What are the different kinds of hearing aids?

There are several types of hearing aids. Each type offers different advantages, depending on its design, levels of amplification, and size. Before purchasing any hearing aid, ask whether it has a warranty that will allow you to try it out. Most manufacturers allow a 30- to 60-day trial period during which aids can be returned for a refund.

There are 8 basic styles of hearing aids for people with sensorineural hearing loss:

	Invisible-In-The-Canal (IIC) 100% invisible, 100% amazing Think hearing aids should be heard, not seen? OtoLens, Starkey’s new invisible-in-the-canal (IIC) hearing aid, might just be your answer. OtoLens is the only custom fit IIC. It’s both completely invisible and packed with Starkey’s industry-leading technology, including the world’s best feedback canceller and the smartest noise reduction and speech preservation system ever developed. Talk to a hearing professional ClickHere to find out if OtoLens is right for you.
	Completely-in-Canal (CIC) hearing aid is largely concealed in the ear canal and is used for mild to moderately severe hearing loss. Because of their small size, canal aids may be difficult for the user to adjust and remove, and may not be able to hold additional devices, such as a telecoil. Canal aids can also be damaged by earwax and ear drainage. They are not typically recommended for children.
	In-the-Canal (ITC) hearing aid is customized to fit the size and shape of the ear canal and is used for mild or moderately severe hearing loss.
	In-the-Ear (ITE) hearing aids fit completely in the outer ear and are used for mild to severe hearing loss. The case, which holds the components, is made of hard plastic. ITE aids can accommodate added technical mechanisms such as a telecoil, a small magnetic coil contained in the hearing aid that improves sound transmission during telephone calls. ITE aids can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback. They are not usually worn by children because the casings need to be replaced as the ear grows.
	On the Ear (OTE) hearing aid is lightweight with a micro-tube and tiny earbud for ultimate discretion.  Appropriate for mild to moderately-high frequency hearing loss
	Behind-the-Ear (BTE). S Series is the best receiver product available on the market today with its best-in-class features optimized by BluWave Signal   Processing and backed with a lifetime circuit warranty that is waterproof.
	Mini (BTE) is the smallest BTE model available.  the model comes with thin tubing and tiny earbus for ultimate discretion.  Appropriate for most types of hearing loss and ages.
	Behind-the-Ear (BTE) hearing aids are worn behind the ear and are connected to a plastic earmold that fits inside the outer ear. The components are held in a case behind the ear. Sound travels through the earmold into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. Poorly fitting BTE earmolds may cause feedback, a whistle sound caused by the fit of the hearing aid or by buildup of earwax or fluid.

S Series™ iQ  |  Specifications

Select A Style:
	BTE  •  Behind-The-Ear Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrix: 128/65 Microphone: InVision Directionality Standard Battery Size: 13 More Information	Fitting Range
	mini  •  Behind-The-Ear Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrix: 126/60 Microphone: InVision Directionality Standard Battery Size: 312 More Information	Fitting Range
	RIC  •  Receiver-In-Canal Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrixes: 110/40, 115/50 Microphone: InVision Directionality Standard Battery Size: 312 More Information	Fitting Range
	RIC AP  •  Receiver-In-Canal Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrixes: 123/60, 131/71 Microphone: InVision Directionality Standard Battery Size: 312 More Information	Fitting Range
	OtoLens  •  Invisible-In-The-Canal Models Available: S Series iQ 11 Matrix: up to 110/35 Battery Size: 10 More Information	Fitting Range
	CIC  •  Completely-In-Canal Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrix: up to 131/71 Battery Size: 10, 312, 13 More Information	Fitting Range
	ITC  •  In-The-Canal Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrix: up to 131/71 Microphone: InVision Directionality Optional Battery Size: 10, 312, 13 More Information	Fitting Range
	ITE  •  In-The-Ear Models Available: S Series iQ 11, S Series iQ 9, S Series iQ 7, S Series 5 Matrix: up to 131/71 Microphone: InVision Directionality Optional Battery Size: 312, 13 More Information	Fitting Range

S Series™ iQ  |  Models & Features

S Series iQ 11 is designed for vibrant lifestyles and includes 16 channels and 16 bands for optimal high-resolution sound imaging, providing optimum flexibility and performance in a broad range of demanding listening environments that include high levels of background noise. Voice iQ, Starkey's new noise reduction and speech preservation system, offers technology so fast and smart that it actually reduces noise between syllables of speech. The hearing instrument's other best-in-class features include PureWave Feedback Eliminator, InVision Directionality, Live Real Ear Measurement*, Live Speech Mapping, and Intuitive Features including T², Music Processing, Voice Indicators, Reminder, Automatic Telephone Solutions and Television Processing.

