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Hearing Aids
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    Understanding Hearing Loss

    Hearing Difficulties

    An estimated 40m people in the U.S. have hearing loss as defined by a hearing test. However, an estimated additional 26 million additional people possess hearing thresholds within the range of normal limits. Still, they, too, complain of hearing difficulty and problems hearing speech when there is background noise. The use of AI technology like Sontro® OTC Hearing Aids could improve hearing speech in noise and improve an individual's quality of life.

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    Different Types of Hearing Loss

    It is difficult to describe the types of hearing loss without first understanding the way sound travels through the ear and auditory system. Initially, sound is captured by the Outer Ear (The Pinna). This is the part of the ear that is attached to the sides of our head and sometimes supports the use of earrings! The hole is the ear canal. After sound is captured by the Pinna, it travels down the ear canal to the eardrum (Tympanic Membrane). The eardrum will vibrate when sound reaches it and will send the sound through our Middle Ear, which is the home of the tiniest bones in our body, i.e., The Malleus (Hammer), Incus (Anvil), and Stapes (Stirrup). After passing through the Middle Ear, the sound will proceed to the Inner Ear, where the Cochlea (Snail-shaped) can be found. We refer to this as the Peripheral Hearing System (Outer, Middle, and Inner Ears). The sound then will be transmitted from the Peripheral Hearing System to the Central Auditory System by traveling to the brainstem and auditory cortex of the brain. https://www.nidcd.nih.gov/health/journey-of-sound-video

    Diagram of the anatomy of the ear

    With this oversimplification of the auditory system, it becomes easier to explain three categories of hearing loss: Conductive, Sensorineural, and Central.

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    Conductive Hearing Loss

    A conductive loss is a breakdown in the transmission of sound from the outer or middle ear. If you have wax in your ear canal, an ear infection, or damage to a bone in the middle ear, it's possible that sound will not travel or be conducted efficiently through the auditory system. This type of hearing problem (conductive) most often can be medically managed by something as simple as cleaning out the wax, treating the ear infection, or surgical intervention.

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    Sensorineural Hearing Loss

    Otherwise known as Nerve Loss. The biggest misconception in hearing care is that people with nerve damage, nerve deafness, damage to the hearing nerve cannot benefit from hearing aids. This just is not true; the majority of people with hearing loss and hearing aids also have damage to their hearing nerve. Sensorineural hearing loss generally takes place in the snail-shaped cochlea. There are small hair cells in the cochlea; they help transmit sound through the nerve and to the brain. Unfortunately, the hair cells can be damaged by several causes, including exposure to loud noise, certain medications, and viruses (see below for more information). As a result, sensorineural hearing loss is permanent. Although there is ongoing research to regenerate the hair cells in the cochlea, that is a long way off, and properly fitted hearing aids are the only treatment for hearing problems associated with sensorineural hearing loss.

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    Central Hearing Loss

    We often hear people with hearing loss complain that "they can hear, but not understand speech, especially in noisy environments like a restaurant." Will a hearing aid help in those situations?

    It is well documented that the auditory centers of the brain change even with mild sensorineural hearing loss. The human brain reorganizes itself when coping with peripheral sensorineural hearing loss. Even though we've suspected this for several years, we now know that these changes can contribute to dementia, more effort listening and understanding speech, especially in noisy environments. However, the newest and most exciting research reveals that these changes might be reversed with properly fit hearing aids. Research suggests that without hearing aids, the brain stops processing information in the brain's auditory centers. However, with properly fit hearing aids, it appears that this can be reversed, and understanding speech in noise improves after several months of wearing properly fit hearing aids.

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    Causes of Hearing Loss?

    Aging, Presbycusis, and Sociocusis

    Presbycusis is the loss of hearing that gradually occurs in individuals as they grow older. While 50% or more adults aged 65 and older have a communicatively handicapping hearing loss, it is not uncommon for people to first notice a change in their hearing at much younger ages. Some refer to this early change in hearing as Sociocusis. This hearing loss is attributed to continuous noise exposures over a lifetime, unrelated to their job or occupation, such as background noises, music, traffic noise, appliances, etc., that can affect hearing abilities.

