Kids With Hearing Loss in One Ear Fall Behind in Language Skills, Study Finds

Reposted from ScienceDaily (May 5, 2010) — By the time they reach school age, one in 20 children have hearing loss in one ear. That can raise significant hurdles for these children, say the results of a new study at Washington University School of Medicine in St. Louis, because loss of hearing in one ear hurts their ability to comprehend and use language.

“For many years, pediatricians and educators thought that as long as children have one normal hearing ear, their speech and language would develop normally,” says lead author Judith E. C. Lieu, MD, a Washington University ear, nose and throat specialist at St. Louis Children’s Hospital.

“But then a few studies began suggesting these children might have problems in school. Now our study has shown that on average, children with hearing loss in one ear have poorer oral language scores than children with hearing in both ears,” Lieu says.

Hearing loss in one ear can stem from congenital abnormalities in the ear, head trauma or infections such as meningitis. Children with hearing loss in one ear may go undetected because they can appear to have normal hearing. Their difficulty hearing may be mistaken simply for lack of attention or selective hearing, says Lieu, assistant professor of otolaryngology.

Even children with recognized one-side hearing loss often aren’t fitted with hearing aids and often don’t receive accommodations for disability.

The study will be published in the June issue of the journal Pediatrics.

The researchers studied 74 six- to 12-year-old children with hearing loss in one ear. Each was matched with a sibling with normal hearing so that the researchers could minimize the possible effects of environmental and genetic factors on the children’s language skills. The children were tested with the Oral and Written Language Scales (OWLS), a widely used tool to assess language comprehension and expression.

An average OWLS score is 100, and hearing loss in one ear caused about a 10-point drop in scores. The oral composite score — which reflects both children’s ability to understand what is said to them and their ability to respond or express themselves — averaged 90 in children with hearing loss in one ear.

Lieu says that the study demonstrated the strongest effect from hearing loss in one ear in children who are living below the poverty level or with mothers who have little education. Poverty levels and maternal education levels are well-established influences on language skills, and hearing loss in one ear may increase that effect.

“This study should raise awareness that if children with hearing loss in one ear are having difficulties in speech or reading in school, their hearing may be part of the problem,” Lieu says. “Parents, educators and pediatricians shouldn’t assume that having hearing in one ear means children won’t need additional assistance.”

The study does not address which possible solutions will be most effective for overcoming the decrease in language skills seen in the children with hearing loss in one ear. But Lieu suggests that studies could be done to see if hearing aids or amplification systems in the classroom will help.

In addition, having an educational audiologist as part of an individualized educational plan might be beneficial.

“The effect of hearing loss in one ear may be subtle,” Lieu says. “These children may shun large group situations because the noise overwhelms them, and they have a hard time understanding speech. They could have difficulties playing team sports because they can’t localize sound well and can’t tell who is calling to them.

“For them, listening takes a lot more work, and they may have to put in extra effort,” Lieu says. “We don’t know yet if the hearing loss ultimately affects their overall educational achievement and eventually, even which occupations they choose.”

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Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Washington University School of Medicine. The original article was written by Gwen Ericson.

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Journal Reference:

1. Lieu JEC, Tye-Murray N, Karzon RK, Piccirillo JF. Unilateral hearing loss is associated with worse speech-language scores in children. Pediatrics, 2010; 125 (6)

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Turning Your iPod Up May Impair Your Ability to Discriminate in Noisy Environments

This article from sciencedaily.com shows us that extended use of loud personal music players can  decrease our ability to hear in noisy environments even though your audiogram (hearing test) may be normal.

 

ScienceDaily (Mar. 10, 2011) — Growing numbers of people enjoy listening to music on portable music players or cell phones, and many tend to turn up the volume, especially in noisy surroundings. In a study published March 2, 2011 in the open-access journalPLoS ONE, researchers explore the potential effects of this behavior on hearing.

Growing numbers of people enjoy listening to music on portable music players or cell phones, and many tend to turn up the volume, especially in noisy surroundings. In a study published March 2, 2011 in the open-access journalPLoS ONE, researchers explore the potential effects of this behavior on hearing.

