Interview with David Fabry, Ph.D., Vice President of Professional Relations and Education for Phonak US

Topic: EUHA and Savia Art

Dybala: Hi, this is Dr. Paul Dybala with Audiology Online. I am here at EUHA here in Frankfurt, Germany and talking today to Dr. David Fabry from Phonak Hearing Systems. So, willkommen Dave!

Fabry: Ya! Willkommen.

Dybala: Guten tag! Well, Dr. Fabry and I have been taking basic German and failing. This is my first trip to EUHA. This is your first trip too, correct?

Fabry: That is correct. I'm a newbie. I've heard about the German Congress, now the European Union Congress, for many years. In fact, many people are surprised, as old as I am, that this is my first time over here.

Dybala: It's interesting when comparing this meeting with meetings in the U.S. To paraphrase a semi-famous movie quote, they have the same things over here that they have in the U.S., but some things are just a little different. Dave, what have you found the most interesting as far as the similarities and the differences?

Fabry: I think for those of us in the U.S., we may not have been aware of the European Congress, but in fact it is the second most important hearing aid meeting in the world. If you look in the past few years, most of the hearing aid companies build their product releases around either AudiologyNow (the meeting formerly known as the AAA meeting) in the Spring and the European Congress in the Fall. In comparison to AudiologyNow, I would have to say the exhibit hall here is a little smaller, a little different in flavor.

Dybala: Among other things, you can order a beer at most of the conference booths.

Dave: Yes. In fact, many of the booths are serving champagne, beer and alcohol beverages and I say bring that back. [laughter]

The other thing I guess I should have been prepared for, surprisingly, is that most of the technical presentations are in German.

Dybala: Who knew?

Fabry: [laughter] But fortunately, they do real time translation and I've been wearing the headset around in the technical sessions. I've also tried wearing it in the exhibit floor to see if I could understand and improve my German, but sadly I find that it doesn't work as well on the exhibit floor.



Figure 1. Dr. Fabry listens to real-time translations of presentations at EUHA.

Dybala: No it doesn't. The other interesting thing is that that most everyone here is multilingual, so a person will come up and ask you a question in German, or some other language and typically there's enough context where you can understand what they are asking. You respond in English. It's right at that moment, you hope that you understood them and that they understood you. In the end, it always seems to work out fine!

Dave, you also mentioned there are a lot of product releases, and that's part of the reason you and I are talking today. Phonak released a new product at EUHA called Savia Art. What I wanted to do, just to give people a taste of Art, is to talk about some of the new features and hit some of the high points of Phonak's new high-end, premium product.

Fabry: I'd be glad to, Paul. Building on the success we've had with Savia over the last couple of years or more since its introduction comes Savia Art. Savia Art, in this case, has a number of features that we think set the standard, if you will, in the industry.

The first is one we call NoWhistle, Phonak's newest feedback phase inversion system. This system sets the standard for feedback cancellation in modern digital hearing aids.

Dybala: It sounds like there have been a lot of advances over the past year in what we traditionally call "feedback phase inverters." How would you compare your new NoWhistle technology with other products that are on the market?

Fabry: The beauty of the NoWhistle system is that it does not make an overall compromise between performance and sound quality by virtue of multi-base programming. That is, it does not require the feedback phase inversion level to be the same for all listening environments encountered by hearing aid users. For example, feedback cancellation levels may be higher for an acoustic phone program, where feedback is more likely to occur, and less aggressive for music, when sound quality is most important.

Another thing that sets NoWhistle apart from other feedback systems is that the Feedback Manager works in combination with the feedback phase inverter works to control both static and dynamic aspects of feedback, respectively, by measuring the "headroom" in a specific fitting (e.g. measured feedback threshold minus maximum fitting gain). When activated, NoWhistle will automatically turn the feedback canceller off in frequency bands that have high headroom.

In summary, NoWhistle sets the standard for modern feedback cancellation, by using different feedback levels in different listening environments AND frequency regions. By only applying feedback cancellation when necessary, it provides optimal performace without compromising sound quality.

Dybala: Related to feedback, Art is also available with "Canal Receiver Technology." One of the advantages of this type of technology is moving the receiver further into the canal. This has an effect of reducing feedback because the receiver is further away from is the microphone. Tell me a little bit more about this feature in Art.

Fabry: Yes. Canal Receiver Technology (CRT) has certainly taken off in the last couple of years. We've had MicroPower, and we are also introducing MicroPower Nine (IX) at this meeting, which is a high-level MicroPower circuit that uses Canal Receiver Technology.

Certainly, there are distinct advantages to a canal receiver, and micro Art CRT is our first product that uses one for "open" fits. We know that's going to be a popular choice because of the number of features -- we probably don't have time to go into them here, but the smoothness of the response, the opportunity for extended high frequencies, smaller overall size, and the ability to move the receiver into the ear canal without reducing high-frequency gain the way some "thin tube" devices do all contribute to the advantages of CRT systems.

