Interview with Dr. Victor Bray, Chief Audiology Officer & Mr. Robert Ghent, Senior Research Audiologist, Sonic Innovations
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Topic: ion™ 200 - A New Level of Reliability
Paul Dybala: As they say in the Czech Republic, "Ahoj", everyone. This is Dr. Paul Dybala with Audiology Online. I am sitting with Victor Bray and Robert Ghent from the Auditory Research Department at Sonic Innovations. Welcome to both of you. Please introduce yourselves to the audience.
Victor Bray: Thanks Paul. It is a pleasure to be talking with you again. I am the Chief Audiology Officer and a Vice President for Sonic Innovations. The Auditory Research Department participates in the R&D process at Sonic Innovations. We work on the research, design, development, verification, and validation of products. We have a working clinical and research laboratory here, and with me is Bob Ghent who, of the three full-time researchers on my staff, has been with me for the longest amount of time, almost ten years. Bob is the lead researcher on our open-ear products, and he has invested close to two years of research on various open-ear factors. Bob, would you like to tell us about yourself?
Bob Ghent: Hello, Paul. I graduated from Brigham Young University about the time the Engineering Department there brought what would become Sonic's seminal technology to the Audiology clinic for its first clinical trials. That was my first exposure to the multi-channel processing upon which we would build our first hearing aids. I worked in private practice for several years after graduating and then was Victor's first hire at Sonic Innovations. I was here for the launch of our first product, and it has been a fun and interesting ride to come along this far and see this technology develop into things that we did not have in school.
Dybala: We are talking about Sonic's ion 200 today. Victor, can you tell us about the device?
Bray: Sure. At Sonic, when we talk about BTEs, there are three different sizes. There is the standard-size BTE, then a smaller version that we call the miniBTE, and then the smallest size that we call a microBTE. We consider the ion family of products microBTEs. They are very, very small, powered by 10A batteries.
It was about a year and half ago at AAA when we introduced the ion hearing aid, which was our first open-fit product. We had tremendous success with that product from the beginning.
Sonic Innovations came to the market in 1998 with the world's best digital CIC hearing aid. I thought that the CIC would always be what we were known for; it was always our number-one-selling product.
The ion open fit platform has replaced the digital CIC as our number-one product, and ion became the leading product within a matter of months. The reception to the product was tremendous and the change in how our customers were moving first-time users and current CIC wearers from CICs into open fit was amazing.
It was a dramatic transition in the market place, and ion is still on the market, doing extraordinarily well. Next we wanted to grow the ion family and introduced ion 200 with new features and case design. We announced the new product at AAA of 2007 and we started shipping it that summer.
Sonic Innovations ion 200 Open-Fit microBTE
We are getting an excellent response, because we achieved all of the things that we targeted for ion 200. First, the original ion was built around a multi-memory configuration, but our customers also wanted a single-memory hearing aid with a Universal program. Therefore, in ion 200 we reconfigured the algorithms to provide a Universal program that can be used both in quiet and in noise. We also have a telephone option that can be programmed as well if the patient wants the option, and we put in an adaptive feedback canceller to help with telephone use, which we do not have in the original ion.
The third issue that we and other manufacturers throughout the industry have found out is that these small BTE cases are prone to moisture problems. We wanted to greatly increase the reliability of the product, and therefore, ion 200 has a brand new case that was designed specifically to improve reliability. It is a quality improvement project that targeted moisture resistance and several engineering changes. Bob has spent a lot of time this year testing for moisture resistance in ion 200, and he actually created a separate research pool where he evaluated moisture resistance in microBTE hearing aids.
One aspect that we maintained from the original ion in the design of ion 200 is the ability to convert the open fit design to a standard configuration using an ear hook. We expect people to want to wear these hearing aids for quite a while. If their hearing loss deteriorates in the lower-mid frequencies and they need a little more amplification, it is very simple to convert the hearing aid from open fit to a conventional BTE for greater amplification.
Sonic Innovations ion 200+ Ear Hook Option
Fitting Range for ion 200 with Thin Tube and Ear Hook Options
Dybala: The Universal program feature seems like a huge advantage for the patient to be able to put the hearing aid on and forget about it.
It also appears that the ion 200 has an innovative moisture-resistance element. What type of protection are you adding to the hearing aid?