The study was a collaboration between Drs. Hidehiko Okamoto and Ryusuke Kakigi from the National Institute for Physiological Sciences, Japan, and Drs. Christo Pantev and Henning Teismann from the University of Muenster. The researchers demonstrated that listening to loud music through earphones for extended periods in noisy surroundings can cause neurophysiological changes related to clear discrimination of sounds, even if the hearing threshold is normal. This auditory abnormality concerns “the vividness of sounds” and cannot be recognized by the usual hearing test in which subjects are examined using a series of individual tones in a silent environment. These results may support a future auditory assessment plan for long-term portable music player users.

The research group examined the brain’s response to sound using the biomagnetism measurement device MEG (magnetoencephalography), which makes it possible to measure the brain activity without any subject’s behavioral response. They recorded the brain responses of two groups of 13 young adults; one group had regularly listened to music at full blast, and the other group had not. Subjects listened to a sound of a specific frequency contained in background noises while watching a movie. The inability to dissociate a sound from background noises was considerably more pronounced in the habitual portable music player users. This difficulty cannot be detected with the current standard hearing test, which yielded the same results in both groups.

According to Dr. Okamoto, “It can be said that listening to music at high volumes burdens the nerves of the brain and auditory system and can cause a decline in the ability to discriminate sounds, even if the usual hearing test results are normal and the subject is unaware of any changes.” He also claims, “It would be better to suppress environmental noises by using devices such as noise cancellers instead of turning up the volume when enjoying a mobile music player in a noisy place.”

 

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Hearing loss hits 1 in 5 U.S. teens

From Liz Szabo @ USA Today

One in five American teenagers now suffers from some type of hearing loss, an increase of 31% since the mid-’90s, new research shows.

Most cases of hearing loss are slight, affecting only one ear and involving mostly high-frequency sounds, according to a study in today’s Journal of the American Medical Association. Many teens may not even notice the hearing change. About one in 20 have “mild or worsening” hearing loss, which can make them struggle to follow conversations or teachers at school.

 

ON THE WEB: NIH tips on protecting kids’ hearing

 

“It’s very concerning,” says study author Josef Shargorodsky, an otolaryngology/head and neck surgery resident at the Massachusetts Eye and Ear Infirmary in Boston.

Other studies show that even a small hearing loss can harm a child’s school performance, language development and social interactions, he says.

Parents may have trouble spotting the change as well, given that teens often tune their parents out, says Shargorodsky, whose research was conducted at the Channing Laboratory at Brigham and Women’s Hospital, also in Boston.

Parents may notice other changes — such as an unexplained drop in grades — that could signal hearing loss, he says.

Because hearing loss is cumulative, these teens are at high risk for significant hearing problems as adults, says Brian Fligor, director of diagnostic audiology at Children’s Hospital Boston, who wasn’t involved in the study. Instead of developing noticeable hearing problems at age 50 or 60, these teens may have trouble hearing beginning at age 40.

Researchers based their findings on records of and interviews with nearly 4,700 kids ages 12-19, led by the Centers for Disease Control and Prevention.

They found no link between hearing loss and ear infections. Kids who reported being exposed to loud noise for at least five hours a week were no more likely to have hearing problems than others, says Shargorodsky, although he notes that teens usually aren’t very good at accurately keeping track of their noise exposure.

Children living below the poverty level were much more likely to have hearing loss, possibly because poor kids have worse health in general, Fligor says.

Shargorodsky says his research doesn’t explain why hearing loss is becoming more common. But doctors say the study points out the need to do more to protect children’s hearing.

“Kids are growing up in a noisier world,” Fligor notes.

An Australian study of kids with “mild to moderate” hearing loss found that using a portable music player, such as an iPod, was linked to 70% increased risk of hearing loss. And in a study of New York college students, Fligor found that more than half were listening to an MP3 player above the recommended exposure levels, which are 90 minutes a day at 80% of the maximum volume.

But iPods and rock concerts aren’t the only source of noise in a child’s world. Kids are also at risk if they fail to protect their ears when mowing the lawn, hunting with a rifle or attending noisy events, such as NASCAR races, Fligor says. Kids can protect their hearing by wearing headphones or inexpensive foam earplugs, Fligor says.

