Category Archives: Audiology

Introducing the First Sound Processor in the Ponto 5 Family

The World’s Smallest Sound Processor is still a Ponto.

Oticon Medical is excited to announce the Ponto™ 5 Mini. This sound processor is packed with new technology providing outstanding sound quality to Ponto recipients while preserving the design and functionality that recipients have come to admire and depend upon. The new Ponto 5 Mini sound processor has a revolutionary approach to feedback and gives patients access to hear sounds from all directions. Additionally, Oticon’s RemoteCare for Oticon Medical enables patients to have their Ponto 5 sound processor adjusted remotely from the comfort of their own home while offering professionals greater clinical efficiency.

More sound to the brain

BrainHearing™ has been the foundation of everything we do at Oticon Medical for more than 30 years. It is based on extensive research on how to optimally support the brain’s natural process while listening especially when the environment becomes challenging. This research has guided the development of Oticon Medical’s solutions and continues to do so. New research confirms that this open soundscape gives the brain what it needs to create a better listening experience. It has been proven to give better speech understanding with less listening effort.[1] With BrainHearing technologies such as OpenSound Navigator™ and OpenSound Optimizer™ in Ponto 5 Mini patients now have access to more sound than ever before.

Clinical evidence evaluating the open sound experience of OpenSound Navigator giving users access to 360° of sound has proven that it improves speech understanding by 21%.1 Other, more traditional, sound processors improve speech intelligibility by removing sound using technologies such as directionality and speech prioritization. The open sound experience also significantly reduces the listening effort needed to make sense of sound. Pupillometry tests carried out on the OpenSound Navigator showed overall pupil dilation was reduced by 36%.1

Premium sound without audible feedback

Patients can enjoy the full dynamics of sound without having to worry about any unwanted sound interference because the OpenSound Optimizer technology in Ponto 5 Mini prevents audible feedback before it occurs.2

Historically, traditional feedback systems have only been able to overcome annoying whistling sounds by reducing gain and removing the dynamics of sound. While this certainly decreases feedback, it also reduces other sounds and can result in impaired speech understanding. The new OpenSound Optimizer in Ponto 5 defies conventional technology with a new, unique, and patented approach to feedback management. OpenSound Optimizer can detect and prevent audible feedback from occurring. This means you can fit patients with up to 6dB more gain without the risk of feedback.[2]

What does this mean for patients? Optimal gain throughout the day with no audible feedback, as the feedback is mitigated before it is about to occur. This provides an overall improvement in sound quality due to the increase in headroom, the additional available stable gain, and prevention of whistling.

Oticon RemoteCare

All aspects of Ponto 5 have been designed to make daily life easier for patients—including follow-up fitting. With the easy-to-use Oticon RemoteCare platform, they can now attend follow-up appointments and adjustments remotely. Recipients simply log into the Oticon RemoteCare app and attend an online fitting. Clinicians can adjust the patient’s program, create new programs, turn on features, and provide counseling using this intuitive platform.

Oticon RemoteCare saves travel time for patients, increases flexibility, and provides valuable insight into a patient’s home listening environment—all of which improve patient care.

The Ultimate in Reliability

The design of the Ponto 5 Mini has been extensively tested so you can be sure it meets the most stringent safety and quality standards. With this proven robustness, your users can rely on Ponto 5 Mini to deliver the performance they need, whatever their lifestyle.

To learn more about the revolutionary Ponto 5 Mini sound processor and its many features we are offering a one-hour CEU course through Audiology Online on October 27, 2021 at 12 PM Eastern (please click through link to register). For brochures and a product demonstration contact your regional clinical specialist.

About the Author

Carissa Moeggenberg is an audiologist who has worked with implantable technologies for 29 years. She is presently the Senior Manager of Clinical Training and Technical Services for Oticon Medical.

References

[1] Manuscript in preparation, Data on File - Clinical study BC102

[2] Data on file at Oticon Medical

Evaluating Benefit and Monitoring Progress in Young Children with a Bone Conduction Hearing Device

Providing early access to sound is critical for children with prelingual hearing loss to develop speech and language skills on par with their typical hearing peers (Sininger, Grimes, and Christensen 2010; Bagatto et al. 2011, 2016; Tomblin et al. 2015). Evidence-based prescriptive formulae, such as DSL v 5.0 and NAL-NL2, are available in hearing aid fitting software and real-ear verification measures when fitting air conduction hearing aids to infants and children who have hearing loss (Scollie et al. 2005; Keidser et al. 2012).

However, strategies for fitting a bone conduction hearing device (BCHD) to a young child is lacking.  Additionally, the use of a consistent protocol within pediatric clinics for children with a BCHD has not been well defined.  In fact, a survey completed by Gordy and Bagatto (2020) found that audiologists are seeking guidance on how to provide optimal amplification to children who use BCHDs, and the aided audiogram is the only consistent measure used to verify BCHD fittings.

