Earwax removal is a far easier process when the person uses an oil to soften the earwax and condition the skin of the ear canal. However, sometimes even with consistent use of the oil, moving earwax is still problematic. I was reminded of this last week when I was referred a customer by a colleague.

Icky Gooey Earwax, Got To Love It

I am one of a rare breed, men and women who get excited by icky gooey earwax, the gooier the better! No, it isn’t a rare fetish, it is the joy of knowing that this will wash out nicely thank you. When we remove earwax from someone’s ear, the wetter the wax is, the easier it is to remove. The easier it is to remove, the better a procedure is for a customer. The key to this is the use of a good ceruminolytic, that’s usually pharmaceutical grade olive oil, or almond oil, or even a mix of both.  

The oil is soaked up by the earwax, like a sponge you know, which makes it wet and sloppy. We like wet and sloppy, to paraphrase Robin Williams, maybe not in a jungle but definitely in our earwax. Wet and sloppy earwax is very easy to suck out using micro suction or wash out using irrigation. The current fashion is for microsuction earwax removal which tends to be quick, easy and without mess. I still like irrigation though, it tends to wash everything away, completely cleaning the canal and eardrum.

Even Oil Use May Not Soften It Enough

However, even using oil as prescribed may not be enough to soften up the wax. It depends on how old the wax is, the longer the wax has been in the ear canal, the higher the difficulty of removal. As I said, I was reminded of this just last week. I looked after three customers last week during a clinic, the first was an exceptionally quick procedure with the earwax in both ears just flowing out with irrigation.

The other two were not quite as easy procedures. I knew one of them was going to be a bit difficult because a colleague had referred the customer to me because he couldn’t get a plug of wax to move with micro suction. In cases like this, irrigation may move what micro suction can’t. The customer had used an oil as prescribed, but the plug was old, dry and pretty well lodged. I eventually broke it down with irrigation until what was left washed to the mouth of the canal so I could pull it out. The customer was shocked by the size of it and the hardness, it was like a little stone.

The third earwax removal of the day was a bit of a doozey, the customer thought there was a problem with one ear only and had been using drops on it. It turned out it was both ears and the wax had been there for a very long time. In essence, both ears were packed with wax and I do mean full to the gunwales. The customer realised he had an issue with one ear after taking a shower and not being able to hear.

Typical Presentation, Earwax Like a Sponge

This pretty typical, it is usually after a shower, a bath or a swim, it goes back to what I said earlier. Earwax is like a sponge, it will soak up fluid and expand in the ear canal. Suddenly it will block out the canal and put pressure on the ear drum and your hearing is dramatically affected. I managed to move most of the wax from one canal, but because the customer had not used oil on the other ear, there was little or no movement there. So, the customer is gone away to use oil for a week and I will remove the rest then.

Use The Damned Oil!

Okay, so sometimes the oil doesn’t do the full job, but it allows some of the earwax to be removed. This exposes the rest of it to the oil, which will make sure that it can be removed at the next session. Using these oils will make it easier for you and for the professional, it makes the process more comfortable and more rapid. In my experience, this is always the case. 

A Thousand and One Earwax Removals

Speaking of experience, I actually don’t know how many earwax removal procedures I have done. I know it is a fair few, but it doesn’t hold a candle to a colleague of mine. Greg Clements just reported his thousandth and thousand and first earwax removal in Glasgow. Now that is a lot of icky, gooey earwax!

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I’m getting annoyed
with my ears
‘cos they don’t hear
properly.
Background noise
destroys sound waves
and I have found
that it’s irritating.
When people are stating
important stuff
and you only catch enough
to make partial sense
of the conversation.
The embarrassment is intense
when you repeatedly
request them
to repeat their words.
Add to this
my increasingly blurred
vision and I guess
I’m being told
by my body
that I’m old

A brand New ITE Hearing Aid Solution For Single Sided Deafness

Phonak have just released their updated CROS solution, the CROS 2. Based on the Venture platform the CROS 2 is actually a range of hearing aids that includes custom ITE hearing devices for the first time. 

Single sided deafness

Single sided deafness or asymetrical hearing loss are complex hearing problems to deal with and CROS or BI-CROS systems are the only way forward. These systems were traditionally difficult for people to use because they only way to deliver them was through a wired system. With the introduction of wireless systems the hearing aids were easier to use and far more effective at what they do. 

Phonak introduced their upgrade CROS system the CROS 2 late last year, and instead of just being the usual BTE device, they introduced a range of devices. A range of CROS devices that for the first time included custom fit ITE hearing aids. 

Phonak has introduced a CROS system with an ITE for the first time

The CROS 2 Hearing Aid Range

The CROS 2 range is made up of four different hearing aid types, two BTE type devices, one with a 312 battery and the other with a size 13. It also includes two ITE devices one with a 312 battery and one with a size 13. The CROS 2 devices will work with any Venture based hearing aid (including another custom ite) of any technology level, however, they will deliver at their best if you pair them with a device from the V70 or V90 technology level.  

In essence what the CROS 2 does is take the signal (the audio) from the bad side and streams or transfers it to the good side. It does it in a way that retains the natural cues so your brain perceives it as coming from your bad side. Using this type of strategy can be hard on the batteries, however, with the introduction of the CROS 2 Phonak also introduced a new power management system that stretches the battery life by 30%. 

I have fitted a few wireless CROS systems and I never failed to be pleased by the results. When you have a customer standing in front of you with the mouth open in shock, you know it is working well. The first question is always, I can hear on my bad side, how is that?? Usually asked in a shocked tone. 

I could explain, but I don’t have the urge to write an academic paper and put you to sleep. Suffice to say, the brain is an astonishing piece of hardware, if you present sound in the manner that it is normally, the brain just works it out. 

Some success stories

I haven’t been involved in the fitting of a Phonak CROS 2 but I know a few who have and the feedback has been excellent. We just heard a great success story from Scotland that we will review on the blog soon. So if you have single sided or asymetrical hearing loss and you think it is time you got yourself a solution, or if you already have but are looking for a new one, the Phonak CROS 2 might just be the system for you. 

As always, if you have any questions about the Phonak CROS 2, or any hearing aid, give us a shout. 

The Widex Fusion is a powerful, versatile and discreet RIC (Receiver in Canal) solution that was introduced a few years ago. It truly is a great hearing aid but it does suffer from the disadvantages inherent in RIC / RITE devices. Let’s take a look a closer look at the Fusion.

Introduced by Widex a couple of years ago, the Fusion is a versatile RIC hearing aid which covers many losses from mild to severe to profound. Depending on the hearing loss, the Fusion can be fitted with an instant tulip tip, a double dome (for more severe losses) or custom tips or moulds. 

As I said, the device covers many hearing losses, but, it is still a very discreet option. The device is quite thin and quite short, it is of course bigger than their ultra discreet Passion RIC. However, this slightly bigger size brings big benefits for the user.

It has an easy to use program button which allows you to change programmes on the go as you move from sound situation to sound situation. It also has telecoil receiver which allows you to connect to loop systems. On top of that is a 312 battery which is easier to handle and gives you more time between changes. 

The device can be used with a choice of four different receivers which gives it a huge fitting range which covers mild hearing loss to severe to profound. The S receiver is the least powerful and thinnest receiver, then there is the M receiver, the P receiver and the HP receiver which is the most powerful. The S, M & P receivers can be fitted with instant tips or custom molds, the HP receiver is a special order and comes in it’s own specially made mold. Below you can see the fitting range of the M receiver and the HP receiver. 

As we said in the Widex Fashion post,  Widex have always had a fantastic power management system which meant they could run hearing aids on smaller batteries. They have introduced a new power management system which again extends the power to consumption ratio and it is available in the Unique range including the Fusion. Alongside the telecoil the Fusion is also wireless enabled and will connect to any of the Widex wireless accessories.  

I have fitted a lot of Fusions to people who were always happy with them. The one issue is that tehy are a RIC / RITE which means there is a possibility of receiver failures if you don’t take care of them. The upside is that most receivers can be replaced in the office of your professional if need be. 

