Today, Hearing loss affects nearly 5% of the global population and, by 2050, this number is expected to double, mostly driven by a growing aging population and an increasing life expectancy. The treatment options include Hearing Aids and Cochlear Implants. Hearing aids are devices typically fitted in or behind a wearer’s ear, designed to amplify the sound. Cochlear implants are surgically implanted devices addressed to people with severe to profound sensorineural hearing loss. The low penetration rate of these devices may represent a strong growth opportunity…

How does the Hearing System work?

The Mechanic Portion

The Cochlea: An Underwater Piano

• Different frequencies cause maximum vibration amplitude and neural tuning at different points along the basilar membrane.
• Adjacent auditory nerve fibers are organized according to the frequency at which they are most sensitive.

Technologies And Features

• Miniaturized Programmable

  Multiple band compression

  Multiple memories

• Digital
• Standard Technology

  Linear amplifiers

  Simple output limiting

  One directional microphone

• Advanced Technology

  Automatic volume control

  Multiple directional microphones

  Automatic programs

• Low battery indicator
• Power-on delay

  It quells feedback as you insert the hearing aid by taking a few seconds to power up

• Background noise reduction
• Telecoil

  People hear better on the telephone and also in auditoriums, theaters

• Feedback reduction
• Titinnus suppression
• Wind noise reduction
• Zoom control

  “Zoom in" on sound coming from one direction

• Bluetooth
• Binaural Synchro

  Ability to wirelessly communicate with each other

• Water Resistance

Implantable Hearing Devices

Cochlear Implants (CI)

• The most common cause of sensorineural hearing loss is the loss of hair cells rather than the loss of auditory neurons
• The remaining auditory neurons can still be directly activated, e.g. with electric stimuli
• Price around $100,000, including surgery, evaluation, device and rehabilitation.
• Cochlear implant surgery lasts about two to three hours and is performed under general anesthesia.

  ✓ The cochlear implant cost in India may vary between $6,000 and $10,000. The lower cost is India is due to the initiatives of the Government.

  ✓ In US most of the CI are covered by insurances and government rebates. 13 states had Medicaid programs which fully cover the cost of cochlear implants for children. 18 states reimbursed less than 80% of the cost of the device and procedure

•  Low penetration rate:

  ✓ Around 6%

  ✓ Australia has one of the highest penetrations of CI in the world 

Diagnosis Instruments

• Audiometers (transmits recorded sounds), tympanometers (for conductive HL diagnosis, measures the reflected sound), and Otoacoustic Emission Instruments
• How do we diagnose hearing loss in babies?

  Outer Hair Cells (OHC) are sounds given off by the inner ear when responding to a sound. Otoacoustic Emission Instruments detect the sounds produced by the OHC

  Weak or totally absent in hearing impaired subjects, even in mild or moderate hearing losses (30-40 dB HL)

  Measured objectively and non-invasively (OAEs are the most sensitive objective indicator of cochlear anatomic/functional integrity in vivo)

Audiology Devices Market In 2016: Geographic Market Unit Split

The Future Of Cochlear Implants: No Exterior Hardware

Next-generation sound processors with technologically advanced chips making the implants invisible

Fully implantable devices: the implant’s exterior unit raises some aesthetic concerns and limits its use in the shower and during water sports.

• MIT has developed a prototype system-on-chip that makes possible a fully implantable cochlear implant. It relies on a piezoelectric sensor, implanted beyond the eard
• The chip is specially designed to be charged wirelessly through a smartphone. It takes just a few moments to charge and it lasts for 8 hours.
• Now that the team has demonstrated feasibility of the system-on-chip paired with a sensor and wireless power supply, they are working to fully package the device and prepare for a clinical trial.
• Moreover, the system presents another benefit; as the sensor is on the other side of the eardrum, it still relies on the natural filtering effect of the outer ear and the ear canal.

The Future Of Hearing Technology: From Wearables To Hearables

A hearable is a wireless in-ear computational earpiece: enhance your listening experience, while also adding additional benefits like biometrics.

