Analogs vs Digitals

Blinded Comparison of Three Levels of Hearing Aid Technology7

A blinded clinical study in which three levels of hearing instrument technologylinear, first-generation DSP utilizing WDRC processing, and second-generation DSP with advanced featuresare assessed.

Old paper, but explains a bit about obsolescence of analogs.

@jeffrey said:

eustachian tubes can muffle sound when they’re blocked

If I may do some pedantic, unsolicited lecturing here- a blocked eustachian tube does not really directly (immediately) affect your hearing. But natural changes in atmospheric pressure will result in a pressure differential with the space in your normally hermetically closed middle ear, where your ossicles transmit vibrations to your inner ear. This will stretch your eardrum, making it less efficient in picking up sound. The role of the eustachian tube is to restore that differential by briefly opening up during swallowing, yawning or by closing your nose and increasing the pressure there a bit.

This bulging of your eardrums happens especially quickly in airplane cabins, where pressure is reduced during cruising to what you see outside at 2-3 km altitude (to reduce strain on the fuselage), then returned to normal before landing.

This makes sense because if I push my ear mould in and it slightly I can feel slight pressure and a pop, usually has moisture trapped inside my heat, so have to take my hearing aid out to let air in to it, sometimes this can be the nuisance if wearing hearing aids all day as your ears aren’t getting the fresh air it needs to circulate.

@RobHooft said:

If I may do some pedantic, unsolicited lecturing here- a blocked eustachian tube does not really directly (immediately) affect your hearing.

Yeah, no. I’ve lived with poorly functioning eustachian tubes–ETD–my whole life. Semantics are one thing. Lived experience is another.
By the way, Eustachian Tube Dysfunction is directly connected to the formation of Cholesteotoma within ears. This last resulted in the destruction of my hammer, anvil and stirrup as a child. That led to numerous surgeries and the restructuring of my ear archticture. And of course the attempt to recontruct my hammer, anvil and stirrup. These bones have “a bit” to due with anyone’s hearing.
So yes, Eustachian tubes can and do affect hearing, both directly and indirectly. During allergy season my tubes are more likely to be blocked. As a musician, I definitely notice the quality of sound being affected.
Happily, my BAHA aid circumvents all of this. And in fact, my ETD was the primary reason that I was covered by Kaiser to install the Osia BAHA I have now. In other words, Kaiser recognizes that my ETD directly affects my hearing and allowed me to have the surgery that implanted the Osia I use today. And indeed it works well. For daily speech! but not so much for music.
All of this is just to speak to those who may suffer from this condition. Anyone who is familiar with this condition will know. that a simple Valsalva maneuver will temporarily restore their hearing levels.
reading the link below made me realize that I use the Frenzel maneuver all the time in an attempt to open my tubes and help my hearing. It makes me a bit eccentric in public. Ear clearing - Wikipedia3

Some brands of hearing aids have a “Music” setting which is probably more flat with less compression and “noise” reduction. As someone else has said, with digitals they can put a maximum power setting on it to protect your hearing from loud (unexpected most likely) noise exposure. But, frankly, I don’t understand why they can’t put all of this into an analog circuit.

Yes, you are right, it probably makes a difference if you live in Schotland’s “Depression Alley” or in the more or less permanent high-pressure areas around the horse latitudes (the subtropical highs), where Florida sits. But I think weather, and natural atmospheric pressure variations in general occur regularly everywhere (there are even diurnal oscillations), so your Eustachian Tube always has a very essential, busy job to do even if you keep your feet on the ground, as Jeff explained, and your experience with allergies shows.

The truth is, I’m sure people could create a modern analogue if they wanted, with variable bands, a proper gain control, long battery, compression of those bands etc etc. the problem is there’s no market for it. You can’t do noise reduction that way, you can’t use AI like that, all the mumbo jumbo that all the makers have to contend with now. I mean heck doctor cliffs reviews would be about 20 minutes shorter if they did that I’m surprised Widex didn’t go the analogue route but again,they’ve fallen victim to a certain extent to putting in noise reduction, speech enhance etc etc. At least they have tried to make pure sound I guess with a tiny delay but even that now has tweaks in it to compress or expand certain sound elements. I can’t remember if I wrote in this thread, but if I think about how hearing aids sounded in 2017 when I 1st started testing them, they wer truely hiddious robotic things… at least to my ears. Now honestly they are all getting closer and closer to that 0 delay. in another 10y or so I think they will all sound very analogue…ish but hopefully with all the adjustability of digital. I mean heck when you block yoru ear with a mold and use the latest Phonaks for example they can get fairly close depending what settings you’re using.