Given the limited availability of clinical tools, such as a skull simulator and prescriptive targets, audiologists need to consider other subjective test measures to use when fitting young children that are readily available in most pediatric audiology clinics.  These include, but are not limited to, parent report measures (e.g., The Auditory Skills Checklist, LittleEARs,) the Ling Six Sound Test, closed-set and open-set speech perception test measures, as well as standardized speech and language assessment measures.

As a leading manufacturer of bone anchored hearing solutions, we felt compelled to develop a suggested assessment protocol for monitoring the auditory skills of children ages three-to-five years fit with the Ponto bone anchored hearing system. This blog provides an overview of a straightforward assessment process that clinicians can incorporate into their fitting and management of young children with a BCHD.

Leveraging the Pediatric Minimum Speech Test Battery (PMSTB) developed by Kristin Uhler and colleagues in 2017, we created a streamlined assessment protocol for audiologists to consider when fitting young children with a BCHD.  This protocol is purely based on subjective assessment measures and a way for clinics to establish consistency among audiologists.  Beginning by verifying that a young child can detect the Ling Six Sounds, an audiologist would move to a closed-set speech perception test measure designed to evaluate a child’s pattern perception abilities and word identification skills.  Assuming the child demonstrated consistent word identification we suggest evaluating how the child responds to recorded open-set word and sentence recognition test measures. Finally, we recommend using a parent report measure to end the evaluation.

The protocol consists of a laminated card outlining the straightforward steps to evaluating benefit using a combination of speech perception measures, a parent report measure, and aided soundfield testing. The protocol provides guidance on the test administration, including suggested test level in dBA and calibration of the audiometric equipment.  A suggested test measures flow chart is provided along with a record sheet to document the child’s results. The protocol is recommended for all BCHD indications for a child ages three-to-five years.

Until a standardized objective verification protocol using a skull simulator with prescriptive targets is developed for young children, we would encourage clinicians to consider using this protocol or something similar to monitor a young child’s auditory development with a BCHD.

To learn more about this protocol, we encourage you to reach out to your regional clinical specialist 

About the Author

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for 29 years. She is presently the Training Manager for Oticon Medical.

References

1. Bagatto, M. P., S. T. Moodie, R. C. Seewald, D. J. Bartlett, and S. D. Scollie. 2011. “A Critical Review of Audiological Outcome Measures for Infants and Children.” Trends in Amplification 15 (1): 23–33. doi:10.1177/1084713811412056.

2. Bagatto, M., S. Moodie, A. Malandrino, C. Brown, F. Richert, D. Clench, and S. Scollie. 2016. “Prescribing and Verifying Hearing Aids Applying the American Academy of Audiology Pediatric Amplification Guideline: Protocols and Outcomes from the Ontario Infant Hearing Program.” Journal of the American Academy of Audiology 27 (3): 188–203. doi:10.3766/jaaa.15051.

3. Dave Gordey & Marlene Bagatto (2020): Fitting bone conduction hearing devices to children: audiological practices and challenges, International Journal of Audiology, DOI: 10.1080/14992027.2020.1814970

4. Keidser, G., H. Dillon, L. Carter, and A. O’Brien. 2012. “NAL-NL2 Empirical Adjustments.” Trends in Amplification 16 (4): 211–223. doi:10.1177/1084713812468511.

5. Scollie, S., Seewald, R., Cornelisse, L., Moodie, S., Bagatto, M., Laurnagaray, D., … & Pumford, J. 2005. The desired sensation level multistage input/output algorithm. Trends in Amplification, 9 (4): 159–197.

6. Sininger, Y. S., A. Grimes, and E. Christensen. 2010. “Auditory Development in Early Amplified Children: Factors Influencing Auditory-Based Communication Outcomes in Children with Hearing Loss.” Ear and Hearing 31 (2): 166–185. doi:10.1097/AUD.0b013e3181c8e7b6.

7. Tomblin, J. B., E. A. Walker, R. W. McCreery, R. M. Arenas, M. Harrison, and M. P. Moeller. 2015. “Outcomes of Children with Hearing Loss: Data Collection and Methods.” Ear and Hearing 36 (01): 14S–23S. doi:10.1097/AUD.0000000000000212.

8. Uhler, K., Warner-Czyz, A., Gifford, R. and PMSTB Working Groups. 2017. “Pediatric Minimum Speech Test Battery” J Am Acad Audiol 28:232–247. DOI: 10.3766/jaaa.15123

Presidential Perspective

Proud to be a Partner in the Recovery of Your Hearing Health Clinic

Congratulations! Your hearing healthcare practice survived the lockdown of 2020. Patients are finally showing up to address their hearing losses, but although you’ve reopened, you still aren’t operating at full capacity. Maybe you lost staff or sadly had to let some people go. Yet you still must provide your patients with the level of care and service they have come to expect from your business.