For those who prefer "Slim Tube" micro devices, we also offer a microArt device with this capability. In addition, we now offer clinicians the flexibility to use either the Slim Tube or a standard earhook micro Art devices. In addition, this feature is compatible with any Micro Eleva, Savia, Art and our newest product, Micro eXtra, and offers much more flexibility to both the patient and audiologist. In particular, it helps minimize the risk if a patient is at the upper end of the fitting range for "open" devices, or has a fluctuating or progressive loss, as it enables the existing device to be adapted to use a standard earhook and custom earmold. We're excited about offer this flexibility to our customers and their patients.

Dybala: That's great. Segueing back into more of the algorithmic effects, I believe you had a Bass Boost feature that was also new in Art. Could you tell us a little bit about that?

Fabry: Yes. That's something that will be available on all 33P (ITEs) and 411 (BTE) devices, which are basically the power full-scale ITE and the power BTE instruments. Phonak has had a long-standing commitment to providing devices that have been designed specifically for use by patients with severe or severe-to-profound hearing loss. BassBoost provides increased gain and output below 1000 Hz than with conventional "power" hearing aids. We found that this feature provides improved sound quality, because although a lot of the focus with "high fidelity" hearing aids has been to improve the frequency response in the high frequencies, there is a significant body ...... of evidence ...... to um, suggest that, uh, low frequencies ...... contribute as much or more to sound quality ......,

Dybala: I'm sorry; we have to stop the interview for a moment because some circus performers just walked by, and Dave and I had to take a breath for a second.

[laughter]

Fabry: Good thing this isn't video! You certainly don't see that at AudiologyNow!

Dybala: No, you don't! It's the little differences ......

[laughter]

Fabry: Where was I? Were we talking about hearing aids?

Dybala: Possibly. I think we were talking about the hearing aids and Bass Boost?

[laughter]

Fabry: Yes, thanks. The issue with Bass Boost and severe to profound hearing loss is that sound quality is as much impacted by low-frequency gain as it is high-frequency gain. But, the thing we've also found is that using Bass Boost in combination with adaptive Digital Surround Zoom provides an additional 1-2 dB benefit, in terms of signal-to-noise ratio, beyond what is provided by directional microphones alone. This is particularly important for patients with severe hearing losses, as they are often significantly challenged to understand speech in noisy listening environments.

Dybala: There's obviously a lot of important speech information in those first two formants. I think that sounds like a very interesting feature.

Lastly, I think the other thing we wanted to talk about today is the self-learning module incorporated into your high-end hearing aids and software, and how you are really taking this to a new level in Art.

Fabry: Yes. We've had data logging with user preference tuning on Savia and Eleva in the past. The difference between the implementations of data logging from other manufacturers is that they are monitoring patient interaction with the volume control in each of the three or four programs, which relates to Phonak's programs that are used in AutoPilot and TriPilot for Savia and Eleva, respectively. The difference with Art is now that these changes may be applied automatically when the patient is wearing the hearing instrument, without the need for a follow-up appointment with the clinician.

Simply put, the hearing aid is constantly monitoring any volume control adjustments made by the hearing aid user (with either the volume control or remote control) in different listening environments. Each time the patient turns the hearing aid off, gain changes on the basis of "real world" use are applied separately for speech in quiet, speech in noise, noise alone, and music environments.

This is a feature which the clinician can choose to disable, but the default is what we call "self learning" because the hearing instrument optimizes automatically as the patient wears it. This is extremely helpful for those patients who cannot get back to see the clinician, or for those clinicians who don't routinely schedule routine follow-up appointments. The beauty of it is, as well as monitoring different listening environments, you can see the changes that have been applied on the follow-up screen in the iPFG software.

Dybala: Excellent. Well Dave, I think that covers everything we wanted to talk about today. I also know that you're doing a live report from EUHA through the Audiology Online portal that Phonak uses.

At this point, I could direct people to check out the recorded versions of the report on EUHA that Dr. Fabry will be presenting live via the Audiology Online e-Learning system. He's also been doing "man on the street," interviews. So, I think if you are looking for additional information about Art or about this conference, you should check it out. It's going to be available via either the e-learning section or through the Phonak web channel (www.audiologyonline.com/channels/phonak.asp), here at Audiology Online. It will be entitled "Phonak Exclusive Sneak Preview Online".

Thanks, Dave, always a pleasure and I'm sure we will be talking to you again soon. I think we should head off to one of those booths to learn more about Phonak technology and have a beverage or two.

Fabry: Klingt gut! (Sounds good!) Thanks for talking with me today, Paul.