[HN Gopher] $1 hearing aid could treat millions with hearing loss ___________________________________________________________________ $1 hearing aid could treat millions with hearing loss Author : gumby Score : 500 points Date : 2020-09-24 12:01 UTC (10 hours ago) (HTM) web link (www.sciencemag.org) (TXT) w3m dump (www.sciencemag.org) | jononor wrote: | Based on the MAX9814 chip, which costs 0.75 USD in 2.5K volume, | leaving 0.25 USD for everything else. The design is not | integrated much (many connectors), so assembly costs will be | high. It also requires 2xAA batteries as a consumable, which | consumer has to pay as well. | | So this is not a 1 USD hearing aid in any way. And if current | units are 500 USD, then going down to 50 or 10 USD would already | be a huge improvement. | jlgaddis wrote: | I'm not surprised that someone who can fit two "AA" batteries | in their ear has trouble hearing! | tyingq wrote: | The pdf shows a MAX98306. Curious where you saw the MAX9814. | jononor wrote: | The HearingAid.sch PDF says MAX9814 on the JP1 connector on | the left side. So are they actually using both? | anamexis wrote: | The MAX9814 is the microphone. | | Here's the BOM which shows the full breakdown coming in | under $1. | | https://journals.plos.org/plosone/article?id=10.1371/journa | l... (Table 1) | tyingq wrote: | Just the BOM image so it's easier to read: https://journa | ls.plos.org/plosone/article/figure/image?size=... | | Also, I'm not sure where he's getting the prices. Prices | for the MAX98306 and MAX9814 seem higher, even in high | quantities, than what he's showing. | kube-system wrote: | Interesting that they list the cost of raw PLA pellets | for the "mass production cost" of the 3d printed case. | | This is starting to smell like an exercise in making an | incorrect BOM to justify the result they were looking | for. Nobody will 3d print you a case for $0.06. If what | they meant was that they'd 3d print the case themselves, | then it should be the filament or resin listed on the | BOM. You probably can get a plastic part pretty close to | that price, but not 3d printed, it would be injection | molded. | dekhn wrote: | If you read enough of Nature and Science you will realize | that skilled scientists are practiced in the art of | misrepresenting many details of their work to get | published. | | Note that the pricing in there is organized around the | idea of a very massive custom purchase by a large | company. | kube-system wrote: | I don't think there's anything wrong with them citing | volume pricing per se. You'd expect something like a | hearing aid to be mass produced. | | It's the incongruency of the materials listed with the | actual materials that would be used in a mass production | scenario that I find unscrupulous. | tyingq wrote: | You can find plenty of these "personal amplifier" devices | for $15 or so. I doubt they are making $14 on each one. | | https://www.ebay.com/sch/i.html?_from=R40&_trksid=p238005 | 7.m... | [deleted] | magicalhippo wrote: | > The MAX9814 is the microphone. | | It's the microphone amplifier. This unit still needs an | external microphone, as well as headset/plugs. | Accujack wrote: | >assembly costs will be high | | You read the article and know this is intended for DIY | assembly, correct? That it's not a commercial product? | emcq wrote: | The most accurate description is probably the authors built a | hearing aid from the 1960s with only $1 today [0]. Its worn | around the neck, doesn't have any fitting, doesn't appear to have | beamforming or feedback management, and low amplification. | | It turns out these things are all important in clinical outcomes | for listening comfort and intelligibility. I've built a modern | hearing aid and done extensive patient testing - the details | matter and it's not just electrical or algorithm problems but | tough mechanical and UX challenges to get something more state of | the art. | | While I haven't worn many neck mounted devices, the Bose | Headphones can get crazy feedback and the feedback path is | similar. This would cause squealing discomfort for patients and | everyone around them. | | [0] https://en.wikipedia.org/wiki/History_of_hearing_aids | rexelhoff wrote: | This. | | The other issue to contend with in his grandparents demographic | is the perception of being deaf and being seen wearing such a | big bulky item. Image consciousness is a large hurdle to | overcome these | | Great ingenuity but commercially it's hard to see it take | traction | shae wrote: | I never wrote part 2 of this blog post, but there's a $300 open | source hearing aid that can do way more than most hearing aids: | https://shapr.github.io/posts/2019-08-03-tympan.html | | Here's the organization building this thing: | https://shop.tympan.org/ | | I'm kinda excited about the four microphone board, where you can | subtract the ambient noise behind the listener from the noise in | the direction they're facing. | newyankee wrote: | Can i mail you ? Where are you based in ? | [deleted] | mothsonasloth wrote: | Hearing aids are useless for people with tinnitus like my | grandmother. | | The most expensive or cheapest are all the same when you have a | medium high pitched buzz in your ear all day | ritchiea wrote: | Too bad we live in the kind of world where the biggest hearing | aid manufacturer will read this, raise additional capital, buy | the patent & rights to the $1 hearing aid and then sell hearing | aids for $5,000 each they'll bill to medicare and big health | insurance co. | pkaye wrote: | You can already buy cheap amplifiers like this on Amazon. | GuB-42 wrote: | Patent this? This is just a microphone, an amplifier and a | headphone jack. That's the most obvious thing. | | There is no real innovation here. The work being done here is | closer to a market research: find the cheapest components that | do the job. | | Cheap is also its only quality. $5000 hearing aids are better | in every other aspect. It makes no sense for big hearing aid | manufacturers to use anything about this design. | pomatic wrote: | It does seem like a bit of a missed opportunity - even | slipping in the most basic ots equaliser or dsp would add a | minimal amount to the BOM, whilst moving from a late 70s | format aid to late 80s, albeit in a dated form factor. (Chest | worn isn't too terrible IME, but expect to replace the | "wiring harness" to the earphones on a regular basis.) | tyingq wrote: | At first, it seemed like a laudable effort. I hate it, though, | when someone makes a github repo and sticks a single zip file in | it: https://github.com/bhamla-lab/LoCHAid-2020-PLOS-ONE | | So I found the pdf in the zip file where you can see what it is. | It's a MAX 98306 amp. The only peripherals are the typical filter | capacitors, resistors, volume pot, microphone, etc. So, it's | basically this: https://www.adafruit.com/product/987 | dcassett wrote: | I was surprised to see a git repo consisting of one zip file. | And that zip file itself contains a zip file. | magicalhippo wrote: | Actually it uses two IC's and the more interesting one, in | relative terms, is the MAX9814[1] microphone amplifier with | automatic gain control. | | I suspect there are cheaper class-D IC's that could be used | than the MAX98306, but for a prototype why not. | | It also puts the volume control potentiometer on the amplifier | output which seems wasteful for a