Ghent: Incorporated into ion 200 are multiple line of defense against moisture. The microphone compartments use advanced GORE™ membranes which protect the microphones from debris and moisture. The battery compartment has on O-ring seal integrated into the battery door to control flow of moisture. Also, the battery door is vented and allows air to flow into the compartment to power a zinc-air battery, while another GORE™ membrane seals the vent from moisture.
You may know that GORE makes several types of membranes that are water-repellent and air-breathable. We have identified a specific GORE membrane that is best for hearing aid applications, which is what we are using in our hearing aids. It is similar to GORE-TEX™ clothing; however, we do not refer to it as GORE-TEX because that is specific to textile applications.
Bray: Correct, GORE-TEX clothing is their textile line. The protective membranes in the hearing aid are not a textile, and if you were to ask me to compare it to a water-resistant windbreaker, I would have no idea how. [laughs]
Dybala: [laughs] Okay, fair enough. Now, you mentioned that Bob had been doing some special testing to look at the effectiveness of the moisture-resistance. Bob, could you discuss this? What techniques did you use and what are the results at this point?
Ghent: Our Engineering Department has put ion 200 devices in a salt-fog chamber to really torture them. This is a laboratory condition that accelerates corrosive moisture exposure. The Auditory Research Department wanted to look more at the real-world situation. We have clinical space here designed for research where we fit hearing-impaired subjects with amplification, and do the usual objective measures of performance—speech in quiet and speech in noise—and we have participants complete questionnaires as to perceived benefit and satisfaction with the hearing aids.
With this particular study we also wanted to look at how the hearing aids survived the rigors of everyday wear. Everyday wear, for these open devices, seems to be a little different from traditional hearing aids; therefore, we recruited a small subject pool—seven people in this case—who we know from past history lead an active lifestyle and have the potential to perspire a great deal while testing the device.
The age range for this specialized subject pool was 43-75 with a mean age of 62, and all of the people in this study are still working except for one gentleman who is retired; however, he is a physical trainer who is very active and wears his hearing aids during workouts.
All of the participants have backgrounds that put them in performance environments that cause copious perspiration. A woman in our study, for instance, is a stage actress. In the summer, she performs with outdoor theater groups. Here in Utah in the summer, there are outdoor theater groups in the southern part of the state: the Neil Simon Festival, the Shakespeare Festival and the Tuacahn Theater. She works all of these festivals during the summer, where outdoor temperatures average around 100 degrees. So she's under hot lights, outside...
Dybala: Mm-hmm. It can get pretty warm sitting in the audience at an outdoor theatre, let alone someone in costume, under the lights.
Ghent: Exactly, a lot of perspiration there.
As I mentioned, another one of our subjects is a trainer; he does a lot of weight-training and wears his hearing aids during those workouts.
One gentleman is a home inspector; he crawls through basements and attics all day long. Another example is a gentleman who works for the Fish and Game Department here in Utah. He is outdoors and active all day long, wearing his hearing aids.
Bray: Another one is an office worker, but his hobby is racing cars, and, of course, when you race a car, you have to wear a helmet. He wants to wear his hearing aids so that he can hear his engine, his tires, etc. For his needs, we need a hearing aid that can survive out on a track, where it is about 110-120 degrees, and he has to wear a hearing aid under a helmet, where he is sweating, and, of course, the helmet is over the open-fit product, so it has to be feedback-resistant.
These are tough, tough people to satisfy.
Dybala: [laughs] Those are pretty intense environments. I am sure our readers are starting to list patients they have had who need hearing aids in similar environments.
Ghent: This last gentleman is one of our employees; therefore, he is the guy that we tend to use as a test pilot for these devices, before we take them to the outside world and put them on our research volunteers.
We started the data collection in the spring when the weather became warm. We completed the data collection on this small study this past summer, and at that time we had accumulated about 3,500 wear hours on these seven subjects in these torturous environments in which they live and work.
After the conclusion of the formal data collection, we left the participants in their ion 200 hearing aids and let them wear them on a continuing basis. At this point, we have accumulated well over 10,000 wear hours, and where, in other BTE products, these folks can kill a hearing aid in a matter of hours to days, we have not had one hard failure of ion 200 on any of these subjects.