Other health trends also may be harming kids’ hearing. Both high blood pressure and obesity can increase the risk of hearing problems, Fligor says. The number of children with diabetes has increased significantly in recent years, and a third of children are now overweight.

“What is scary is that these kids are setting themselves up for earlier hearing decline,” says Mark Brown, an Austin otolaryngologist who treats a lot of children. “We will see the consequences of this down the road.”

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Hearing Impairment Common, Perhaps Preventable, Chronic Disease Among Middle-Aged Adults

In background information in the article, the authors estimate that at least 29 million Americans have a hearing impairment. “Population-based epidemiological prevalence estimates range from 20.6 percent in adults aged 48 to 59 years to 90 percent in adults older than 80 years,” the author report. “The severity of this condition has been shown to be associated with a poorer quality of life, communication difficulties, impaired activities of daily living, dementia, and cognitive dysfunction.”

Scott D. Nash, M.S., from the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues analyzed data collected as part of the Beaver Dam Offspring Study, an epidemiological study of aging. The study included 3,285 participants ranging in age from 21 to 84 years, with an average age of 49. The researchers evaluated hearing impairment as a pure-tone average greater than 25 decibels hearing level in either ear, and also measured word recognition at different sound levels and with male and female voices. Study participants also provided information about medical history, behaviors and environmental factors.

The prevalence of hearing impairment was 14.1 percent and the average word recognition in quiet was 89.6 percent, but 63.5 percent in competing message environment. “Hearing impairment was more likely in men, in participants with lower education levels, and in those working in noisy occupations or with a history of ear surgery,” the authors report. Other factors suggest there may be cardiovascular correlates associated with hearing impairment as based on the word recognition scores, including statin use, a higher hematocrit percentage (a marker of blood viscosity), and intima-media (artery walls) thickness. The authors note that participants in the study also had significantly higher odds of a parental history of hearing impairment and that this is a highly heritable condition.

“Hearing impairment is a common condition in middle-aged adults. Cardiovascular disease risk factors may be important correlates of age-related auditory dysfunction.” The authors conclude that if hearing impairment is detected early, it may be a preventable chronic disease.”

Journal Reference:

1. Scott D. Nash; Karen J. Cruickshanks; Ronald Klein; Barbara E. K. Klein; F. Javier Nieto; Guan H. Huang; James S. Pankow; Theodore S. Tweed. The Prevalence of Hearing Impairment and Associated Risk Factors: The Beaver Dam Offspring Study. Archives of Otolaryngology — Head & Neck Surgery, 2011; DOI:10.1001/archoto.2011.15

 

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Tinnitus Treatment: Rebooting the Brain Helps Stop the Ring of Tinnitus in Rats

Researchers Dr. Michael Kilgard and Dr. Navzer Engineer from The University of Texas at Dallas and University-affiliated biotechnology firm MicroTransponder report that stimulation of the vagus nerve paired with sounds eliminated tinnitus in rats. A clinical trial in humans is due to begin in the next few months.

Described as a ringing in the ears, tinnitus causes mild irritation for some people but is disabling and painful for many others. The U.S. Veterans Administration spends about $1 billion a year on disability payments for tinnitus, said Kilgard, associate professor in the School of Behavioral and Brain Sciences at UT Dallas and co-author of the journal article.

Tinnitus

Tinnitus is a symptom some people experience as a result of hearing loss. When sensory cells in the inner ear are damaged, such as from loud noise, the resulting hearing loss changes some of the signals sent from the ear to the brain. For reasons that are not fully understood, some people will develop tinnitus as a result.

“We believe the part of the brain that processes sounds—the auditory cortex—delegates too many neurons to some frequencies, and things begin to go awry,” said Michael Kilgard, Ph.D., associate professor of behavior and brain sciences at UT-Dallas, and a co-principal investigator on the study. “Because there are too many neurons processing the same frequencies, they are firing much stronger than they should be.”

In addition, the neurons fire in sync with one another and they also fire more frequently when it is quiet. According to Dr. Kilgard, it’s these changing brain patterns that produce tinnitus, which is usually a high-pitched tone in one or both ears, but it may also be heard as clicking, roaring, or a whooshing sound.