battery operated device. | | [1]: | https://www.maximintegrated.com/en/products/analog/audio/MAX... | andai wrote: | Looks like that's it in the first photo in the article: he's | holding it in his hands and using earbuds. Presumably it would | go in a pocket or clip on to your belt. | vpribish wrote: | here's a more detailed write-up including pictures of the device: | | https://journals.plos.org/plosone/article?id=10.1371/journal... | | It's a crude, bulky, ugly, and fragile thing and the $1 price is | not realistic - but it would be less than $10. It seems like a | decent product for the poorest places - which is their goal. | | The hearing aid biz in the US is glaringly inefficient and | obviously ripe for disruption - but this product will not do it | here. There's definitely a demand for hearing aids in the couple- | of-hundred dollar range that doesn't require audiologist visits | and insurance hassle - but the entrenched interests will not help | bring it about. | jiofih wrote: | This is basically using academic journals as a marketing | channel. As someone else linked above, there are tons of | similar devices available from China, probably even using the | same chips, at equally low prices. | pontus wrote: | With all the advances in tech, why does it seem that hearing aids | are still from the 80s? | | I guess ultimately you're limited by your interface to the brain | (something maybe neuralink could address?), but even still | shouldn't there be some "magic" machine learning stuff going on | in this space? Not at all an expert in audio processing, but I | would imagine that we could do a decent job distinguishing voices | from background noise, automatically thresholding sound in | different environments, and possibly modulating sounds into | different frequency bands when there are e.g. multiple speakers. | | For all I know, stuff like this is already going on. | red_hare wrote: | My mother, who's fully deaf in one year and mostly deaf in the | other, has heavily depended on strong and expensive hearing | aids her whole life. | | Over the years her hearing aids have improved in battery life, | gotten smaller, and improved in things like filtering | background noise. Every new hearing aid would start by sounding | distorted and weird but her brain adapts to the new sounds | after a couple of weeks. | | The single largest life improvement I've seen for her was about | 10 year ago when she could finally get a hearing aid with | bluetooth. Suddenly she didn't have to decide between the | "whistling" (feedback) or not hearing to talk on the phone. We | got her an iPad and she stopped watching TV almost entirely and | now watches YouTube and Netflix. And she can do her yoga over | Skype. | | Her biggest challenge, at this point, isn't a hearing aid | problem but a bluetooh one. Her iPhone inconstantly switches | between her hearing aid and her Volkswagen (pre-CarPlay). | | I agree hearing aids are stuck in the past, but I'm also | convinced most of the problems are lower hanging fruit than a | neuralink :). | jki275 wrote: | If she likes watching on a TV, the Apple TV can talk to | bluetooth audio devices. Have never tried it, but it would | probably be able to talk to the hearing aids directly. | skybrian wrote: | These days they are fairly sophisticated; my hearing aids will | automatically switch between several different programs | depending on the environment. (It doesn't work how I'd like it | to, though, so I have a program that I manually set for music.) | There is also a phone app for adjusting settings, though it's | limited and buggy. | | It's difficult to evaluate hearing aids because they are | proprietary. Reading about the features in a brochure for a | hearing aid is like reading the features for a TV set or | stereo. Who knows what those trademarked terms really mean when | it comes to how the code works? | pontus wrote: | Would be cool to create an open standard and perhaps even | open source the development. If nothing else, I would imagine | that there are quite a few hearing impaired engineers and | scientists out there that would gladly work on something like | this if it meant that they themselves could benefit from the | improvements. | emcq wrote: | Both https://audatic.ai/ and https://whisper.ai/ are taking the | ML approach for speech enhancement, and the large companies are | starting to get on board. It's the future! | shariqm wrote: | I agree! We're working on this at AudioFocus (YC S19). You can | see an old demo here: https://www.audiofocus.io/demo | | There are a lot of challenges with putting this in a hearing | aid: low latency inference (10ms), small power budget, | consistent performance, fault tolerance, etc. Still a fair | amount of R&D to be done, but change is coming. | pkaye wrote: | How many microphones do you need to do this filtering? I wear | hearing aids myself and if you can do it that that level on a | real hearing aid that would be amazing. | newyankee wrote: | Is it too difficult to ask for one that distributes the | processes between phone/external device, rims of glasses and | in the ear speaker. It will go a long way in addressing the | issue of stigma and enabling more people to use it early. | jononor wrote: | Looks like Chinese manufactures already sell hearing aid devices | in the 25-50 USD price range. | https://www.banggood.com/search/hearing-aid.html Unlike the | device from the article (which would cost more like 10 USD than | 1), these are rechargeable and fully integrated over-the-ear | units. | | Would love to see a low-cost open/hackable hearingaid/hearable | though. For example BOM of 5-10 USD. But then it should use a | reprogrammable chip for the signal processing, so that one can | make improvements in software. Even the cheapest and simplest | hardware is harder / more expensive to improve than software. | newyankee wrote: | Honestly what is needed is a cheap secondary device like a | mobile phone which contains a custom designed chip to do | Machine learning fast on sound and transmit it to the ear. Even | if this costs 500 $ i would reckon the benefit would be worth | it. I guess battery technology has advanced to a level that the | said device can easily be recharged daily or probably swapped | with batteries if needed. | sputr wrote: | Damn that link made me happy. Was wondering if anyone has done | to hearing aids what they did for glasses. | | We just brought my father progressive glasses for 100usd (would | be 400+usd here at a 'normal' store). Now he needs a hearing | aid and we're dreading the multi-hundred payment on top of what | is covered with insurance for a basic device. | | So.. What's the catch with these cheap hearing aids? Why would | we not buy these? | bagacrap wrote: | quality? doesn't this question apply to every cheap Chinese | product? My mom has had poor hearing for decades and always | spent thousands on her hearing aids for marginal improvements | in quality (e.g. noise cancelling, size, noticeability). The | only thing that really made a big improvement was when she | finally got a cochlear implant. | criddell wrote: | > doesn't this question apply to every cheap Chinese | product? | | The question is always valid but the answer isn't always | the same. | | I'm thinking specifically of cheap eyeglasses.I've had | nothing but good experiences buying glasses that cost | 10-20% of what I would pay from