There isn’t yet a test (for humans) to diagnose “hidden hearing loss”— difficulty hearing speech in noise—but I sometimes wonder if it could be that. spanish is my mother tongue, since I grew up in Argentina. Then I lived and studied in Israel and learned Hebrew, and now I am in the U.S. using English. So I speak three different languages, which makes me think about speech sounds, meanings, accents, and tones on a daily basis.
Jennifer Resnik, Ph.D.’s grant is funded by Hyperacusis Research Ltd. for her work investigating hyperacusis. We thank Hyperacusis Research for its support of studies examining hyperacusis and other severe forms of loudness intolerance.
We need your help in funding the exciting work of hearing and balance scientists. Please consider donating today to Hearing Health Foundation to support groundbreaking research. Visit hhf.org/name-a-grant.
HamiltonCapTel.com/Apps Voice and data plans may be required when using Hamilton CapTel on a smartphone. Copyright © 2018 Hamilton Relay. All rights reserved. • Hamilton is a registered trademark of Nedelco, Inc. d/b/a Hamilton Telecommunications. • CapTel is a registered trademark of Ultratec, Inc. Hamilton CapTel may be used to make 911 calls, but may not function the same as traditional 911 services. For more information about the benefits and limitations of Hamilton CapTel and Emergency 911 calling, visit www.HamiltonCapTel.com/911.
Internet Protocol Captioned Telephone Service (IP CTS) is regulated and funded by the Federal Communications Commission (FCC) and is designed exclusively for individuals with hearing loss. To learn more, visit www.fcc.gov. • Third party trademarks mentioned are the property of their respective owners.
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LIFE IS FULL OF HIGHS AND LOWS YOU DEFINITELY WANT TO HEAR IT
SYNCHRONY EAS SYSTEM Have you been told you have too much hearing for a cochlear implant? Electric Acoustic Stimulation is the combination of two technologies: a cochlear implant for the high frequencies, and acoustic amplification for the low frequencies. The new SYNCHRONY EAS System combines the lightweight SONNET EAS Audio Processor with the unparalleled MRI safety* you get with the SYNCHRONY Cochlear Implant.
SYNCHRONY EAS System
Together, the two technologies cover the full range of hearing. Visit medel.com for more details. SYNCHRONY Cochlear Implant is approved for MRI scanning at 1.5T and 3.0T without magnet removal. Please ensure that all conditions described in the IFU for scanning are followed. For MRI scanning instructions and information on potential risks and contraindications relating to implantation, please visit www.medel.com/us/isi-cochlear-implant-systems/