The Widex Clear 330 and Clear 330 Fusion

The mid range Widex Clear 330 platform is a strong instrument range with the new Clear processor and Widexlink technology and the inclusion of some of the renowned Widex strategies. The 330 platform is a full family from custom to BTE including the Passion and the new Fusion form factor.

At present we have available all of the BTE instruments and we hope to have the custom instruments within a few months. I shall of course keep you informed of our progress with this.

The instruments are ten channel instruments as opposed to the 15 available on the Clear 440. They retain several of the inter ear features available on the 440, such as IE Feedback Cancellation, IE Zen, program synchronisation and volume control.

The instruments, were applicable, have multi channel adaptive directionality with the HD Locator and also the digital Pinna. Whilst it lacks the extra localisation cues given by the IE Compression system, the HD Locator combined with the Digital Pinna will give front to back localisation cues. The HD Locator system is already a fantastic directionality system, combined with the new processor in the Clear platform it will excel even further.

The instruments will also have the Free Focus feature if paired with an M Dex. The noise reduction system supplied is the Speech Enhancer, the noise reduction system that was utilised in the Widex Mind 440.

The Speech Enhancer is still the only noise reduction system ever shown to effect signal to noise ratio without any assistance from directional strategies. That is several years after its release in the Mind 440.

Applied in tandem with the faster and more powerful processor available in the Clear platform the Speech Enhancer should be even more effective in dealing with real world complex sound situations than it currently is in the Mind 440.

The Widex Clear 330 also has the two Widex Cornerstone audiological strategies the Audibility Extender and Zen. The early feedback on the latest generation of Audibility Extender is extremely positive with experienced users of the strategy reporting that it is the best one yet.

The instruments will have 4 programmes + Zen and will also be able to utilise compound programs as with the 440. The Zen as mentioned before will be the new Inter Ear version. The 330 will have connectivity to the full Dex Range.

On the programming side, the Widex Clear 330 and 220 platforms can only be programmed and fine tuned with Compass 5.4. When connecting to the instruments it is imperative that you give it certain information. Particularly the acoustic properties and receiver selection if applicable. This information is vital for the efficacy of the instrument and can be input in the selection screen

 

 

the Widex Clear 330 platform has access to the expanded sensogram, giving you the ability to undertake the sensogram across 14 frequencies. My opinion would be that if you can, you should undertake the sensogram across the 14 frequencies, it will make a difference to you and your Patient. Your Patient will have an instrument as closely fit to their hearing loss as is possible and the pay off for you is reduced follow up and fine tunes. A win win for everyone I think.

In the Fine tuning sphere you also have access to the channels for fine tuning purposes. Again this feature was first introduced with the Clear 440 and it has been included for the 330 platform. the occlusion control feature has been included to assist with those difficult fits.

I think this touches on the main run down of the instruments, if you have any questions, don’t hesitate to get in touch.      

The launch of the Clear 330 & 220 Instruments

 

We at Widex Ireland have just finished launching the Widex Clear 330 & 220 instruments to the Irish market. The launch was very successful and the devices were well received by customers and non customers alike.

With the introduction of the full Widex Clear technology range run in tandem with the existing Widex Mind platform offerings we feel that we are finally offering a strong balanced series of instruments to our Customers and their Patients.

Some of our Customers were in fact worried that we were going to allow the Mind platform to slip from our offerings. I was glad to assuage their worries telling them that the Mind platform and particularly the Mind 220 family were some of our most successful instruments ever and were here to stay for the moment.

In Ireland, just like other areas in our world, economic times have been tough for business. Our business is no different and has been effected by the prevailing economic climate. For our Customers the introduction of the Mind 220 family occurred at exactly the right time.

It meant that not only could they offer a hearing instrument to their Patients at a low price but they could have faith that it was an outstanding instrument with Widexs’ renowned sound quality and the efficacy that they had come to expect from the Mind series.

But I digress, the launch of the new products is what I should be rabbiting on about. The new downgrades were really well received, particularly the Clear Fusion 330 and Clear Fusion 220. We think the introduction of these devices will deliver un-restricted versatility to our customers in fulfilling the needs of a large proportion of their Patients.

The Clear Fusion has exceeded our expectations in every market that it has been launched in and has caused quite a headache for our manufacturing and production teams. I believe the expression is flying off the shelves, our manufacturing team are working at full tilt to supply demand, so if you are having difficulty acquiring one, don’t fear, Fusions are winging their way towards you as we speak.

We also gave the Dispensers a sneak preview of the Phone Dex, a landline wireless streaming solution which I will be sacked for mentioning here! But hey, I cant resist :) and Widex have come to expect it of me :) I shall just throw in a “sorry Mike”, “I prostrate myself before your towering benevolence and famed forgiveness, oh and you’ll miss me if you fire me”, “I shall never do it again until next time” here. Have to hedge your bets right.

Our customers where really impressed by the Phone Dex, oh those words again, and felt confident that it would be an ideal solution for more than one or two of their Patients. As I spoke about the instruments and the connectivity options I could see several of the Dispensers thinking about the Patients they would fit them to.

It brought me back to when I was in practice and product launches I had attended. It is easy for Dispensers to get jaded by product launches, you would also think that it would be easy for us to become jaded giving presentations. But there is real excitement around the Clear platform, both at Dispenser level and internally within the Widex family.

We at Widex feel that we have made a huge leap forward in technology with the Clear platform, laying the foundations for even more advances based on that technology both in hearing instruments and other possible applications for near field wireless connectivity.