a local store. | NonEUCitizen wrote: | What's a good place for buying these cheap eyeglasses? | criddell wrote: | I've only used Zenni Optical. Their glasses start under | $10 but different frames and different lenses can change | the price. | | My biggest complaint with Zenni is that shipping can | sometimes be slow. I've waited 4 weeks for glasses to | show up and other times it's only a week. I think it | depends if they come from China or their US facility. | coupdejarnac wrote: | These are hearing amplifiers, not hearing aids. The | difference being that hearing aids can boost certain | frequency bands to compensate for hearing loss at those | frequencies. The hearing amplifiers boost all the audio | frequencies in a one size fits all manner. There's no signal | processing going on. Maybe that is good enough for your | father, maybe not. | pkaye wrote: | I just got myself some Costco Signature hearing aids a month | ago. Its $1499/pair. Its made by a major manufacturer named | Phonak. The feature set is close to their top of the line | model. Half the cost of the hearing aids in the US is | actually the fitting by the audiologist and they have to pay | for their expenses. You have to spend considerable time with | the audiologist to measure, fit and calibrate the device to | your needs. Costco is able to minimize the cost overhead | since the office is inside a normal Costco store. | | The hard part about hearing aids is making them work in | noise. You don't want to just amplify everything or you just | hear more noise. Also you need to tune it to your hearing | loss otherwise you may damage your hearing. They do things | like expanding the dynamics or compressing to prevent loud | noises. They suppress wind noise. They can focus on the voice | of someone in a group of people. | | So the catch with the cheaper hearing aids is that may not | help help your dad with understand speech as well as a better | quality one. | | I'd suggest you watch the videos of Dr Clif Aud on Youtube. | He is very informative. | colejohnson66 wrote: | Why are multiple audiologist visits necessary? Can't they | just take a 3d scan of your ear and have a computer decide | which shape will fit best? I recall when Apple introduced | the EarPods, they said they scanned thousands of ears and | derived a shape that would fit the most. So it is | possible... | volkadav wrote: | they have to tune the DSP settings to get the | amplification et al. profiles to match the patient's | individual hearing loss pattern. that takes custom | interface/programmer hardware the manufacturers generally | only (afaik) give to licensed audiologists as it takes | specialized education to do this work properly. the ear | dome/mold bits themselves are a minor component of the | overall fitting process. (src: been wearing hearing aids | for about thirty years) | pkaye wrote: | I went with standard domes but it took a second visit to | get the size right since they take time to conform to | your ears. Custom molds are another option but they told | it I would get a more plugged up feeling so I stay with a | more open dome unless really needed. Also there is some | time for adapting to any changes in settings. They also | bump up the gain with each visit to reach target levels. | A big jump might be too much. | | I think there is room for optimizing the whole process | but anything medical related tends to move slowly. I | still find the phone app a little slow and cumbersome. | And switching between bluetooth devices is a pain. I wish | Apple and Google would put more effort in improving that | aspect. | [deleted] | brento wrote: | I was told I could benefit from hearing aids, but was told they | would cost $5K to $8K depending on which ones I wanted. I've | decided for now that I'll put up with the issues associated with | not having them for now. I was also told they blue tooth doesn't | work very well if you have an android phone, so I'm hoping that | there can be some real innovation and competition in this space | to drive the prices down and also improve the technology! | mgerdts wrote: | If you can find your way to Costco, make an appointment with | their audiologist. The test is free and hearing aids are less | than $900 each. Follow-up visits are free. You do not need a | Costco membership unless you decide to make a purchase. If you | are unhappy with your purchase you can get a refund on the | hearing aids and the membership. | | I believe that most of their hearing aids support bluetooth, | but only when you get a pair. I only need one, so no bluetooth | for me. | | I've had fittings by two people at Costco. One is an | audiologist and the other was less credentialed, but I forget | the title. I could hear better when fitted by the audiologist. | jki275 wrote: | This is so true! We were told 8k, Costco got us a top of the | line set with all of the features the other set had for less | than 2k for the set. Costco made a customer for life out of | that deal. They do glasses as well, though I haven't used | them for that and don't know if the discounts are as good or | not. | Hovertruck wrote: | I don't have any first-hand experience to share, but my wife | used to work at https://www.audicus.com/ which is a startup | focused on exactly this problem, in case you're interested in | further research. | dhosek wrote: | That seems really high. I have the fanciest hearing aids that | Costco sells (rechargeable, Bluetooth, optional external | microphone) and I spent under $5K on it. | gedy wrote: | If you have access to Costco their in house brand is much less | (~$1600 pair) and good. Also I really like Bose Hearphones | which work better for me and were $500, assuming you don't mind | looking like you are on a conference call all the time. | pkaye wrote: | I just started using hearing aids and went with the Costco | Signature. Half the cost of hearing aids is the office | overheads since hearing aids need significant tuning. Costco is | able to leverage its existing store overhead to minimize it. | The Costco ones re made by Phonak and based on the features on | the Phonak Marvel series. | netdur wrote: | Ok I will bit, I want to build this and redistribute in Africa, I | lack technical knowledge to do this, what is best approach? | janekm wrote: | Talk to a Chinese factory on what's the lowest price they'll | sell you the hearing aids for that they already make at near- | cost prices. The article is literally a "my first soldering | project" combining an OTS microphone amp module with an R-C | high pass filter. https://www.ebay.co.uk/itm/Rechargeable- | Digital-Hearing-Aid-... | person_of_color wrote: | Reminds of the clock boy who designed CPUs | janekm wrote: | The $1 figure in the headline is clickbait as it's only the | cost of components for the PCB. Add the PCB + mechanical | components + battery + plastic enclosure + assembly + testing | + factory margin + overhead and it would be a miracle to come | under the cost of existing low-cost hearing aids. | anamexis wrote: | That's not true, the $1 figure for all of the parts. Here's | the original, search for "Table 1" for the BOM | | https://journals.plos.org/plosone/article?id=10.1371/journa | l... | tyingq wrote: | The BOM prices are just wrong. You can find the volume | pricing for the MAX9814 and MAX98306. Those two alone add | up to more than $1. | jononor wrote: | Good luck sourcing 