We get it. That’s why we have taken concrete steps to ensure you receive the extra support you need during this challenging transition back from 100 percent remote care to at least some in-person. I’d like to share with you just some of what we offer as extra benefits for partnering with Oticon Medical.

Direct patient services

We offer a direct-to-patient repair and accessory service, so you can help patients who are still unable to visit your clinic and to reduce the number of walk-ins. This is done in close cooperation with you to ensure regulatory compliance, traceability, and that the best hearing solution is provided to your patient.

The Ponto Loaner Program

As some elective surgeries remain on hold, Oticon Medical can offer demo processors and loaner devices for some of your patients. Those who are experiencing surgical delays can wear their Ponto™ on a softband while awaiting their procedure, and still enjoy many benefits of bone conduction hearing. Please contact your sales representative for details on this program.

Customer and Insurance Support Services

Oticon Medical’s Customer Service Team is available to answer patient inquiries during office hours Monday-Friday 8am-7pm ET. Please tell your patients to call (888) 277-8014. Outside of normal business hours or for patients who find phone calls challenging, we also have a dedicated email, info@oticonmedical.com, that is checked regularly throughout each day.

Additionally, we have a dedicated team of Insurance Specialists available to help your patients navigate their insurance benefits to determine and verify coverage of the costs of their surgery and/or sound processor. While the insurance process can be daunting, our team is here to make it is as easy as possible, for patients and your practice. Contact the team at (855) 400-9761 during normal business hours or by email at insuranceservices@oticonmedical.com.

Clinical support

You can request an Oticon Medical Clinical Support representative be present at your patient’s appointment in-person or via an online platform. Our audiology professionals can answer questions, offer advice, and guide your fitting. We can also train you and your staff in the use of our fitting software, Genie Medical.

Step-by-step support online

On our website, you will find the Support page for hearing healthcare professionals. Here you can find extensive resources and tools at your convenience, at any time, to guide you and your patients through the Assessment, Trial, Surgical, Healing, Sound Processor Attachment, and Aftercare phases.

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I hope this information makes you feel even more confident working with Oticon Medical as we work together to recover from the challenging (to put it mildly) 15-plus months. Of course, if you even have any questions, concerns, or just plain want additional help, please don’t hesitate to contact your local representative.

Supporting Early Access to Sound with the Ponto Loaner Program

Sound matters to everyone with a hearing loss but is critical to children who are in their formative years of speech and language development. Children need early stimulation of the inner ear (cochlea) for development of neural connections within the auditory cortex.  Oticon Medical’s Ponto Loaner Program is designed to ensure these children receive premium hearing care as soon as possible, while patiently waiting for third-party insurance approval. This month’s blog focuses on increasing awareness of this program and reviewing the enhancements that have been implemented.

Children ages 0-18 years of age who are candidates for a bone conduction hearing device are eligible for the Ponto Loaner Program at no cost to the families or clinic. Navigating the third-party reimbursement process for families of children with hearing loss can take several months. Our goal is to ensure that children requiring immediate hearing assistance have access to the technology needed for speech and language development while insurance reimbursement is secured.

The Ponto Loaner Program is an easily accessible and simple process for families to complete

We understand that families can feel overwhelmed as they begin the journey to better hearing for their child. We also know that hearing clinics have limited time and resources to spend on third-party insurance negotiations. This is where the services we provide at Oticon Medical can provide much needed support! Our Insurance Support Department has specialists available to guide families through the third-party reimbursement process and alleviate the burden placed on clinics.

So how does this program work?

The Ponto Loaner Program is an easy process to complete by either the parent(s) or clinic. The length of the loan period is three months from the date of shipment. During this three-month loan period we work with the family to secure reimbursement from their insurance provider for the Ponto sound processor and accessories. Making it easier on clinics, we empower families to take the lead with this program and hold ultimate responsibility for final payment of the product.

Components of the Ponto Loaner Program consist of a one-page order form from which the type and color of the sound processor(s) is selected as well as the color of the softband and additional accessories. The completed Ponto Loaner form can be emailed, faxed, or mailed to our Insurance Support Department for processing. Upon receipt and verification, we ship a new Ponto sound processor(s) with accessories to either the clinic or family depending on what was specified on the order form. The processor and accessories are exclusive to that child and cannot be transferred to another child.

Additional Ponto Loaner Program features include access to repair services and one-time loss and damage coverage should the family need it during the loaner period. Pediatric-friendly components to ensure product safety are also provided to the family. Once third-party reimbursement has been secured, the loaner program ends with the option to keep the sound processor and accessories already dispensed or to return them for a different color and/or style of sound processor. All program services are provided for free to our families and clinics.

