Interview with Ravi Sockalingam, Ph.D., Director of Clinical Research and Professional Relations, Oticon Medical

Topic: Introducing Oticon Ponto Pro Power

Ravi Sockalingam, Ph.D.

SMAKA: I'm talking with Dr. Ravi Sockalingam from Oticon Medical. Oticon Medical has expanded their bone-anchored family, with a new power bone-anchored device, the Ponto Pro Power. Ravi, what's unique about this new device?

SOCKALINGAM: The Ponto Pro Power is the most technologically advanced ear-level bone-anchored device on the market. It is the most powerful bone-anchored device also. It is based on the RISE platform, the same platform as Oticon's premium hearing instruments such as Agil, which enables it to have many of the advanced signal processing features of those premium products.



SMAKA: What specific features or technology are you referring to?

SOCKALINGAM: I'm referring to features such as the compression system, Speech Guard. Speech Guard is designed to preserve the speech cues in different listening environments, even as they change quickly. The compression system is designed to preserves the sound quality and provide a very natural sound without the distortion that you would see with traditional wide dynamic range compression systems.

In addition, Ponto Pro Power also has a two-stage Feedback Management System, which is an innovation never before available in a bone-anchored device. Feedback has been a major challenge with bone-anchored systems, especially for power devices. We have Dynamic Feedback Cancellation (DFC) to address feedback that occurs as a result of changing environments. As you move from one environment to another and the gain in the device increases, there's a greater likelihood that it might begin to feed back. Head movement or getting close to a person or object can also cause feedback, which is very limiting from a functional standpoint. Those feedback conditions would be due to the changes in the dynamic conditions of the device, and DFC handles those changes remarkably well.

We also have a unique innovation that measures individual feedback limits due to static conditions. Our advanced Feedback Manager automatically measures individual feedback conditions and define the maximum gain curve across the frequency range.

SMAKA: So it sounds like this allows you full use of the volume control, with less risk of feedback.

SOCKALINGAM: Exactly. Typically, when we're programming hearing instruments or bone anchored devices, in order to suppress feedback at high volume control levels, we turn the gain down. With Ponto Pro Power, the advanced feedback management system will actually take advantage of all the head room available to provide the maximum gain across frequencies without the professional having to turn the gain down. This enables the wearer to use the volume control as needed to its fullest capacity.

At Oticon Medical, we believe that users and professionals always should have the freedom to choose which ever solution fits their needs and always have the opportunity to take advantage of the latest technological developments. Therefore all old and new features are available in the Ponto sound processors. These include the novel Speech Guard compression system, Two-Stage Feedback Management system, Noise reduction, Multiband Adaptive Directionality with the unique split directionality mode, and a new Battery Management system. Split directionality is a feature exclusive to the Ponto sound processors;it allows users to obtain directional benefit in more listening situations.

SMAKA: Ravi, with the availability of more power, who is now a candidate for Ponto Pro Power?

SOCKALINGAM: People with mixed hearing loss or conductive hearing loss and bone conduction thresholds down to 55 dB are candidates for this device. People with single-sided deafness are also candidates.

As you know, two years ago we introduced the Ponto and Ponto Pro. These devices had advanced processing technology, and they provided gain suitable for people with hearing losses up to 45 dB. There was an obvious need for a power device. Since the original launch, we have been working on providing that power device, and working out known issues in power systems, such as the feedback issue we discussed.

If you consider single-sided deafness where the sound has to be routed from the affected side to the better hearing side, there is going to be some signal attenuation that has to be compensated for. With Ponto Pro Power, we can now provide more gain in the higher frequencies for instances that require more trans-cranial energy. Additionally, if the better hearing side has a mild to moderate hearing loss, then the requirement for a more powerful device is also met with this device.

SMAKA: In hearing instruments, more power typically means a larger-sized instrument. I'm assuming the same is true for bone-anchored systems?

SOCKALINGAM: Ponto Pro Power is based on the same design as Ponto with its easy to use push button that has been preferred by patients. The Ponto Pro Power is a little bit thicker than the Ponto device due to its bigger battery but the maximum legth and width is the same.

SMAKA: Is Ponto Pro Power interchangeable with other Ponto sound processors, or is there anything different with the abutment or surgery required for this device?

SOCKALINGAM: It's absolutely interchangeable. It looks just like a Ponto in terms of the coupling to the abutment. You don't have to have a special abutment or implant.

This is very advantageous for people with progressive hearing loss. People can upgrade to Ponto Pro Power without worrying about additional surgery or compatibility. In addition, there are some people who may be borderline candidates between Ponto or Ponto Pro, and Ponto Pro Power. Using Ponto Pro Power will give them more head room, and they can have the same abutment if they ever choose to go back to the Ponto or Ponto Pro.

SMAKA: Is Ponto Pro Power softband compatible?

SOCKALINGAM: Yes, definitely.

I should also add that Speech Guard, the Two Stage Feedback Management System and BC-In-Situ Audiometry we discussed earlier can be added to any existing Ponto or Ponto Pro device,

SMAKA: Ponto Pro can be updated?

SOCKALINGAM: Absolutely, through our Genie Medical software, version 2011.1, patients who are using Ponto or Ponto Pro can visit their audiologist and upgrade to enjoy the new advanced features, simply by having their device re-programmed.

SMAKA: I know you're in charge of clinical research for Oticon Medical. Is there anything new that you can share?

SOCKALINGAM: Yes, there are many studies currently underway.

When you and I discussed the 2011 OSSEO conference, I believe I mentioned the recent independent study at Radboud University in Holland that compared Ponto Pro Power with the Cochlear Intenso power device on speech intelligibility, feedback, wind noise, and overall patient preference. In all measures, the Ponto Pro Power came out significantly better, and of course we were very excited about that. This study was independently conducted;Oticon Medical just provided the devices.

There are several other implant and processor studies in progress. There are studies that compare the performance of our sound processors to the other devices. And there are studies looking at the performance benefits of upgrading from Ponto Pro to the Ponto Pro with all the new features including Speech Guard and Two Stage Feedback Management System. We have anecdotal evidence that patients who had their Ponto devices upgraded can instantly notice improvements - better quality of own voice, better sound quality in noise, and reduced or elimination of feedback. It would be nice to investigate this systematically.

SMAKA: We'll look for that data when it's available. Sounds like they're keeping you very busy, Ravi! Thanks for your time today.

SOCKALINGAM: Thanks Carolyn. It's a pleasure as always.

For more information about Oticon Medical, visit www.oticonmedical.com/ or the Oticon Medical web channel on AudiologyOnline.