Sonic CROS Hearing Aids feat. Dr. Scott Bunnell | Sr. Global Product Manager

The Hearing Matters Podcast discusses hearing technology (more commonly known as hearing aids), best practices, and a growing national epidemic - Hearing Loss. The show is hosted by father and son, Blaise Delfino, M.S. – HIS, and Dr. Gregory Delfino, Au.D., CCC-A, who treat patients at Audiology Services in Bethlehem and Nazareth, PA.

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Blaise Delfino: 0:06

You're tuned into the Hearing Matters Podcast with Dr. Gregory Delfino and Blaise Delfino of Audiology Services and Fader Plugs, the show that discusses hearing technology, best practices, and a growing national epidemic, hearing loss. On this episode, we are welcoming back, Scott Bunnell, Dr. Scott Bunnell from Sonic. He is the Global Product Manager. Scott, welcome to the show.

Scott Bunnel: 0:36

Thanks, Blaise. It's great to be here. Again, I'm a I'm a huge fan of podcasts. And I'm a huge fan of your podcast. So I really appreciate you having me on again.

Blaise Delfino: 0:44

Well thank you. We are like I said, very excited to have you back on the show. We had you on a couple of months ago discussing the Sonic Radiant line. And since then, Scott, there has been some incredible exciting news from Sonic. Since the last time we spoke, I understand that Sonic has released a new Radiant product. Can you tell me what is new with the Radiant product line this fall?

Scott Bunnel: 1:11

Yes, absolutely. So at the beginning of the year, you know, like you mentioned, we launched the Radiant product. So Radiant product was on a brand new platform. So basically a new microchip, new processing schemes and strategies. And it's been done very well. And we've had a tremendous success with it. But you know, the Radiant product was just one model, it was the Mini RITEtr T for telecoil R for rechargeable, you know, we found that majority people want rechargeable hearing aid. And our rechargeable solution is quite good. It's not, you know, have very, very few problems. But there's some people out there proximately 10, to 15% of the people don't really want a rechargeable hearing aid, and they're just not sold on it for whatever reason. And so we've now offer our offering the Mini RITE T so it's a non rechargeable hearing aid, it uses a 312 zinc air battery, it looks exactly like the Mini Rite TR, it just got a 312 battery, the functionality is pretty much exactly the same. So for those people who aren't sold on the rechargeable we have that to offer. And we're excited about that. We also are offering a new ear mold. So we've added another ear mold or custom ear mold option on our on our current ear mold portfolio. So it's called the micro shell. And it's really going to help people with smaller ears or hard to fit years. It's basically if you took out the small the regular receivers, 85 and 60s, we as the numbers we use, and we take those and kind of strip them down to their bare bones and then you can encase it in a mold, you can make that very small, it could fit deeper in the ear canal, it can help with comfort, it can help with retention. And it's going to be a great offering for those people again, with the smaller ears for people just want a deeper fit or fit that doesn't people can't see as much. And I think the last time I was on, we talked a lot about music. We talked about our smart music program. Yes. And what we've done is we basically upgraded that to the smart music pro program. So in the past, we first launched with the smart music, we had smart music for live music, and it had this that had this great extended dynamic range features. So we allow for the inputs that come into the hearing aid to kind of be extended up up to 113 decibels to let in kind of the peaks of music that we're traditional hearing aids kind of cut off, because speech only gets about 95 decibels. And so the smart music Pro does that as well. But it's it's actually has another feature. And there's a lot of r&d that went into this another feature and brand new, we call it a fitting rationale specific to music and specific to this program. Well, so we have all the fitting rationale, we talk about fitting rationales we're talking about are basically different processing strategies. How are you going to apply gain? How are you going to apply compression and so forth? Fitting rationales have been around a long time and they've always been for speech?

Blaise Delfino: 4:07

Yes.

Scott Bunnel: 4:08

Right. They're just always for speech. And that's the way it should be. So you have like the generic fitting rationales nl And DSL and then for Sonic, we have our best fit fast. But for this new program, we've created a fitting rationale specific to music so it's takes place the changes the gain and compression characteristics to be more in line for the spectral and loudness characteristics of music rather than speech. So you know, it's got more bandwidth to use. And it kind of makes things a little more linear and parts of the signal that needs to be more linear to kind of preserve all those peaks of music and kind of keep everything intact. So the smart music pro basically takes the place of the old music program and the old smart music program. So we take those two programs will be gone and now we just have smart music pro so we could probably do an episode on that someday maybe But

Blaise Delfino: 4:55

Absolutely. Music and for musicians and music lovers. Absolutely, we've had great success with our patients that we fit with the the Radian product line, specially with that smart music pro they've reported. They just love it. It's awesome.