3d-printed casings at 0.06 USD, or PCB | at 0.05 USD a piece, even in 10k or higher scale. | | And of course in addition to the BOM comes production | costs. | anamexis wrote: | The casing is just a rectangular plastic box with some | holes in it, I'm sure you could get some made at that | price. | | Even if the PCB costs 5x the quoted price, you're still | rounding down to $1. | | That said, I have no idea what production costs are for | something like this. | jononor wrote: | The casing is about 2 hours 3d-printing a piece. That is | 20'000 printer hours for 10k units, giving a machine-time | cost of 0.025 USD (including plastic). That is off by a | factor of 10-100, at least. | | For injection molding, one would need to make the molds. | That would cost probably more than 1000 USD, excluding | engineering costs (the design is not injection molding | ready). Amortizing the mold costs over 10k units alone | would be 0.1 USD per unit. Then comes actually making the | parts. Maybe 0.5 USD is doable. | | I checked an off-the-shelf casing (no custom molds | needed) it was quoted at 0.20 USD at 1K units - but this | then needs to be CNC machined on 2 sides to add the | necessary openings. Probably 1 USD a piece, at the least. | | The costs in the scientific article does make any sense. | It is really sad to see that it gets through peer review | so easily... I mean OK that the scientist does not really | know what things cost to produce, but then they need to | consult someone who does! Ask a manufacturing or even a | design house for a cost estimate. Quality check your | numbers at least a little bit. | jononor wrote: | I would estimate the PCB costs, excluding Assembly time, | to be 10x the quoted price. | janekm wrote: | I can understand how it may seem that way when a plastic | takeaway box costs $0.1, why should this cost any more... | | The article's cost assumption is just based on the cost | of the raw plastic material, which is hilarious (3D | printer time doesn't really come free). | | But in more realistic mass production you'd make a mold, | and the cost of the mold is dependent on how many "shots" | you want to get out of it. Making plastic parts at the | cost of takeaway boxes requires expensive high-volume | molds. | | At 10k volume you'd be happy to get the box for $1 | including amortised mold cost (though in reality the box | could be much smaller, reducing mold & material costs | some). | grenoire wrote: | Step one is to come in contact with an electrical/industrial | engineer who will be able to assist you in the manufacturing | aspects. | pkphilip wrote: | Talk to someone in Africa who works with repairing mobile | phones, laptops etc. They will have enough skills to assemble | such a device. | | Recruit one of them or work with of them to make the devices in | bulk. | sokoloff wrote: | Repair and bulk assembly are substantially different | expertise. Almost no matter how cheap the local labor is, | doing automated assembly with manual finishing is probably | going to be way cheaper in China (especially since the supply | chain for components is well established there). | aaron695 wrote: | Say you want a order of 10 million made up for a name brand | company to a Chinese company. | | Send in the plans for them to check. Put on an expensive | looking logo and paperwork. | | Done. | Jaruzel wrote: | > _the scientists anticipate that LoCHAid's parts will wear out | after about a year and a half._ | | Why would that be, I wonder. Anyone know? | londons_explore wrote: | Perhaps the AA batteries need changing that frequently? | | Or thats the average time till they get crushed/wet/stood on by | the user? | dpweb wrote: | Unfortunately that $1 aid will cost $1000 when it hits the public | market. It would be nice to see open source hardware in medical | devices. And a health/safety approval of the DESIGN. At least | devices that won't kill you if they fail. So I can build my own | like I build my own desktop computer. | | Buying any Chinese electronics off Aliexpress doesn't excite me | too much. Generally, they suck. | ggrothendieck wrote: | Personal sound amplification devices already exist at | significantly less cost than conventional hearing aids. | https://jamanetwork.com/journals/jama/fullarticle/2635618 | https://www.nytimes.com/wirecutter/reviews/best-personal-sou... | danjc wrote: | I get that this product is about super low cost but seems to me | that with a custom firmware, the AirPods Pro could do a brilliant | job of noise cancellation and amplification of specific frequency | bands. Ostensibly, you could even employ some ML to enhance | clarity of spoken words, etc - like Krisp | caymanjim wrote: | This is not a $1 hearing aid and never will be. The material cost | of almost any device is insignificant compared to the overall | cost of manufacturing, testing, and distributing it. The barrier | to low-cost hearing aids in most countries is medical regulation | and liability coverage, not expensive parts. Maybe India's | regulations are lax enough that someone could bulk-manufacture | cheap, poorly-tested medical devices to get the price down to a | few dollars, but there's no technological breakthrough in this | "new device" that would enable that; if there were a viable | market, it would already be manufactured. There's no profit to be | made, so why would anyone bother? | paulcarroty wrote: | > if there were a viable market, it would already be | manufactured. There's no profit to be made, so why would anyone | bother? | | Big market, not super-complex tech, it's only matter of time | when cheap solution comes. | markc wrote: | >There's no profit to be made, so why would anyone bother? | | Really dude? | jiofih wrote: | > if there were a viable market, it would already be | manufactured | | Yup. | https://m.aliexpress.com/wholesale/hearing+aid.html?channel=... | joerango wrote: | I wonder how different it is from something like this: | https://www.ebay.com/itm/Pocket-Hearing-Aid-Sound-Voice-Ampl... | [deleted] | ajnin wrote: | So this is a very simple circuit. Basically a microphone | amplifier directly connected to some earphones with a volume | knob. No frequency control of any kind. I'm wondering why this | sort of device is not already available like loupe type glasses | that we can easily find. I'm thinking this has something to do | with legislation and maximum allowed earphone sound levels? Or | maybe it is too crude to be actually useful? | janekm wrote: | It is available, even as in-ear style "hearing aid", for <$10 | from the usual factories. I gather it's a little problematic | selling them in the US due to medical device regulations... | pkaye wrote: | You can choose among hundreds of cheap "hearing aids" on | Amazon. | coupdejarnac wrote: | They can be sold here, but they can't be marketed as "hearing | aids" afaik. | subhashp wrote: | My mother has been wearing Hearing Aids for over 20 years. These | days she has trouble with hearing what is on TV even with a | powerful hearing aid. Most times she just sits quietly in front | of the TV watching moving pictures. | | I have always wondered why it is so difficult to make hearing aid | which can be connected to a bluetooth enabled TV or Mobile phone, | so senior citizens can watch TV or talk to their loved one. | Whatever is available on the market is so expensive. | jaclaz wrote: | Well, my mom has one of