I am really excited that the full platform is now nearly released, with the exception of the custom devices, the technology utilised in the platform across the different technology levels is outstanding giving truly strong instruments in every technology level and price point. Each tech level of the Clear platform represents itself well within that market segment and dare I say it is a front runner if not the leader in its market segment.

Below is a quick comparison sheet for the Widex Clear platform, I shall detail the devices and technology utilised within in separate posts.

Widex M Advert,

I still think this advert drips style and sophistication.

WidexLink

WidexLink
- a New, Industry-leading Technology for Wireless Transmission

In recent years, we have seen a variety of new hearing aids on the market with different wireless communication abilities. Some offer the possibility of transmitting sound to the hearing aid from a mobile phone, a TV, or an MP3 player. Others hearing aids are capable of exchanging coordination data, and a small number are able to transmit sound to one another.

We believe that the key to new achievements in the hearing aid industry lies in the ability to use a sophisticated wireless transmission technology which will facilitate the coordination of dynamic settings between two hearing aids, high quality transmission of audio from external sound sources, and wireless transmission of data between two hearing aids.

We are convinced that wireless technology is the future in the hearing aid industry. However, the success of any given wireless transmission technology will depend on at least three key issues when applied to hearing aids: Sound quality, transmission robustness, and power consumption.

WidexLink is our new proprietary digital radio frequency transmission technology. The new technology has been designed to provide the highest audio quality and efficiency. WidexLink offers new possibilities for extended bandwidth audio transmission between hearing aids (for example, CROS and BiCROS applications),extended bandwidth audio streaming from external assistive listening devices (for example, DEX devices) to hearing aids, and the continuous exchange of synchronisation data between hearing aids and external devices (Inter-ear communication).

The unique, digital wireless link offers an unparalleled low latency (delay) of <10 ms when transmitting audio. This ensures minimum distortion and echo-free audio quality when direct acoustic sound in the room is mixed with transmitted sound.

The need for a new technology

Today, Bluetooth is probably the most popular wireless technology for transferring data and digital sound between devices. The Bluetooth technology is available in a large variety of "plug-and-play" chip solutions. From an engineering point of view, therefore, Bluetooth is the fastest way to a digital wireless design. However, Bluetooth has some drawbacks which create serious problems in hearing aid applications.


First and foremost, Bluetooth is an extremely energy-demanding technology. The Bluetooth chip uses so much power that it has no practical application in the hearing aid industry. Moreover, even if another chip is used, battery drainage is still very high during Bluetooth transmission. Hearing aid manufacturers are therefore forced to find ways to optimise Bluetooth transmission if the power consumption is to be kept at a reasonable level.


Another serious drawback is that standard Bluetooth has a high built-in latency (delay) of 150 ms when transferring audio through the Bluetooth codec. That is, transmitted sound will reach the ear 150 ms later than the direct acoustic sound in the room. In hearing aid applications, this is a serious issue because the time delay between sound sources comprises important psychoacoustic cues about direction and distance to sound sources. The latency can be reduced by switching off some of the technological features while transferring digital audio, but there is a limit to how far this optimisation can be forced. As far as is known, the Bluetooth latency can be reduced no further than approximately 45 ms which is not sufficient to avoid artefacts in hearing aid applications.

Latencies and artefacts

A small delay of 1 to 10 milliseconds is unproblematic. However, when the delay between transmitted and direct sound becomes longer than 10 milliseconds, artefacts begin to occur. The first artefact to occur will be an audible comb-filter effect. It is called "comb-filter effect" because it filters away frequencies like a comb, making notches in the spectrum. The resulting sound will be hollow and metallic. Above 40 milliseconds the streamed sound will be perceived as an echo of the direct sounds. An additional problem can occur when sound is transmitted from for example a TV. When the delay reaches around 150 milliseconds, which is the default delay with Bluetooth, lip movements will begin to appear unsynchronised with the sound. Thus, hearing aid manufacturers who rely on Bluetooth or another technology which introduces a delay above 10 ms will not be able to avoid artefacts in their applications.

Also included on the list of Bluetooth drawbacks are the relatively large chip size and the high current consumption which are obviously essential parameters in a hearing aid design.

The artefacts that can occur as a result of the delay between direct sound and digital audio stream are listed in the figure below:

Figure 1. Psycho-acoustic artefacts due to latency (delay) between direct sound and transmitted sound.

 

The new technology from Widex has un-paralleled low latency of less than 10 ms between the direct acoustic sound and the digital audio stream. And in CROS and BiCROS applications, the delay is even shorter.

Advantages of WidexLink

It is no simple matter to design a system which can simultaneously maintain high audio quality, low battery drain, and robustness against transmission errors.
Widex achieved these goals by developing a very efficient audio coding method which is custom-designed for use in a hearing aid platform.


It was considered of the utmost importance that the highest possible audio quality should be maintained with the new wireless technology. In order to achieve this goal, several key components of the wireless system were carefully designed. First, a very efficient and robust audio codec (short for encoding/decoding) and radio frequency (RF) transmission system were developed to ensure fast, stable, and trouble-free transmission of sound and data during normal use.  It was a requirement that the digital audio codec be based on a coding principle which will ensure that the signal is perceived to be as close to the original sound as possible.  Another factor in maintaining a high audio quality was a low audio delay over the wireless transmission system.  To achieve this, the digital coding system was designed in such a way that no data would need to be re-transmitted and consequently slow down the transfer of the audio signal as a result.