One caveat here, Widex does not like allowing hearing healthcare professionals to replace the HP receivers if they fail. They are a bit difficult to replace and they can be damaged if not handled properly. So if you have a HP receiver and it fails it may have to be sent away for repair.  You can read more about the hearing aid types and their pros and cons on the hearing aid types page.  

I really think these are fantastic hearing aids and a great choice for discretion and versatility, just be aware of the possible drawbacks. As always, if you have any questions about the Widex Fusion, or any hearing aid, give us a shout. 

The Audeo V 10 is the smallest hearing device in the new Audeo Venture range. It runs on a size 10 battery and can be fitted with two types of receiver which allows it to cover many hearing losses.

With the introduction of the new Venture chip Phonak re-designed the casings on their hearing aids. The Audeo V 10 has an updated casing with a push button that allows manual programme changes. The device is available in eleven different colour choices. Even though it is a highly discreet hearing aid it is also a versatile one. 

Wireless but no telecoil

It can be fitted with an S or X receiver which allows it to cover most hearing losses down to severe. It is a wireless enabled hearing aid and can connect to all of Phonak’s outstanding wireless accessories. However,the device has no telecoil receiver so it is not loop enabled.

It is a RIC device and so it suffers from the usual pros and cons of those devices. If you don’t take care of it, the receivers are liable to fail. They can of course be easily replaced by your professional in the case of failure which probably makes it a better option.

Versatile, discreet, wireless but lacking a telecoil

The Audeo V range has been available for a while and the feedback we get from hearing professionals is that they are quite reliable. If you are looking for a versatile but discreet wireless enabled hearing aid, this might be the one for you. 

I really think these are really strong offerings from Phonak, they are a great choice for discretion but just be aware of the possible drawbacks. As always, if you have any questions about the Audeo V 10, or any hearing aid, give us a shout. 

A new form of ear cleaning is being introduced by Independent hearing healthcare Practices. across the UK and Ireland. The new procedure is called Endoscopic Earwax Removal, two of our partners have introduced the procedure to their Practices, let’s see what they have to say.

Earwax Removal Services Worcester

Victoria and Tom Dixon of Worcester Hearing Centre have introduced the new procedure in their practice. They already offer extensive ear care services including irrigation earwax removal and microsuction earwax removal in Worcester. Victoria was the first in the Practice to become certified in the new process and she was kind enough to have a word with us about it. 

Victoria has years of experience in offering clinical hearing care and she is a highly respected member of the hearing healthcare profession. She said that offering the new earwax removal method made sense for them and their Practice. It was just part of their commitment to providing better and more in-depth choices to their Patients. 

In essence the procedure is similar to microsuction earwax removal, with the exception that a video endoscope is used instead of a microscope. Victoria said that the use of the endoscope makes the process so much easier, the endoscope gives a wide view of the ear canal and just watching it on the video screen makes it so easy to remove the wax. 

Earwax Removal Services Cork

The second partner to introduce the process is Audiology Medical Services in Cork, Ireland, Trevor Cronin, one of the senior professionals there spoke to us. He agreed with Victoria’s sentiments, he said that Kay and Charles Lewis ( the owners of the business) were committed to offering cutting edge services to the customers. They saw the new earwax removal process as a natural extension of their services. They also offer irrigation earwax removal and microsuction earwax removal in their practices in Cork, Waterford, Tralee and Kilkenny.

Trevor echoed Victoria’s statement about the video monitor, he also said that he felt the view given was far easier than keeping your eyes to the microscope and made manipulating the suction tube far easier. The two things combined made removing the earwax totally very easy. 

The Procedure

You probably will have gathered by now, the procedure is usually undertaken with a video endoscope and a medical suction machine. Although, it can be undertaken with the endoscope and manual earwax removal tools. The wide view of the video endoscope makes the procedure easy, safe and thorough. Our partners see it as a natural extension of their commitment to offering a cutting edge service and we expect more of them to add the service to their offerings.

I have recently returned to Practice, mainly because I missed dealing with people and the simple joy of solving their problems. I have been surprised at how much denial of hearing loss is still a factor in my consultations. For some reason, I assumed that over the years I have been away doing other things that education and awareness would have changed things. I was pretty shocked to find out it hadn’t!