Dybala: Really? Is there any ongoing maintenance that they need to do as far as cleaning them, or is it just routine maintenance that you should do with any hearing aid?
Ghent: We have them doing a couple of things that are pretty typical for some of these thin-tube fittings to reduce moisture condensation from accumulating in the thin tubing.
Cleaning Moisture Out of the Sound Tube
If there is moisture in the tubing that causes a clog, the patient can run the black cleaning rod that looks like a cat whisker through there and keep the tubing cleared out. If moisture accumulates over the microphones, the GORE membrane causes the moisture to bead up so that it will not get inside the hearing aid. Therefore, the patient can wipe a tissue across that opening to remove the moisture.
Dybala: That is great. Dry-aid kits are good for long-term maintenance, but the great aspect of ion 200 is that it keeps moisture from actually getting into the microphone, reducing the risk of waiting too long before removing the moisture. It seems like moisture-resistance would be great for school-age children as well.
Bray: That is absolutely correct. As I go around the country and meet with clinicians, I see tremendous success with open fit devices on school-age children.
That is a tough environment to keep a hearing aid working in; however, ion 200 is solid, and now it is available in red, blue, and black, in addition to the available neutral colors, making it more pediatric-friendly.
Sonic Innovations ion 200 Color Options
Dybala: BTE devices are becoming more and more popular. What is the primary demographic for the microBTEs and open fittings?
Bray: The trend that I am seeing as I talk with customers and clinicians all around the world is that for initial fittings these open fit products are now the recommended first fit. Previously, people came in and they wanted small and invisible hearing aids and they were getting CICs. You had to counsel your client to live with the occlusion effect while they lived with amplification. Now, clinics have converted to fitting these people with these microBTEs with thin tubes. Patients take to them immediately; therefore, they are being used for first fittings, which are typically the youngest people in our demographic.
View of ion 200 on the Ear
Ghent: The other group is active people. People are wearing hearing aids in environments where we used to tell people not to wear them. You are going jogging? Do not wear your hearing aid. You are going to play tennis? Do not wear it. We have these people in harsh environments that want to wear their hearing aids. Therefore, younger and active lifestyles are definitely part of an emerging demographic.
Dybala: Not only do patients want to wear their hearing aids, they actually need them in those environments for better performance and safety. Victor, you mentioned this earlier about the racecar driver. That is a great point.
Bray: It helps to have great hearing for racing cars. I don't know if you've been on the track Paul, but you really gauge a lot of how hard you're driving through the turns by listening to what's going with your tires. As they say, "If the tires are squealing, they're happy," and so you tune your ear to how much you can push those tires through a curve. This particular person is racing autocross. To get the feel for his car he's getting information in his hands through the steering wheel and in his ears listening to the squeal of those tires to know if he's pushing the right amount or too hard or not hard enough.
And of course tire squeal is a high-frequency cue right where his hearing loss is. Wearing the hearing aids helps him to be a better racecar driver.
Dybala: As a final question, you mentioned that you are working on ion 400, what can you tell us about that?
Bray: I cannot tell you much at this time as it is still in the final stage of development. We are working on it, and it will be even better than ion 200. One thing I can tell you is that we plan to take the new, moisture-resistant case from ion 200 and introduce it into ion 400 as well as the original ion hearing aid. We plan to have information on both of these new products at the AAA meeting in Charlotte.
Dybala: Well, Victor and Bob, thanks for spending time with me today. I do want to encourage the readers to visit the Sonic Innovations website at https://www.sonici.com for more information on ion 200 . You can also learn more about Sonic Innovations on the Sonic Innovations web channel on Audiology Online or read other interviews with Victor and his colleagues from Sonic Innovations at www.audiologyonline.com/channels/sonic_innovations.asp.
Victor, Bob, thanks again and I hope you guys have a great day!
Bray: Thank you, Paul!
Ghent: Thank you, Paul!
About Sonic Innovations
One reason that Sonic Innovations has experienced great success over the years is because of their Digital Signal Processing platform. This platform leads to the small, reliable, and durable hearing aids that Sonic Innovations provides to the hearing-impaired population. Sonic Innovations has a wide line of hearing aids ranging from their entry-level hearing aid, Tribute, to their premium digital hearing aid, Velocity, which are both available from CIC to BTE styles. Now, patients can also enjoy ion 200 open fit hearing aid. This device delivers the power to fit a severe high-frequency hearing loss in a small and comfortable open fit design. For more information on ion 200 and the entire Sonic Innovations line, visit the Sonic Innovations website or call your local representative.
Victor Bray: Thanks Paul. It is a pleasure to be talking with you again. I am the Chief Audiology Officer and a Vice President for Sonic Innovations. The Auditory Research Department participates in the R&D process at Sonic Innovations. We work on the research, design, development, verification, and validation of products. We have a working clinical and research laboratory here, and with me is Bob Ghent who, of the three full-time researchers on my staff, has been with me for the longest amount of time, almost ten years. Bob is the lead researcher on our open-ear products, and he has invested close to two years of research on various open-ear factors. Bob, would you like to tell us about yourself?
Bob Ghent: Hello, Paul. I graduated from Brigham Young University about the time the Engineering Department there brought what would become Sonic's seminal technology to the Audiology clinic for its first clinical trials. That was my first exposure to the multi-channel processing upon which we would build our first hearing aids. I worked in private practice for several years after graduating and then was Victor's first hire at Sonic Innovations. I was here for the launch of our first product, and it has been a fun and interesting ride to come along this far and see this technology develop into things that we did not have in school.
Dybala: We are talking about Sonic's ion 200 today. Victor, can you tell us about the device?
Bray: Sure. At Sonic, when we talk about BTEs, there are three different sizes. There is the standard-size BTE, then a smaller version that we call the miniBTE, and then the smallest size that we call a microBTE. We consider the ion family of products microBTEs. They are very, very small, powered by 10A batteries.
It was about a year and half ago at AAA when we introduced the ion hearing aid, which was our first open-fit product. We had tremendous success with that product from the beginning.
Sonic Innovations came to the market in 1998 with the world's best digital CIC hearing aid. I thought that the CIC would always be what we were known for; it was always our number-one-selling product.
The ion open fit platform has replaced the digital CIC as our number-one product, and ion became the leading product within a matter of months. The reception to the product was tremendous and the change in how our customers were moving first-time users and current CIC wearers from CICs into open fit was amazing.
It was a dramatic transition in the market place, and ion is still on the market, doing extraordinarily well. Next we wanted to grow the ion family and introduced ion 200 with new features and case design. We announced the new product at AAA of 2007 and we started shipping it that summer.
Sonic Innovations ion 200 Open-Fit microBTE
We are getting an excellent response, because we achieved all of the things that we targeted for ion 200. First, the original ion was built around a multi-memory configuration, but our customers also wanted a single-memory hearing aid with a Universal program. Therefore, in ion 200 we reconfigured the algorithms to provide a Universal program that can be used both in quiet and in noise. We also have a telephone option that can be programmed as well if the patient wants the option, and we put in an adaptive feedback canceller to help with telephone use, which we do not have in the original ion.
The third issue that we and other manufacturers throughout the industry have found out is that these small BTE cases are prone to moisture problems. We wanted to greatly increase the reliability of the product, and therefore, ion 200 has a brand new case that was designed specifically to improve reliability. It is a quality improvement project that targeted moisture resistance and several engineering changes. Bob has spent a lot of time this year testing for moisture resistance in ion 200, and he actually created a separate research pool where he evaluated moisture resistance in microBTE hearing aids.
One aspect that we maintained from the original ion in the design of ion 200 is the ability to convert the open fit design to a standard configuration using an ear hook. We expect people to want to wear these hearing aids for quite a while. If their hearing loss deteriorates in the lower-mid frequencies and they need a little more amplification, it is very simple to convert the hearing aid from open fit to a conventional BTE for greater amplification.
Sonic Innovations ion 200+ Ear Hook Option
Fitting Range for ion 200 with Thin Tube and Ear Hook Options
Dybala: The Universal program feature seems like a huge advantage for the patient to be able to put the hearing aid on and forget about it.
It also appears that the ion 200 has an innovative moisture-resistance element. What type of protection are you adding to the hearing aid?
Ghent: Incorporated into ion 200 are multiple line of defense against moisture. The microphone compartments use advanced GORE™ membranes which protect the microphones from debris and moisture. The battery compartment has on O-ring seal integrated into the battery door to control flow of moisture. Also, the battery door is vented and allows air to flow into the compartment to power a zinc-air battery, while another GORE™ membrane seals the vent from moisture.