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    Work or Hobby-Related Noise Exposure

    Individuals who work around loud noise, such as farmers or industrial workers, and people who may have hobbies like shooting or operating loud equipment, could have acquired hearing loss over their lifetimes. In addition, hearing loss is typically at higher frequencies for hearing speech, leading to difficulties hearing or understanding the higher-pitched voices of children or females.

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    Other Causes of Permanent Hearing Loss

    There are an estimated 600 various causes or contributing factors associated with permanent hearing loss. These include Diabetes, Cancer, Dementia, Kidney and Renal disorders, and heart disease; certain medications like cisplatin with chemotherapy, many Mycin/Micin drugs like Streptomycin, Kanamycin, and Gentamicin. In addition, genetic factors that can contribute to inherited hearing loss and viruses like Meningitis, Rubella, Cytomegalovirus (CMV) are among the leading causes of hearing loss.

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    Treating Hearing Loss

    Visit a Professional

    If you suspect hearing difficulties, then your initial step should be to visit a professional who can determine if your loss is correctable by something as simple as removing ear wax or treating a medical condition.

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    Purchasing a Hearing Aid Online

    If you choose to bypass the professional visit, then you can go directly to the Soundwave Online Hearing Test and screen your hearing in the comfort of your home. The hearing screening will help determine if you have audible problems and the sounds that may give you some difficulty.

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    Explaining Hearing Loss

    Many people can hear some sounds lower in pitch than sounds in high pitches. Therefore you may be able to hear a pin drop (low frequency) but cannot clearly hear the voice of children or females (higher in pitch). The Soundwave Online Hearing Test may not provide complete diagnostic information about the cause or appropriate medical treatment for your hearing problem. Only an audiologist or physician can provide that information—but the hearing screenings may provide some information about your ability to hear certain sounds.

    Our human ear can hear sounds ranging from 20 Hz (cycles) to 20,000 Hz (cycles). However, a hearing screening with properly calibrated earphones will measure a much narrower range associated with hearing speech (500 Hz – 4,000 Hz), the range of sounds of a standard telephone, and the sounds necessary to hear and understand 90% of speech.

    The figure below provides a graphic image of various environmental and speech sounds. On the left axis is the volume or intensity of sounds. For example, a baby crying would be at around 60 decibels, while a whisper is approximately 30 decibels on this scale. Across the top are the frequencies so that our vowels (e.g., ah, ee, oo) tend to be lower in pitch and our consonant sounds (/s/, /sh/, /th/) are higher in pitch.

    If a person can hear well in the lower frequencies (500 and 1,000), they may be able to hear vowels, but if they have a problem hearing higher-pitched sounds (e.g., 2000-4,000 Hz), they may not hear the consonants. Therefore, it may be difficult for them to distinguish between "bath" and "bat." They hear the vowels but not the consonants. As a result, they may complain that they hear speech, but it's not clear or that people are mumbling. A hearing test using the Soundwave Online Hearing Test would provide you with information to determine if you have a hearing problem that could benefit from Sontro OTC Hearing Aids and the otoTune® app.

    Illustration of decibal scale

    Using the Soundwave Online Hearing Test will provide markers to help you better understand if Sontro OTC Hearing Aids are right for you. Your self-fitting Sontro OTC hearing aids will offer you improvement in your ability to hear sounds in your living environment. Think of the self-fitting Sontro OTC Hearing Aids as a piece of chocolate. Once you have a taste, you may decide you want to eat the entire candy bar. Similarly, once you have the experience of hearing again, you may decide you want the best hearing experience and fit available to assure you hear well in all listening situations. You may find the Sontro OTC Hearing Aids provide you with excellent hearing and offer you the same quality of hearing as much more expensive hearing aids. However, if you still have hearing difficulties, you could contact an audiologist or hearing care professional to evaluate your hearing loss further.

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    What is Tinnitus?

    Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, low, or high pitched. You may hear the sounds in both your ears or just one.

    According to the U.S. Centers for Disease Control, 15% percent or nearly 50m adults in the United States have experienced some form of tinnitus. The U.S. Department of Health and Human Services Healthy People 2030 report(https://health.gov/healthypeople) aims to increase the proportion of adults who have seen a specialist for their tinnitus.

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    What Causes Tinnitus?