Scott Bunnel: 5:11

Oh, yeah. Yeah. And it is really quite good. So that's available now with with with the new Radiant product. So if you have somebody out there that already has rated, we could do a firm, you do a firmware update, which you want to do every time anyway, now their firmware updates for wireless. So that's much more helpful.

Blaise Delfino: 5:26

Yes, no more wires.

Unknown: 5:27

Yeah, right. So you do a firmware update, and then you'll have that smart music pro program. So that's kind of exciting for us. And the last thing we have is something called cross transmitter. So I've been with Sonic now for 15 years, actually, my 15 year anniversary is coming up in the next month. So if my boss is listening, I hope she's paying attention to that and hope I get a nice present, but right, right, thank you. So but I've been around 15 years, the company has been on like to overwhelm over 20 years, and we've never had a cross transmitter. So this is the first time ever, and the CROS transmitter can also be formatted as a bi CROS. But people have been asking since day one I've been but I've been working for Sonic is Hey, every now and then, do you guys have a cross transmitter? And now we're able to say yes, we do. So we're excited about that.

Blaise Delfino: 6:16

Which I think is incredible, because and for our listeners tuned in who don't know what a cross stands for? It's CROS. And it stands for contralateral routing of signal, correct, Scott? What type of patient do we fit with a CROS or a bi CROS system?

Unknown: 6:38

Right. So we have patients with basically patients with single sided deafness, people patient that cannot benefit and you say deafness, right? It can mean a lot of different things, not just primarily that they don't hear any beef, so they don't hear speech. Basically, they cannot benefit from a hearing aid on one year. And so we call that maybe an unable hearing on one side, and either a normal or hearing that can benefit from a hearing aid on the other side. So you talked about CROS and bi CROS. And you mentioned that CROS is the contralateral routing of signal, one of the many, many, many acronyms we use in the field of audiology, we always we use way too many acronyms, if you think CROS is a mouthful, the bi CROS is the bilateral contralateral routing a signal, which basically means that we have an unable you're on one side, and we're going to we're going to transmit that signal wirelessly to the other hearing aid. And we're going to do that, you know, through wireless technology. And then across set up there the other hearing aid, the receiving hearing aid will just be taking that signal and amplifying it into the ear. And a bi CROSS, it'll be taking that signal as well as the signal coming from the the hear the the other ear that has the problem that could have could have some hearing loss and can benefit from more sound coming on that side. So it's kind of complicated, but it's basically taking the signal and putting it into the other ear. So the patient can be a two sided two sided listener, rather than a one sided listener. And will the sonic transmitter we're using nfsi or nearfield magnetic induction for our wireless protocol to do that from one ear to the other. The FMI is has very little battery drain, it also transmits to transmission distance is very short. But remember, we're just trying to get it from one year to the other. And so unless the person has a very, very large head, circumference of their head, right, which is pretty rare. They can get that signal across wirelessly and they can benefit from the cross transmitter.

Blaise Delfino: 8:42

Now, Scott, I'm just curious, what are the causes of single sided deafness?

Scott Bunnel: 8:48

The cause of single sided deafness? It's a great question can be a lot of things. So sometimes we can be this thing called sudden sensory neural hearing loss. And most of these cases of subtle, sudden sensory hearing loss, they basically wake up and they don't have hearing, all of a sudden, a lot of those are idiopathic or otherwise unknown. But single sided deafness can be caused by trauma, I can be in a convenient infection, it can be an auto immune disease, ototoxicity can can occur and one side of the year sometimes ototoxicities. If someone's in the hospital, and they have a very life threatening disease or infection, we can use very strong antibiotics like gentamicin, for instance, that can be potentially toxic, but it also saved the person's life. And it can cause single sided deafness and in some, some cases, many years disease is something that can also cause single sided deafness, diseases of the inner ear like a perilymphatic fistula, which I saw that a handful of times when I worked at the hospital doing vestibular testing, but single sided deafness can also be retro calculator, which really means it's not involving the peripheral part of the ear, the inner ear, the ear canal and all that that thing. It can be something that's more related to the central nervous system. Some of the brain like a stroke, there's some tumors that can occur on the eighth nerve. Because acoustic neuroma or vestibular schwannoma, demyelinating disease can cause things can cause single sided deafness, such as multiple sclerosis is the common one.