Ensuring battery efficiency was also a major concern in the design of WidexLink. This goal was achieved through the employment of a very efficient data compression method, and the invention of a new, highly sensitive radio receiver which permits low transmission power.


Robustness was achieved in multiple ways. In addition to the inherent robustness of the audio codec and the radio receiver mentioned above, robustness was also attained by means of a highly efficient channel coding which detects and handles errors quickly and securely.


How WidexLink addresses the key factors will be discussed in more detail below.

High sound quality

Audio bandwidth

Audio bandwidth is one of the key factors in maintaining a high sound quality. Thanks to the new technology in the Clear product range, we are able to offer an exceptionally broad audio bandwidth in models with a Clearband receiver, stretching from 100 Hz to 11.2 kHz for transmitted sound. This is industry leading.

One area where a broad audio bandwidth makes a clear difference for hearing aid users is when they listen to music. The high frequencies provide ambience and brilliance to the sound. Thus, the sound experience will be somewhat richer with an upper bandwidth of 11 kHz when listening to the crispy sound of a hi-hat or cymbals, for instance. Similarly, an audio bandwidth stretching as far down as 100 Hz will produce a fuller bass.

Codec

Another way to maintain a high sound quality is to develop an efficient codec. Digital audio data as we know them from CDs are extremely bulky. It is therefore necessary to reduce digital audio data in some way as the transmission bandwidth is too narrow to effectively transmit the raw audio signal. This is achieved by means of data compression (not to be confused with the dynamic compression of the audio signal in the hearing aid).

Digital audio data compression is achieved by means of a set of complex algorithms called an audio codec.  An audio codec consists of two parts:  encoding and decoding.  The purpose of the audio encoding is to reduce the size of the digital data representing the original signal. The purpose of the decoding is to reconstruct the encoded audio signal in a manner which ensures that it is as close as possible to the original audio signal. This process is analogous to the shipping of a parcel by mail. If you wished to send an office desk from the U.S. to Europe, you could simply place the assembled desk inside a large box and send it. This shipping method would be quite expensive, though, due to the size of the parcel. A more efficient and less expensive method of shipping the desk would be to disassemble the desk into smaller pieces and package it in a much smaller box. The same principle applies to the transmission of digital audio. The cost of sending digital audio is related to its size. The larger the size of the digital audio data, the larger the transmission bandwidth has to be.


Two different compression techniques are typically used in order to squeeze the audio information into a smaller package.  Both compression techniques rely on the fact that audio signals have a great amount of redundancy.  


One commonly used technique is Redundancy Coding. This technique is similar to the process used when computers compress files into ZIP files. This type of compression can be demonstrated by a simple example:

If we need to send the number 1000000, we may compress it to 10⁶.

The compressed number represents the same digits as the original number, but comprises fewer characters. If each character requires four bits, the uncompressed number would require 28 bits (4 bits x 7 characters), while the compressed number would require 12 bits (4 bits x 3 characters). The technique is effective with data where there is lots of redundant information as is the case with digital audio signals. However, the technique has one major drawback; namely that it is relatively time-consuming. It is therefore not very suitable for hearing aid applications where a minimal delay is of the utmost importance.


Another commonly used technique for achieving a low bit rate is Irrelevance Coding.  It is widely used today to create MP3 and other types of digital audio files.  Widex also uses this technique for analysing and compressing audio data in a special part of the codec. .


It is well-known that raw, uncompressed audio contains more information than the human ear can actually detect. Our irrelevance coding algorithm removes all perceptual redundancies by extracting all of the irrelevant audio information which cannot be heard by the listener due to psychoacoustic masking effects in the cochlea. In other words, the irrelevance coding algorithm uses knowledge of masking to remove audio signal elements which are outside the limits of the human auditory system.  


Irrelevance coding relies on a phenomenon known as the Simultaneous Masking Effect. When listening to a soft and a loud sound simultaneously, it is often difficult to hear the soft sound because it is drowned by the loud sound. The masking effect is largest when the soft sound is in the same frequency range as the soft sound (Moore, 2006: 66). This psychoacoustic phenomenon is very useful vis-à-vis audio data compression. The irrelevance algorithm utilizes knowledge of this psychoacoustic effect to remove softer, less dominant sounds which will be masked by louder, more dominant sounds, from the audio signal.


Basically, our irrelevance algorithm reduces the amount of audio data that needs to be transmitted wirelessly by removing sounds which would not be audible to the listener in any case. And by removing sounds in the audio signal which the listener cannot hear anyway, while preserving the sounds the user can hear, the audio signal can be reduced significantly in size without compromising the high sound quality.

Safe digital transmission

Channel coding

An important aspect to consider when sending any type of digital data over a wireless connection is the potential for errors induced by radio frequency interference.


Errors will occur from time to time with any kind of transmission and especially in wireless transmission. The distance between the devices may change, the orientation of the antenna in the controller might be altered, or interference from radio noise might disturb the connection. Such errors must be handled effectively to minimise the inconvenience caused to the hearing aid user in the shape of crackling, dropouts in the sound, etc. Therefore, in order to prepare the audio data for transmission and ensure the integrity of the transmission with respect to correct receiver as well as the quality of transmitted data, channel coding is introduced.

Error detection and handling

The main task of the channel coding algorithm is to provide a method for ensuring that the digital audio signal which is received is indeed correct and error free. A common and very basic way to do this is to calculate what is called a checksum on the basis of the compressed data. The checksum is enclosed in the shipment alongside the data. When the data are received at the other end, a comparison of the checksum and the data is conducted to determine if any errors have been introduced into the digital audio signal.