Opticon, Samsung, Google, Heart Math, Zen Sensor, Valencell, BitBite are developing new hearing tech.

Types Of Hearing Loss

Causes And Risks

Main Causes

• Ageing: One third of people over 65 years
• Exposure to excessive noise: 1 bn of young people (12-35 yrs) are at risk of hearing loss
• Gene Therapy: Clinical Trials Ongoing: Nearly half of all cases of deafness have a genetic root. The mutation consists in one DNA base pair in a copy of a gene called TMC1 that is off.

  ✓ 2015: Genetically deaf mice treated with TMC1 gene therapy recovered some of their hearing

  ✓ 2017: Studies were performed to treat Usher syndrome (severe anomalies in hair cell structure) and they succeeded in restoring hearing and balance in a mouse model.

  ✓ 2018: The Department of Otolaryngology-Head and Neck Surgery at Columbia University is trying to regenerate hair cells using a drug containing a gene

  ✓ 2018: Novartis is recruiting patients for its clinical trial to introduce a DNA sequence that will help the ‘’broken’’ gene to work again.

Hearing Loss, An Unmet Need

Prevalence Of Moderate And Severe Disability (in mn)

Ten Leading Causes Of Burden Of Diseases, World, 2004 And 2030

Types Of Hearing Aids

Hearing Aids

• Function: to boost the level of the electrical signal that is delivered to the hearing aid’s loudspeaker. The amplification is divided into two stages:

  1. Filtering: to control how much amplification occurs at certain frequencies

  2. True amplification (GAIN)

• Deep insertion: CIC devices preserve the natural amplifier effect of the pinna but have drawbacks as well..

  ✓ Separate MIC and loudspeaker as much as possible (easier in BTE)

  ✓ Seal off the ear canal

• Acoustic Feedback: when the amplified sound from the loudspeaker is directed back into the microphone of the same amplifying system. The higher the intensity of output the more likely that feedback will occur
• A Hearing Aid lasts 3 to 5 years. The battery lasts between 5 days to several weeks

How Much Hearing Aids Cost?

• Price range from $799 for a basic device to $3,600 for a premium hearing aid

Every Year 15 Million Hearing Aids Are Sold Around The Globe

Technologies And Features

Implantable Hearing Devices

Implantable Hearing Devices

Cochlear Implants (CI)

Cochlear Implants (CI)

Price around $100,000, including surgery, evaluation, device and rehabilitation.
Cochlear implant surgery lasts about two to three hours and is performed under general anesthesia.
 

• The cochlear implant cost in India may vary between $6,000 and $10,000. The lower cost is India is due to the initiatives of the Government.
• In US most of the CI are covered by insurances and government rebates. 13 states had Medicaid programs which fully cover the cost of cochlear implants for children.
  • 18 states reimbursed less than 80% of the cost of the device and procedure.

Diagnosis Instruments

• Audiometers (transmits recorded sounds), tympanometers (for conductive HL diagnosis, measures the reflected sound), and Otoacoustic Emission Instruments.
• How do we diagnose hearing loss in babies?
  • Outer Hair Cells (OHC) are sounds given off by the inner ear when responding to a sound. Otoacoustic Emission Instruments detect the sounds produced by the OHC.

Audiology Devices Market In 2016: Geographic Market Unit Split

Hearing Healthcare: Trends

And The Winner Is...

The higher market opportunity is represented by Cochlear implants because of:

The most reliable implants in the industry today are The best in terms of cumulative survival percentage (CSP)

The Future Of Cochlear Implants: No Exterior Hardware

• Next-generation sounds processors with technologically advanced chips making the implants invisible.
• Fully implantable devices: the implant's exterior unit raises some aesthetic concerns and limits its use in the shower and during water sports.
  • MIT has developed a prototype system-on-chip that makes possible a fully implantable cochlear implant. It relies on a piezoelectric sensor, implanted beyond the eardrum in the middle ear, to transmit sounds information by picking up on vibrations from hearing bones.
  • The chip is specially designed to be charged wirelessly through a smartphone. It takes just a few moments to charge and it lasts for 8 hours.
  • