Welcome to issue 3 of our training newsletter.

Thank you to everyone who entered our competition for the dementia lounge kit in the last issue. We are delighted to announce Jane McCann from Salford Royal Audiology Department as the winner of the dementia kit. Congratulations Jane!

In this issue we explore CROS and BICROS solutions. Starkey Hearing Technologies have a strong reputation for delivering exceptional CROS and BICROS hearing solutions to support patients with single-sided hearing and unequal loss. In this issue our Education and Training team look at this hearing technology in more detail alongside some of the benefits and challenges that are presented when fitting these types of solutions.

We have a 3D Ear Model - 3 times life size - worth £64 to give away to a lucky winner so be sure to click and enter for a chance to win.

At Starkey Hearing Technologies we believe to hear better is to live better and we are proud to offer you our Summit and Kinnect hearing technology that connects and engages your patients into their world in more ways than ever before.

We hope this information is useful and we look forward to supporting in clinic training.

Best wishes, The Starkey Team

Welcome to Starkey Hearing Technologies

Starkey ProfessionalTraining & Education Newsletter | Issue 3

Starkey offer 3 Summit wireless CROS/BICROS systems to our health service customers, they allow a wide range of hearing levels in the better ear to be appropriately fitted whilst providing a robust connection for wireless transmission from an unaidable ear.

We know that providing a solution for those with unilateral hearing loss can be challenging and I’d like to cover some of the main challenges and solutions here, however I would also recommend you read our full white paper on fitting CROS/BICROS which has a higher level of detail and continues the advice from here, that white paper is at https://starkeypro.com/pdfs/technical-papers/Considerations_in_CROS_BiCROS_Fitting.pdf

The issue we are trying to overcome with a CROS fitting is the head shadow effect which can significantly reduce detection of sounds arriving on the side of the poorer-hearing ear and therefore traditional hearing aid solutions

fitted to just the better hearing ear may be insufficient. The head shadow effect occurs when sound arriving on one side of the head is physically obstructed by the head itself, which causes attenuation and filtering of sounds before they reach the other side. Frequencies above 2000 Hz are attenuated by as much as 15-20dB, while frequencies below 1000 Hz are typically attenuated by less than 10dB (Taylor, 2010; Upfold, 1980).

Why do we need memories for hearing aid alone settings? Starkey CROS/BICROS products allow manual control of transmission of sound from the poorer hearing side in listening conditions that are unfavourable for CROS/BICROS systems (i.e., when noise is presented to the poorer-hearing side). In each program it is possible to say the devices are set to Hearing aid alone, CROS or BICROS allowing up to 4 choices for the end user. Users can achieve better speech understanding in noise with a manually controlled CROS/BICROS system than with a conventional CROS/BICROS system when speech is presented to either ear, and noise is presented from the front, back and side contralateral to the speech.

There is some robust evidence for the type of situation where different configurations of the CROS/BICROS systems and unilateral hearing instruments could be recommended. The table below summarises the advice.

Introducing Summit CROS/BICROS Systems

STARKEY HEARING TECHNOLOGIES: SUMMIT CROS/B ICROS SYSTEMS

Comparison Speech Location Noise Location Outcome

CROS vs. Unaided Front Poor Side CROS

CROS vs. Unaided Better Side Front CROS

CROS vs. Unilateral CIC Better Side Front CROS

BICROS vs. Unilateral Hearing Aid

Better SideFront, Back

and Poor SideBICROS

Unilateral hearing loss with an UNAIDABLE ear can be a significant problem for patients

Head shadow effect

• Approximately 15 dB attenuation• Mostly in the high frequencies

Speech Signal

• Approximately 6.5 to 7 dB attenuation of speech

https://starkeypro.com/pdfs/technical-papers/Considerations_in_CROS_BiCROS_Fitting.pdfhttps://starkeypro.com/pdfs/technical-papers/Considerations_in_CROS_BiCROS_Fitting.pdfhttps://starkeypro.com/pdfs/technical-papers/Considerations_in_CROS_BiCROS_Fitting.pdf

The Summit i1600 CROS/BICROS System

Verification In the health services all hearing instruments are routinely verified using Real Ear Measurements, CROS and BICROS systems should also be verified using REM. Proper fitting and verification of a CROS system should result in similar hearing sensitivity of sounds arriving at either ear (Dillon, 2001).