Blaise Delfino: 10:14

Scott, some of these causes are, and can be sudden. So you wake up one morning, and I can't hear out of my left ear, that has got to be incredibly frightening. And we've had patients here in the office who do present with sudden idiopathic hearing loss, of course, referral to the end right away now, for the brain to relearn using a CROS system. What does that look like? Especially when it comes to treatment options? You know, are there other treatment options available for single sided deafness, other than across what is available to these patients?

Scott Bunnel: 10:58

Good question Blaise, you know, there, there can be a few different options, the CROS transmitters, probably the least invasive option, and it's really not invasive at all, you're just putting hearing aid on RTA, you're basically putting two hearing aids the CROS transmitter on one side and the and then the receiving hearing aid on the other side. But the other treatment options are, we have this thing called the BAHA the Bone Anchored Hearing Aid, another acronym and it's a minimally invasive surgery to implant this BAHA. And it's it uses this, we call it a percutaneous solution. So the percutaneous means through the skin and they actually they put in a vibrator, that's when a plug that's in your, on your mastoid I think you're close to your mastoid on your through your skull. And then you bought you plug in as BAHA device, and it kind of vibrates the skull and the other ear. So to kind of restore that two sided listening, it's actually it's not for everybody, not everybody wants to have some kind of Frankenstein like plug that comes out of there that's in their skull. But it can be very effective at kind of restoring that two sided listening. The other option, really, which is a lot more invasive is a non reverse reversible invasive surgery, which be the cochlear implant. And it's really not that common for single sided deafness, you would call a cochlear implant more of a transcutaneous solution, which means that it's kind of measured across the depth of the skin. Hmm. And I'm not an expert on cochlear implants. But basically, it's this electrode array, that's, that's surgically put into the Cochlea. That's like kind of inserted into the Cochlea and then it has a magnet that's under the skin that connects to another magnet to the speech processor. That speech processor takes the sounds and can kind of Converse acoustic theory into electric hearing in the most basic form. And you could probably do a podcast or many podcasts in a cochlear implants. Because they are really one of the My belief is they're the one of the true miracles of my lifetime. And I think that's going to be coming. People will see in the next few years when these kids that have been implanted with cochlear implants, like 20 years ago are kind of kind of saturate more of the marketplace. And you know, and workplace, people will see really what a miracle it can be. But I'm definitely not an expert on that. And but I do know that it can be used in single sided deafness. There's actually an article that just came out that somebody may be aware of yesterday. And in Germany, they did a study with kids treated with a cochlear implant for single sided deafness. And the results were quite good and quite successful.

Blaise Delfino: 13:37

So, Scott, I want to bring this up, we actually have a question from one of our followers from Dallas, Texas, asking us when an individual presents with single sided deafness, and they are fit with a CROS system? Will this assist in increasing speech understanding in noisy situations?

Scott Bunnel: 13:59

Good question. And that is basically the general idea. So I can answer that with a yes, in most cases, you know, single sided deafness. Kind of go back on that topic. It's more common, then you think for one thing, about 1% of the population has some sort of single sided deafness. That's about 60,000 Americans a year 25 years ago, or so 25-30 years ago, they didn't really treat single sided deafness. kids in school, can hear out of one ear. Well, you got a good here, right? So you're fine. Adults, the same thing. Then they started doing more research. And they just started saying, hey, people with single sided deafness have reduced speech understanding, especially in noise, then they lose this ability to localize where sound is coming from, and especially kids and they did studies on kids and they found the kids who are not untreated for single sided deafness. We're doing quite a bit worse than the other kids with normal hearing in the classroom. So they started treating single sided deafness with CROS transmitters. I remember in the hospital, I saw somebody with this. These are the current first CROS transmitters had a wire, they were fully wired with this before I've started this technology. And they would have, and that's obviously not, most people don't want to wear that. But that's how they did treat it back in the day. And now that wireless technologies got so much better, they're able to treat it much, much easier and better nowadays. But the challenges that people with single sided deafness are really a direct result of losing their binaural hear the importance of binaural hearing is pretty understated. I think there's quite a few different things when it comes to binaural hearing that we probably don't realize, and some things that I kind of forgot about. I remember when I was in grad school, so I kind of read for this podcast, I kind of

Blaise Delfino: 15:43

Dove back into the textbooks. Right?