Figure 2. The data in the shipment are compared
to the checksum on arrival to determine if any
errors have arisen.


However, a checksum will only establish whether or not an error has occurred. It does not provide a solution to how errors should be handled. A major advantage of Widex' channel coding algorithm is that, thanks to a so-called error corrective code, it ensures that a restricted number of errors can be both detected and corrected.

In a Bluetooth transmission technology, for example, the channel coding will by default ask for a retransmission of data which did not pass the receiver's error checking algorithm (www.bluetooth.com). Since retransmission requests will cause an extra delay whenever the system has to wait for the repetitions of the data to arrive, such a method is not a very good choice in a hearing aid application.

Another method involves the removal of audio data packages which contain errors. This method is for instance used in connection with DAB (Digital Audio Broadcasting). DAB-receivers cannot request a retransmission of signals vitiated by errors. Errors in audio data are simply handled by making dropouts in the sound, resulting in there being no sound playback when errors occur. An error handling method which results in clicks or dropouts in the sound is obviously not very suitable for a hearing aid application either.

Widex rely on a special channel-coding technique which is based on the principle of Graceful Degradation. This technique has none of the unfortunate by-products (long delay and dropouts) mentioned above. Instead, it provides a smooth, seamless listening experience for the hearing aid user.



Figure 3. Widex's channel coding algorithm
can both detect and handle errors.


Widex's channel coding algorithm has been designed to ensure that a small number of transmission errors can be corrected by the algorithm itself. A larger number of errors will be handled by means of the above-mentioned Graceful Degradation-based technique. This technique ensures that a large number of errors will not result in any abrupt changes in the output signal, such as dropout or cracking, heard by the hearing aid user. If the errors are too numerous for the algorithm to be able to correct them, the result will be a gradual fading of the sound. While transmission is interrupted, the HA will switch to the Master program. When the quality of the transmission channel is good enough to allow audio transmission once more, the sound will gradually fade in again to provide a nice, smooth listening experience for the hearing aid user.

Figure 4. Summary of three methods for error handling in connection with digitally transmitted data.

Digital Audio Transmission by WidexLink

 

The WidexLink technology makes it possible to minimise the amount of data that needs to be transmitted in order to ensure a high quality output signal. This is essentially possible thanks to the identical audio generators in the encoder and the decoder. More specifically, because the WidexLink encoder and decoder both contain identical synthetic audio generators, it is not necessary to transmit the original signal, or even the synthetic signal. All that needs to be transmitted is information about the discrepancy between the original sound signal and the synthetically generated signal. A more detailed discussion is included in the sections below.


The WidexLink encoding procedure can be divided into five main stages. In the first stage, the original audio signal is compared with a synthetic signal generated by a Synthetic Audio Generator. A Discrepancy Analyser generates information about how close the synthetic sound is to the original. A perceptual model is then applied to determine if discrepancies are audible or not (irrelevance coding). To keep the amount of data to a minimum, only audible discrepancies are allowed to influence the sound generation process. Next, the best approximation to the discrepancy between the original sound and the synthetic signal is retrieved from a large number of synthetic sounds stored in a Sound Sample Archive. And finally, information about which sample is the best approximation to the discrepancy between original and synthetic signal is transmitted to the decoder.

Figure 5. The WidexLink encoder principle.


With WidexLink, the sampling rate is 25.44 kHz, which means that the above procedure is repeated 25,440 times for each second of sound. This enables us to exploit the fact that there is typically not very much variation from one sound sample to the next to generate an increasingly accurate synthetic representation of the original signal.


The first time a discrepancy analysis has been conducted, information about the best approximation is used to create a Sound Model with information about the discrepancy between original and synthetic sound. This knowledge about the discrepancy between synthetic and original sound contained in the model is permitted to influence the generation of the next synthetic sound, whereby the difference between the new synthetic sound and the original sound sample can be reduced. By updating the model every time a sample has been processed by the encoder, the system is able to reduce the difference between original and synthetic signal to a minimum very quickly.


The decoder in the hearing aid contains an exact replica of the synthetic audio generator module in the encoder. Thus, information about the discrepancy-based best approximation is sufficient to provide all the necessary information for the synthetic audio generator in the hearing aid to be able to generate an exact copy of the synthetic signal in the encoder. In other words, the output signal generated by the hearing aid is a 100% synthetic sound identical to the synthetic sound generated in the encoder. The decoding sequence is presented schematically below.




Figure 6. The WidexLink decoder principle.

Transmission Robustness

A new, highly accurate and robust receiver has been developed for the Widex Clear product range to ensure safe transmission and low battery drainage. The accuracy of this new, patent-pending receiver enables us to operate with a low transmission power, which in turn contributes towards extending battery life.

Moreover, the modulation technique employed to send digital data over the wireless system also contributes to maintaing a high degree of robustness.

When sending digital data over a wireless system, a modulation scheme must be used. Modulation essentially determines how the digital information is sent through the radio frequency spectrum. One very commonly used digital modulation technique is Frequency Shift Keying(FSK). In an FSK modulation system, two frequencies are used to represent a binary "0" or a binary "1", respectively (see figure 7 below). So once the audio has been digitised, i.e., turned into a series of 0s and 1s, it can be transmitted by means of two different transmission frequencies which represent either a 0 or a 1. The receiver has to detect which of these two frequencies is being transmitted in order to determine if the transmitter is sending a 0 or a 1. The receiver then demodulates the signal by interpreting the frequencies received as either a 0 or a 1.