What are the benefits of this program?

The program’s benefits to the child and their family include immediate access to advanced hearing technology, guidance, and support from our dedicated Insurance Support Department to secure third-party reimbursement and a lifelong service and technology commitment from Oticon Medical!

The advantages of the Ponto Loaner Program for the clinician include instant support for any child up to 18 years of age who is a candidate for a bone conduction hearing device, a simple streamlined process to obtain premium technology for the patient, and ongoing assistance to the clinic with their reimbursement needs.

To learn more about this program and begin benefiting from its features please contact your regional clinical specialist.

 About the Author

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 29 years. She is presently the Training Manager for Oticon Medical.

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Raising Awareness of Hearing Loss

To highlight and help increase awareness of hearing loss, this blog is dedicated to the efforts that surround the national campaign for May as Better Hearing and Speech Month. Hearing loss is ranked as one of the most common chronic health conditions that U.S. adults experience, affecting an estimated 48 million people nationwide. New polling released by the American Speech-Language-Hearing Association (ASHA) reveals an overwhelming disconnect between the high value that Americans say they place on their hearing and their low willingness to be treated for any hearing loss. This has prompted a new public service announcement (PSA) campaign: Act Now on Hearing. This PSA will air nationwide for the next year educating Americans on the signs of hearing loss and guiding those affected to find care from a certified audiologist.

People with hearing loss often wait an average of seven years before seeking treatment. When left untreated, hearing loss has been linked to several other health problems, including social isolation and depression, cognitive decline, and increased stress levels. A 12-year study found that mild hearing loss doubled dementia risk, moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia (Lin, et al, 2011).

Additional statistics learned from a poll conducted by ASHA of nearly 2,500 adults ages 18 and older found:

  • 80% of Americans say maintaining their hearing heath is extremely important or very important to their quality of life.
  • Only 2 in 10 (20%) adults have had a hearing test in the past five years, compared with roughly 6 in 10 (61%) who have had their vision tested.
  • More than half (51%) of all adults reported having hearing problems, but only 11% of those respondents have sought treatment.
  • More than three-quarters (78%) of those with hearing problems have had these difficulties for one or more years—and over one-third (35%) have had trouble for five or more years.
  • A 42% plurality of Americans understand that mild hearing loss can impact a person’s life or daily functioning. Yet, more than half of those with untreated hearing problems (56%) say that they would be unlikely to treat it unless it was “severe.”

Click through for additional information on Attitudes and Actions Towards Hearing Health Survey Results findings from ASHA.

A global spotlight

The World Health Organization (WHO) released the first-ever World Report on Hearing projecting that by 2050, 2.5 billion people will be living with some degree of hearing loss. This translates into 1 in 4 people worldwide, at least 700 million of whom will require rehabilitation services.

Hearing loss can be addressed through effective and timely interventions. In children, almost 60% of hearing loss is due to causes that can be prevented through measures such as immunization, improved maternal and neonatal care, and screening for, and early management of, otitis media. In adults, legislation on noise control and safe listening, and surveillance of ototoxicity can help maintain hearing trajectories and reduce the potential for hearing loss.

Click through to learn more about the World Report on Hearing.

Take action now

It is important to act now for a variety reasons, but in particular the recent COVID-19 pandemic highlights the importance of hearing, which allows us to remain connected to others when social distancing and losing visual cues due to the use of masks.

As audiologists we have the platform to help increase awareness, motivate those struggling with hearing loss to take that initial step toward treatment, educate others on hearing technology and its benefits, and counsel each patient we treat on the importance of protecting our ears from loud noises.

How can you get involved?  Consider any of the following:

  • Volunteer to present to your local community on the effects of hearing loss.
  • Post the present statistics surrounding hearing loss and the benefits of hearing technology on your social media accounts.
  • Offer free hearing screenings at your facility.
  • Encourage your inner circle of friends and family to complete a basic hearing test.
  • Lead by example and treat your own ears with kindness by reducing exposure to loud noises.

If we each commit to doing one thing to help raise awareness together, we can make a difference!

 

References

Kochkin S & Rogin C.  Quantifying the Obvious: The Impact of Hearing Instruments on Quality of Life;  The Hearing Review, January 2000.

Lin FR, Metter EJ, O'Brien RJ, Resnick SM, Zonderman AB, Ferrucci L. Hearing loss and incident dementia. Archives of neurology. 2011; 68(2):214-20. NIHMSID: NIHMS336097 PubMed PMID: 21320988, PMCID: PMC3277836

American Speech Language Hearing Association (ASHA) 2021. Attitudes and Actions Towards Hearing Health. Survey Results; www.asha.org

 World Health Organization (2021): Report on Hearing; www.who.int

About the Author:

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 29 years. She is presently the Training Manager for Oticon Medical.