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Designed for active lifestyles, S Series iQ 9 includes 12 channels and 12 bands for high-resolution sound imaging, providing excellent performance in a broad range of demanding listening environments that include moderate levels of background noise. Voice iQ, Starkey's new noise reduction and speech preservation system, offers technology so fast and smart that it actually reduces noise between syllables of speech. The instrument's other best-in-class features include PureWave Feedback Eliminator, InVision Directionality, Live Real Ear Measurement, Live Speech Mapping, and Intuitive Features including T², Automatic Telephone Solutions and Television Processing.

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S Series 7 is designed for social lifestyles and includes eight channels and eight bands for precise sound imaging, providing good performance in environments with minimal-to-moderate levels of background noise. Voice iQ, Starkey's new noise reduction and speech preservation system, offers technology so fast and smart that it actually reduces noise between syllables of speech. The hearing instrument's other features include PureWave Feedback Eliminator, Live Real Ear Measurement, Live Speech Mapping, and Intuitive Features including T², Automatic Telephone Solutions and Television Processing.

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Designed for calm lifestyles, S Series 5 includes six channels and six bands for performance in environments with minimal-to-moderate levels of background noise. The device's features include PureWave Feedback Eliminator, standard Acoustic Scene Analyzer, AudioScape, InVision Directionality, Live Real Ear Measurement, Live Speech Mapping, and Intuitive Features including T², Automatic Telephone Solutions and Television Processing.

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S Series™ iQ  |  Drive Architecture™

Powered by multi-core technology, Drive Architecture utilizes independent and fully programmable open architecture processors that efficiently carry out tasks in parallel by utilizing simultaneous multi-threading technology (SMT). Drive Architecture triples the processing power of previous platforms, allowing for super efficient, high-speed multi-tasking of signal processing algorithms for better performance. All this, while significantly improving battery life over our previous technology platform.

Simply put, Drive Architecture's multi-core, open architecture configuration enables the enhancements that maximize your patient's experience. With unprecedented clarity in noise, superior feedback elimination and high-resolution sound imaging — Drive Architecture is the force behind more successful patient results.

Powered by BluWave 2.0, Drive Architecture delivers an unprecedented audio experience with optimal power, efficiency and flexibility.

PureWave Feedback Eliminator

The company that defined feedback cancellation just redefined it with our patent-pending PureWave Feedback Eliminator. With broad bandwidth, faster processing and intelligent artifact elimination, this next generation in feedback cancellation is setting standards that have never existed before. Through the use of intelligent artifact elimination, even the most complex signals won't cause distortion in this class-leading feedback canceller.

Voice iQ

Voice iQ is so fast and smart it reduces noise between syllables of speech. Its two-part algorithm uses dynamic voice identification, coupled with a spectral noise control that calculates appropriate gain on a per channel basis. The result is unprecedented sound quality, ease of listening, and intelligibility of speech in noise.

InVision Directionality

Based on clinical performance measures and patient-proven results, our industry-leading directional system is designed to perform best in highly complex backgrounds of noise. S Series™ boasts the highest mean DI scores and the lowest operational noise floor, helping patients significantly increase their speech understanding in noise.

T² Remote

The new breakthrough T² Remote technology allows your patient to control their hearing aid using any cell or touch-tone phone, avoiding the need to carry additional hardware. T² discreetly and instantly classifies the touch-tone signal and automatically adjusts. Patients can use any touch-tone phone to select a memory or adjust volume.

Live Real Ear Measurement

Starkey was the first company to integrate real-ear measurement into a hearing aid. Now Live Real Ear Measurement in S Series takes this capability to the next level. With this system and the power of Inspire® fitting software, hearing care professionals can watch the hearing aid output in a patient's ear, live in real-ear SPL, while the system evaluates the hearing aid response and matches to your selected target — providing you with the most precise fitting information available.