Figure 7. Illustration of the Frequency Shift Keying principle. In an FSK modulation system, two frequencies represent a binary "0" or a binary "1", respectively.


Traditional methods of wireless demodulation employ a simple two point sampling of the received wireless signal. This means that, in effect, the receiver relies on only two measurering points when it has to determine if the received signal is a "1" or a "0". Figure 8 below contains a model of the demodulation of a signal without noise.

Figure 8. Model of the demodulation of a signal without noise. Traditional methods of wireless modulation employ two points of sampling. In the example, the sample points indicate a rise. The signal will therefore be interpreted as a 1.

 

The demodulation method described above works very well with a clear signal and no noise. However, as illustrated in figure 9 below, using only two sampling points to determine if the transmitted signal is a 1 or a 0 can result in mistakes if noise is also present in the signal.

Figure 9. Model of the demodulation of a signal with noise. Signals can be wrongly identified when noise is present in the signal.

 

Consequently, Widex has developed a more secure variety of the FSK-method for the reception of wireless transmissions with a high degree of noise in the transmitted signals. The new method introduces a larger number of measuring points than the traditional two, which means that the receiver is able to determine with a much higher degree of certainty whether a received signal should be interpreted as a 0 or a 1.

Application

The new digital transmission technology is a central element in our new Widex CLEAR product range. It is used for the transmission of both data and audio signals in a large number of situations.

Transmission of audio

WidexLink is used for the transmission of audio signals from external devices to the hearing aids when the user watches TV, talks on his mobile phone, or listens to music.

Transmission of Audio via WidexLink
Typical Situation:	Sender and recipient:
TV	TV-Dex – Hearing aids
Hi fi	TV-Dex – Hearing aids
Mobile phone	M-Dex – Hearing aids
Personal audio device (Ipod, mp3 player, etc.)	M-Dex – Hearing aids

 

Transmission of data

WidexLink is also the employed in the transmission of data between remote control (RC-Dex) and hearing aid, and in the exchange of synchronization data between hearing aids (Inter-ear communication).

Transmission of data via WidexLink
Sender and recipient:	Feature:
RC-Dex - hearing aid	Remote control
Hearing aid - hearing aid	HA synchronisation Volume control Program shift
Hearing aid - hearing aid	IE coordination Compression Feedback cancellation Noise reduction
Hearing aid - hearing aid	WidexLink Surveillance Lost partner alarm

 

References:

Moore, B. C. J. (2006). An introduction to the psychology of hearing. Elsevier Publishing Company

www.bluetooth.com

 

 

 

Clear 440 Launch

The Clear 440 platform was launched very successfully to the UK & Irish market last weekend at the AIHHP conference at the Cobham Hilton in Surrey. The platform was well received by all who attended, with particular interest paid to the interear features and strategies and also the wireless connectivity.

We have launched initially the RIC format and BTEs and towards the end of the year, perhaps early next year  ‘in the ear’ versions will be released. The general feeling was that the connectivity options  look really elegant . Initially there will be options to stream wirelessly from TV and audio sources (TV-Dex) with no discernable time lapse or lip sync issues, the mobile phone streaming option (M-Dex) will follow very shortly. The new remote control option for the Clear 440 (RC-Dex) is very stylish, simple and intuitive.



Features in the Widex Clear 440 include Binaural Synchronisation, the new Widex range of hearing aids will ‘talk’ to each other in binaural fittings, this will  lead to better localisation, speech enhancement and improvements in hearing speech in noise. Another benefit is great feedback management and significantly improved directionality of sound.

Another couple of interesting features built into the new Clear 440 are an enhanced bandwidth , in fact the widest bandwidth currently available including enhanced low frequencies down to 70Hz, good for full appreciation of music. Also FreeFocus, allowing a Patient to hear in selected directions without turning their head.

We will begin to post educational posts pertaining to the Clear platform, features, strategies and fitting on the blog shortly.

The Audibility Extender and how to individualise it

This bulletin describes the Audibility Extender program, the default settings in Compass, how to fine tune the Audibility Extender program as well as how to individualise it. The descriptions in this bulletin refer to the Graphics panel and the Audibility Extender settings panel in the Fine tuning window of the program in  Compass. Please refer to Compass in order to see the details of the screen. References will be found in the final section.

Audibility Extender default setting in Compass 

The Audibility Extender program uses linear frequency transposition and is developed for clients with little or no hearing in the high frequency area. Compass uses Sensogram data to set the start frequency of the transposed signals where normal aided speech cannot be made audible by normal amplification. The frequency range of the transposed signals is, by default, set to three frequency bands.



In the Fine tuning window in Compass you can see how the start frequency is automatically set, based on the Sensogram.

Fine tuning the Audibility Extender program

In the Fine tuning window, you can fine tune the Audibility Extender program. The elements that can be changed are:
The start frequency o • f the transposed signal
• The loudness of the transposed signal
• The frequency range of the transposed signal (Basic or Expanded)

Individualising the Audibility Extender program

Proper fine tuning ensures that the client is able to detect and discriminate relevant sounds. If a client
fitted with the Audibility Extender in the default setting has not benefitted from the program after a period of acclimatisation, it is recommendable to fine tune the start frequency and the Audibility Extender gain. One way to find the optimal setting is to make sure that the hearing aid user can hear the/s/ sound at normal speech level (approx. 30 dB HL). The energy of the /s/ sound lies in the range between 4 KHz and 6 KHz and is of great importance in speech understanding in many languages. It should therefore be in the transposed signal and be audible with the appropriate settings.