The Benefits of OpenSound Navigator in Children with Hearing Loss

Fitting children with advanced sound processing algorithms in their hearing devices is not always straightforward. Does the clinical evidence support it? Will it provide more access to all sounds, promote incidental learning, and improve speech understanding in challenging environments? These questions are frequently considered, and a conservative approach is often taken. Whereas, when fitting adults, there is typically clinical evidence to support advanced sound processing and they are better at reporting sound quality issues, so audiologists are more likely to take a less conservative fitting approach. However, if we take too much of a conventional approach with children, are we missing an opportunity to provide improvements in sound quality, hearing in noise, and reduced listening effort?

In 2019, OpenSound NavigatorTM was incorporated into the Ponto 4 sound processor. The success of this sound processing strategy had been seen in Oticon hearing aids with many research studies documenting the benefits provided to patients. So, what is unique about OpenSound Navigator that might provide optimal benefit for children with hearing loss?

OpenSound Navigator is a groundbreaking speech enhancement algorithm that preserves speech and reduces noise in complex sound environments. OpenSound Navigator operates as a holistic system that handles all sound environments from the quietest to the noisiest, by selectively reducing the dominant noise sources while preserving speech in all directions. OpenSound Navigator adapts seamlessly without modes or mode switches. Utilizing an omnidirectional beam that captures a 360° sound panorama of the environment along with a back-facing cardioid that estimates noise from the sides and back provides users with a natural sound experience.

Research has been conducted in children using OpenSound Navigator. Browning et al, 2019 demonstrated OpenSound Navigator improves speech recognition in noise for children. In fact, with speech to the front and noise from behind, OpenSound Navigator provided an average 5 dB SNR improvement as compared to an omnidirectional microphone. Elaine Ng, 2017 further demonstrated that OpenSound Navigator reduces perceived listening effort during a speech recognition task. This benefit is particularly important because hearing loss imposes increased fatigue and effort as experienced by children. Oticon Medical’s BrainHearing™ technology is designed to support the unique day-to-day challenges and developmental needs of children. Together with hearing technology prescribed according to best practice, OpenSound Navigator delivers an optimized speech signal and hence provides these children with the optimal conditions to listen and learn.

Based on the supporting research, we recommend the fitting of OpenSound Navigator in a child’s Ponto™ 4 sound processor starting at one year of age. From ages one to four years, we suggest OpenSound Navigator is active with the transition set to low, and then as the child ages to four years and older, the transition can be adjusted to medium or high similar to adult recommendations. These are the default pediatric settings incorporated into Genie Medical (2019) fitting software. To summarize, unlike conventional directionality and noise reduction technology, OpenSound Navigator does not require children to look directly at the talker the whole time to enjoy better speech understanding in noise. Young listeners may move around freely and can still experience the benefits of OpenSound Navigator.

Another important feature of OpenSound Navigator is that it preserves interfering speech coming from different directions. This new technology allows access to other talkers in the environment, which is fundamental to incidental learning for school-age children.

The groundbreaking technology of OpenSound Navigator marks a breakthrough in the development of speech enhancement systems. It is not only designed to improve acoustics at the child’s ears, but also to facilitate the brain’s own processing. It does not isolate the front talker but preserves access to all talkers. Its accurate and fast spatially informed noise estimator allows the Balance module to selectively attenuate noise sources at given locations. The Noise Removal module removes the remaining noise even between words. OpenSound Navigator opens many possibilities for new pediatric users.

To learn more about the clinical evidence supporting OpenSound Navigator in children we encourage you to register for our upcoming training on April 21, 2021 or reach out to your regional clinical specialist.

About the Author

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 28 years. She is presently the Training Manager for Oticon Medical.

 

References:

Jenna M. Browning, Emily Buss, Mary Flaherty, Tim Vallier, and Lori J. Leibolda American Journal of Audiology Vol. 28, 101–113, March 2019

Elaine Ng, E. 2017. Benefits of OpenSound Navigator in children. Oticon Whitepaper.

Genie Medical (2019) Fitting Software

 

Welcome to the Presidential Perspective

We are launching a new column from the president of Oticon Medical North America, John Sparacio. Each month, John will share his perspectives on the hearing healthcare industry, insights into the future of implantable hearing devices, and provide guidance on how audiology practices and clinics can thrive. 

Hearing Healthcare in the New Normal

Moving Beyond Surviving to Thriving

The new normal. Bet you’re as sick of seeing that term in every news article, think piece, and social media pontification as I am. Unfortunately for us, it is the reality we are facing. Life, and the hearing healthcare industry as a whole, will simply not go back to what we used to call “normal” anytime soon—if ever.

