Interview with Michael Howitz, Director of Product Management, ReSound US

Topic: be by ReSound™ - a New Style of Hearing Instrument

Dr. Paul Dybala: Hello everybody, this is Dr. Paul Dybala with AudiologyOnline, and today I am speaking with Michael Howitz from ReSound. Michael, thanks for taking time to speak with me today.

Michael Howitz: Glad to be here, thanks for having me, Paul, I have always admired your work.

Dybala: Thank you and likewise, Michael. Could you share with our readers a little bit about your professional background?

Howitz: Sure. I started out as an audiologist in the Twin Cities area and worked in clinical and dispensing practices for about a dozen years;this was in the old days of trim pots and analog technology. Then about ten years ago, I came into the ReSound brand family, through the Danovox division. Prior to moving into my current position, I served as the Director of Customer Support Services for a number of years here at ReSound. Three years ago, I became the Director of Product Management and have been part of the launch of many of our best and most innovative products in the ReSound portfolio, including ReSound Azure, dot by ReSound and be by ReSound.

Dybala: Today we're here talking about be by ReSound, notably this device has a new form factor that takes hearing aids to the next level. Michael, could you tell us about this new style of hearing aids?

Howitz: Sure. We won't be surprised if the impact of be by ReSound is very much like the impact we made on the hearing industry with the ReSoundAIR back in 2003. That's where we really elevated the industry to a new level with Open fittings, thin tubes, and instant-fit products that were non-occluding and feedback free. be by ReSound will most likely be very much like ReSoundAIR- a brand new type of instrument that has not really been seen in the industry before. We're focused on what patients and our customers like about behind-the-ear (BTE) products and in-the-ear (ITE) products as well as what they don't like about both of those form factors. We have put together a new instrument that removes all the obstacles to hearing aid success between those two form factors and that also brings in everything that people really like about existing products.

Dybala: Right, let's run through a couple of those. Give me some examples of what people do and don't like about ITEs and BTEs, and how you were able to achieve your vision with be.

Howitz: Well, probably one of the things that most people don't like about custom products is the patient's ability to wear them successfully and have them be comfortable as well as non-occluding. be by ReSound is not custom fit, per se, but it is dimensionally a product that fits very well into the ear canal in a comfortable way. You can wear one all day long and not feel like it's even there. So, it is a very comfortable product to wear. It is also non-occluding because, unlike a custom product where you build the instrument and then you try to squeeze the vent into the mold after the fact, be by ReSound has a square configuration in a round ear canal so there is venting all the way around the entire product.

Dybala: So, it's an occasion where a square peg in a round hole actually works (laughing).

Howitz: (laughs). Exactly! So back to your question, some of the things that people don't like about BTEs, even when you get into very small BTEs, includes problems with wind noise. Because the microphones are exposed, people complain that their hair is scraping against the microphones, or that their glasses don't fit along with the BTE as well as they would like. All of those issues with BTEs get taken away when you take the entire form factor and put it inside the concha.

Dybala: Because this is a different concept, could you give a description of where each part sits in the ear and also the various colors available? I know there are certain things you are trying to achieve with the cosmetics of be.

Howitz: Right. The standard product color is an anthracite or charcoal color. That is the main body of the hearing instrument. It will go into the ear canal very much like a CIC, but without the custom cosmetic and occlusion issues that CICs tend to introduce. So, the largest part of the instrument goes into the ear canal. The only thing that comes out of the ear canal is a thin tube which leaves the ear canal and comes up and circles around the inside of the concha. At the end of the tube is the microphone itself, which is placed at the helix point.

I think one of the important things to note is that the product comes standard in anthracite or charcoal. This is because, cosmetically, as we've been out in the market testing this and looking at it on different people and different ear canals, we have seen that the best cosmetics are achieved when we actually just match the hearing aid to blend into the natural shadow right outside of the ear canal. Theoretically, it kind of goes against what most people are used to doing: matching the hearing instrument to skin or hair color. You're trying to hide this in the shadow instead. Actually, be by ReSound accomplishes this beautifully when you see it on someone's ear.

Dybala: How do you compare cosmetic appeal of be versus a CIC?

Howitz: Well, we know that be by ReSound can fit a very high percentage of ears, and we're using a criterion which is pretty strict in terms of cosmetic appeal. What we get in terms of cosmetic acceptance, is about a 90%+ achievement rate for the goal that we're looking for here.