My own cognitive bias

I am afraid it is my cognitive bias at play, I am the type of person that if I have a problem I deal with it. So when I come to the time when I have a hearing loss, I will deal with it without much thought. I also suffer from something called don’t really care. I am not very good at considering what other people think about me. It is not arrogance or pig-headedness, it is simply the concept that what other people think about me is none of my business. I look to myself for my own happiness. So stigma will not be an issue for me to consider when the time comes.

Limiting your life

If you don’t address your hearing loss you are in fact limiting your life, limiting the experiences you have and the people you communicate with. I have always known this but it came into stark contrast in one particular consultation recently. One person explained to me that they knew they had hearing loss and associated problems, but what they had done was to change what they do to accommodate it. They went to quiet restaurants and cafes, their friends knew they had hearing loss so they adjusted to help out. They just avoided noisy situations so they didn’t face problems. 

Why, oh why, oh why?

I wanted to scream, I wanted to say WHY! So let me get this straight, you have a problem, but it is not that bad because you are limiting your lifestyle so you don’t have to face the problem. Oh, and all your friends know so they adjust their behaviour. Really? And this makes sense to you why? Many of us professionals find it difficult to deal with this level of denial, most of us look on our job as to identify a hearing loss, identify the areas that the hearing loss is having an effect on in your life and then educating you on what is happening and providing treatment options for you to make decisions on. 

When we are faced with this level of denial we begin to ask questions, but in doing so we feel that we are moving towards selling you a solution. Many of us feel uncomfortable in that position because we see ourselves as quasi-medical professionals, not sales people. Don’t get me wrong, we know there is a sales element in what we do, but it is not the over-riding focus of our profession. There are many things I can say here, that I feel comfortable with, things that I might not feel comfortable saying in a consultation. So here goes, with both barrels, buckle up!

Are you mad?

Honestly, are you mad? Your denial is ruining your enjoyment of life and all of its wonders. Your denial is limiting the experiences you expose yourself too. It is limiting you socially, something that we know has a dramatic effect on your general well being. I know you are smarter than this, so the question I will ask again is are you nuts?

Your family and friends are exasperated

Yup, they have a pain in their famous place with you and your denial, believe me, they are. Expecting them to adjust for you and your problem is really arrogance, you have decided to limit your life so they should as well? They won’t, what will happen is eventually you will end up isolated. They will become exasperated with repeating themselves, they will become exasperated with always being your interpreter. 

People aren’t god damned mumbling!

Nope, they aren’t, you can’t hear them properly, your ability to hear the high-frequency consonants in speech has been dramatically affected. Those sounds are exceptionally important for the clarity and understanding of words. They are still saying them, you just aren’t hearing them properly. So again, hate to burst your bubble, it isn’t them, it’s you. 

Everywhere is so noisy, no one can really hear properly

Nope, most people manage in noisy environments unless of course the noise is completely overwhelming. Believe me, if the noise was completely overwhelming people would not go there. The problem is that noise makes it much harder for you to hear the consonants in speech. Something that you already have a serious problem with. Again, sorry, it’s not the noise it’s your hearing. 

The effects of hearing loss on mental health and relationships

If you ignore your hearing loss you will have a dramatic effect on both your own mental health and your relationships with family and friends. I talked about this a little earlier but let’s look at what clinical studies say. Unfortunately, the biggest studies are US based, but people are people no matter where they live. A study by the National Council on Aging (NCOA) in the States found that those with untreated hearing loss were more likely to report depression, anxiety, and paranoia. Paranoia was a bit of surprise for me, but when you consider it, it probably makes sense. 

This study also attempted to understand the impact of untreated hearing loss on the family members and close friends of people who suffered with it. They questioned just over two thousand close family members or friends of the hearing impaired were asked a parallel set of questions both before treatment and after treatment. It was shown that the benefits of treatment with hearing aids were significant. There were improvements in many areas of life including relationships, social life and sense of independence. In fact, in most areas there was a dramatic increase. Strangely enough, the benefits were always felt more by the family members rather than the hearing impaired (1.).

