Check Out This Awesome Video On Why Cochlear Implant Users Can’t Hear Music Well

Kudos to Hearing Review for catching this awesome video of a TED conference talk on why cochlear implant users can’t hear music well. This one hits home for me, because when I lost most of my hearing nine years ago, music suddenly became a discordant jumble of noise that was impossible to enjoy any more. Now I find it’s exactly what cochlear implantees experience.

Dr. Charles Limb describes how devastating the loss of  music can be to his cochlear implant patients while explaining in layman’s terms why it happens. As both a musician and a cochlear implant surgeon, he combines his two passions to study the way the brain creates and perceives music. He is an Associate Professor, Otolaryngology, Head & Neck Surgery, at Johns Hopkins who performs cochlear implantations on patients who have lost their hearing. He is also an accomplished musician on the faculty of the Peabody Conservatory of Music who plays sax, piano and bass.

If you listen to the comparison on the video between “normal” symphonic music and an estimation of what people with cochlear implants hear, you will understand the problem better. Cochlear implantees can’t hear the difference–both sound equally bad (I can’t hear the difference either).

Part of the problem is that neither cochlear implants nor hearing aids are optimized as much for music as for speech. The chart that Dr. Limb displays shows the frequencies and sound levels you need to replicate or amplify for speech, versus the much wider range of frequencies required to convey the richness of music.

But the problem also extends to the brain’s ability to process sound as both music and speech, including the emotional impact music can have. Dr. Limb is fascinated with the idea “that acoustic vibrations in the air can make you feel deep emotion, something that can affect your life.” Music requires a comprehension of pitch, tone and timbre, but cochlear implantees, and people like me with certain kinds of hearing damage, can’t discern warmth in a tone or the timbre of a violin versus a trumpet–qualities that enable music to stir powerful emotions.

The interaction between the mechanical hearing functions and how the brain processes sound and music still is not very well understood. Sound waves are shaped within the ear canal and transmitted through the ear drum and middle-ear bones to the hearing-hair-cell nerves in the cochlea, where they are transformed into electrical impulses carried by the auditory nerve. But then the brain takes over and interprets those sound waves, understanding them as speech, music, a baby’s chatter or cry, random noise or other sounds.

Readers of Musicophilia by Oliver Sacks will be familiar with the mysteries of how the brain processes sound. I found some comfort in the research the book reviewed on the brain’s amazing ability to rewire itself to improve its comprehension of audio inputs after the hearing organs have been damaged. In one of his case histories (and to a lesser degree in my own experience), the brain is able to improve its comprehension of speech over time, and to a lesser extent music as well–to fill in the gaps when the hearing organs are malfunctioning.

But as Dr. Limb makes clear, a lot more is unknown than known at this point. How the brain processes and discerns the quality of music — pitch, tone and timbre — is relatively new territory for researchers. While cochlear implants (and hearing aids) have been wildly successful in restoring the ability of the deaf to hear and understand speech, there’s still a long way to go before they can restore a complete ability to appreciate music.

“If you had a sense to lose, we are furthest along medically and surgically with hearing,” says Dr. Limb, but he adds, “Most implant users really struggle and dislike music because it sounds so bad. So when it comes to this idea of restoring beauty to somebody’s life, we have a long way to go.”

It’s Official: One In Five American Adults Has Hearing Loss

The recent Johns Hopkins survey of hearing loss in the United States, which finds that one in five Americans aged 12 and over suffers from hearing loss, shouldn’t surprise anyone. But it’s still a shocker, especially when you realize that only a small minority of that 20 percent is getting any help for their hearing loss.

Those of us who write about hearing loss usually cite government data putting the number in the range of 30 to 35 million Americans. The Johns Hopkins study says 30 million American adults–about 12 percent–have hearing loss in two ears, and that 48 million, or 20 percent, have hearing loss in at least one ear.

The survey also uses the World Health Organization’s definition of hearing loss: not being able to hear sounds of 25 decibels or less in speech frequencies. So the results are relevant to the hearing health care profession.

The Johns Hopkins hearing-loss survey is important because it’s hard to find current data from an impeccable source. Johns Hopkins is one of the world’s top public-health research institutions, so its count is probably the most accurate new assessment of the prevalence of hearing loss in the U.S. The survey used data from the National Health and Nutritional Examination Surveys (NHANES) conducted by the U.S. Centers for Disease Control, and the painstaking methodology the researchers used provide credibility to their claim that the results are representative of a cross-section of Americans.