And that is certainly more that what CICs accomplish. A lot of CICs are built larger and end up looking like mini-canal aids sticking out, in which case you are more likely to get a better cosmetic appearance if you make a beige faceplate. In most cases, the charcoal color is more appropriate for the patient because it really does sit right down in there in that shadowed area of the ear canal.

We will also launch another main color, which is beige, and there are two reasons for that. One, because we know we have customers who are very ingrained in fitting beige instruments, so we are giving them that choice. Alternatively, if you have a patient who is in that small percentage where it cannot fit well in the same cosmetic way we were hoping for, a beige color might be the best option for them. But we are trying to encourage the majority of users to go with the charcoal because that is what we have seen to be cosmetically best.

Dybala: I see. And you obviously have some advantages by where the microphone is placed in the pinna.

Howitz: Yes, you've got a couple of good advantages. With the microphone placed exactly in that spot, you end up being relieved of just about all wind noise, because it is completely protected where it is. You also take advantage of pinna resonance, so that you end up with a directional benefit, much like you would with the CIC, because it is taking advantage of some of the natural acoustics of the patient's ear and head. The other advantage of the microphone placement further away from the instrument is that it allows us to manage feedback in a better way.

Dybala: One thing that comes to mind, now that we're getting everything further into the ear canal, is how is be designed in terms of comfort?

Howitz: be by ReSound does fit a very high percentage of the population. One of the number-one reasons it is so comfortable is because it doesn't occlude with all of that venting. But also, being that it is a square configuration in a round canal, there are not a lot of contact points between the instrument and the patient's ear. Honestly, how many CICs have you fit where the patient has reported it to be completely comfortable in the ear, because it is fairly good-sized instrument with a lot of contact points in the ear canal? You can achieve a good fit with a CIC, but it is more difficult, because there is a lot of contact between the patient's ear and the hearing aid.

Dybala: I remember that with the CICs, absolutely.

Howitz: You know, for example, my own experience is that I can put be in and practically forget that it is even there. Our Director of Engineering was telling a story the other day of wearing one of the dummies, and then he actually went to bed with it and remembered quite a bit later that he was still wearing the instrument. They are really that comfortable in the ear.

Dybala: What's the general fitting range that this is made for?

Howitz: The fitting range is going to be about the same fitting range as that of ReSoundAIR. It is for mild to moderately-severe hearing losses, which we realized when we launched AIR is about 66% of the patients who are going to be coming into the average dispensing practice's door. It's going to be able to fit a wide range of patients. In terms of technology levels, it's going to be coming in two technology levels: one in the premium category and one in the mid-rage category.

Dybala: My understanding is that you conducted a pretty substantial clinical trial here in the U.S. - can you tell us a little bit about that?

Howitz: Yes, we recently completed a 12 week trial of be instruments. We employed a fairly large group of customers across the United States. Amongst those sites, we fit over 1,000 instruments. We had a fairly rigorous clinical protocol, involving patient questionnaires, dispenser questionnaires and verification measures, so that we obtained a great deal of data and verification that this instrument will be as successful as it was in our alpha trials. One thing I'll mention about the alpha trials is that patients who did not feel that it was the most cosmetically appropriate instrument for them actually did not want to give the instruments back after all was said and done!

Typically, when we do an alpha trial and the trial is over, the patient gives the instrument back and then they have the option to repurchase one once the product has been released. We have had reports from our research audiology group that they have had difficulty getting some of the patients to actually return the instruments because they liked them so much. We experienced much of this same success in our clinical trials - especially with first-time users and previous users of custom products. This product has been enormously successful for our clinical trial sites at brining new patients into their doors as well as bringing back previous patients who are looking for the latest and most updated technology.

Dybala: When will be be released for sale?

Howitz: be by ReSound just became available for general sale from ReSound a few days ago - October 1st.

Dybala: Thank you, Michael, this sounds really interesting. For more information, please visit: www.trybebyReSound.com. Or, visit ReSound's Web Channel here on AudiologyOnline, where you can find the latest news, information and continuing education programs from ReSound offered through our eLearning platform: www.audiologyonline.com/channels/gn_resound.asp.

Michael, thanks again for meeting with me and I will be looking forward to speaking with ReSound again very soon.

Howitz: Thank you, Paul.