Live Speech Mapping

Live Speech Mapping verifies hearing aid's processing of speech, or any live acoustic input, in real time. The 3D display engages patients and their families in the fitting process.

Automatic Telephone Solutions (ATS)

ATS automatically detects telephone use and adjusts to the optimal acoustic frequency response for telephone listening.

Intuitive Features

Hearing aids aren't helpful if people don't wear them. And too often, patients become confused when learning to use their hearing aids, abandoning the use of multiple features or programs. That's why Starkey's hearing instruments have convenient features to make using the devices simple and intuitive.

• Voice Indicators
  Alert the patient to the status of the hearing aid, low battery, memory and telephone modes in their choice of male or female voices in a wide variety of languages.
• Reminder
  Offers the option of programming audible voice or tone reminders for follow-up appointments and maintenance checks.
• Leisure Listening: Music Processing
  Offers multiple music genre settings designed to maximize sound quality and listening enjoyment.
• Leisure Listening: Television Processing
  This is a new memory program designed for optimal performance while watching television.

Body Aids are used by people with profound hearing loss. The aid is attached to a belt or a pocket and connected to the ear by a wire. Because of its large size, it is able to incorporate many signal processing options, but it is usually used only when other types of aids cannot be used.

Do all hearing aids work the same way?

The inside mechanisms of hearing aids vary among devices, even if they are the same style. Three types of circuitry, or electronics, are used:

• Analog/Adjustable: The audiologist determines the volume and other specifications you need in your hearing aid, and then a laboratory builds the aid to meet those specifications. The audiologist retains some flexibility to make adjustments. This type of circuitry is generally the least expensive.
• Analog/Programmable: The audiologist uses a computer to program your hearing aid. The circuitry of analog/programmable hearing aids will accommodate more than one program or setting. If the aid is equipped with a remote control device, the wearer can change the program to accommodate a given listening environment. Analog/programmable circuitry can be used in all types of hearing aids.
• Digital/Programmable: The audiologist programs the hearing aid with a computer and can adjust the sound quality and response time on an individual basis. Digital hearing aids use a microphone, receiver, battery, and computer chip. Digital circuitry provides the most flexibility for the audiologist to make adjustments for the hearing aid. Digital circuitry can be used in all types of hearing aids and is typically the most expensive.

What can I expect from my hearing aids?

Using hearing aids successfully takes time and patience. Hearing aids will not restore normal hearing or eliminate background noise. Adjusting to a hearing aid is a gradual process that involves learning to listen in a variety of environments and becoming accustomed to hearing different sounds. Try to become familiar with hearing aids under nonstressful circumstances a few hours at a time. Programs are available to help users master new listening techniques and develop skills to manage hearing loss. Contact your audiologist for further information about programs that may suit your individual needs.

What questions should I ask before buying hearing aids?

Before you buy a hearing aid, ask your audiologist these important questions:

• Are there any medical or surgical considerations or corrections for my hearing loss?
• Which design is best for my hearing loss?
• What is the total cost of the hearing aid?
• Is there a trial period to test the hearing aids? What fees are nonrefundable if they are returned after the trial period?
• How long is the warranty? Can it be extended?
• Does the warranty cover future maintenance and repairs?
• Can the audiologist make adjustments and provide servicing and minor repairs? Will loaner aids be provided when repairs are needed?
• What instruction does the audiologist provide?
• Can assistive devices such as a telecoil be used with the hearing aids?

Digital Hearing Aids: Current "State-of-the-Art"

by Todd A. Ricketts

There has been explosion in the number of digital hearing aids on the market in the last five years. At last count, there are 22 manufacturers with digital hearing aids marketed under 40 different model names. Manufacturers are moving toward their third or fourth generation of digital products. The technology is here to stay--but are digital hearing aids really better?

Digital hearing aids first came to market in 1987 with two manufacturers introducing hearing aids with digital signal processing (DSP) before the end of the 1980s. While high-tech for their time, these hearing aids had little success and were soon abandoned due to their large size and high battery drain.

Nearly a decade later, two separate manufacturers once again introduced digital hearing aids. By this time, the technology had improved so that these hearing aids could be produced in a range of popular styles, from behind-the-ear (BTE) to completely-in-the-canal (CIC). Despite their higher cost, they were well received by clinicians and consumers. This early success, combined with the promise of highly advanced signal processing, ensured that digital hearing aid technology had come of age.