    Tinnitus sometimes can be the first sign of hearing loss. Still, it can also be caused by many factors, including wax in the ears, exposure to loud noise, infections, heart disease and vascular disorders, and tumors.

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    Can Hearing Aids Help Tinnitus?

    According to the fact sheet from the NIDCD at the National Institute for Health (NIDCD/NIH), https://www.nidcd.nih.gov/health/tinnitus, hearing aids could alleviate the tinnitus for people who have hearing loss along with tinnitus. Wearing a hearing aid adjusted to control outside sound levels may improve your hearing. The better you hear, the less you may notice your tinnitus.

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    Preventing Hearing Loss

    Did you ever notice that the volume control on your TV or tablet is inching up as you try to watch a show? This could be an early sign that you are developing hearing problems. The key question is how to avoid a handicapping hearing loss. The National Institute of Health released data in 2012 showing that most people with hearing loss in their 70s first knew they were starting to have hearing problems in their 40's and 50's. If they took simple precautions, they may have been able to avoid problems later in life.

    The U.S. Departments of Health and Human Services, along with the National Institute for Occupational Safety and Health, recommend guidelines to avoid permanent hearing loss, which also can be associated with dementia, heart problems, depression, ringing in the ears, loss of enjoyment of sounds in our world, and even lower-income among individuals with hearing loss.

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    Hearing Protection

    Use hearing protection when around noise. This includes our social activities like riding a motorcycle, hunting, using power tools, or lawn maintenance.

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    Loud Noise

    Typical warning signs that noise may be too loud and causing damage to your ears include:

    • You have ringing in the ears when you leave the noise.
    • You have a stuffy feeling in your ears that lasts several hours after leaving the noise.
    • You have to raise your voice to be heard by another person who is an arm's length away.
    • A sound that is not 'painful' does not mean that it is safe.
    • Make sure you do not have a build-up of earwax that is blocking the ear canals.
    • Check your medications for hearing loss risk. For example, even high doses of aspirin can cause hearing problems.
    • Check your hearing at least annually.
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    Signs of Hearing Loss

    AARP Warning Signs

    The AARP recently shared the 10 warning signs of hearing loss

    They include:

    • People sound like they are mumbling
    • It's difficult to follow conversations
    • Talking on the phone is more challenging
    • Some sounds seem louder than normal
    • It's challenging to carry on a conversation in a crowded room
    • You are being told to turn down the volume on the TV
    • You feel like you are getting clumsier
    • You don't remember what people tell you
    • You don't get the jokes like you used to
    • You get distracted more easily

    Are these familiar? They could be signs of hearing loss, and you should take the first steps of discovering your hearing ability with the Soundwave Online Hearing Test.

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    What are Over The Counter (OTC) Hearing Aids?

    OTC Hearing Aids

    We have heard a lot on the news in recent years about OTC hearing aids. In 2017, Congress passed legislation to permit the FDA to develop guidelines for OTC hearing aids for individuals with mild to moderate hearing loss. While it is anticipated that the OTC devices would have the same fundamental technology as traditional hearing aids, it is anticipated that the FDA will ensure quality by regulating and approving the OTC devices. To date, there are no published guidelines but in July 2021, President Biden signed a comprehensive Executive Order which directed the U.S. Department of Health and Human Services “to consider issuing proposed rules within 120 days for allowing hearing aids to be sold over the counter.” It is anticipated that these rules will be published by the end of 2021 and products like the Soundwave Sontro OTC Hearing Aid will be available to consumers over the counter in 2022 and prior to that time by other distribution channels.

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    What are the Different Types of Hearing Aids?

    The fundamental purpose of hearing aids is to amplify sound, and the process is called amplification. Today, hearing aids often are referred to as amplification systems due to their incredibly sophisticated digital computer-based technology. Hearing aids are small electronic devices worn behind the ear or in the ear, to increase sound for those affected by hearing loss. While some people wear hearing aids to hear environmental sounds better (e.g., hunters), the primary goal of most hearing aid fittings is to improve communication with friends, family, and coworkers.

    The hearing aids of our great-grandparents are certainly not the technology of today. Decades ago, hearing aids were big and bulky and were designed to merely amplify sounds without much consideration for the degree of hearing loss. It was a 'one size fits all approach to hearing care.

