Treatment Technology

Hearing care is not just about making sounds audible, it is about reducing the cognitive load and improving listening. We prefer to view hearing technology as a means of maximizing the Bottom Up Signal so that Top Down functions are easier & more efficient. We want to improve hearing and listening in all of life’s situations, all day and every day.Treatment technologies used at Cubex are available as Daily Wear, Extended Wear and Implant solutions.

Daily Wear Solutions

Extended Wear Solutions

Implant Solutions

Ear Hearing Technology

Ear hearing technology is designed to compensate for damage in the ear and focuses primarily on making things audible and improving the speech to noise ratio. Typically, this would entail use of directional microphone systems, noise management systems, frequency lowering and wide dynamic range compression.Research Roundtable: 20Q: The Highs and Lows of Frequency Lowering Amplification Joshua M. Alexander, PhD StereoZoom: Improved speech understanding even with open fittings

Brain Hearing Technology

Every sound has a spatial signature yet hearing loss is commonly addressed on the spectral and amplitude components only. Increasing speech intelligibility depends on so much more. Amplifying sounds while preserving not only the dynamics of the signal but also as many as possible of the fine temporal structures and subtle acoustic cues is essential in our hearing care.The brain is wired to absorb all of the sensory information around us and to organise it into meaningful percepts. It untangles and separates different sound sources – such as one voice from another; sounds coming from the kitchen versus sounds coming from the TV in the next room; traffic noise versus playground noise, etc. The more accurately and naturally the information can be presented, the easier it becomes for the brain to create order out of the apparent acoustic chaos of a soundscape. Auditory input is extremely complex: rapidly changing acoustic events can contain everything from intricate timing cues, harmonics and loudness information to a phenomenal amount of information embedded in the frequency spectrum. The purpose of hearing care today is to help the brain restore order to what seems like chaos, using whatever sources of information are available, including: visual cues, situational cues and acoustic information such as spatial cues and speech characteristics.In the past, research and development of hearing technology focused primarily on making things audible and managing noise. Processing chips in daily wear devices were not fast or efficient enough to restore spatial hearing and replicate the Inter-aural level and time differences of binaural hearing. Today, solutions used in our rehabilitation programmes are designed to support the natural spatial organization process of the cognitive system – organise, select, follow.Technology isn’t used to indiscriminately ‘raise the volume’, but to sharpen the focus of what our patients hear. So patients are better able to hone in on a conversation in a wall of party noise, and shift attention from one voice to another as they choose.

Research Roundtable:Issues in Cognition, Audition, and Amplification – Exploring the fascinating links between cognition and hearing healthcare. Moderated by Douglas L. Beck, AuD with,Brent Edwards, PhD; Larry E. Humes, PhD, Ulrike Lemke, PhD; Frank R. Lin, MD, PhD; Thomas Lunner, PhD; and M Kathleen Pichora-Fuller, PhD Setting our insights on the future of audiology by Thomas Behrens is Head of Clinical Evidence and Communication in the audiology division of Oticon A/S.

PRESERVING NATURAL PINNA CUES WITH DIGITAL PINNA by Petri Korhonen

The Lyric

Lyric is the world’s first completely invisible hearing aid which can be worn for extended periods of time providing 24/7 replacement of the sense of hearing. It is the result of a unique collaboration between a group of ENT physicians, audiologists, and engineers.Lyric was launched commercially in January 2007, however, it has been extensively studied in hundreds of clinical research patients since 2001. Audiologists who have completed all training required by Phonak are deemed as Lyric Qualified Professionals. We are one of only three clinics in London who are able to offer the Lyric and currently have 4 trained, competent and experienced Lyric practitioners. Patient motivation is extremely high and we are experiencing great success with Lyric.Due to the deep placement of the device, Lyric uses the natural properties of the patient’s outer ear to improve localisation making it easy for the patient to make sense of their surrounding and follow conversation. The most significant benefit of the Lyric is the provision of hearing stimulation to the brain 24/7 with natural acoustic cues. It is used successfully by our patients for all daily activities, including showering, exercising and sleeping. No daily insertion or removal, battery changes or maintenance.Although not initially designed for tinnitus, we have also been able to use Lyric to provide relief from tinnitus during the daytime as well as at night, when tinnitus sufferers need it most for a restful and healthy sleep.

Research Roundtable24/7 Hearing Research & Development with Dr Jacob Johnston MD Insert 5_Johnson Presentation_Research.movClinical Safety with Dr Jacob Johnston MD Insert 4_Johnson Presentation_Clinical Safety.mov

Resource

Download Lyric Candidacy Download Lyric FAQ’s

Working with MED-EL, the world’s technology leader in the field of implantable hearing solutions, we are able to advise on the most suitable implant system for a range of hearing losses. For patients meeting the criteria for these innovative solutions we offer comprehensive pre-operative audiological assessments, post-operative audio processor fitting, and ongoing rehabilitation and support.All implantable solutions supported by us involve a day-surgery procedure performed under general or local anesthesia, at a London-based private hospital. In offering these solutions, Cubex are proud to partner with some of the UK’s most respected and experienced ENT surgeons.