A simple method, based on this, is described below:

1. 
   
   Increase The start frequency three steps


2. 
   
   Check the audibility of the /s/. If audible end, if not audible proceed


3. 
   
   Adjust AE gain in steps


4. 
   
   Check the audibility of the /s/ after each step. If audible end, if not audible proceed


5. 
   
   Lower start frequency one step (reset AE gain to 0


6. 
   
   Repeat from step 2       

For clients who cannot hear the /s/ sound even at lowest start frequency, use the /sh/ sound (the energy
of this sound lies in the range from 2 KHz to 4 KHz). Be aware that it will normally take some time for the client to get used to the new sound. Several clinical trials have shown that benefit of the Audibility Extender improves over time (Kuk et al. 2008)

Frequently asked questions:

Who are candidates for the Audibility Extender?
Candidates for the Audibility Extender are both children and adults with an unaidable high frequency hearing loss. Clients who have hearing loss that is greater than 70 dB at and above the start frequency can often benefit from the Audibility Extender.

Verified fitting range for the Audibility Extender. From Kuk et al 2008

Is fine tuning always necessary?
If the client is satisfied with the Audibility Extender in the default setting, fine tuning is not necessary. If the client cannot get used to the sound in the Audibility Extender program after an acclimatisation period, fine tuning is necessary.

How long is the acclimatisation period in general?
Studies indicate that clients still improve in a speech discrimination test 6 weeks after being fitted with the Audibility Extender (Auriemmo et al 2008, Kuk et al 2007).

Can I make an objective evaluation of the settings of the Audibility Extender?
It is possible to make an objective evaluation of the settings in the Audibility Extender program by using SoundTracker: Say the /s/ sound and look at the bars of the transposed signals in SoundTracker. If the bars of the transposed signals exceed the thresholds, the sound should be audible. This is also a method that can be used if the client cannot provide a verbal response.

References and other relevant literature

Auriemmo, J., Kuk, K., & Stenger, P. (2008). Criteria for evaluating the performance of linear frequency
transposition in children. Hearing Journal, 61(4), 50, 51-54
Auriemmo, J., Thiele, N., Marshall, S., Quick, D., Pikora, M., & Strenger, P. (2008). Effect of linear
frequency transposition in school-aged children. AAA. American Academy of Audiology 2008, 1
Kuk, F, Keenan, D., Peeters, H., Korhonen, P., & Auriemmo, J. (2008). 12 Lessons learned about linear
frequency transposition. Hearing Review, 15(12), 32, 34, 36-38, 40-41
Kuk, F. (2007). Critical factors in ensuring efficacy of frequency transposition. Part 1: Individualizing
the start frequency. Hearing Review, 14(3), 60, 62-64, 66
Kuk, F., Keenan, D., Peeters, H., Lau, C., & Crose, B. (2007). Critical factors in ensuring efficacy of
frequency transposition part 2: Facilitating initial adjustment. Hearing Review, 14(4), 90, 92, 95-96.
Kuk, F., Korhonen, P., Peeters, H., Keenan, D., Jessen, A., & Andersen, H. (2006). Linear frequency
transposition: Extending the audibility of high-frequency information. Hearing Review, 13(11), 42,
44-46, 48.

Customising receiver ear-sets for Passion hearing aids and removing the battery drawer to connect programming cables

Audiological bulletin no. 50
Customising receiver ear-sets for Passion hearing aids and
removing the battery drawer to connect programming cables

In this bulletin you can learn how to assemble the Passion EarWare. The receiver ear-sets described in
this bulletin are ear-sets from the Widex EarWare RIC box for Passion hearing aids. This bulletin also
contains instructions on how to correctly remove the Passion battery drawer to connect the programming
cables.

You find the following topics in this bulletin:

Acoustic identities: Instant open, Instant flex or Custom flex (vented) 2
• Fitting the EarWare 3
• EarWare maintenance 14
• How to connect the programming cables to a Passion hearing aid 17
• Tips to correct bad fits 18
The procedure of fitting a Passion RIC ear-set is very similar to fitting the ear-set of an m hearing aid
or a 9-model. An additional step in preparing the receiver ear-set is assembling the EarWire with the
receiver.

Acoustic identities: Instant open, Instant flex or Custom flex (vented)

The Passion hearing aid is flexible and can be configured as an instant open fitting or an instant/custom
flex fitting with a vent. When fitting a Passion RIC hearing aid, make sure that the physical and
acoustic identities are the same. Once you have the physical ear-set of the Passion RIC hearing aid,
you must select the corresponding acoustic identity in Compass. This ensures that the correct data set
is loaded into the hearing aid.
Fitting type                                  Acoustic identity                                    Ear-set tip
Open fitting                                     Wire open                      Instant receiver ear-tip open,small (S) or large (L)

Flex fitting with optional vent              Wire flex                         Instant receiver ear-tip flex

(size 8 to 11) or  Custom receiver ear-tip flex

Note that you cannot convert a Passion hearing aid to have a closed instead of an open acoustic identity
and vice versa when you fit Passion with the iP5 programmer. When using iP5, make sure that
the Passion has the desired acoustic identity, i.e. wire open or wire flex.