those. | | They are actually two pieces, one is a match-box sized thingy | that can connect to Bluetooth devices and that she wears around | her neck that transmits to the devices in her ears and also has | a microphone, it is very handy as she can easily answer the | phone by pressing a button on it (leaving the telephone in the | bag, it works as hand-free) and it also has two buttons that | can regulate the volume of the hearing aids (the volume of her | hearing aids can be regulated also through a teeny-tiny button | on the back of the hearing aid, right hand one up, left hand | down, but she simply cannot find/push them properly). | | We got the above first to better adjust volume and for the | telephone use, then she started getting issue with the TV and | we bought the following. | | Then there is a small transmitter connected to the TV that can | link to the matchbox-like device (that has a fourth button to | connect/disconnect to the TV device), it has both RCA plug and | an optical input. | | She is very, very happy of this setup for the TV, much more | than what she had before (wireless headphones). | | Prices are steep, to give you an idea, if I recall correctly: | | hearing aids EUR 2,500 | | neck matchbox-like thingy EUR 250 | | TV transmitter EUR 300 | pomatic wrote: | They do come up on ebay - I got the tv link for my cochlear | implant for PS30. Yes, I was lucky. I assume it was a | deceased estate sale, and I'm grateful for their | consideration. A charity shop specialising in recycling of | this kind of tech would fill a definite gap in the market. | pkaye wrote: | There are bluetooth enabled hearing aids. Also you can get | normal headphones with bluetooth capability. I have 60dB | hearing loss and use the bluetooth headphones from time to time | both with and without my hearing aids. | patorjk wrote: | As an aside, there's a lot of exciting regenerative work going on | related to hearing at the moment. Sometime soon we may no longer | need hearing aids. There are some neat drugs either in clinical | trials or about to begin clinical trials that will re-grow hair | cells and broken synapses in the cochlea (ex: FX-322, OTO-413, | OTO-6XX). | volkadav wrote: | wow! ah, other than naive googling on those drug candidate | identifiers, are there any sources you'd recommend to read more | about this? | | (I have a genetic condition that tl;dr impacts hair cell | substrate material leading to hearing loss by early teens. | Being able to hear natively again would be ... words fail me.) | snegu wrote: | Are any of these supposed to work on congenital hearing loss, | or only when hearing loss is caused by damage/age? | newyankee wrote: | In theory i believe if regeneration of cells is involved it | should work with congenital but i guess there might be other | complexities that might be involved (not a medical | professional). | ygjb wrote: | It depends on the nature of the hearing loss, for example, | FX-322 and OTO-6XX appear to work by triggering regeneration | of hair cells, while OTO-413 appears to work by triggering | regeneration of synaptic connections (both of which are | probably egregious oversimplifications because I am a | security nerd, not a medical researcher :P) | xtracto wrote: | I am closely following FX-322, but mostly for tinnitus. I do | have hearing loss, but it is that disrupting so far. But the | tinnitus is something I could definitely live without. | newyankee wrote: | Any other clinical trials that you can recommend ? Has the | path from clinical trials to commercial launch shortened ? | newyankee wrote: | Stefan Heller from Stanford's lab had set a goal somewhere | around in 2010 to cure hearing loss by 2020 by trying to | convert stem cells to hair cells. I have never heard of any | breakthrough. I hope this happens in 10 more years at least. | patorjk wrote: | This is similar to how Frequency's FX-322 drug works. It | stimulates progenitor cells [1] within the cochlea to divide | and form new hair cells. From what I've read, progenitor | cells are basically one step away from a stem cell. | | [1] https://en.wikipedia.org/wiki/Progenitor_cell | newyankee wrote: | thanks, looks interesting. I hope these are only first | steps to more interesting developments. | biggieshellz wrote: | A few notes here: | | * This is intended to treat presbycusis, or old-age hearing loss, | where the highest frequencies are lost first. It would not be | effective for noise-induced hearing loss, where the frequencies | around 4 KHz are lost first (the "s" and "f" sounds in speech). | This matters in the low-income countries it's targeted for, | because occupational health is not as strict and PPE is not as | widely utilized, so people are more often exposed to damaging | levels of noise at work. | | * It does not handle loudness recruitment, a common effect of | damage to the outer hairs in the cochlea which causes loudness | perception to become non-linear. Someone with a moderate hearing | loss would hear an 80 dB sound as just a few dB softer than | someone with normal hearing, but a 40 dB sound as many dB softer | than someone with normal hearing, and a 20 dB sound as not | audible at all. So if you do what this hearing aid does and boost | it all by 15 dB, the 20 dB sound becomes barely audible, the 40 | dB sound is perceived as "about right", but the 80 dB sound is | perceived as nearly 95 dB (really freaking loud). You have to | have some non-linear compression in there to adjust for this, and | not just overall -- it needs to be per frequency band | (https://en.wikipedia.org/wiki/Bark_scale) to match the way the | ear works. | | * Another commenter mentioned that the "bandwidth to the brain" | is not available. That's only true in the case of damage to the | inner hairs of the cochlea. What's more common is damage to the | outer hairs, which amplify the sounds, and that can be | compensated for with a hearing aid. | | What we really need is a common way to program a hearing aid, so | we can have apples-to-apples competition. Right now, when you go | to the audiologist, you get an audiogram, which tells you the | minimum threshold of sound that you can perceive at each | frequency band. But beyond that, there are proprietary | adjustments for compression, noise reduction, profiles for | different types of loss, and so forth. It's not like getting | glasses, where your prescription fully defines the lens, and you | can take it to any vendor and have them make it for you. | | Edit: If you're really into this stuff from a technical | perspective, http://refined-audiometrics.com/wordpress1/ is worth | a read -- it's a project by an engineer who experienced a hearing | loss later in life who has built a software system to make music | sound right for him again, basically building a "super hearing | aid" running on a desktop CPU to do more fine-grained processing | than what is possible within the power budget and form factor of | a regular hearing aid. | jerome-jh wrote: | 15dB amplification is very little. A 15dB hearing loss can really | go unnoticed. It may help a few people, however this will never | be a medical device mainly because it has no medical use. | HashingtheCode wrote: | $1 hearing aid costs about $20...... what?? Clickbait. | rini17 wrote: | Hearing aids (nor cochlear implants, for that matter) do not | "restore hearing", except for light hearing loss. They are only | like crutches (not even wheelchair). For example, to follow | conversations or phone/skype with multiple people is very | exhausting even with fancy device, because in most cases the | "bandwidth" to the brain just isn't available. | | That said, the hearing aids vendor lock-in is really atrocious | and can use a disruption. They don't like users configuring the | aids themselves, you are expected to make appointments with | audiologist - in fact several of them because every hearing loss | is different and it's hard to exactly measure, so usually the | aids won't fit on first or second try. The algorithms are | strictly proprietary - when there's 40dB difference between | responses to different frequencies such as I have, usual | equalizer won't do. To enable bluetooth the rule is to buy | expensive add-on streamer. | darkmoney007 wrote: | DIY Hearing Aids is on the rise because of this. | | It's more accessible now than before. | ampdepolymerase wrote: | For a few dollars more it is possible to put a FPGA with | perhaps a neural accelerator on it. It may tremendously | simplify some of the DSP stack. More importantly, there should | be a full-proof app or UI to allow the user to tune the hearing | aid appropriately (or coupled with a training course for | audiologists in the targeted regions to do so). | KSteffensen wrote: | Hearing aids are tremendously constrained with regards to | power and mechanics. There is no way you will be able to get | an FPGA in a hearing aid. An FPGA runnning complex DSP | algorithms will: | | 1. Get hot. I don't want a +60C FPGA in my ear. | | 2. Eat up the battery. The batteries are small and fiddly to | replace for an 85 year old with bad eyes and arthritis in the | fingers. They should last for at least a week before needing | replacing. No they are generally not rechargeable in the | device. That would require a connector, which takes up | precious volume. Wireless recharging requires a coil with the | same problem. | | 3. Take up way too much PCB real estate. They are just too | big to fit in your ear. Sure, you can run a wire to a box | outside the ear, but that messes with the fashion statement. | Most hearing aid users want small and discrete, so the world | isn't reminded they have a disability. | | Besides, why would you put an FPGA in there? Hearing aids | already feature some of the most high-grade low-power DSP | ASICs available, custom made for that companys DSP | algorithms. | boogies wrote: | > a connector, which take up precious volume. Wireless | recharging requires a coil with the same problem. | | Couldn't a "connector" just be a tiny gold contact to meet | another in a charging cradle/case like a smart watch or | wireless earbuds? Would that be too big? | etskinner wrote: | More than just a connector, it also needs a charging | circuit, which would also take up space. | boogies wrote: | Does that charging circuit need to be inside the hearing | aid, and not in the charging cradle/case/dock thing? | ygjb wrote: | Generally, yes. The circuitry for power does more than | charge the battery, it provides power regulation to | prevent over discharge and reduce the likelihood of short | circuits (among other things) | loa_in_ wrote: | About the precious volume and heat - the technology still | seems very unimpressive given we have wireless earbuds in | stores. Mounting something behind the ear doesn't seem very | extravagant these days and vendors only profit from this | forced conservative approach because it smothers any | potential competition that thinks it has to be this way. | magnetic wrote: | There are trade-offs. | | Behind the ear is great when you still have reasonable | hearing in a good chunk of the spectrum, so the dome from | the BTE provides the boost that is additive to the | natural signal. | | Wireless earbuds' counterparts in the hearing aid world | are called "in ear" or "in canal" or "completely in | canal" or "hidden", and they provide some benefits, but | do have a couple of drawbacks: they can often give the | impression of a plugged ear because they keep the natural | signal out (exacerbating tinnitus, which is common with | hearing loss), and they can irritate the ear canal from | all the friction (that part of our body is very | sensitive). They can also prevent the natural outflow of | cerumen (wax) and cause its accumulation. | DanBC wrote: | Yes. Plenty of people prefer behind the ear devices | because they are either rechargable, or brightly | coloured. Young people in particular benefit from being | able to chose an aid that's brightly coloured, and you | see some YP modify their aids with skins or stickers. | | Here's the colour range for one modern aid: | https://www.fmhearingsystems.co.uk/PDF/FocusColours.jpg | | Rechargable: https://www.phonak.com/uk/en/about- | us/rechargeable-technolog... | mdw wrote: | Having a brightly coloured hearing aid as an adult | doesn't look professional. Are these marketed towards | younger people? | ygjb wrote: | This is your opinion. In many parts of the world, | criticizing a piece of accessibility equipment as | unprofessional is likely an HR violation, and probably | grounds for termination. | lostlogin wrote: | It is and you are correct. It's not unreasonable for | someone to want a more neutral colour if that is their | preference though. Some HA users are self conscious and | hide that they are wearing them. | dhosek wrote: | As an adult, I want a brightly colored hearing aid. I | don't care about hiding my disability--in fact I'd rather | it be difficult for others to ignore--and I want it to be | easy to find if my kids knock one out of my ears which | happens less now that they're six but still happens. | libraryofbabel wrote: | Why not? People wear brightly colored jewelry or | "statement" eyewear in a professional context all the | time. | | Are you saying that it's "professional" to hide your | disability if you have hearing loss? If so, then I | strongly disagree. It's a personal choice. | nicoburns wrote: | Indeed, to make an even more direct comparison: brightly | coloured glasses are very common these days. They seem to | be treated like neckties: it's acceptable for them to | standout even in very formal situations. | csunbird wrote: | is it possible to use the users phone for those | calculations ? | | Think about a dumb hearing aid, with a microphone and | bluetooth connection, which is able to connect to any | compatible phone and phone does the processing. | coupdejarnac wrote: | Easier said than done. I developed a hearing aid app for | iOS. | ampdepolymerase wrote: | Realtime audio is tricky without hardware acceleration. | Someone wrote: | A recent smartphone has enough hardware for that, I would | think, and if it hasn't, but the idea made sense, it | would be added. If the hardware can power a GPU and a | million-pixel display, it can power quite a beefy DSP, | too. | | I would worry about the latency of a round-trip over | Bluetooth. Google search tells me it's, optimistically, | 100ms single-trip, so 200ms round trip | (https://www.headphonesty.com/2020/07/fix-sound-delay- | bluetoo...) | pmayrgundter wrote: | See madspindel's comment above ^^^ about Bluetooth 5.2 LE | Audio and this: | | LE Audio: Announced in January 2020 at CES by the | Bluetooth SIG, LE Audio will run on the Bluetooth Low | Energy radio lowering battery consumption, and allow the | protocol