“Brain changes in response to nerve damage or cochlear trauma cause irregular neural activity believed to be responsible for many types of chronic pain and tinnitus,” he said. “But when we paired tones with brief pulses of vagus nerve stimulation, we eliminated the physiological and behavioral symptoms of tinnitus in noise-exposed rats.”

The researchers are, in essence, retraining the brain to ignore the nerve signals that simulate ringing. They monitored the laboratory rats for several weeks after therapy, and the improvements persisted.

“This minimally invasive method of generating neural plasticity allows us to precisely manipulate brain circuits, which cannot be achieved with drugs,” said Dr. Navzer Engineer, vice president of preclinical affairs at MicroTransponder and lead author on the study. “Pairing sounds with VNS provides that precision by rewiring damaged circuits and reversing the abnormal activity that generates the phantom sound.”

The research team is developing parameters for a clinical trial in humans. Vagus nerve stimulation (VNS) is currently used in humans for treatment of epilepsy and depression. “The translation from basic science to the clinic has been quite rapid,” Engineer said. “It’s exciting that the National Institutes for Health has been so supportive of our efforts to move this work along faster, in hopes of providing effective treatments to tinnitus patients.”

The National Institutes of Health (NIH) early in 2010 granted Kilgard and MicroTransponder $1.7 million to further investigate whether nerve stimulation offers a long-term cure for tinnitus.

The first patient could be treated in Europe by early 2011, Engineer said. The initial set of human participants will have the electrodes attached to the left vagus nerve in their neck during a short outpatient procedure. They will come to the clinic Monday through Friday for a few weeks of treatment. At each daily session, they will experience VNS paired with sounds.

MicroTransponder, a neuroscience based medical device company, was founded by UT Dallas PhD candidate Will Rosellini and sponsored by the school’s Institute for Innovation and Entrepreneurship. MicroTransponder is developing a less invasive wireless medical device to stimulate the vagus nerve. The UT Dallas/MicroTransponder team also is studying how best to optimize the paired therapy for tinnitus patients.

Past research has shown that the severity of chronic pain and tinnitus is tied to the degree of plasticity in the brain’s cortex. A previous study showed that repeatedly pairing sensory stimuli with electrical stimulation of a brain structure called nucleus basalis generates powerful and long-lasting changes in cortical organization. Since the vagus nerve is easier to access for clinical use, and is known to trigger the release of molecules in the brain that promote neural changes, follow-up studies were performed on the vagus nerve.

For the VNS study, the research team used a “gap detection model” to document tinnitus in rats that were exposed to loud noise for one hour while under anesthesia. Each of the noise-exposed rats used in this study exhibited a significant impairment in the ability to detect a quiet gap in a tone near their tinnitus frequency, but exhibited no impairment when the gap was placed in a higher or lower tone.

“Previous research showed that a frequency-specific impairment in gap detection is a likely sign that noise-exposed rats experience a mid-frequency tinnitus ‘ringing’ that fills the silent gaps,” Kilgard said. “Though it isn’t possible to evaluate the subjective experience of rats, this gap impairment has been taken as an indicator of tinnitus.”

When the rats were exposed to VNS paired with sounds, the gap impairment was eliminated — indicating that the tinnitus was gone.

Today’s therapies for tinnitus have limited success and frequently must be modified over time because they become ineffective. “The VNS treatment would be an improvement over current therapies involving medications or counseling because it offers a possible permanent end to the condition and doesn’t appear to cause any significant side effects,” Kilgard said.

Additional sponsors of the work include the James S. McDonnell Foundation, the Norman Hackerman Advanced Research Program and the Texas Emerging Technology Fund.

The paper’s other authors were: UT Dallas neuroscientists Drs. Jonathan Riley, Jonathan Seale, Will Vrana, Jai Shetake, Sindhu Sudanagunta and Michael Borland. The article will be published in the Jan. 27 print edition of the journal.

www.hearingaiddocs.com

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New Poll

Just curious….

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HearingAidDocs Hearing Aid Reviews

Hello everyone!