So, what can we do about it from a business standpoint? I’ve been racking my brain over that for some time now, and while I’d like to say I came up with the answer, I am pretty sure there isn’t one, at least not a one-size-fits-all, capital A answer. However, what I did come up with is a way we can better navigate these uncharted waters—by sharing our experiences, including what has worked, what hasn’t, and what we believe will help our industry not only survive, but thrive. I will be sharing my experience and perspective monthly, and I hope you will stop by and not only give it a read but share your own thoughts and experiences in the comments.

Personally, I’ll admit this past year has been a doozy. I barely had time to settle in as the president of Oticon Medical North America when the challenge of guiding our business through the Covid-19 crisis landed in my lap like a ticking bomb. We had all just returned from a highly successful international sales meeting in Cancun, and our future outlook was as bright and sunny as that beautiful location.

Then… bam! Less than a month later, the coronavirus was identified, and the entire world began shutting down. I told our office staff they would be working at home for a couple of weeks (ha, I know), and then everything just… stopped. Our customers couldn’t open their offices, our sales team couldn’t travel, our events couldn’t be held, product launches were delayed… It was one door after another slamming shut. And with each one that closed, my fears for the future of our company and of our customers’ businesses grew.

So, what has gotten us through the darkest days of this crisis? Adaptation is top of my list. Worldwide, our leadership teams used robust scenario planning exercises to confront the challenges posed by the pandemic head-on. We maximized our communications infrastructure so that we could conduct meetings and events online. We provided our employees with the equipment required to work from home with as much ease and efficiency as possible. We supplied our field staff with the PPE needed to remain safe while still supporting our clinician and surgical customers.

In short, we adapted. And like any organism facing down a threat, our adaptation meant we survived. In fact, I’ll tiptoe out on a limb and go so far as to say we are thriving. Sure, sales could be better—that’s always true regardless of a worldwide pandemic! But in the course of adapting, we discovered smarter, more efficient ways to conduct business. These lessons will not be discarded once whatever passes for normalcy takes hold, but rather be used to make us an even stronger, more efficient leader in hearing device manufacturing. Which in turn will make us an even better partner to our hearing care professional customers reopening their businesses and relaunching their important services to patients, many of whom have had to postpone getting vital hearing care and are now eager for assistance.

So, back to the new normal. What is that going to look like when it comes to bone-anchored hearing devices and other hearing products and services? Well, some of the changes we’ve already seen, such as the increase in telehealth options, will be sticking around. As for whatever other changes and advancements are coming? I can only speak for my corner of the hearing industry, but there are indeed exciting innovations on the horizon in technology, product, and service offerings. I eagerly look forward to sharing them with you as we all move forward—together.

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Only certain staff members are allowed into our Somerset US headquarters right now—essential workers. Who decides who is essential? Me. I found it weird carrying around a letter from me declaring myself an essential worker, so I simply bought the T-shirt.

 

 

Counseling Patients through the Ponto Trial Journey

Benefits of Direct Sound Transmission

Patients considering a bone anchored solution for their hearing loss have many options.  As clinicians begin the process of discussing patient choices there are many factors patients often consider, including sound processor style, surgical features, wearing comfort, and cosmetic appeal. However, the candidate often overlooks or undervalues intangible benefits. These benefits relate to the importance of a solution that provides clarity of the signal without distortion or feedback, ample amount of power output to overcome the hearing loss and a broad frequency response to capture all of the acoustic elements important for the understanding of speech.

Bone anchored hearing devices can be placed into two broad categories: either they deliver sound via Skin Transmission, where the vibrating unit is placed on top of the skin and the sound vibrations have to pass through the skin and are attenuated before they reach the bone or via Direct Sound Transmission, with sound vibrations going directly to the bone and then on to the inner ear. Skin Transmission solutions are non-surgical options (e.g., a softband) versus Direct Sound Transmission percutaneous solutions, where the processor sends sound information through the skin to an implanted vibrating unit in direct contact with the bone.

Is there a difference between these two solutions?

Clinical evidence comparing patient outcomes between a skin transmission device and a direct transmission device indicates there is a significant difference. It has been shown that hearing thresholds obtained with Direct Sound Transmission solutions are about 5-20 dB lower (better) between 600 and 6000 Hz and speech reception thresholds are also 4-7 dB lower (better) than with conventional devices (Håkansson et al., 1984; Verstraeten et al., 2009). Beyond this fact, research shows that by choosing Direct Sound Transmission, such as a Ponto percutaneous solution, recipients can learn faster and remember more Pittman (2019) and Lunner et al. (2016) found that using Direct Sound Transmission can increase the learning speed in children by 2.5 times and improve recall abilities by 13 percent in adults.

