Interview with Becky Finlen, Au.D., Manager, Clinical Product Development, Phonak

Topic: Phonak nano - Product Overview and Clinical Validation Study Results

Becky Finlen

CAROLYN SMAKA: Today I'm speaking with Becky Finlen, an audiologist and manager of clinical product development with Phonak. Becky, what are some of your responsibilities at Phonak?

BECKY FINLEN: As manager of clinical product development, I conduct validation studies on new products before they are released. The purpose of a validation study is to ensure that the product's features are working as they were designed to work, and to gather feedback from professionals and clients before the product makes its way into the market.



SMAKA: It sounds exciting to be on the ground floor of new technology before it's available in the market.

FINLEN: Yes, it is exciting. It's also great to work closely with my colleagues in Switzerland on new global product developments. They provide us insight into new product development and welcome our input which, in many cases, ultimately impacts the final product. I really value our close working relationship.

SMAKA: One of the most recent clinical product validations you've been working on is the nano product - can you give us an overview?

FINLEN: I'd be happy to. Nano is the smallest custom product that Phonak offers. When the field study was conducted, nano was available in both the Ambra and Solana performance levels. It's a new form factor called a micro-in-the-canal or MIC (sometimes called an IIC). Phonak nano is fully-featured with all the automatic processing of our Spice+ platform, and designed to deliver satisfaction in terms of being discreet, comfortable and providing exceptional sound quality.

SMAKA: How does a nano compare to the Lyric devices?

FINLEN: Phonak nano is a daily wear product that is the smallest custom device that Phonak builds for a patient's ear. Phonak nano is a discreet fully featured custom hearing instrument, complementing our 100% invisible Lyric® extended wear device.

SMAKA: Thanks for that explanation. For professionals that might not be familiar with Ambra and Solana performance levels, can you elaborate?

FINLEN: Ambra is a Premium performance level instrument which was developed to satisfy the most demanding clients who desire and expect nothing but the best. Ambra has a complete set of trail-blazing solutions which uniquely address hearing challenges while enhancing understanding in even the most difficult listening situations. Solana is an Advanced performance level instrument. This Advanced product level provides a wide set of features which still provide a high level of performance a value price, and as such, is designed to elevate the perception of a mid-range hearing solution.

SMAKA: Let's get into the details of the recent nano validation study.

FINLEN: Sure. When we conduct validation studies, in addition to bringing in subjects to the Phonak facility and to conduct our own product fittings, we also enlist hearing healthcare professionals in the field. We get feedback from both audiologists and specialists, on their experience fitting the product, which is obviously very important. In the recent nano study we worked with five different accounts across the United States. A total of 51 people were fit with the Ambra nano.

We focused on three key areas: comfort, as in the physical fit;spontaneous acceptance of the sound quality during the month-long period that the clients wore the product;and feedback from the professionals about their experience fitting and programming nano.

SMAKA: Were the 51 subjects new users or previous users, and what was the age range?

FINLEN: Sixteen clients were previous users of the RIC category, 17 used CICs, 17 patients were new users, and one client had tried Lyric for a year, as well. The average client age was 64.2.

SMAKA: Why were these people selected?

FINLEN: We wanted clients who found cosmetics important because we were looking at fit and comfort of this very discreet device and that is why CIC users were included. The RIC category is a growing category, and we wanted to see how clients using RIC devices would feel about using a custom product in terms of fit, cosmetics and sound quality.

SMAKA: So how did these 51 people rate comfort, cosmetics and the spontaneous acceptance with sound quality?

FINLEN: In regards to comfort, we conducted ratings at the initial fitting as well as after wearing the devices for about a month. Ninety-two percent of the clients reported that the nano device was comfortable to wear. Retention of small, custom devices can sometimes be an issue. When the clients were asked about retention during the study, 98% reported that they had great retention with their nano devices. We were very excited about these high ratings in regards to both the fit and the comfort of nano.

SMAKA: Judging by the photos of nano that I've seen, I would imagine that cosmetics also rated very high. What did the data show?

FINLEN: The clients indicated that in terms of cosmetics, i.e. the design and the size, nano was just right. In fact, 83 percent of the clients rated nano better than the CIC, which previously was our smallest product. The nano is designed to fit deeply in the ear canal with the faceplate sitting at the first bend. Using some new features exclusive to nano, we were able to design it to be smaller and more recessed in the ear.

SMAKA: Can you tell me about those new features that enabled you to make nano smaller and more recessed?