You may know that GORE makes several types of membranes that are water-repellent and air-breathable. We have identified a specific GORE membrane that is best for hearing aid applications, which is what we are using in our hearing aids. It is similar to GORE-TEX™ clothing; however, we do not refer to it as GORE-TEX because that is specific to textile applications.
Bray: Correct, GORE-TEX clothing is their textile line. The protective membranes in the hearing aid are not a textile, and if you were to ask me to compare it to a water-resistant windbreaker, I would have no idea how. [laughs]
Dybala: [laughs] Okay, fair enough. Now, you mentioned that Bob had been doing some special testing to look at the effectiveness of the moisture-resistance. Bob, could you discuss this? What techniques did you use and what are the results at this point?
Ghent: Our Engineering Department has put ion 200 devices in a salt-fog chamber to really torture them. This is a laboratory condition that accelerates corrosive moisture exposure. The Auditory Research Department wanted to look more at the real-world situation. We have clinical space here designed for research where we fit hearing-impaired subjects with amplification, and do the usual objective measures of performance—speech in quiet and speech in noise—and we have participants complete questionnaires as to perceived benefit and satisfaction with the hearing aids.
With this particular study we also wanted to look at how the hearing aids survived the rigors of everyday wear. Everyday wear, for these open devices, seems to be a little different from traditional hearing aids; therefore, we recruited a small subject pool—seven people in this case—who we know from past history lead an active lifestyle and have the potential to perspire a great deal while testing the device.
The age range for this specialized subject pool was 43-75 with a mean age of 62, and all of the people in this study are still working except for one gentleman who is retired; however, he is a physical trainer who is very active and wears his hearing aids during workouts.
All of the participants have backgrounds that put them in performance environments that cause copious perspiration. A woman in our study, for instance, is a stage actress. In the summer, she performs with outdoor theater groups. Here in Utah in the summer, there are outdoor theater groups in the southern part of the state: the Neil Simon Festival, the Shakespeare Festival and the Tuacahn Theater. She works all of these festivals during the summer, where outdoor temperatures average around 100 degrees. So she's under hot lights, outside...
Dybala: Mm-hmm. It can get pretty warm sitting in the audience at an outdoor theatre, let alone someone in costume, under the lights.
Ghent: Exactly, a lot of perspiration there.
As I mentioned, another one of our subjects is a trainer; he does a lot of weight-training and wears his hearing aids during those workouts.
One gentleman is a home inspector; he crawls through basements and attics all day long. Another example is a gentleman who works for the Fish and Game Department here in Utah. He is outdoors and active all day long, wearing his hearing aids.
Bray: Another one is an office worker, but his hobby is racing cars, and, of course, when you race a car, you have to wear a helmet. He wants to wear his hearing aids so that he can hear his engine, his tires, etc. For his needs, we need a hearing aid that can survive out on a track, where it is about 110-120 degrees, and he has to wear a hearing aid under a helmet, where he is sweating, and, of course, the helmet is over the open-fit product, so it has to be feedback-resistant.
These are tough, tough people to satisfy.
Dybala: [laughs] Those are pretty intense environments. I am sure our readers are starting to list patients they have had who need hearing aids in similar environments.
Ghent: This last gentleman is one of our employees; therefore, he is the guy that we tend to use as a test pilot for these devices, before we take them to the outside world and put them on our research volunteers.
We started the data collection in the spring when the weather became warm. We completed the data collection on this small study this past summer, and at that time we had accumulated about 3,500 wear hours on these seven subjects in these torturous environments in which they live and work.
After the conclusion of the formal data collection, we left the participants in their ion 200 hearing aids and let them wear them on a continuing basis. At this point, we have accumulated well over 10,000 wear hours, and where, in other BTE products, these folks can kill a hearing aid in a matter of hours to days, we have not had one hard failure of ion 200 on any of these subjects.
Dybala: Really? Is there any ongoing maintenance that they need to do as far as cleaning them, or is it just routine maintenance that you should do with any hearing aid?
Ghent: We have them doing a couple of things that are pretty typical for some of these thin-tube fittings to reduce moisture condensation from accumulating in the thin tubing.