It is widely established that children with a hearing loss have a reduced vocabulary compared to normal-hearing children (Blamey et al., 2001; Pittman et al., 2005). Hearing solutions for children with a hearing loss should help to close this gap. This is why the results seen by the Andrea Pittman (2019) study are so significant. The Pittman study is the first to show the influence of different sound transmission pathways on the essential domain of auditory learning with the effects of Direct Sound Transmission clear – children learn new words faster.

It has been shown that adults with hearing loss use many additional cognitive resources to recognize, listen to and process sounds. One of these cognitive resources is our working memory. Working memory can be used for both processing and storing information. Thus if more resources are used for processing, fewer resources are left for storage. In fact the ability to remember information can be used as an estimate of how many resources are left for storage, and how effortful it was to process that signal. Lunner and colleagues (2016) compared the ability to remember information using Ponto connected to either a softband (Skin Transmission) or an abutment (Direct Sound Transmission). Their results showed that the Ponto users’ recall ability was significantly higher with the sound processor connected to the abutment (52%) as compared to the Softband solution (46%). These findings suggest that transmitting the sound via Direct Sound Transmission to the temporal bone without skin dampening yields better signal quality and less effortful processing.

 

To summarize, the Ponto System uses Direct Sound Transmission, allowing for the most efficient transmission of speech and sounds via the skull bone directly to the cochlea without skin dampening. With the most powerful abutment-level sound processors available on the market, we can provide access to a larger range of everyday sounds with less distortion.

We believe that counseling on the benefits of a system beyond what is concrete to the patient will impact their future hearing outcomes and contribute to their overall quality of life. So, moving patients from softband to an abutment should include discussion of the advantages of Direct Sound Transmission.

To learn more about the benefits of direct sound transmission, we encourage you to register for our upcoming training on March 24, 2021 or reach out to your regional clinical specialist.

 About the Author

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 28 years. She is presently the Training Manager for Oticon Medical.

References:

Blamey, P. J., Sarant, J. Z., Paatsch, L. E., Barry, J. G., Bow, C. P., Wales, R. J., Wright, M., Psarros, C., Rattigan, K., Tooher, R. (2001). Relationships among speech perception, production, language, hearing loss, and age in children with impaired hearing. Journal of Speech, Language, and Hearing Research 44: 264–285.

Håkansson, B., Tjellstrom, A., Rosenhall, U. (1984) Hearing thresholds with direct bone conduction versus conventional bone conduction. Scand Audiol 13: 3-13.

Lunner, T., Rudner, M., Rosenbom, T., Ågren, J., and Ng, E.H.N. (2016) Using Speech Recall in Hearing Aid Fitting and Outcome Evaluation Under Ecological Test Conditions. Ear Hear 37 Suppl 1: 145S-154S.

Pittman, A. L., Lewis, D.E., Hoover, B.M., and Stelmachowicz, P. G. (2005). Rapid word-learning in normal-hearing and hearing-impaired children: Effects of age, receptive vocabulary, and high-frequency amplification. Ear Hear 26: 619–629. Plack, C. J. (2005). The sense of hearing.

Pittman, A. L. (2019) Bone conduction amplification in children: Stimulation via a percutaneous abutment vs. a transcutaneous softband. Ear Hear.

Verstraeten, N., Zarowski, A. J., Somers, T., Riff, D. and Offeciers, E. F. (2009). Comparison of the audiologic results obtained with the bone anchored hearing aid attached to the headband, the testband, and to the “snap” abutment Otol. Neurotol 30: 70-75.

Clinical Test Protocol for Evaluating Bone Anchored Hearing Benefit During Patient Trial Process

Bone anchored hearing implants are beneficial hearing solutions designed to improve patients’ hearing through direct bone conduction. They are indicated for use in patients who have conductive or mixed hearing loss or in patients with single-sided deafness (SSD).

Adult candidates considering a bone anchored solution have the opportunity to experience sound through an acute simulation during a routine evaluation appointment.  It is during that appointment that the audiologist typically will counsel on device, discuss the benefits and outcomes, and provide the opportunity for the patient to hear sound through a clinic demo device, such as a Ponto 3 SuperPower or a Ponto 4 sound processor. This simulation provides significant value to the patient considering non-surgical versus surgical treatment options.

As clinicians, we are taught the importance of verifying device benefit for patients with hearing loss when considering their hearing device options, and then again as they are being fit with their device. In fact there are well-established protocols and tools in place for hearing aid verifications and cochlear implant assessments. However, there are few recognized protocols in place for validating benefit in a patient using a bone anchored device. It is for this reason that Oticon Medical has developed a bone anchored hearing system test protocol to assess benefit and compare performance with various hearing technologies.