Scott Bunnel: 15:46

Exactly, exactly. But the binaural hearing has a lot of different characteristics. So we have binaural loudness summation, which is the signal is perceived as louder or more salient. And it improves bilateral hearing vessels by three dB, compared to just hearing in one on one ear. Yes. So you have binaural loudest summation, so you lose that with single sided deafness, you lose this thing called by no redundancy. And that's this kind of just brains and native ability to fuse the same signal that is received independently by both ears, creating a more complete sound picture than either ear can do alone. So they also have binaural squelch was brain's ability to suppress noise from spatially separated sources as well. And then finally, this thing I think I talked about earlier, but the head shadow effect, the intensity of high frequency sound is reduced when sound travels from one ear to the other side of the ear, just because your head's in the way. Yes, right. Yep. So the low frequencies have longer wavelengths and kind of travel around a lot easier. But we lose through that transmission a little bit, just because the heads in the way. And that's that head shadow effect. And so for all those things add up to pour localization, and not be able to hear as well and noise. So across transmitter can kind of restore that binaural hearing and improve that speech understanding of noise. So that's a long answer to that first, but

Blaise Delfino: 17:03

You definitely brought me back to school. Scott, really? And Dr. Miller, if you're listening, Scott just brought me back, because I remember that being on one of our exams, but and that's a question that we get often Scott. So to our patients tuned in, right now, if you're a patient of ours, and we fit you with a CROS system, and you're doing really well, the technology decreases that listening effort. And our patients have reported decreased listening effort in those noisy situations. Scott, out of curiosity, does a CROS or bi CROS transmitter, does it have any type of noise reduction in it? Or how does that really work?

Scott Bunnel: 17:46

That's a great question. Yeah, so for the, I can't speak to all the manufacturers, but for this new CROS transmitter for Sonic, we are cleaning the signal with noise management, our noise reduction care, you know, impulse noise reduction, all these noise reduction features that we have in our current hearing aids, are gonna help clean the signal the crossing before it's transmitted. Now, the thing about the CROS is, it's basically only using the microphone, and it's taking that signal and sending it over to the other ear, and the other ear is amplifying it and putting it out to the receiver. It's cleaned with noise reduction. So as you know, Sonic does noise reduction, just about as good or better than anybody out there. And I could say that with a lot of confidence. So it's, yeah, definitely, it's gonna should be using noise reduction, we definitely want that signal cleaned before we amplify on the other ear.

Blaise Delfino: 18:32

That is such great news to hear. Because oftentimes got when we have patients in the office, their question is, is this going to help me in noisy situations, and the fact that you are cleaning up that signal? Because imagine just sending a garbled up signal to the better ear? That's really not going to help? So that is wonderful news to hear. Scott, is the CROS considered to be an actual, quote, hearing aid, or is it something different?

Scott Bunnel: 19:00

Yeah, that's another good question, Blaise because, you know, the CROS transmitter, it looks like a hearing aid. It looks exactly like a hearing aid, right? So if it looks like a duck, and it quacks like a duck, right, if you're that saying, well, it actually doesn't quack like a duck because it's, it's it's only using the microphone and then some of that noise reduction capabilities. The receiver on the CROS hearing aid is not actually it's basically a dummy receiver receiver. It's it's just there to keep the transmitter from falling off your ear. Basically, it's not amplifying anything into that ear because that ears is can't be helped with a hearing aid

Blaise Delfino: 19:36

As a provider and a hearing healthcare professional, I am personally so excited to help our patients who do present with single sided deafness to get them into this technology and hear how wonderful they are understanding in noisy situations, but even in quiet situations because single sided deafness, the individual who presents with single sided deafness that can be incredibly frightening, for lack of a better term, especially if it is sudden. And we love working with our patients that we do fit with with a CROS system because when you fit them with the system, Scott, it's like, oh my gosh, this is this is what I remember. This is how I remember hearing it and they have such better spatial awareness. Scott, another question from one of our followers. This is actually from Orlando, Florida. Will the CROS transmitter just be rechargeable? Or will it also be disposable battery operated?

Scott Bunnel: 20:40

Right now, the CROS transmitter is rechargeable. So the only offering we have is rechargeable hearing aid. So it'll probably work best if you have the rechargeable receiving hearing aid and we have a common set right now we don't have a CROS transmitter with a zinc air battery or non rechargeable CROS. That's something we may be offering later. For right now. It's just a rechargeable.

Blaise Delfino: 21:02

You're tuned into the Hearing Matters Podcast with Dr. Gregory Delfino and Blaise Delfino of Audiology Services and Fader Plugs, the show that discusses hearing technology, best practices and the growing national epidemic hearing loss. On this episode, we had Scott Bunnell from Sonic. He is the senior Global Product Manager, Scott Bunnell, thank you so much for coming on to the Hearing Matters Podcast again. We look forward to your next episode. And until next time, hear life's story.