This is the first video of a series of hearing aid reviews designed to assist the hearing aid prospect into finding the right hearing aid for their hearing loss.  We  will assess several aspects and important factors in purchasing a hearing device.  Come check us out and help us spread the word!

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Unitron Introduces Hearing Test Application for iPhone

Unitron Introduces Hearing Test Application for iPhone

Unitron introduces uHear—a hearing test application for the iPhone and iPod touch.

Despite widespread concern about the impact of hearing loss on their quality of life, 49% of North Americans expose themselves at least once a week to potential harm, and 61% haven’t had their hearing tested within the past 5 years, according to a new survey from Unitron (US headquarters in Plymouth, Minn) and Angus Reid Strategies, a market research company.
Available on iTunes for FREE, uHear is a self-administered screening test to identify potential hearing loss through three assessments: hearing sensitivity, speech in noise, and a questionnaire about common listening situations, the company says. It is a sophisticated and comprehensive test with real-life results, calibrated to test actual hearing thresholds and calibrated for both ears, according to the company. People can retake the test at different times to see if their hearing thresholds have temporarily shifted, such as after a rock concert, listening to a loud MP3 player, or following a head cold. It offers a locate function, to help find the nearest hearing care professional for a full follow-up.

From April 8 to April 14, 2009, Angus Reid Strategies conducted an online survey on behalf of Unitron among a randomly selected, representative sample of 1,000 adult Americans and 1,003 adult Canadians, the company says. They report that the margin of error for the total sample is +/- 2.2%, 19 times out of 20, and within each country the margin of error is +/- 3.1%, 19 times out of 20. The results have been statistically weighted according to the latest Canadian and American Census data for age, gender, region, and education to ensure a representative sample of the entire adult population of North America (the United States and Canada), according to Unitron. The survey reports that one-third of North Americans haven’t tested their hearing in more than 10 years.
While hearing loss affects an estimated 35 million people across North America, the survey shows a disparity between North Americans’ awareness of how they’re damaging their hearing, and their willingness to prevent or assess potential hearing loss. Nearly 60% never wear hearing protection, and most don’t seek the necessary care when it comes to their ears—some 13% of respondents said they’ve never had their hearing tested, according to the survey.

Younger adults (ages 18 to 34) are most at risk—30% have admitted they expose themselves to potential hearing damage at least once a day, the company says. Some 84% said they’ve turned up their MP3 player to block out noise in everyday situations at home, on the street, or while on transportation, ignoring the recommended 60/120 rule: listen at 60% of the maximum volume for up to 120 minutes; any more can lead to permanent hearing loss.
Among the survey’s findings:
• Men do more damage, but take better care: 58% of males exposed themselves to potential hearing damage at least once a week versus only 41% of females, yet more than double the number often or always wear hearing protection (18% versus 8%), and 17% more males than females have had their hearing tested in the last 5 years (48% versus 31%).

• Survey results show noise at home is on par with noise on the subway, with 33% of respondents saying they’ve turned up their MP3 player to block out noise, both at home and while on transportation.

• Older people forego protection: at 70%, the 55+ age group had highest response to never wearing hearing protection, compared to 55% of 34 to 55 year olds and 54% of 18 to 34 year olds.

Click here to download uHear. If you do not have iTunes, you can access uHear off of the apple.com/itunes Web site by following links to the appstore/medical/uHear.

Unitron, a member of the Sonova Group, specializes in technologically advanced hearing instruments. The company says it plans to donate proceeds from the sale of uHear to charities that support hearing loss awareness and education.
[Source: Unitron]

To view Unitron Products go to www.hearingaiddocs.com

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Phonak Partners with Voiis to Offer Wireless Bluetooth Connectivity Options

Phonak’s iCom Bluetooth device has changed the way in which hearing impaired individuals hear using peripheral devices such as cell phones, TVs, iPods, etc.  With the iCom, hearing aid users with compatible hearing aids can wirelessly pair their hearing aids with virtually any bluetooth device on the market.

Bluetooth Device for your Hearing Aids

The great thing about this is, you hear in stereo!  AND… you can mix the level of environmental sound with the amount of music or tv or telephone conversation to your liking.  In other words, if you like to hear what’s going around you while having music in the background, you can do it!  If you want to completely block out all environmental amplification while only amplifying the voice on the other end of the telephone, you can do it!