At Oticon Medical, we understand the demands placed on our clinics each day and also know the importance of providing best audiological practice to patients considering a bone anchored solution.  Therefore, we took on the goal developing a simple test protocol for audiologists using the resources already available in their clinic.

The protocol consists of a laminated card outlining four straightforward steps to verify benefit with a bone anchored system or compare performance between different solutions and a test record sheet for documenting the patient’s results. Using published research from Snapp, et al (2010) we modified their suggested protocol to create our version that reinforces the use of a test band for simulations, sound field speech in noise testing using the QuickSin, and the administration of a self-assessment questionnaire. Finally, the protocol outlines additional verification measures that can be completed as well as highlighting the proper reimbursement codes that may be used for this appointment. The protocol is recommended for all bone anchored hearing loss indications.

To learn more about this protocol, we encourage you to register for our upcoming training on February 24, 2021 or reach out to your regional clinical specialist.

About the Author:

Carissa Moeggenberg is an audiologist who has worked in the hearing healthcare field for the past 28 years. She is presently the Training Manager for Oticon Medical.

References:

QuickSin Speech-in-Noise Test. User Manual. Etymotic Research Inc. Version 1.3

Current Procedural Terminology (CPT) Codes. Audiology. American Medical Association 2019

Snapp, H.A. et al (2010) A Clinical Protocol for Predicting Outcomes with an Implantable Prosthetic Device (BAHA) in Patients with Single-Sided Deafness. J Am Acad Audiol, 21: 654-662.
Female audiologist

Reducing the Clinic’s Burden: Online Patient Resources from Oticon Medical

The demand to provide hearing healthcare services remotely has reached new levels this past year due to the COVID-19 pandemic. Remote hearing healthcare is not new—it has been discussed in audiology research circles for more than 20 years, been piloted and launched by Government Services and used by clinicians serving remote geographic locations.

TeleHealth, as defined by the World Health Organization, is “the use of electronic means to deliver information, resources and services related to health”. TeleHealth covers many domains, including electronic health records, mobile health, and health analytics. TeleHealth (also called eHealth) has the potential to provide more services to a wider population in a personalized manner. Prior to 2020, it was primarily intended to supplement in-person appointments, but has taken on a new meaning due to the recent pandemic and need for social distancing.

Reducing the burden on clinics by providing support for patient-related services and offering remote assistance to patients is a priority for us at Oticon Medical, which is why we have either created or further expanded several online support services for our hearing healthcare professionals over the last year. We detail a short summary of these services in this first blog of the New Year.

The Ponto Care™ App was expanded specifically to address the need for social distancing. It now provides your patients with an Aftercare section allowing them to access relevant information about everyday life with the Ponto, including user guides, instructional videos and a diary. More importantly, the Aftercare section allows recipients to monitor their implant site to ensure proper care is taken should an issue with the healing process occur. The app provides recipients with the ability to photograph their implant site documenting any changes that may occur over time. These photos can be shared or discussed with their healthcare provider should an issue occur during their recovery process, thus empowering patients for simple, easy device care.

Replacement Processor Support is an essential service for you and your patients. Should your patient need a replacement sound processor, we will extract their current program from their non-functioning processor, load the program(s) onto their new sound processor and ship directly to the patient. This removes you from the process so that you can focus your time on clinically billable services.

Oticon Medical Online Support Pages

Patients often have many questions regarding the insurance reimbursement process during their journey to getting a Ponto System or when upgrading their current sound processor. In order to reduce the amount of time you spend counseling on topics related to insurance reimbursement we have expanded our online services to provide additional support for your patients. Our Insurance Support Team has posted online information that includes the list of in-network insurance providers, frequently asked questions, intake forms and direct contact information on how to reach a member of our team.

Additional online programs to assist your patients can be found on our website under Support.  This section of our website offers instructional product videos, online warranty registration and product use guides.

Ongoing guidance and support from other recipients who have been on the BAHS journey to better hearing play a key role in assisting patients who are new to this technology. We encourage you to direct your patients to our Oticon Medical Friends program

for a deeper connection that only another bone anchored recipient can impart, thus easing the amount of time you spend on counseling.

Finally, to provide a place for you to build your expertise about Oticon Medical’s products, we have partnered with Audiology Online to extend opportunities for you to attend live webinars or watch recorded webinars from the comfort of your home or office. These sessions are typically 60 minutes in length and offer continuing education credits. Topics include clinical evidence, product updates, product fittings and advanced clinical management of bone anchored recipients.

We Value Your Feedback

We are committed to continually evaluating the services we provide and developing innovative remote care solutions that present value to those customers who fit and receive our products. Should you have suggestions or ideas on how we can improve our remote service programs please let us know!

We wish you all the best for 2021! Your dedication and skill make a difference every day to those affected by hearing loss.