1. Relations at home improved by 56 percent according to the user, 66 percent according to family and friends.
2. Self-image improved by 50 percent according to the user, 60 percent according to family and friends.
3. Life overall improved by 48 percent according to the user, 62 percent according to family and friends.
4. Mental health improved by 36 percent according to the user, 39 percent according to family and friends.
5. Social life improved by 34 percent according to the user, 41 percent according to family and friends.
6. Relations at work improved by 26 percent according to the user, 43 percent according to family and friends.

Listen, we could go on here but the point of this article is not to beat you over the head with your failings. Because they aren’t failings, hearing loss is a simple condition that needs treatment. It is not a failing, it is not a sign of weakness, it is not something that reduces you. It is only all of these things when you don’t decide to treat yourself. That is your only failing. Because not treating the problem leads to consequences for you, your family and your friends. That is the real problem. 

1. Untreated Hearing Loss Linked to Depression, Social Isolation in Seniors

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Walgreens have partnered with Connect Hearing to sell hearing aids in a small number of Walgreens stores as a trial to see if dispensing from big-brand pharmacies is a viable business model. Connect Hearing is owned by Sonova, the Swiss hearing aid manufacturer, which owns the Phonak and Unitron hearing aid brands.

In response to a HearingHealthMatters articles about this partnership, Sonova’s Michael Issac confirmed that Walgreens stores in Dallas, Phoenix, Orlando and Chicago had been selected for the trial. He also said that no decision had been made as to whether a wider rollout would take place.

Having a hearing care centre in high-street stores is common here in the UK – the Boots pharmacy chain have a large number of shops with a hearing aid dispenser section, which are run by Sonova. Specsavers, traditionally a glasses dispenser, also have a large number of stores with an in-house audiologist and have a competitively-priced selection of white label haring aids branded as their own (I believe they are Phonak but don’t know for sure).

Sonova had previously partnered with Costco but that didn’t go so well for them and they ended up posting lower profits and annoying independent hearing aid dispensers, their traditional sales outlet. It is interesting that they are trying again and it is possibly a nod towards the future of hearing aid purchasing.

According to California-based Grand View Research, Inc. the hearing amplifiers market is expected to reach $78.2 million by 2022.

The market research and consulting group published a report in June on the global hearing amplifiers market by product. The total market value of the sector was $54.3 million in 2014 and is expected to grow at a compound annual growth rate (CAGR) of 4.7% from 2015 to 2022, to reach this projected performance.

Hearing amplifiers are usually lower-cost, lower-spec alternatives to hearing aids. One example of an amplifier on the market today is the SoundHawk.

The report cites two major growth factors: increasing prevalence of deafness and hearing disorders, and the rise in the cost of hearing aids. Hearing amplifiers are expected to become preferred products for certain patients with more easily manageable hearing loss because of the significantly lower cost compared to hearing aids (three to five times lower on average). Changing customer dynamics and high research & development expenditure are also expected to play positive roles.

In terms of product type, on-the-ear amplification devices accounted for a far larger proportion of the market than in-the-ear models. Both product types are however expected to see constant growth over the forecast period, the first because of comfort and high connectivity, and the second because of performance and esthetic appeal.

The report covers North America, Europe, Asia-Pacific, and the rest of the world (RoW). The Asia-Pacific region is forecast to see the highest growth as a result of rapid expansion in retail healthcare and overall aging of the population in China. Introduction of technologically advanced devices in China is also expected to support the market.

Source: Digital Journal

The phrase Smart Hearing has been coined over the last few years. It usually relates to GN Resound hearing aids, specifically the Made For iPhone devices. However, the term can cover many of the most modern hearing aids available from the biggest manufacturers. For the purpose of this article though, we will really concentrate on the Resound hearing aids.

Smart Hearing

So what is Smart Hearing? In this context it really refers to hearing aids that connect freely and easily to other devices, in particular smart phones. Only two hearing aid manufacturers have gone down the path of direct connection to smart phones, GN Resound and Starkey. GN Resound was the first to market with the LiNX, which they quickly followed with the original Enzo. They have been wildly successful, the LiNX and its replacement the LiNX2 have been well received and widely adopted by professionals. 