    Of course, none of that is true today. Hearing aids are now incredibly small, sophisticated and utilize sophisticated digital and computer-based technology. As a result, they offer the most effective management and treatment for people with hearing loss.

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    Hearing Aid Styles

    Today, hearing aids are available to wear either behind the ear or in the ear. Behind-the-ear (BTE) models are available as either traditional behind-the-ear (BTE) hearing aids or as receiver-in-canal (RIC) hearing aids. In-the-ear models are available as in-the-ear (ITE), in-the-canal (ITC), completely-in-canal (CIC), and invisible-in-canal (IIC). https://www.nidcd.nih.gov/health/hearing-aids

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    Behind the Ear Hearing Aids

    In BTE hearing aids, all the electronic components—including the speaker—are contained within the hearing aid body, which is worn behind the ear. The hearing aid is coupled to the ear by an earmold custom-made from an impression of the ear. This style works well for individuals with more severe hearing loss.

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    Receiver in the Canal (RIC) Hearing Aids

    RIC hearing aids are very similar in appearance to BTE hearing aids. In both the BTE and RIC, the hearing aid is worn on the ear, and the electronic components are in the hearing aid body. The significant difference is that, in RIC hearing aids, the speaker (i.e., receiver) is separated from the hearing aid body and rests in the ear canal. The speaker, or "receiver," is connected to the body of the aid by a thin wire.

    The advantages of a RIC hearing aid include: they are less noticeable, more comfortable, and tend to have more natural sound than a traditional BTE hearing aid.

    In the Ear (ITE), hearing aids fit completely inside the outer ear. The hard plastic case is custom molded by a hearing care professional from an impression of the ear, and the electronics are housed within this case. This process typically takes two weeks to receive the final product.

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    In the Ear (ITE) Hearing Aids

    An ITC hearing aid fits into the ear canal opening. It is barely noticeable while providing enough power for many degrees of hearing loss. The hard plastic case is custom molded by a hearing care professional from an impression of the ear, and the electronics are housed within this case. This process typically takes two weeks to receive the final product.

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    In the Canal (ITC) Hearing Aids

    CIC hearing aids sit more deeply in the ear canal and are almost invisible. They are best for mild-to-moderate hearing loss and are popular with consumers concerned about appearance and stigma. However, they often lack features in larger models because of their small sizes, such as directional microphones and wireless streaming. In addition, some consumers find it challenging to change their small batteries. The hard plastic case is custom molded by a hearing care professional from an impression of the ear, and the electronics are housed within this case. This process typically takes two weeks to receive the final product.

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    Completely In the Canal (CIC) Hearing Aids

    IIC's are virtually invisible, sitting close to the eardrum. A thin plastic filament extends from the hearing aid body to retrieve it from the ear canal. Most often prescribed for mild-to-moderate hearing loss, their appeal is mainly cosmetic. They may be limited in their technology due to the size of the product and the size of some ears. The hard plastic case is custom molded by a hearing care professional from an impression of the ear, and the electronics are housed within this case. This process typically takes two weeks to receive the final product.

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    Invisible In the Canal (IIC) Hearing Aids

    From the technology perspective, today's hearing aids have features like feedback management to assure they will not whistle when in the ear, noise management to make it easier to hear in a background of noise, and sound adjustment to meet the individual needs of the users. The smaller the product, the greater the chance these features may not be included in the final model.

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    How to Purchase Hearing Aids

    So, you think you have a hearing loss that can benefit from hearing aids. You've read all this information about the different types and styles of products, and now you are ready to give hearing aids a try? Back to top


    FDA Recommendations

    The U.S. Food and Drug Administration (FDA) recommends the following ((21 CFR 801.420(c)(3)):

    "Good health practice requires that a person with a hearing loss have a medical evaluation by a licensed physician (preferably a physician who specializes in diseases of the ear) before purchasing a hearing aid. Licensed physicians who specialize in ear diseases are often referred to as otolaryngologists, otologists, or otorhinolaryngologists. The purpose of the medical evaluation is to assure that all medically treatable conditions that may affect hearing are identified and treated before the hearing aid is purchased."

