Starkey Professional Training & Education Newsletter | Issue 3

Welcome to Starkey Hearing Technologies

Welcome to issue 3 of our training newsletter. We have a 3D Ear Model - 3 times life size - worth £64 to give away to a lucky winner so Thank you to everyone who entered our be sure to click and enter for a chance to win. competition for the dementia lounge kit in the last issue. We are delighted to announce At Starkey Hearing Technologies we believe to Jane McCann from Salford Royal Audiology hear better is to live better and we are proud Department as the winner of the dementia kit. to offer you our Summit and Kinnect hearing Congratulations Jane! technology that connects and engages your patients into their world in more ways than In this issue we explore CROS and BICROS ever before. solutions. Starkey Hearing Technologies have a strong reputation for delivering exceptional We hope this information is useful and we look CROS and BICROS hearing solutions to support forward to supporting in clinic training. patients with single-sided hearing and unequal Best wishes, loss. In this issue our Education and Training The Starkey Team team look at this hearing technology in more detail alongside some of the benefits and challenges that are presented when fitting these types of solutions. STARKEY HEARING TECHNOLOGIES: SUMMIT CROS/BICROS SYSTEMS

Introducing Summit CROS/BICROS Systems

Starkey offer 3 Summit wireless CROS/ fitted to just the better hearing ear may be BICROS systems to our health service insufficient. The head shadow effect occurs customers, they allow a wide range of hearing when sound arriving on one side of the head is levels in the better ear to be appropriately physically obstructed by the head itself, which fitted whilst providing a robust connection for causes attenuation and filtering of sounds wireless transmission from an unaidable ear. before they reach the other side. Frequencies above 2000 Hz are attenuated by as much as We know that providing a solution for those 15-20dB, while frequencies below 1000 Hz are with unilateral hearing loss can be challenging typically attenuated by less than 10dB (Taylor, and I’d like to cover some of the main 2010; Upfold, 1980). challenges and solutions here, however I would also recommend you read our full white paper on fitting CROS/BICROS which has a higher Why do we need memories for level of detail and continues the advice from hearing aid alone settings? here, that white paper is at https://starkeypro. Starkey CROS/BICROS products allow manual com/pdfs/technical-papers/Considerations_ control of transmission of sound from the in_CROS_BiCROS_Fitting.pdf poorer hearing side in listening conditions that are unfavourable for CROS/BICROS systems Unilateral hearing loss (i.e., when noise is presented to the poorer- with an UNAIDABLE ear can be a hearing side). In each program it is possible to significant problem for patients say the devices are set to Hearing aid alone, CROS or BICROS allowing up to 4 choices Head shadow effect for the end user. Users can achieve better • Approximately 15 dB attenuation speech understanding in noise with a manually • Mostly in the high frequencies controlled CROS/BICROS system than with Speech Signal a conventional CROS/BICROS system when • Approximately 6.5 to 7 dB speech is presented to either ear, and noise attenuation of speech is presented from the front, back and side contralateral to the speech.

The issue we are trying to overcome with a There is some robust evidence for the type of CROS fitting is the head shadow effect which situation where different configurations of the can significantly reduce detection of sounds CROS/BICROS systems and unilateral hearing arriving on the side of the poorer-hearing ear instruments could be recommended. The table and therefore traditional hearing aid solutions below summarises the advice.