Many hearing aid manufacturers have introduced hearing aids that they label Made For iPhone, while they will connect to an iPhone, they will only do so through a streaming device. The difference with ReSound’s and Starkey’s Made For iPhone hearing aids is that they connect directly without any intermediate devices. Something that many of their users appreciate, one less thing to carry around or forget to charge.  

Resound Enzo² Hearing Aids

Super Power Smart Hearing

ReSound Enzo²™ is the next generation of Smart Hearing aids from GN Resound for people with severe and profound hearing loss. The Enzo²™ is the latest Made For iPhone super power hearing aid from GN Resound. In fact GN Resound are the only company that make a true Made For iPhone super power hearing aid. The range comes in two devices, the 88 and the 98 which is a 675 battery device. The range comes in three levels of technology, the 9 which is the top of the range, the 7 and the 5 which is the entry level.

GN have included Spatial SenseTM in ReSound Enzo², the user comments on this new feature is outstanding. The feature has been developed to give users a greater understanding of where sounds are coming from. Combined with other key features, it delivers a rich, balanced sound.

Direct connection to your Smart Phone without any intermediate streamer make these hearing aids really Smart

Wireless connectivity

So this is where we really talk about smart, the ReSound ENZO² allows you to connect directly with an iPhone, iPad or iPod touch, and makes your Smart Hearing aids work like wireless headphones. This allows you to enjoy phone and video calls with ease. It is interesting to note that for people who have severe to profound hearing loss visual cues are a real help for speech understanding. In a study undertaken by GN Resound, visual cues provided by a FaceTime video call were shown to have significant benefits for people with severe and profound hearing loss. Even if you don’t have an iPhone you can still stream phone calls and music from your Android smartphone or any other Bluetooth-enabled phone by using the ReSound’s Phone Clip+.

Resound LiNX² Hearing Aids

As we said, Resound launched the LiNX in 2014, however the very quickly followed it with the LiNX2 in 2015. With this release, ReSound is once again leading the pack in the Made for iPhone hearing aid space. The LiNX2 is available in the same 3 technology levels as the previous generation, that being the top of the range 9, the 7 and the 5, but they offered an expanded range of new hearing aid styles with this release.

ReSound LiNX²™In The Ear Hearing Aids

New styles

Up to the release of the LiNX², Made for iPhone hearing aids had only been available in behind-the-ear styles. Along with the popular BTE and RIE styles, the LiNX² is available in the following additional custom styles: IIC, CIC, ITC, ITE and MIH.

However, only the ITC, ITE, and MIH styles are wireless capable and compatible with the ReSound Smart™ App and can support direct audio streaming. In addition, the RIE and BTE styles had an updated redesign, with new casing and user controls.

IIC Invisible in Canal

non-wireless (invisible-in-canal)

CIC Completely in Canal

non-wireless (completely-in-canal)

ITC In The Canal

wireless Made for iPhone (in-the-canal)

ITE In The Ear

wireless Made for iPhone (in-the-ear) with telecoil

MIH-S Microphone in Helix Small

non-wireless (small microphone-in-helix)

MIH Microphone in Helix

wireless Made for iPhone (microphone-in-helix) with telecoil

RIE 61

wireless Made for iPhone (receiver-in-ear) with push button

RIE 62

wireless Made for iPhone (receiver-in-ear) with volume control and telecoil

BTE 77

wireless Made for iPhone (sound-tube BTE or standard BTE) with push button, volume control and telecoil

BTE 88

wireless high-power Made for iPhone (standard BTE) with push button, volume control and telecoil

That is the Resound Smart hearing aids line up, we think Resound is the pre-dominant manufacturer in this category. The Halo from Starkey hasn’t been nearly as well received, although they too have launched a new and updated range. We shall talk about them another time. 

Happy users

The feedback from users of the Resound Smart hearing aids has been excellent, there have been some issues with bluetooth connection, but that is really down to the vagaries of bluetooth. As opposed to any real problems with the hearing aids. People really like the freedom that the devices allow them, they also like the functionality that the Resound Smart app delivers. As always, if you have any questions, or you would like some thing explained, drop us a line.