Contraversial point of view here: I don’t think makers are that concerned with how things sound through hearing aids. They make all the right noises, natrual sound etc etc, but the only company that has “respect all sound” as its motto, is widex. That really tells you something right there about what HA makers think is important. bTW Widex often gets critisized for not so great speech in noise, lack of feedback manager et cso it’s really hard to win at this I go back to my argument that I’ve made time and time on this forum. Speech is important, absolutely. However if you make it important at the expense of all else, your hearing is going to be focused on a very specific band of frequencies and a very specific type of noise. Which guess what? they all are. All this to say, yes there might be a market for analogues yes they might sound more natural, but they don’t really follow the locked in pattern of HA development in general, just like the odd Widex review I found doesn’t follow the HA review pattern. People aren’t willing to go off the beaten path in many instnaces. I have faith that if you set up the top makers HA’s to more or less the same output and stuck them in peoples ears blindfolded, many people would notice no difference between them and struggle to tell them apart

I am not certain if you are the person who is asking about the eardrum replacement. I did have that done about 40 years ago. It has affected the conductivity for hearing in that ear but my speech recognition in that ear far exceeds the speech recognition in my other ear. So I have profound hearing loss in the side with the ear drum replacement due to the amount of amplification needed. My other ear is simply severe hearing loss due to age - I turn 80 this year. The other caviate that is know is that the replacement of the ear drum creates a constant elevated moisture environment which means I have been quite limited in the type of HA I can safely wear - they must be BTE with custom earmolds. People do not believe me when I say this but if I wear any other type of HA I end up with a constant ear infection due to the moisture. It isn’t major but it means sometimes you have to explain to people that this is what you must wear and they don’t want to believe you.

@MeBPatB said:

I am not certain if you are the person who is asking about the eardrum replacement. I did have that done about 40 years ago.

I want only to point out that surgical techniques now are completely different than those of 40 years ago…

@MeBPatB said:

The other caviate that is know is that the replacement of the ear drum creates a constant elevated moisture environment

I I wonder what was done accurately in the surgery. There are many people who have moisture problems without any surgery—perhaps you are simply one of them, but had that problem slightly relieved pre-surgery because of two-way airflow (from the Eustachian tube and ear canal).

I get that a lot regarding when I’m describing my hearing and hearing aids situation to people in my life on a daily basis, I know how I like to hear and what works for me, I don’t need a breakdown why this or that hearing aid is better, it’s not better for me sooooo, regarding hearing infections, because I have permanent perforated ear drum, I have to keep my ear dry or make sure I don’t get water in my ear at all even when I’m in the shower or washing my hair…any moisture gives me ear infection too because of my exposure

The more I spend time on this forum I think hearing aids are a bit like shaving. IN shaving, it’s recognised that your milage may vary, or YMMV, because different beard types, blades, angle of shaving, razor, preference as to what you want, cost, creams/soap, end goal etc etc etc. No person is really alike and although we can start off with some good suggestions based on audiograms, a good audiologist needs to work with someone to understand their needs and fit them properly. I’m a prime example of this, someone who is using hearing aids in a rather different way to the norm. this post right here is a good example of people looking for other solutions to the norm. The only thing we can really do is to keep on looking, keep on working on the best result for us. AT the end of the day, hearing aids are basically just suffisticated amplifiers. There is no magic cure at the moment. in that way, it’s a bit like choosing a hifi system. What sounds great to someone may not to someone else

Yeah thanks I like this analysis, this pretty much sums up a lot of us, I don’t tend to follow what my audiogram says about my hearing, I still have a preference how I like to hear and what works for me.