Bonebridge

Bonebridge is the world’s first intact skin active bone conduction implant, which uses the natural conductive elements of bone to create the sense of sound. Bonebridge is an award-winning option ideal for customers who need a solution where they can just put it on and go, with no daily maintenance required.The Bonebridge can be an effective implant solution for individuals aged 5+ with a mild to moderate conductive loss and mixed hearing losses, or single sided deafness.Bonebridge has only two components: an internal implant and an audio processor (Amadé BB).

Implant and audio processor

The Amadé is worn externally on intact skin, held in place by a lightweight magnet, and can be worn discreetly under the hair. It also sits off the ear so is ideal for customers who wear glasses.The implant is surgically fixed under the skin during a short, routine surgery. Bonebridge converts sound from the Amadé BB processor into minute mechanical vibrations that are conducted through the skull directly to the inner ear.This small processor is so lightweight that wearers find it comfortable to wear all day. Combined with the fact that Bonebridge is virtually a no-maintenance option, patients tell us their average time of daily wear is almost double that of other bone conduction devices.

Vibrant Soundbridge

The Vibrant Soundbridge is the world’s most successful middle ear implant system. Most patients describe a very natural hearing experience, being able to join in with conversations in busy restaurants, enjoy their favourite music, and experience sound to the full.The Vibrant Soundbridge is a ground-breaking alternative to conventional hearing aids, especially for patients who cannot wear them, either due to medical reasons or because the hearing aid does not provide sufficient benefit. The ear canal remains open making it an attractive option for suffers of ear canal inflammation.This proven intact skin technology provides a hearing solution to customers aged 3+ who have a mild to severe sensorineural hearing loss, or a conductive and mixed hearing loss.Implant and audio processorVibrant Soundbridge has two components: an internal implant called the VORP (Vibrating Ossicular Prosthesis) and an audio processor (Amadé).The Amadé is worn externally, held in place by a lightweight magnet, and can be worn discreetly under the hair.During a short, safe surgery, the internal implant is fitted entirely under the skin and connected to a small Floating Mass Transducer (FMT), which is attached to the structure of the middle ear. It is the FMT that converts sound signals from the Amadé audio processor into mechanical energy and vibrates the suitable vibratory structure in the middle ear. This imitates the natural movement of bones in the middle ear, delivering sound waves to the inner ear, and creating sound.

Personalising Hearing Solutions

In addition to objectively verifying hearing instruments, the subjective nature of hearing loss makes personalisation a critical factor in achieving satisfaction.To achieve even greater satisfaction with hearing aids, Cubex Audiologists address hearing loss according to the individual’s personal preferences. This process enables us to tailor a personalised solution that factors in more of the patients individual listening needs and sound preferences

The goal of the Personalisation Process is to help each patient reach a higher level of overall satisfaction with the hearing device fitting experience. The process focuses on patients playing an active role in determining how their devices sound. The patient’s perceptual experience of sound preference and device performance is central to this process. It also reinforces shared decision-making and goal setting between the Audiologist, patient and their partners.

Initial Fitting

The Initial Fitting session is an interactive session between the Audiologist and the patient. Setting the devices will be based on the client’s age, audiometric information, objective verification, experience and their personal answers to the preference-related questions.

Active Listening

Active Listening ‘take home’ tasks captures the patient’s own experience with different sound environments in daily life. We provide instructions and reminders to the patient about the types of environment to be assessed. This information is crucial carrying out the personalized performance optimization process.For experienced hearing instrument users, the listening experience evaluation period lasts about 2 weeks. For those new hearing technology, the evaluation period typically lasts between 2 and 4 weeks.

Optimisation session

The Optimisation process forms a cornerstone of the Personalisation Fitting Process. The process consists of two steps: Debrief and Structured Listening.During the Debrief, information is gathered from clients about their Active Listening. This information can be used to select sound samples in the Structured Listening to make any necessary fine tuning changes.Structured Listening walks clients through a structured listening task to further match their sound preferences to the device settings to achieve a truly personalised fitting.

Research Roundtable Personalised Hearing Care – Clinical Update 2014

Auditory Training

“Listening is Where Hearing Meets Brain”  (Beck & Flexer, 2011)Improving hearing functionality means we need to think beyond hearing. Brain training is used to improve the patient’s opportunity for Listening Success! The type of training programme used depends largely on the needs and ability of the individual.

Programmes commonly used at Cubex include:

LACE by Neurotone
SENTENCE MATRIX
LUMOSITY
Auditrain

Research Roundtable On the Importance of Working Memory with Regard to Hearing, Listening, Amplification, Prodigies, and More. Opinion Editorial by Douglas L. Beck, AuD Training to improve hearing speech in noise: biological mechanisms. Song JH1, Skoe E, Banai K, Kraus N.