So how far have we come? What is the current "state-of-the art" technology in digital hearing aids? Are digital hearing aids really superior to their analog counterparts? To determine whether digital hearing aids are better for patients, it is important to focus on the superior processing and features of these instruments. Digital hearing aids can't be described as if they are a separate entity from analog hearing aids. "Digital" simply indicates that the analog waveform is converted into a string of numbers for processing; and unfortunately, there is nothing inherently magical about this process. A linear, output-clipping, digital hearing aid could easily be built that would provide sound quality and speech recognition inferior to many analog hearing aids. Therefore, digital isn't superior just because it's digital, but because DSP allows manufacturers to create hearing aids with enhanced processing and features.

The Digital Advantage

Fortunately, for both dispensing audiologists and patients, there are features and advanced signal processing schemes available in current digital hearing aids that do have significant advantages over those found in analog instruments. Potential digital advantages include those related to:

Gain Processing. One of the primary benefits associated with flexible gain-processing schemes is the potential for increased audibility of sounds of interest without discomfort resulting from high intensity sounds. While this is more generally a benefit of compression rather than digital processing per se, the greatly increased flexibility and control of compression processing provided by DSP--such as input signal-specific band dependence, greater numbers of channels, and kneepoints with lower compression thresholds--can lead to improved audibility with less clinician effort. Expansion, the opposite of compression, has also been introduced in digital hearing aids. This processing can lead to greater listener satisfaction by reducing the intensity of low-level environmental sounds and microphone noise that otherwise may have been annoying to the user.

Digital Feedback Reduction (DFR). The most advanced feedback reduction schemes monitor for feedback while the listener is wearing the hearing aid. Moderate feedback is then reduced or eliminated through the use of a cancellation system or notch filtering. DFR can substantially benefit users who experience occasional feedback, such as that associated with jaw movement and close proximity to objects.

Digital Noise Reduction (DNR). This processing is intended to reduce gain, either in the low frequencies or in specific bands, when steady-state signals (noise) are detected. Although research findings supporting the efficacy of DNR systems are mixed, they do indicate that the DNR can work to reduce annoyance and possibly improve speech recognition in the presence of non-fluctuating noise. DNR is sometimes advocated as complementary processing to directional microphones. While directional microphones can reduce the levels of background noise regardless of its temporal content, they are limited to reducing noise from behind or to the sides of the user.

Digital Speech Enhancement (DSE). These systems act to increase the relative intensity of some segments of speech. Current DSE processing identifies and enhances speech based either on temporal, or more recently, spectral content. DSE in hearing aids is still relatively new, and its effectiveness is largely unknown.

Directional Microphones and DSP. The ability of directional hearing aids to improve the effective signal-to-noise ratio provided to the listener is now well established. In some cases, however, combining DSP with directional microphones can act to further enhance this benefit. In some hearing aids, DSP is used to calibrate microphones, control the shape of the directional pattern, automatically switch between directional and omnidirectional modes, and through expansion, reduce additional circuit noise generated by directional microphones.

Digital Hearing Aids as Signal Generators. Since digital hearing aids have a DSP at their heart, they are able to generate--as well as to process--sound. Current digital hearing aids use this capability to perform loudness growth and threshold testing in order to obtain fitting information specific to an individual patient's ears in combination with a specific hearing aid. Sound levels also can be verified through the hearing aid once it is fit. This technology has the potential both to increase accuracy of hearing aid fittings and potentially streamline the fitting process by reducing the need for some external equipment.

Current digital hearing aids are certainly exciting, and the future possibilities are endless. Before long, digital hearing aids will replace their analog counterparts altogether. We must, however, present this technology to patients in an informative and educational manner. Like many other high-tech devices, high expectations often accompany digital hearing aids. Counseling patients about appropriate expectations will continue to be more--not less--important as technology continues to advance.

Todd A. Ricketts is an assistant professor in the department of hearing and speech sciences at Vanderbilt University and director of the Dan Maddox Hearing Aid Research Laboratory. His research interest is focused on various high-tech aspects of hearing aids and their impact on listener's benefit from, and satisfaction with, amplification. Contact him by email at todd.a.ricketts@vanderbilt.edu