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Digital Hearing Aids Digital Hearing Aid design considerations and challenges, and suggested products. Design Considerations Design Challenge Designers of hearing aids have stringent technological requirements. Hearing aids must be small enough to fit inside or behind ones ear, run with extremely low power, and introduce no noise or distortion. To achieve these requirements, current hearing aid devices consume less than 1 mA, operate at 1 V, and utilize less than 10 mm2 of silicon area which usually means two or three devices stacked on top of each other. The typical analog hearing aid consists of an amplifier with a non-linear input/output function and a frequency dependent gain. However, this analog processing suffers from a dependency on custom circuits, lack of programmability and a higher cost when compared to digital processing. Recent digital devices have reduced device costs and lowered power consumption compared to their analog counterparts. The greatest advantage offered by digital devices is their improved processing power and programmability, allowing hearing aids to be customized to a specific hearing impairment and environment. Instead of a simple sound amplification and adjustable frequency compensation, more complex processing strategies can be achieved to improve the sound quality presented to the impaired ear. Such strategies, however, require the very sophisticated processing that a DSP can provide. Typically, hearing loss is divided into two categories: conductive hearing loss and sensorineural hearing loss (SNHL). A conductive hearing loss occurs when the transduction of sound through the patient´s outer or middle ear is abnormal, and a sensorineural hearing loss occurs when either the sensory cells in the cochlea or the neural mechanisms higher in the auditory system fail. With a conductive hearing loss, sound is not properly transmitted through the middle or outer ear. Because sound is primarily attenuated with a conductive loss, amplification of sound is essentially all that is required to restore near-normal hearing. No special signal processing is necessary, and traditional analog hearing aids work well. However, only 5% of those inflicted with some hearing loss are attributed to conductive losses alone. The other type of hearing loss is SNHL. This includes hearing loss that is associated with aging, as well as noise-induced hearing loss and loss caused by drugs that are harmful to the auditory system. Most types of SNHL appear to be caused by a cochlear malfunction. SNHL is thought to be caused by damage to inner hair cells, outer hair cells, or both. However, the underlying physiology is complicated. Different people will have different pathologies which means that patients with identical audiograms will not necessarily have the same kind of hearing loss. Further, patients may even have differing kinds of impairment over different frequency ranges. The effects of SNHL usually result in: 1) lack of input in some frequency channels, 2) lack of sensitivity, and 3) widened auditory filters. These effects, in turn, significantly impact the listeners perception of sound. Compared to normal hearing listeners, listeners with SNHL will most likely experience loudness recruitment (the range of comfortable listening levels is compressed when compared with normal) and loss of frequency resolution, among other difficulties. These changes in sound perception have significant effects on a listeners ability to understand speech. Because SNHL is not simply a problem with the transmission of sound, but actually a problem with the processing of sound, this loss is not likely remedied through simple amplification - making garbled sounds louder does not make them clearer. Therefore, one potentially effective way to help an SNHL patient is through pre-processing the signal to enhance complex tonal patterns to compensate for the hearing loss. It is unlikely that the various manifestations of SNHL will be remedied by the same optimal treatment. Processing of the sound can make speech more intelligible. However, the best processing algorithms will differ among individuals and may even change for one individual in different listening conditions such as a quiet room versus a noisy stadium. The key to accommodating these differences is hearing aid flexibility. Traditionally, hearing aids have been amplifiers encased in custom earmolds fitted to the end user. The hearing aid system contains a microphone, an amplifier, a Zinc-Air battery and a receiver/speaker. Most of these amplifiers incorporate some kind of compression function, essentially a non-linear input/output relationship, that is used to compensate for loudness recruitment. Also, the gain in different frequency bands can be adjusted, and the number of frequency bands varies, but is usually two or three bands. Many of the newest aids are digitally programmable, which means that although they have analog signal processing, the processing is controlled by digital parameters that can be adjusted by an audiologist. In addition, some analog aids have several programs, or sets of parameters, for different listening environments. Some of the digital hearing aids in the market are ASICs with programmable coefficients. These ASICs provide a few sets of algorithms and several frequency bands that were not possible in typical analog devices. For example, the digital hearing aids have a combination of the following features: 2 to 14 frequency bands with adjustable crossover frequencies, one microphone, dual microphones for directional listening, background noise reduction, automatic gain control (AGC), speech enhancement, feedback reduction and loud sound protection. Overall, the amount of processing that can be done is impressive, especially when compared with the traditional processing in an analog aid. |