Comparison Speech Location Noise Location Outcome

CROS vs. Unaided Front Poor Side CROS

CROS vs. Unaided Better Side Front CROS

CROS vs. Unilateral CIC Better Side Front CROS

BICROS vs. Unilateral Front, Back Better Side BICROS Hearing Aid and Poor Side Verification Manufacturers such as Natus for the Aurical and Interacoustics for Callisto and Affinity have In the health services all hearing great guides on verification of CROS/BiCROS. instruments are routinely verified using Real Ear Measurements, CROS and BICROS systems should also be verified using REM. Wireless Transmission Proper fitting and verification of a CROS It is important to note that in order to get system should result in similar hearing a robust signal across the head for sound sensitivity of sounds arriving at either ear transmission our wireless system must be (Dillon, 2001). highly sophisticated. Starkey use a proprietary 900sync wireless technology for the CROS/ To verify a CROS/BICROS system we need to BiCROS system which provides a low energy, Present signals to the transmitter microphone ultra high-definition streamed audio signal in one location, and then measure from the live with quality, clarity and consistency of sound. receiver instrument in the better hearing ear. The technology processes sound quickly to In our white paper you will find details of how ensure there is no time lag for the transmitted to verify a CROS/BICROS systems using real signal, so streaming is done in real time. ear equipment. 900sync technology also allows your patient to receive signals from T.V. streamers, remote As real ear equipment set up is individual it controls and remote microphones direct to the is always best to approach your equipment hearing aids with no intermediate device. You manufacturer for details of how to verify using can read more about the wireless accessories the equipment you have. The process is usually available to your patients direct from simple when you understand how to control the Starkey Hearing Technologies at microphones for recording from the good ear http://www.starkeyconnect.co.uk/ and presenting a stimulus on the poorer ear. The Summit i1600 CROS/BICROS System Compatibility • Summit mini BTE 312 CROS is compatible with Summit mini BTE 312 • Summit BTE 13 CROS is compatible with Summit BTE 13 • Summit Power Plus BTE 13 CROS is compatible with Summit Power Plus BTE 13 Audio Information Special Features Audio Quality: 20 kHz sampling frequency • Clear and consistent wireless streaming using 900sync™ technology Radio Information Antenna type: Integral Dual Parallel Loop Antenna • Acuity OS 2 brings audibility and speech understanding to patients in any environment Operation frequency: 902-928 MHz Occupied bandwidth 300 kHz • Full Adaptive Directional functionality (99% BW): on the CROS transmitter Modulation: FSK • Telecoil standard in Summit CROS receivers Operating range: 1 m

™ mini BTE 312: -23 dBm • Compatible with SurfLink accessories Transmit Power: BTE 13: -25 dBm arriving at either ear. Power Plus BTE 13: -22 dBm HEAR BETTER. LIVE BETTER: STARKEY HEARING TECHNOLOGY

Starkey Professional Online Competition Simply answer the following question for a chance to win a 3D Ear Model - worth £64 “3 times life size ear anatomy model, showing the outer, middle and inner ear.” Q. Which of these has never been a prescription gain formula?

A. Cello B. Lybarger Half-Gain Rule C. Pogo D. Libby

Visit http://bit.ly/starkey-quiz3 to complete the competition online. Hurry! Closing date for entries is the 21st February 2020. The perfect hearing solution for every patient

Today’s patient demands hearing technology that keeps up with their busy lifestyle. Our Summit and Kinnect wireless platforms represent our best ever NHS technology, delivering pristine sound and carefree wireless connectivity in every situation to help patients live their best life. To view our full range, please visit https://uk.starkeypro.com/nhs/guides SUMMIT PROD UCT S For help and support, please contact Lesley Holland on 0800 042 0000, I N SUMMIT PRODI UCT S i2400/i2000/i1600 M BTE 312 email [email protected] THIN TUBE or chat to your Area Manager. (Size 3, Occluded)

Measurement ANSI/IEC IEC OES ANSI/IEC IEC OES Fitting Guide i2400/i22cc00 Coupler0C/ouplie1r 62cc0 C0oupler Coupler

0 Peak OSPL90 (dB SPL) 130 136 120 126 10

) 20

BTE 1L 3 HFA OSPL90 (dB SPL) 117 N/A 108 N/A

H THIN TUBE

( 30

EARHOOK

B 40 (Size 3, Occluded) d RTF OSPL90 (dB SPL) N/A 121 N/A 112

n 50

l 60

e v

e 70 Peak Gain (dB) 60 66 60 66 L

ANSI/IEC IEC OES ANSI/IEC IEC OES

80 g

n Measurement

Fitting Guidi e 90 2cc Coupler Coupler 2cc Coupler Coupler

r HFA Full-On Gain (dB) 51 N/A 49 N/A a

e 100 H 110 RTF Full-On Gain (dB) N/A 57 N/A 57 -10 120 QuickPeak OSPL90 (dB SPL) 130 137 122 127 0 Reference Guide 250 500 1K 2K 4K 8K

10 Frequency Range (Hz) <100-8100 <100-8600 <100-6800 <100-7700 )

L 20 HFA OSPL90 (dB SPL) 122 N/A 113 N/A H

( Frequency (Hz)