to carry sound and add features such as one set | of headphones connecting to multiple audio sources or | multiple headphones connecting to one source It uses a | new LC3 codec. BLE Audio will also add support for | hearing aids. | TheRealSteel wrote: | Can anyone who knows about Bluetooth comment on why I can | ping google in 50ms (wirelessly, even), but a Bluetooth | round trip over a few centimetres takes 2 - 3X that? | callalex wrote: | Please don't think of me as an expert, because the sum of | my knowledge comes from browsing Wikipedia articles. But | the summary of the issue is that Bluetooth gets all its | energy efficiency and robustness by constantly scanning | the spectrum it is to live in, and hopping around | extremely fast to different slices of channels, | essentially taking advantage of the tiny "gaps" in other | signaling protocols that share the same free spectrum. In | other words it operates on sloppy seconds/scraps like a | vulture, which means it's timing is very loose and cannot | provide any guarantees. But it's very low power as a | result because it almost never has to shout over anyone | else. | EricE wrote: | And wireless introduces significant latency! You don't | want wireless anything if you can at all avoid it with | real time audio. | chrisweekly wrote: | full-proof -> fool-proof | | NOT being pedantic, just trying to be helpful / educational | (esp given the large % of non-native English speakers on HN) | ampdepolymerase wrote: | Sorry the auto correct changed the spelling. I meant fool- | proof. I am a native speaker. | SeasonalEnnui wrote: | Multiple-decades of hearing aid wearing here. I agree with most | of that. I ended up buying the programmer for my aids to do | small tweaks (not the prescription/audiogram, just the program | configuration where you can edit the level of DSP in various | situations). | | I would say that this latest generation of hearing aids (Phonak | Marvel) is the first generation where I've felt like they've | got it right. Direct bluetooth connection that _just works_ , | and with a very wide range of volume adjustment (older models | that used add-on streamer would not go loud enough). People | receiving my voice over bluetooth, using the hearing aid's | onboard microphones, report good sound quality. Magic. | tobtoh wrote: | I'm about to trial a replacement for my current HA (about 5 | years old) for the Phonak Paradise (the just released | successor to the Marvel). The bluetooth connectivity has been | a big reason why I want to upgrade - the work from home | situation this year with constant phone calls and Zoom | meeting requiring headsets has been a constant annoyance. | | I use an Airpod in my right ear and leave one HA in my left | for those situations - but its fiddly and annoying to keep | switching things in and out. The new IOS14 feature where I | can tailor the Airpod audio response to my hearing frequency | loss is simply amazing! However, being able to connect/stream | audio directly to my HA will be even better. | | They are seriously pricey though - cheapest model is Aus$2700 | (US$2000) and the top line model is Aus$8400 (US$5900). | However, given I feel I got made redundant from a previous | job five years ago due to my hearing loss (1), I'll basically | spend 'whatever' to ensure I can hear as easily as possible. | | (1) In that job, I was wondering why as the years went on, I | felt like I was struggling to pickup new concepts or get a | handle on projects as fast as I used to. I seriously felt | like I was getting stupider. After I got my hearing aids, I | realised how much speech I was missing - I was heavily | relying on lip reading and also using the context of | conversation to fill in the gaps of words I couldn't hear. | Which is passable in general conversation - but when managing | new projects or new technology concepts, you don't have the | experience to generate the context that fills in the gaps. It | was literally life-changing when I got my HA. Go an get your | hearing tested if you ever feel you are even remotely | struggling with your hearing! | rajandatta wrote: | Whats your view of the Phonak aids? As a user, would you | say they are worth the money? | jiofih wrote: | > The new IOS14 feature where I can tailor the Airpod audio | response to my hearing frequency loss is simply amazing! | | What feature is it? Can't the same be achieved with EQ? | tobtoh wrote: | https://support.apple.com/en-in/HT211218 | | I'm not sure ... i was under the understanding the that | EQ function on iOS only applied to music. I guess the | other advantage is that audiogram function makes it a | one-click accurate configuration of the 'EQ' based on a | hearing test. | ChuckMcM wrote: | Wow, I wrote Apple and suggested they do exactly that. | That this feature isn't part of the "introduction to your | airpods" stuff is wrong. It should be! | otoburb wrote: | And the Phonak Marvel's retail price is north of $1,000 USD. | Can some of the cost to the individual be defrayed through | medical insurance in the US? | snegu wrote: | My insurance covers hearing aids, but it definitely varies. | dhosek wrote: | I've never had insurance cover hearing aids. It's | criminal that something so essential isn't covered. | [deleted] | m0zg wrote: | I think skype is exhausting not for this reason but because | algorithms cut speakers out when someone else starts speaking | for echo and feedback suppression. I wish there was true full- | duplex mode that assumes everyone is wearing headphones, so | there aren't any reverberation concerns. | madspindel wrote: | It's because it's a medical device. The OTC Hearing Aid Act | will change that so Bose (and I would guess Samsung and Apple | in the future) can sell hearing aids directly to consumers. | | Bluetooth 5.2 LE Audio will solve the vendor lock-in. So the | future looks bright for us with hearing loss. | | Edit: And with iOS 14 you can use AirPods Pro as hearings aids | by adding an audiogram to the Apple Health app. Works really | well. | [deleted] | inetsee wrote: | There is a hearing aid app called Fennex that seems to be | very highly rated. It works with any IPhone running iOS 11 or | later (thus less expensive IPhones) and works with any | Bluetooth earbuds, not necessarily the AirPods Pro (thus less | expensive earbuds). I have never owned an IPhone, but this | app seriously tempts me to buy one. | WrtCdEvrydy wrote: | iPhone SE locked down to a specific carrier used in A-rate | (best quality) goes for $50 on ebay. iOS14 is guaranteed to | work on it for at least one year. | | Edit: I am not an Apple guy but needed some cheap AF | development hardware. | coupdejarnac wrote: | I developed a hearing aid app for iOS in the past. You | might not be happy with the delay that wireless earphones | introduce. | Someone wrote: | Apple already sells a hearing aid that they can't legally | call 'hearing aid'. https://support.apple.com/en-us/HT209082: | | _"With Live Listen, your iPhone, iPad, or iPod touch can act | like a microphone that sends sound to your AirPods or | Powerbeats Pro. Live Listen can help you hear a conversation | in a noisy area or even hear someone speaking across the | room."