The study’s authors say the findings “suggest that many more people than previously thought are affected by this condition,” which isn’t a surprise, as they used more recent data than many of the other studies that are more often quoted. It just reinforces the intuitive conclusion that as the Baby Boom generation ages, the incidence of hearing loss across the population is going to increase at a predictable rate.

But the “one in five” headline is still a shocker. Especially when you realize that only a small minority of that 20 percent is getting any help for their hearing loss. Let’s see if the headlines make a difference.

Nearly Half Of AARP-ASHA Survey Respondents Say Their Hearing Is Getting Worse, But Majority Fail To Take Action

Why do so many people who know their hearing is getting worse fail to seek treatment? That question screams from the remarkable survey results just released by AARP and the American Speech-Language-Hearing Association (ASLH).

There are a number of answers, but according to the survey, the high cost of hearing aids and inadequate insurance coverage for hearing-loss treatment (or lack of health insurance entirely) are high on the list of reasons people don’t seek out help for their hearing problems.

Check out some of the results of the survey of AARP members:

• While 88 percent said they had their vision tested in the past five years, less than half that number, 43 percent, had their hearing checked.
• But in the same period, nearly half (46 percent) said their hearing has gotten worse, with 61 percent saying they have difficulty following conversations in noisy situations.
• And even though 85 percent said maintaining hearing health is of great importance to them personally, 57 percent of respondents with hearing difficulties said they are not seeking treatment.
• Why do they fail to seek treatment? Here’s the kicker: “Nearly two-thirds of poll respondents (63 percent) cite health insurance coverage limitations, concerns about cost, and lack of health insurance as reasons for not getting treatment for hearing difficulties.”

AARP is the world’s biggest organization for people over the age of 50, and when it zeroes in on an issue it can move mountains. What would happen if AARP got on the hearing-loss bandwagon in a big way? Would we see more insurance companies providing coverage for hearing aids? Would we see more pressure on hearing-aid manufacturers to provide more affordable solutions?

Unfortunately, there may be an even bigger problem than high costs and lack of insurance coverage for the failure of people to seek out help. The survey also reveals there’s still a tremendous fear of the stigma that, rightly or wrongly, so many people associate with hearing loss. When you read the full report on the results (click here to download the PDF), you see too many troubling mentions of survey respondents wanting to “cover up” evidence of their hearing loss:

Fifty-seven percent of those with untreated hearing problems say their problems don’t warrant treatment and are easy enough to “cover up.” The foremost reason for not seeking treatment is a perception that their hearing issue isn’t severe enough – that they are getting by without treatment. They seem to have found ways that they believe cover up their hearing issues, and do not see a connection to an improved quality of life that treatment may provide.

Maybe the best result of the AARP focus on the hearing-loss issue will be a reduction in the stigma associated with hearing aids and a greater acceptance by the over-50 Baby Boomer set of the notion that a little help with their hearing could go a long way. But I’m not holding my breath!

Study Linking Hearing Loss To Dementia Raises More Questions Than It Answers

When Johns Hopkins researchers demonstrated a strong correlation between hearing loss and dementia, they confirmed previous research on the same subject but failed to answer what the study’s author termed “the 50-billion-dollar question”—whether hearing aids or cochlear implants correcting hearing loss could serve to prevent the onset of dementia.

The new study, published in the Archives of Neurology, used data collected by the Baltimore Longitudinal Study on Aging to follow more than 600 dementia-free adults between the ages of 36 and 90 for an average of 12 years. Those who had hearing loss at the start of the study were significantly more likely to develop dementia: those with mild, moderate, and severe hearing loss had twofold, threefold, and fivefold, respectively, the risk of developing dementia over time.

But according to the principal author of the study, ear surgeon Frank Lin, M.D., Ph.D., the results do nothing to answer the most obvious questions it raises: Might hearing loss be a cause of dementia? Or does hearing loss simply accompany dementia, without any cause or effect? Can diagnosed hearing loss can be used to predict onset of dementia? And that 50-billion-dollar question: can hearing correction enabling seniors to communicate better actually fend off onset of dementia? Additional research will be required to answer any of these questions, let alone understand why there is a connection at all. Two earlier studies, one in 1989 and another in 2008, came to a similar conclusion but left open the same questions.

“We really need to begin studying what the exact mechanism is,” Lin told Fox News. “And we need to begin studying whether hearing aids could have an effect on the onset of dementia.”