30 Reference Test Freq. (kHz) N/A 2.5 N/A 2.5

B d

40 RTF OSPL90 (dB SPL) N/A 136 N/A 119

n i

l Summit mini BTE 312 ﬁtting range. HFA Frequencies (kHz) 1.0,1.6,2.5 N/A 1.0,1.6,2.5 N/A e

v 60 e Peak Gain (dB) 70 75 68 73

L 70

g Reference Test Gain (dB) 40 46 31 37

n 80

i r

a 90 HFA Full-On Gain (dB) 62 N/A 57 N/A e

H 100 Equivalent Input Noise (dB) 25 25 32 32

Multiflex Tinnitus 110 RTF Full-On Gain (dB) N/A 75 N/A 61 120 Harmonic Distortion 250 500 1K 2K 4K 8K Technology Frequency Range (Hz) 500 Hz (%) <100-7600 <100-7800<3 <100-4<6300 <100-68<030 <3 Frequenc y (Hz ) CROS CompatibilityReference Test Freq. (kH80z)0 Hz (%) N/A 2.5 <5 N/A<5 2.5 <3 <3 Summit BTE 13 fitting range. HFA Frequencies (kHz) 1600 Hz (%) 1.0,1.6,2.5 N/A <3 1.0,1.6,2.<3 5 N/A <3 <3 KINNECTW IRELESS SurfLink Accessory R eference Test Gain (dBInd) uction Coil Sensitivit44 y 61 36 44 Multiflex TinCnoitmups atibility Equivalent Input Noise (dBHFA) SPLITS (ANSI) (dB2 S4PL) 100 29N/A 90 N/A MASL (IEC) (dB SPL) N/A 87 N/A 86 Technology Harmonic Distortion Model Maximum Matrix 2cc Coupler Battery Size Channels Memories Telecoil Directional Microphone User Control Frequency Lowering Bandwidth Wireless Protocol Wireless Accessories Available* ANSI/IEC 500 Hz (%) <3 <3 1.5 <31.4

CROS Compatibility 800 Hz (%) Idle Current (mA) <5 <5 1.3 <31.3 <3 1.3 1.3 Mini Remote Media Mobile Remote Programmer BTEMobile Mic1rroopphhone3 1600 Hz (%) <3 <3 <3 <3 Estimated Battery Life Summitfor 16-Hour Day 115/50 Adaptive Rocker 900 Sync SurfLBinEk HAIcNceDs-sTorHyE -E AR Induction Coil Sensitivity THIN TUBE Color Guide 312 Zinc Air (days) 7-9 7-9 EARH7OO-9 K 3127-9 16 4 Yes Yes 10kHz Yes Compatibility HFA SPLITS (ANSI) (dB SPL) 101 N/A 96 N/A (Size 3, Occluded) Standard RIC 312t 120/60 Directional Switch Only COMPATIBLECROS / BICROS Colors Tinnitus Therapy Stimulus MASL (IEC) (dB SPL) N/A 101 N/A 93 Max RMS Output (dB SPL) 87 ANSI/IEC 87IEC OES ANSI/IEC IEC OES ANSI/IEC Measurement FITTING GUIDE 1.8 1.4 1.62cc Coupl1e.4r Coupler 2cc Coupler Coupler Battery Current (mA) Weighted RMS Output Level (dB SPL) 87 87 Mini Remote Media Mobile Remote Programmer 0 Idle Current (mA) 1.3 1.3 1.3 1.3 Mobile Microropphhone Max 1/3 Octave Output (dBPea SkPL O)SPL90 (dB 8S7PL) 131 87 134 120 123 10

) 20

L Estimated Battery Life HFA OSPL90 (dB SPL) 120 N/A 110 N/A H

( 30 for 16-Hour Day Adaptive Multifunction 900 Sync B Summit BTE

Color G40uide d Matrix 130/60

n 50 RTF OSPL90 (dB SPL) N/A 133 N/A 115

i 13 Zinc Air (days) 9-13 10-14 130/609-13 10-14 312 16 4 Yes Yes 10kHz Yes

Standard l 60 e

Colors v Directional Single Switch or Wired e 70 MiniBattery Siz312e 312 L Tinnitus Therapy Stimulus Peak Gain (dB) 70 74 64 67

g n

i 90 r

a Max RMS Output (dB SPL) 87 87

e 100 HFA Full-On Gain (dB) 63 N/A 52 N/A H 110 Weighted RMS Output Level (dB SPL) 87 87 120 RTF Full-On Gain (dB) N/A 74 N/A 56 250 500 1K 2K 4K 8K OSPL90 FOG 50 Max 1/3 Octave Output (dB SPL) 87 OSPL90 FOG 50 87 80 130 85 130 Frequency (Hz) Frequency Range (Hz) 100-7400 100-7400 100-7400 100-7400