3
Fitting the EarWare

Passion EarWare box

When you fit a Passion RIC hearing aid, you need the EarWare box for Passion. It contains all the
items you need to build a Passion ear-set, that is EarWires in different lengths for the left and for the
right ear, instant receiver ear-tip open and instant receiver ear-tip flex in several sizes, lock rings,
anchors, wax guards, vent tubes, vent blocks, receiver housings, an assembly tool, a measurement tool,
a measurement dummy and an instruction sheet showing how to assemble the ear-set.
EarWires for the right ear are marked with red numbers and EarWires for the left ear are marked
with blue numbers.
Note: Do not use ear-tips from the m or élan EarWare box for Passion hearing aids and vice versa.

Step 1: Finding the appropriate EarWire length

Start the fitting process by finding the appropriate length of EarWire. To find the correct EarWire length, you can use the measuring tool in the EarWare RIC box. Place the measurement tool on the client’s ear. The desired receiver ear-tip must be level with the centre of the tragus.The ear in the photo to the left needs a length 2 EarWire.

Alternatively you can use the EarWire measurement dummy available in the EarWare RIC box. Place the hearing aid dummy on the client’s
ear. Count the plastic markings from the top down. They correspond to the available EarWire lengths.The ear in the photo will be best fitted with a length 2 EarWire.

4
Step 2: Connecting the receiver to the EarWire and attaching the NanoCare wax guard

Place the EarWire with the black protector in the black assembly tool. Disconnect the EarWire from the protector and dispose of the protector. Note that the number printed on the terminal end of the EarWire should be facing upwards.

Place the receiver housing with receiver inside in the assembly tool with the side with the number 1 upwards and the small plastic pin downwards. Place the EarWire in the assembly tool with the number pointing upwards. Push the tool together. Remove the EarWire by lifting it upwards and out of the tool.

5

Attach the NanoCare wax guard to the end of the receiver that is not attached to the EarWire. The procedure used is the same as when attaching a wax guard to a Widex ITE or CIC hearing aid. Instant receiver ear-tip open

For open fittings select an Instant receiver ear-tip open. This receiver eartip is available in a small (S) and a large (L) version. Select the appropriate size for the client’s ear canal.

Step 3: Attaching the receiver ear-tip: Instant open, Instant flex or Custom flex.
6

Slide the Instant open ear-tip onto the receiver housing.

Make sure the ear-tip is securely fastened to the receiver housing. Instant receiver ear-tip flex Select the appropriate receiver ear-tip from the four sizes, from 8 (smallest) to 11 (biggest).

7

Push the receiver housing into the larger of the two canals in the Instant
receiver ear-tip flex.

Make sure the blue or red number on the EarWire and the anchor holes
are still visible. Vent: There are three vent options for the Instant receiver ear-tip flex: 1.7 mm (default), 1.0 mm and closed. 1 mm vent: insert the vent tube in the Instant receiver ear-tip flex. 0 mm vent: insert the vent block in the Instant receiver ear-tip flex.

Custom receiver ear-tip flex
For the Custom receiver ear-tip flex place the lock ring onto the receiver
housing. The lock ring makes sure that the receiver ear-tip is sealed acoustically and that the receiver sits properly in the Custom receiver ear-tip flex.

8
Insert the receiver and EarWire backwards onto the Custom receiver
ear-tip.

9

Push the Custom receiver ear-tip over the receiver housing.

Make sure that the Custom receiver eartip is firmly secured by the lock ring.

10

Step 4: Trimming the anchor (Instant open and Instant flex) if needed

Thread the pointed end of the anchor through the upper hole.

Pull the anchor until it is stopped by
the grip at the end.

11

Now bend the anchor downwards until you can guide the pointed end through the lower hole to form a small loop.

Define a suitable loop size according to the ear canal of the client.

Cut off any excess anchor with finecutting nippers or scissors, leaving only the loop.

Take care to cut off all the excess anchor protruding out of the hole, so that the end of the anchor loop is flush with the small hole and there are no sharp edges.

12

Step 5: Connecting the EarWare to the hearing aid

The EarWire is connected to the hearing aid by means of a click-on mechanism.

To disconnect the receiver ear-set  from the hearing aid, pull the ear-set firmly.

Insert the colour coding (blue for left, red for right) above the battery compartment of the hearing aid.

13

Step 6: Placing the hearing aid on the ear

Place the hearing aid behind the client’s ear and place the receiver ear-tip in the ear.

The hearing aid should rest comfortably behind the ear without hanging freely above the ear or pulling the hearing aid or the ear-tip. When the hearing aid with the receiver ear-set is positioned correctly on the ear, the EarWire should closely follow the contour of the ear.

14
EarWare maintenance

Exchanging the NanoCare wax guard
Instruct the client thoroughly on how to change the NanoCare wax guard. The receiver can remain in the receiver housing when exchanging the NanoCare wax guard. For Custom receiver ear-tips flex, exchange the NanoCare in the same way as you would with an ITE or CIC hearing aid.

Important
Instruct the client thoroughly that the EarWire may never be washed in water.

Replacing the receiver
If the receiver stops working properly, it should be replaced. See below for instructions on how to replace the receiver for each Passion receiver ear-tip type.

Replacing the receiver housing
To ensure a stable and secure joint, the receiver housing must be changed every time it is removed from the EarWire. The procedure for exchanging the receiver housing depends on the type of receiver ear-tip used.