Harvard Health Study Finds 20 Percent Of U.S. Adolescents Have Significant Hearing Loss–But Will We Do Anything About It?

Researchers at Harvard University and Brigham and Women’s Hospital in Boston have concluded that nearly one in five American adolescents suffers from the same degree of hearing loss comparable to the age-related loss normally found in adults in their ’50s and ’60s. And people immediately are pointing the finger of blame at all the usual suspects: rock concerts, cell phones, and the ubiquitous Apple iPod and other portable music players. That’s all well and good, but it begs the question of all the other environmental noise people are subjected to from birth. The sad fact is we’re living in a much noisier world than 20 or 30 years ago, and no matter how many times we tell people to turn down the iPod, there is no substitute for a far more organized response to the epidemic of environmental noise-related hearing loss than we have seen to date. Read more

U.S. Hearing Aid Sales Recovery Stalls In Second Quarter Of 2010 Even As Veterans Administration Fits More Hearing Aids Than Ever

Are we in for a double-dip recession in the hearing-aid business? According to the most recent analysis of U.S. hearing aid sales by the Hearing Industries Association (HIA), the number of hearing aids sold in the U.S. only grew by 2.9 percent in the second quarter of 2010. When you exclude an 11.6 percent increase in units bought by the U.S. Veterans Administration (VA), which now purchases 20 percent of the hearing aids sold in the U.S., the American market grew by an anemic one percent in the quarter. Similarly, in the entire first half of 2010, the overall market grew 4.2 percent, with VA sales growing 15 percent but private sales growing only by 1.8 percent over the first half of 2009.

The slowdown from the much faster sales ramp in 2009 is bad news for an industry hoping for a quick recovery from the 2008-2009 recession. It may also indicate that even the raft of new products and capabilities introduced by hearing aid manufacturers in the past two years may not be enough to spark the long-awaited takeoff in hearing aid sales to a generation of Baby Boom consumers steadily losing their hearing at predictable rates.

The surge in government-funded purchases by the VA can be attributed to loosened restrictions on reimbursement for veterans needing hearing aids over the past several years, as well as to the age wave of Korean War and Vietnam War veterans now requiring hearing assistance and the many younger veterans returning from Iraq and Afghanistan with hearing damaged by overexposure to environmental noise in the war zones.

While the government-supported VA market is a welcome shot in the arm to the industry, it’s still an open question why sales to ordinary consumers have yet to take off. With up to a third of the 35 million Americans in need of hearing assistance doing without hearing aids, the question to answer is “when,” not “if.” However, the poor sales improvement in 2010 so far makes it clear the hearing aid industry has yet to crack the code to realizing the expected surge in sales to a market that needs hearing assistance more and more all the time.

Product Review: Songbird Ultra Digital Hearing Aids Are A Good First Step If You Think You Might Need Hearing Assistance

I purchased a Songbird Ultra Digital Hearing Aid over the internet recently and have been trying it out myself and with other users in different listening situations. The good news is that the inexpensive entry-level device is a true open-fit, behind-the-ear digital hearing aid that performs like other comparable low-end hearing-aids. That’s also the bad news: because it performs like other comparable low-end hearing-aids, it has many of the same drawbacks you find in many entry-level digital hearing aids.

But given the Songbird Ultra’s ultra-low $300 (USD) price compared to many other digital hearing aids with similar features, for me the net takeaway is that it’s a great first step for those who think they might need hearing assistance but aren’t yet ready to take the plunge with a visit to an audiologist that will most likely end up costing several thousand dollars or more. You can think of the Songbird Ultra in the same way a first-time home buyer thinks of a “starter home”: buy it at an affordable price, get used to the demands of owning it, and spend some time in a perfectly adequate situation until you get to know exactly what kinds of features you want when you can afford a more expensive one.

Songbird is a leader in the new class of “over-the-counter” (OTC) hearing aids that you can buy and use right away without a prescription from an audiologist (think of reading glasses purchased at the pharmacy versus prescription eyeglasses purchased from an optometrist), which I’ve written about before. If you are a Baby Boomer struggling with the early signs of high-frequency hearing loss — i.e., you can’t hear what they’re saying on TV or in the movies as well as you used to, understanding conversation in restaurants is more challenging, and your spouse and children are starting to complain you either don’t listen or can’t hear — it’s worth investigating OTC hearing aids. You can buy them online, try them out, and in the case of the Songbird Ultra, if you don’t like it, just return it within the 30-day no-questions-asked money-back guarantee period.