70 120 75 120

) )

L L

) ) P

60 110 P 65 110 Adaptive Rocker 900 Sync B

B Reference Test Freq. (kHz) N/A 1.6 N/A 1.6 S

Kinnect BTE 13 ﬁtting range. SummitS

d d

( (

B B

d d 0

0 50 100 55 100

( (

5 130/70 13 16 4 Yes Yes 10kHz Yes

0 0

9 9

G G L

40 90 L 45HFA Frequencies (kHz) 1.0,1.6,2.5 90 N/A 1.0,1.6,2.5 N/A

O O

P P F

F Directional Switch or Wired

Matrix BTES 130/7 013 O

30 80 O 35 80

20 70 25Reference Test Gain (dB) 43 70 58 33 40 Battery Size 13 TRULINK TEC10 HNOLOGY 60 15 60 100 1000 10000 Ha100rm onic Distortion1000 10000 iPhone 6, iPhone 6 Plus, iPhone 5s, iPhone 5c, iPhone 5, iPhone 4s, iPad Air, iPad Air 2, iPad (4th generation), Compatibility: Frequency (Hz) Frequency (H z) iPad mini with Retina display, iPad mini, iPad mini 3 500 Hz (%) <5 <5 <5 <5 and iPod touch (5th generation). OSPL90 FOG 50 OSPL90 (gray) and Full-On Gain (black) curves OSPL90 FOGOS 50PL90 (gray) and Full-On Gain (black) curves for the Summit mini BTE 312 with Earhook. for 800the HSummiz (%) t mini BTE 312 with Thin<2 Tube. <2 <2 <2 85 135 Summit85 BTE 135 Adaptive Rocker 900 Sync

T75ruLink 125 75 125

) )

1600 Hz (%) <1 <1 <1 <1

L L

App 140/80 13 16 4 Yes Yes 10kHz Yes

) ) P

65 115 65 115 P

B B

S S

d d

( (

B B

d d Directional Switch or Wired

105 105 0 55 0 55

( (

Power PlusAN SI/IE13C

5 5

1.50 1.5 1.5 1.5

9 9

G G L

T45ruLink 95 45 Battery Current (mA) 95 L

O O

P P

F F

Programmer S O

35 85 35 85 O

Idle Current (mA) 1.4 1.4 1.4 1.4 25 75 25 75

15 65 15 65 100 1000 10000 100 Estim1000ated Battery Life 10000 COLOR GUIDE for 16-Hour Day Frequency (Hz) Frequency (H z) Standard 13 Zinc Air (days) 9-13* 9-13* 9-13* 9-13* Omni Wired OSCPoLlor90s (gray) and Full-On Gain (black) curves SummitOSPL90 (gray) and Full-On Gain (black) curves 2 for the Summit BTE 13 with Earhook. for the Summit BTE 13 with Thin Tub110/40e. 10 16 4 No T Remote Yes 10kHz None Kinnect Special EasyFit CIC Directional Only Edition Colors

Matrix 131/70

Battery Size 13 2.4GHz Apple Adaptive Multifunction Kinnect 131/70 13 12 20 Yes Yes 8kHz Made for Products Directional Single Switch BTE w40 13 iPhone (below)

*Results will vary based on wireless usage.

OSPL90 FOG 50 OSPL90 FOG 50 *Remote Control, SurfLink Media, Remote Mic, SurfLink Mini Mobile 85 135 85 130

75 125 75 120

)

) P Kinnect BTE connects directlyP to Apple products for streaming, remote control, remote mic & mobile phone use

65 115 65 110

(

0 (

55 105 55 100 (

G L

45 95 45 90 L

S O

35 85 35 80 O

25 75 25 70

15 65 15 60 100 1000 10000 100 1000 10000

Freque ncy (Hz) Frequency (Hz)

OSPL90 (gray) and Full-On Gain (black) curves OSPL90 (gray) and Full-On Gain (black) curves for for the Kinnec444125342t BTE 13 with Earhook. the Kinnect BTE 13 with Thin Tube.