_ | | It even supports hearing aids (a few? Some? Many? The most | popular? I wouldn't know). See https://support.apple.com/en- | us/HT210386 | emcq wrote: | Unfortunately live listen is more like a replacement for | remote microphones, not the hearing aids themselves. It | adds around 70ms latency with a bluetooth headset. This is | enough to be very uncomfortable. For comparison, most | hearing aids on the market today have around 8ms of end to | end latency. | | Source: I've built a hearing aid and done extensive latency | tests :) | eyesee wrote: | I have a major hearing impairment in one ear. Using one | AirPod with Live Listen was completely unusable to me | because of this latency. | TaylorAlexander wrote: | Hmm and I also heard John Carmack talking about problems | with audio latency in conversations. 70ms is a lot! | coupdejarnac wrote: | I had a hearing aid app on the iOS app store for a few | years, and all I got was whinging about my app not fully | supporting Airpods/bluetooth headphones. I had in the app | description and on the website recommending using wired | headphones so there was no delay, but people don't | understand how things work even when they are told point | blank. The reason why people don't notice the delay with | bluetooth devices during media playback is that media is | delayed to sync with the bluetooth audio. When Apple | deprecated wired headphones, I called it a day. | pmayrgundter wrote: | My gosh, thanks for posting this! It's been very frustrating | watching hearing loss affect my older family members and | seeing how bad the hearing aid situation is. The OTC Act + | the updated Audio spec looks like the right solution! | tootie wrote: | Eargo lets you calibrate yourself, but the devices themselves | are still fairly expensive. | etse wrote: | > That said, the hearing aids vendor lock-in is really | atrocious and can use a disruption | | Agreed about the disruption in this space. | | > They don't like users configuring the aids themselves | | I get the feeling most users don't want to configure the aids | themselves, and even if they did, wouldn't feel comfortable | doing it or don't have the ability or audiology knowledge | needed. | | Later on you mention how helping with hearing loss is not quick | or straightforward, which seems to support that the default of | encouraging sessions with an expert is right approach, at least | to start. | wefarrell wrote: | Cochlear implants do not "restore hearing" but they do allow | people who are completely deaf to sense sound well enough to | understand speech. | | That's a huge change in a deaf person's life. | canada_dry wrote: | > to sense sound well enough | | My understanding is that it's like a low-sighted person being | able to see _contrasts and outlines_ of things. It 's enough | to differentiate things, but significantly less than the | detail of regular ability. | jonathanlb wrote: | That could be for Deaf people. I'm a cochlear implant user, | having been hearing impaired most of my life. Because I | know what things sound like, I have an advantage over Deaf | users of CIs. Thus, for me, hearing is like the difference | between a RAW image or the same image in JPEG with heavy | artifacting, or like seeing something in 60fps- you know | what you're sensing, but it's just off a little, but still | much better than sensing nothing or very little at all. | noisem4ker wrote: | There are several simulators on the Internet, so you can | hear what it sounds like. | jbarham wrote: | > Hearing aids (nor cochlear implants, for that matter) do not | "restore hearing", except for light hearing loss | | This claim is totally false for cochlear implants. I am a | cochlear implant recipient and before the implant I had | essentially no hearing in my right ear ("profoundly deaf"). | With the implant in my right ear my hearing has been restored | to 90%+ of normal hearing. | mgh2 wrote: | I work on ecommerce, so I often see trendy products being | marketed: usually sourced from China and hyped to sell at | 20-50x its price. | | I am trying to see how different this device is compared to | sound amplifiers marketed as 'miracle hearing aids' found in | any ecommerce site. The last thing HN wants is to fall victim | to an advertorial disguised as a scientific discovery. | | Note: I worked for a company that wrote 'scientific' articles | like this as landing pages. | TaylorAlexander wrote: | Yep. I have a pair of fully functional Bluetooth earbuds that | cost $8 including shipping. It is already possible to make | cheap amplifying earbuds. The problems are largely | regulatory. I'm glad someone said the US passed or will pass | a law that allows earbud manufacturers to sell their devices | as hearing aids. I found a broken/crushed AirPod on the | ground and my goodness they pack serious engineering into | those tiny things. | Waterluvian wrote: | This all sounds similar to my experience with CPAP machines. | Snitch-Thursday wrote: | TL;DR: someone could make bank selling < 150USD a pop receiver- | in-canal wireless bluetooth headphones. | | This is semi OT. I use a hearing aid every day. the hearing aid | features are turned off, i just use it for bluetooth streaming | and phone conversations. it is a receiver in canal hearing aid, | and I've put a non-occluding ear dome on it so I can hear | normally with it in, but when I play music, the music just | arrives in my ear. its also very discrete, people dont notice it | unless i tell them its there. | | Why someone doesn't take a cheap android/iphone bluetooth- | compatible receiver in canal hearing aid and sell it not as a | certified hearing device (heck, disable the hearing aid part in | sw) but as a discrete wireless headphone set is a mystery to me. | | Wireless headphones give me earaches with pressure on my ear | canal, over the ear headphones give me headaches with pressure on | my ears, then glasses, then skull. Custom in-ear monitors conform | to my ears just fine but block out most other sound and have | wires to deal with. | | These? I put them in, forget about them for a long time, and have | sound just floating into my ears when I turn on music. | | It's my go-to startup idea. | DenisM wrote: | Related to hearing problems there is also a thing called"Auditory | processing disorder": | | _Individuals with APD usually have normal structure and function | of the outer, middle, and inner ear (peripheral hearing). | However, they cannot process the information they hear in the | same way as others do, which leads to difficulties in recognizing | and interpreting sounds, especially the sounds composing speech. | It is thought that these difficulties arise from dysfunction in | the central nervous system_ | | https://en.wikipedia.org/wiki/Auditory_processing_disorder | artonge wrote: | The blueprints are hosted on github: https://github.com/bhamla- | lab/LoCHAid-2020-PLOS-ONE | | Edit: there is also a video showing the building process: | https://www.youtube.com/watch?v=e0gnbOJ3nDo | anamexis wrote: | And the original scholarly article: | | https://journals.plos.org/plosone/article?id=10.1371/journal... | Abishek_Muthian wrote: | This is nice, I was looking at this problem a while back and was | wondering whether implementing sound amplification features on | cheap TWS earphones can solve that[1], of course it wouldn't be | $1 and I wonder whether the latency of BLE would defeat its | purpose. | | [1] https://needgap.com/problems/22-enabling-hearing-aid- | feature... ___________________________________________________________________ (page generated 2020-09-24 23:00 UTC)