Buying a Songbird hearing aid is a snap: just go to the company’s web site, get out your credit card, and follow the directions. The hearing aid arrives in an attractive package with a carrying case, cleaning tools and a pack of standard 312 hearing-aid batteries. You get left-ear and right-ear tubes with sound tips so you can use the hearing aid with either ear. The soft, pliable open-ear tips are comfortable and easy to insert, and they solve the one-size-fits-all problem with a generous length of tubing to the processor that sits behind the ear, and a retention cord extending from the ear tip that is easy to grab when you want to remove the hearing aid but which also sits in the bowl of the ear and applies just enough pressure back on the tip to keep it snuggled deep within the ear canal. There is also a well-laid-out user instructional brochure that makes care, use and troubleshooting of the Songbird Ultra crystal clear. Read more

Phonak Uses World Cup Vuvuzela Noise As Design Laboratory For New Hearing Protection Products

Phonak’s Hear the World initiative got so much attention from its announcement that vuvuzela horns were damaging World Cup attendees’ hearing that the hearing aid company’s product designers sprung into action to adapt Phonak’s popular Serenity industrial hearing-protection products with a new line of consumer devices for fans who need to protect their hearing at stadium events such as major league sports events and rock and roll concerts. Hear the World announced that Phonak customized a new version of its Serenity state-of-the-art hearing protection systems–typically used by helicopter pilots, fire-fighters, industrial staff and security professionals–and sent it to World Cup journalists in Johannesburg, South Africa, to see how well it would filter out the endless drone of the vuvuzela. The noise makers emit sound at an ear-splitting 127 decibels (dB), louder than a lawnmower (90 dB) and chain saw (100 dB). Continuous exposure to noise at more than 85 dB will cause permanent hearing damage, so virtually all fans in a stadium enduring an extended chorus of vuvuzela noise are at serious risk of hearing loss. Read more

VitaSound Neuro-Compensator Applies Brain Science To A Unique And Potentially Revolutionary New Sound Processing System For Hearing Aids

VitaSound Audio, Inc., a young hearing-aid company in Canada, has come up with an entirely new approach to sound-processing software for hearing aids that could fundamentally change the way we think about compensating for damaged hearing. I got a demo of VitaSound’s Neuro-Compensator technology several months ago and have been struggling ever since to come up with appropriate words to describe it. “Unique,” “new,” “unprecedented” and “potentially revolutionary” are the best I can do for starters.

The Neuro-Compensator sound processing system is based on nearly two decades of research at McMaster University in Hamilton, Ontario, into how the human brain comprehends the signals processed by the auditory system, from the middle ear through the auditory nerve. The researchers mapped the signals produced by hundreds of auditory inputs processed by people with healthy hearing, coming up with a hugely complex model of “normal” hearing response to sounds ranging from human speech to music to pure tones to rush-hour traffic to cocktail-party noise. Then they developed the Neuro-Compensator software to compare the norm to that of a person with damaged hearing, and to produce a hearing-aid amplification program that not only amplifies the frequencies where hearing has been lost, but also filters out sounds that a healthy auditory processing system would normally suppress. The benefit is better comprehension because the system constantly adjusts amplification at multiple frequencies in response to different sounds to match the auditory profile of a normal, healthy auditory system responding to various listening environments. Read more

‘Invisible Hearing Aid’ Pioneer Lyric Hearing Is Fast Out Of The Gates In A Market That Is Sure To Draw Plenty Of Competition

Lyric Hearing is only a few years old, but the “invisible hearing aid” pioneer is first out of the gate in a market that is sure to attract plenty of competition. Lyric Hearing Aids are tiny devices placed so deep within the ear canal that it is truly impossible to see them. Because they are so small and located so close to the ear drum, they claim to deliver auditory benefits that normal hearing aids can’t provide. And, once they are inserted, they remain in place 24 hours a day for up to four months, so the user doesn’t have to worry about replacing batteries or keeping track of them when not being worn. Lyric Hearing also has an unusual business model, selling the hearing aids on an annual subscription basis, with old hearing aids removed and replaced with new ones every few months by your audiologist. Just as the transition to soft, extended-wear contact lenses expanded the share of contacts versus regular glasses and changed the dynamics of the vision correction market in substantial ways, Lyric Hearing’s innovation has the potential to dramatically alter the hearing-aid market. How big an impact will Lyric Hearing and other “invisible” hearing aids like it have on the market? It depends largely on the tradeoffs between the many benefits and several significant drawbacks. Read more

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