Phonak is also distributing the Voiis Stereo Wireless Music Gateway.  Don’t be fooled by the name… this device offers more than just wireless music.  Here is a review by cnet.com

Bluetooth Transmitter for iCom

“The good: The Voiis Stereo Wireless Music Gateway is a simple way to stream music to and from your home stereo via stereo Bluetooth. You can stream music from the home stereo to a stereo Bluetooth headset, from the PC to the home stereo, and from a cell phone to the home stereo. You can even stream music from your iPod to a stereo Bluetooth headset. Also, setup is easy.  [one person can use it with their hearing aids and another can use it with a bluetooth headset simultaneously!]

The bad: The Voiis Stereo Wireless Music Gateway only has one button for all the functions, plus Bluetooth pairing can be a little tricky when both devices don’t have any displays for confirmation.

The bottom line: The Voiis Stereo Wireless Music Gateway is a great way to transmit music to and from your home stereo without any wires.”

Check it out on our website:
www.hearingaiddocs.com

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Envoy Medical’s Esteem Gaining Momentum

Envoy Medical has developed a middle ear implant that utilizes the natural eardrum, middle ear bones, a receiver, and a transducer to send amplified signals to the cochlea (inner ear).

How We Hear

1. Naturally, hearing starts off with sound entering the earcanal as acoustic energy.  This sound then vibrates the eardrum which transduces the acoustic energy into mechanical energy.
2. The eardrum then puts into motion a series of very small bones in the middle ear: the malleus, incus, and stapes (aka hammer, anvil, & stirrup).
3. The stapes footplate then pumps the fluids of the cochlea (inner ear) like a hydraulic system.  The waves of fluid movement then stimulate thousands of hair cells called stereocilia.
4. The stereocilia then convert that hydraulic energy into electrical impulses which are then sent along the auditory nerve, via the brainstem, to the auditory cortex where meaning to sound is achieved.

The Esteem does not utilize  conventional microphone, amplifier, and speaker components.  Instead, it relies on the natural eardrum to act as the microphone.  The vibrations are then sent through a processing/amplifying process and the stapes bone is directly stimulated and its vibration enhanced. The battery is said to last up to 9 years.

This technology, which is not available to the general public yet; however Envoy Medical claims that this product can fit approximately 80% of all individuals with sensorineural hearing loss.  The process requires surgery of the implant and estimated costs are around $25,000.  Envoy states that they will not pursue the insurance companies for coverage because they do not want the insurance companies to delegate how much reimbursement this device should receive.

My Opinion
One of the advantages I currently see in the Esteem over current technologies  is that it uses the natural eardrum to pick up sound information and does not have to rely on the fidelity of a microphone.

However, a sensorineural hearing loss is a sensorineural hearing loss is a sensorineural hearing loss!  Due to damaged sensory cells, nerve degeneration in the inner ear and beyond, sensorineural hearing loss adds a distortive component to all sound coming into the inner ear.  My criticism is this:  how is a middle ear implant going to significantly outperform a traditional hearing aid for individuals with sensorineural hearing loss when the problem is not the outer or middle ear…. it’s the inner ear!  Either way, the distortion is still going to be there!

For individuals with certain middle ear/outer ear related issues, this product will most likely outperform a traditional hearing aid.  Because it is bypassing what the hearing aid cannot.

Finally….
Envoy Medical’s Esteem product definitely provides some interesting ideas into the hearing solutions industry.  Is it worth pursuing?  I would wait… see the results… and then wait until there’s a second or third generation of the product.  The launch of a new product is often accompanied by problems and issues.  Just look at the start of the cochlear implant industry and the meningitis scare… whew!  Glad that’s over….

Here are some questions that I still have regarding this product.

Is there a digital processor?

Does it use compression/expansion for loud and soft sounds?  I would like to know a little more about the processor.

Does it have to be explanted if the batteries run out?

3 out of 100 patients had to be explanted… seems like quite a lot…that’s 1 out of every 33 patients had to have surgery again to explant… what’s the comparison w/ other middle ear surgeries?

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