15

Instant receiver flex
1. Push the receiver housing out of the Instant ear-tip by squeezing the solid ear-tip.
2. Place the EarWire and the receiver housing in the closed assembly tool with both the number printed on the receiver housing and the terminal end of the EarWire facing upwards.
3. Hold the EarWire and receiver housing in place while pulling the assembly tool open.
4. Remove the EarWire and the receiver from the tool.
5. Press the receiver and receiver housing into the hole with the pin of the assembly tool. The receiver should eject from the old housing.
6. Place the new receiver housing into the patent hole in the assembly tool, and press the receiver into the new housing.
7. Connect the new receiver housing to the new Ear-Wire using the assembly tool. The number on the receiver housing and the terminal end of the Ear-Wire must point upwards.
8. Attach a NanoCare wax guard.
9. Connect the Instant receiver ear-tip flex.

Instant receiver open
1. Disconnect the ear-tip from the rest of the ear-set by pushing it off.
2. Place the EarWire and receiver in the closed assembly tool.
3. Hold the EarWire and receiver in place while pulling the assembly tool open.
4. Remove the EarWire and receiver from the tool.
5. Press the receiver and receiver housing into the hole with the pin of the assembly tool. The receiver should eject from the old housing.
6. Place the new receiver housing into the patent hole in the assembly tool, and press the receiver into the new housing.
7. Connect the new receiver housing to the new EarWire using the assembly tool. The number on the receiver housing and the terminal end of the EarWire must point upwards.
8. Attach a NanoCare wax guard.
9. Connect the Instant receiver ear-tip open.

16

Custom receiver flex
1. Disconnect the EarWire from the BTE part/housing by pulling it off the hearing aid
2. Push the receiver and EarWire using the NanoCare holding pin into the custom flex.
3. Remove and discard the lock ring.
4. Place the EarWire and receiver in the closed assembly tool.
5. Hold the EarWire and receiver in place while pulling the assembly tool open.
6. Remove the EarWire and receiver from the tool.
7. Press the receiver and receiver housing into the hole with the pin of the assembly tool. The receiver should eject from the old housing.
8. Place the new receiver housing into the patent hole in the assembly tool, and press the receiver
into the new housing.
9. Connect the new receiver housing to the new EarWire using the assembly tool. The number on the receiver housing and the terminal end of the EarWire must point upwards.
10. Attach a NanoCare wax guard.
11. Place a lock ring on the new receiver.
12. Thread the EarWire through the Custom receiver ear-tip as described in step 3 of Fitting the EarWare.

Sound bore and vent in the Instant receiver ear-tip flex
The Instant receiver ear-tip flex has two canals: The sound bore for the receiver housing (lower canal) and the vent canal (upper canal). You can block the smaller canal partially or completely.
1 mm vent: insert the vent tube (1.7 mm > 1.0 mm)
0 mm vent: insert the vent block

17
How to connect the programming cables to a Passion hearing aid
The Widex CIC programming cables are used to program Passion. Before you can connect these, you must remove the battery drawer. In order not to damage the tiny hinges of the Passion hearing aid we recommend that you follow the procedure below to remove the battery drawer.

Open the battery drawer at an angle of 90 degrees. Insert the loose anchor between the hinges. See the pictures to the left.

Keep the anchor in place and push the battery drawer as if to close it.

Remove the battery drawer. The Passion hearing aid is now ready to be connected to the Widex programming cables. Use the same cables as for the CIC hearing aids.

Click them on at an angle of approx. 30 degrees.

When you have finished programming the Passion hearing aid, remove the programming
cables.

Attach the battery drawer to the hearing aid as shown in the picture to the left.

Push it firmly into the hinges. Open the battery drawer and insert a battery (size 10), then close the battery drawer.

18

Tips to correct bad fits
Symptom                                         Cause                                                   Possible remedy
Hearing aid hanging                         EarWire too long                       Choose a smaller length of EarWire. above the ear
EarWire pulling at the                       EarWire too short                      Choose a larger length of EarWire.
ear and hearing aid 
EarWire protruding from                     EarWire too long                  Choose a shorter length of EarWire     the ear canal                           Anchor loop too large                      Make the anchor loop shorter                                                  Anchor not placed appropriately      Make the anchor loop larger and                                                                                                  position the anchor outside of the ear                                                                                                 canal

Discomfort or itching                 Anchor not trimmed appropriately   Check that the anchor is trimmed

flush with the small hole of the EarWire

Ear-set too small                          Choose a larger length of EarWire

Ear-tip incorrectly sized                 Choose a different size of ear-tip
                                               Anchor size or position            Make the loop smaller and position the 
                                               inappropriate                         anchor inside the ear canal

Ear-tip detaches from the         Ear-tip not firmly pressed         Check that the ear-tip is firmly attached  
ear-set                                    onto ear-set                          to the ear-set

Ear-tip size is too large and so not     Choose a smaller ear-tip                                            easily removed from ear canal

Hearing aid easily detaches    Ear-set has been attached and            Replace the ear-set
from the ear-set                  removed too many times 
                                          Ear-set is being inappropriately          Counsel the client on appropriate   
                                          removed                                        removal technique

Hearing aid falling off the     Anchor not providing adequate     Make the anchor loop larger and position 
client’s ear                         retention                                   it outside the ear canal, or make it 
                                                                                      smaller and position it in the ear canal. 
                                        Ear-tip too small                        Choose a larger size of ear-tip      
                                        Incorrect size of ear-set             Choose another ear-set
 
No sound coming from the     Ear canal blocked by wax             Arrange for or perform wax removal      
hearing aid                                                                     and clean or replace the receiver ear-tip

 

Download link for pdf copy of the bulletin Customising earsets for Passion