FINLEN: Sure. We are using a new design and a new shell material that is used in the dental industry. In order to make nano so small, we made the shell wall a little thinner in order to fit all the components inside. Obviously, when you make a thinner shell you have potential problems with the shell cracking or breaking over time. To help with the stability, we used ceramic filler that makes the shell stronger so that it won't break. In addition, we've redesigned the faceplate in order to make it more recessed in the ear while maintaining comfort. Part of that redesign included a new battery door as well as improvements to the placement of the components to achieve a deeper fit. Along with a tube placement of the microphone, the final result is an incredibly small design that is more recessed into the ear canal.

SMAKA: What's interesting is that those innovations aren't necessarily apparent to the naked eye, such as the thinner shell with the ceramic-like filler. When you see nano, you simply see a tiny hearing aid. What battery size does it take?

FINLEN: It uses a 10a battery which provides a battery life of about a week, like with a CIC. The functionality is similar to the other products of the same performance level, Ambra or Solana. Because nano is so discreet, wireless capability is not available and the features are similar to a CIC.

SMAKA: One aspect of the validation study we haven't touched on is the spontaneous acceptance of sound quality.

FINLEN: Yes, the sound quality for the fitter's voice yielded a result of 100 percent acceptance. That is, all clients said that it was acceptable at the first fitting when listening to their fitter's voice. They indicated that the fitter's voice sounded exactly the way they expected it to and that it sounded good. Regarding their own voice, 76 percent indicated nano was acceptable for the sound quality. This data was collected during the first-fit without completing adjustments. We were pleased that the first fit algorithm with our Phonak Target™ fitting software was acceptable to the clients. Sound quality improved further with minor fine-tuning adjustments.

SMAKA: Speaking of finetuning, I assume conducting probe mic measures with nano would be similar to conducting probe mic with a CIC style device?

FINLEN: Yes, you can most definitely perform probe mic measures with nano. In fact, we have a new programming cable for nano designed so it won't pull out of the client's ear. So, you can still get your probe mic down into position, fit the instrument in, and perform real ear measures.

SMAKA: Great to hear. That leads us right into the professionals' feedback - what did the professionals who participated in the validation study have to say about nano?

FINLEN: Professionals were very excited about nano. We selected hearing healthcare professionals fit Lyric, as we wanted to provide them with another discreet device for times when Lyric may be contraindicated due to the size of the ear canal. The providers were happy that all 51 clients were able to be fit with nano, so they had the smallest custom device available to them as an option. Additionally, nano doesn't require any special impression techniques, which makes it very easy to fit. It requires the same impression as a CIC, just past the second bend.

The providers also indicated that their clients' found the size and the design of the nano to be very appealing. So, overall they were pleased to be able to expand their offering with a daily wear product with virtual invisibility that is comparable to the Lyric® extended wear device.

SMAKA: In summary, then, both the patients and professionals gave high marks to nano.

FINLEN: Yes, the study concluded that nano was rated highly for spontaneous acceptance of sound quality, design and comfort. Hearing care professionals found nano to be a very appealing and easy to fit solution. We know that clients look for cosmetic hearing solutions. They want invisible;they expect hearing aids to be comfortable and they want them to have good sound quality. Phonak nano meets these demands very well. I authored a recent article that includes more details of the study (Finlen, 2012) for readers that are interested.

SMAKA: Thanks for that info - I will check out the article and include the reference at the end of our interview.

For professionals who want to get started with nano, what's available in terms of support and training?

FINLEN: The great thing for professionals is that it is so easy to offer nano - as we discussed, patients find it very appealing, no special impression techniques are required, and programming nano is not any different than programming other Phonak products. In June, we will also offer a full product line with nano! We are excited to introduce the addition of Cassia nano, a Standard performance category!

Since we initially launched nano in October, our sales and training teams have been providing training and support. We offer education courses on nano and all of our products on AudiologyOnline as well - you can view our library of courses at www.audiologyonline.com/phonak.

SMAKA: Becky, it was great meeting you today to talk about Phonak nano. Thanks for your time.

FINLEN: Thanks, Carolyn. We were really excited with the results of this validation study, and it's been great speaking with you about it.

Reference

Finlen, B. (2012). Improved hearing with a new discreet micro-in-the-canal hearing instrument. Hearing Review, 19(4), 28 - 33.

To learn more about Phonak, please visit www.phonak.com or the Phonak web channel on Audiology Online.