Cleaning Moisture Out of the Sound Tube
If there is moisture in the tubing that causes a clog, the patient can run the black cleaning rod that looks like a cat whisker through there and keep the tubing cleared out. If moisture accumulates over the microphones, the GORE membrane causes the moisture to bead up so that it will not get inside the hearing aid. Therefore, the patient can wipe a tissue across that opening to remove the moisture.
Dybala: That is great. Dry-aid kits are good for long-term maintenance, but the great aspect of ion 200 is that it keeps moisture from actually getting into the microphone, reducing the risk of waiting too long before removing the moisture. It seems like moisture-resistance would be great for school-age children as well.
Bray: That is absolutely correct. As I go around the country and meet with clinicians, I see tremendous success with open fit devices on school-age children.
That is a tough environment to keep a hearing aid working in; however, ion 200 is solid, and now it is available in red, blue, and black, in addition to the available neutral colors, making it more pediatric-friendly.
Sonic Innovations ion 200 Color Options
Dybala: BTE devices are becoming more and more popular. What is the primary demographic for the microBTEs and open fittings?
Bray: The trend that I am seeing as I talk with customers and clinicians all around the world is that for initial fittings these open fit products are now the recommended first fit. Previously, people came in and they wanted small and invisible hearing aids and they were getting CICs. You had to counsel your client to live with the occlusion effect while they lived with amplification. Now, clinics have converted to fitting these people with these microBTEs with thin tubes. Patients take to them immediately; therefore, they are being used for first fittings, which are typically the youngest people in our demographic.
View of ion 200 on the Ear
Ghent: The other group is active people. People are wearing hearing aids in environments where we used to tell people not to wear them. You are going jogging? Do not wear your hearing aid. You are going to play tennis? Do not wear it. We have these people in harsh environments that want to wear their hearing aids. Therefore, younger and active lifestyles are definitely part of an emerging demographic.
Dybala: Not only do patients want to wear their hearing aids, they actually need them in those environments for better performance and safety. Victor, you mentioned this earlier about the racecar driver. That is a great point.
Bray: It helps to have great hearing for racing cars. I don't know if you've been on the track Paul, but you really gauge a lot of how hard you're driving through the turns by listening to what's going with your tires. As they say, "If the tires are squealing, they're happy," and so you tune your ear to how much you can push those tires through a curve. This particular person is racing autocross. To get the feel for his car he's getting information in his hands through the steering wheel and in his ears listening to the squeal of those tires to know if he's pushing the right amount or too hard or not hard enough.
And of course tire squeal is a high-frequency cue right where his hearing loss is. Wearing the hearing aids helps him to be a better racecar driver.
Dybala: As a final question, you mentioned that you are working on ion 400, what can you tell us about that?
Bray: I cannot tell you much at this time as it is still in the final stage of development. We are working on it, and it will be even better than ion 200. One thing I can tell you is that we plan to take the new, moisture-resistant case from ion 200 and introduce it into ion 400 as well as the original ion hearing aid. We plan to have information on both of these new products at the AAA meeting in Charlotte.
Dybala: Well, Victor and Bob, thanks for spending time with me today. I do want to encourage the readers to visit the Sonic Innovations website at https://www.sonici.com for more information on ion 200 . You can also learn more about Sonic Innovations on the Sonic Innovations web channel on Audiology Online or read other interviews with Victor and his colleagues from Sonic Innovations at www.audiologyonline.com/channels/sonic_innovations.asp.
Victor, Bob, thanks again and I hope you guys have a great day!
Bray: Thank you, Paul!
Ghent: Thank you, Paul!
About Sonic Innovations
One reason that Sonic Innovations has experienced great success over the years is because of their Digital Signal Processing platform. This platform leads to the small, reliable, and durable hearing aids that Sonic Innovations provides to the hearing-impaired population. Sonic Innovations has a wide line of hearing aids ranging from their entry-level hearing aid, Tribute, to their premium digital hearing aid, Velocity, which are both available from CIC to BTE styles. Now, patients can also enjoy ion 200 open fit hearing aid. This device delivers the power to fit a severe high-frequency hearing loss in a small and comfortable open fit design. For more information on ion 200 and the entire Sonic Innovations line, visit the Sonic Innovations website or call your local representative.
Victor Bray, PhD
Chief Audiology Officer