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    Most State License laws require an examination from a State Licensed Audiologist or Hearing Instrument Specialist. The purpose of these evaluations is to assure that people with hearing loss do not have a condition that is medically or surgically treatable. These laws and guidelines are changing in 2021-2022 for individuals with mild to moderate hearing loss who may be eligible to order hearing aids over the counter based on the results of an online screening test such as the Soundwave’s otoTune app delivered via a mobile phone. It's a great way to initiate your journey to better hearing.

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    Among the most recent advancements is in purchasing and delivering hearing aids, i.e., Over-the-Counter (OTC). Congress passed a law to permit hearing aids to be sold directly to consumers. The challenge, of course, is assuring the accuracy of a hearing test to identify markers for self-fitting by consumers.

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    Soundwave’s Solution

    Soundwave has solved this problem. Our otoTune app permits people to test their hearing at home for Sontro OTC Hearing Aids. Following a 3-minute otoTune hearing test, the patient can make adjustments to assure the Sontro OTC Hearing Aids are correctly fit and provide the best amplification essential to enhance communication.

    There is no need to negotiate the price as the same model hearing aids carry the same low costs. In addition, there is little reason for multiple appointments for fitting and adjustments because the Sontro OTC Hearing Aids are designed to be self-fit and adjusted, and there is customer support available to help you fine-tune your hearing aids.

    Sontro OTC Hearing Aids are designed, engineered, and assembled in the U.S.A. by Soundwave Hearing, LLC, a Chicago-based company. Their advisory and leadership teams include engineers, audiologists, and business people with extensive experience in the world of hearing care. Rather than a company evolving from consumer electronics, it is a company emerging from the hearing aid industry with extensive validation and support from renowned universities and specialists.

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    What is the Difference: PSAP vs. Hearable?

    PSAP vs. Hearing Aid

    Hearing aids and Personal Sound Amplification Products (PSAPs) both affect our ability to hear sound, but the products have different intended uses and are therefore subject to different regulatory controls. A PSAP is a wearable electronic product that is not intended to compensate for impaired hearing but rather is intended for non-hearing-impaired consumers to amplify sounds in certain environments, such as for hunting or other recreational activities. PSAPs typically are simpler sound amplification devices with fewer features and less functionality than hearing aids, although some of the technology and functionality of hearing aids and PSAPs may be similar. The FDA relies on the intended use of the hearing aid and PSAP to determine whether it is a medical device or an electronic product. The intended use may be established by labeling or promotional materials. Any suggestion in the description of the devices that suggests it is a medical device that is intended to improve hearing would be a hearing aid. The PSAP strictly has the use of amplifying sound but not for individuals with hearing loss. (FDA Guidance 1832).

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    Hearable and Hearing Aids

    The term “Hearable” was first coined in 2014 to describe any hearing device which included wireless connectivity. That is, a device that did not require a wire to be plugged into the device, and the sound source could be delivered wirelessly and through Bluetooth headphones. At the time, hearing aids were excluded because they did not utilize wireless connections to devices like mobile phones. All that has changed in the past few years as the hearable market has become the fastest-growing consumer technology sector we have ever seen. Around a hundred million pairs of earbuds have been sold in the past few years. Wherever you are in the world, you’ve probably noticed a pair of white Apple AirPods. More recently, there has been significant competition, with the appearance of other colors and shapes adorning people’s ears. (The Hearables Report: 2020-2025, N. Hunn, WiFore Consulting, January 2020). In addition, since the ear is a great place to make measurements, Hearables (now including hearing aids) also are being used for augmenting hearing loss, measuring biometrics like heart rate and potential for falling, voice recognition with foreign language translation, and communication with smart home devices. The hearing aids of our grandparents are continuing to transition to the Hearable of today and future generations.

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    Take the Next Step in your Hearing Journey

    Take a Hearing test

    No one likes a challenging exam, so we made ours simple. You can take a free online hearing test on your mobile phone, tablet, or laptop – and with your headphones, as an initial step to understanding your hearing loss.

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    Purchase your Hearing Aids

    Our Sontro OTC Hearing Aid is an artificially intelligent, hearing aid.

    Our otoTune app allows you to customize your hearing aids with our 3-minute hearing test on your mobile phone, The otoTune app’s results are clinically verified and comparable to professionally administered audiograms.

    Soundwave offers a risk-free 45-day money-back guarantee, free shipping, returns, and support. Get Back to Hearing, Get Back to Life.

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