To verify a CROS/BICROS system we need to Present signals to the transmitter microphone in one location, and then measure from the live receiver instrument in the better hearing ear.

In our white paper you will find details of how to verify a CROS/BICROS systems using real ear equipment.

As real ear equipment set up is individual it is always best to approach your equipment manufacturer for details of how to verify using the equipment you have. The process is usually simple when you understand how to control the microphones for recording from the good ear and presenting a stimulus on the poorer ear.

Manufacturers such as Natus for the Aurical and Interacoustics for Callisto and Affinity have great guides on verification of CROS/BiCROS.

Wireless TransmissionIt is important to note that in order to get a robust signal across the head for sound transmission our wireless system must be highly sophisticated. Starkey use a proprietary 900sync wireless technology for the CROS/BiCROS system which provides a low energy, ultra high-definition streamed audio signal with quality, clarity and consistency of sound. The technology processes sound quickly to ensure there is no time lag for the transmitted signal, so streaming is done in real time. 900sync technology also allows your patient to receive signals from T.V. streamers, remote controls and remote microphones direct to the hearing aids with no intermediate device. You can read more about the wireless accessories available to your patients direct from Starkey Hearing Technologies at http://www.starkeyconnect.co.uk/

Compatibility• Summit mini BTE 312 CROS is compatible

with Summit mini BTE 312

• Summit BTE 13 CROS is compatible with Summit BTE 13

• Summit Power Plus BTE 13 CROS is compatible with Summit Power Plus BTE 13

Special Features • Clear and consistent wireless streaming

using 900sync™ technology

• Acuity OS 2 brings audibility and speech understanding to patients in any environment

• Full Adaptive Directional functionality on the CROS transmitter

• Telecoil standard in Summit CROS receivers

• Compatible with SurfLink™ accessories arriving at either ear.

Audio InformationAudio Quality: 20 kHz sampling frequency

Radio Information Antenna type: Integral Dual Parallel Loop Antenna

Operation frequency: 902-928 MHz

Occupied bandwidth(99% BW):

300 kHz

Modulation: FSK

Operating range: 1 m

Transmit Power: mini BTE 312: -23 dBm BTE 13: -25 dBm Power Plus BTE 13: -22 dBm

http://www.starkeyconnect.co.uk/

The perfect hearing solution for every patient Today’s patient demands hearing technology that keeps up with their busy lifestyle.

Our Summit and Kinnect wireless platforms represent our best ever NHS technology, delivering pristine sound and carefree wireless connectivity in every situation to help patients live their best life.

To view our full range, please visit https://uk.starkeypro.com/nhs/guides

For help and support, please contact Lesley Holland on 0800 042 0000, email lesley_holland@starkey.co.uk or chat to your Area Manager.

HEAR BET TER . L IVE BET TER: STARKEY HEARING TECHNOLOGY

444125342

w50 / w40 / w30

KINNECT WIRELESS

Standard Colors

Kinnect Special Edition Colors

TRULINK TECHNOLOGY

FITTING GUIDE

COLOR GUIDE

BEH IND-THE-EARBTE 13

*Results will vary based on wireless usage.

TruLink Programmer

TruLink App

Compatibility:

iPhone 6, iPhone 6 Plus, iPhone 5s, iPhone 5c, iPhone 5, iPhone 4s, iPad Air, iPad Air 2, iPad (4th generation), iPad mini with Retina display, iPad mini, iPad mini 3 and iPod touch (5th generation).

Measurement ANSI/IEC 2cc CouplerIEC OES Coupler

ANSI/IEC 2cc Coupler

IEC OES Coupler

Peak OSPL90 (dB SPL) 131 134 120 123

HFA OSPL90 (dB SPL) 120 N/A 110 N/A

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

Peak Gain (dB) 70 74 64 67

HFA Full-On Gain (dB) 63 N/A 52 N/A

RTF Full-On Gain (dB) N/A 74 N/A 56

Frequency Range (Hz) 100-7400 100-7400 100-7400 100-7400

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

HFA Frequencies (kHz) 1.0,1.6,2.5 N/A 1.0,1.6,2.5 N/A

Reference Test Gain (dB) 43 58 33 40

Harmonic Distortion

500 Hz (%)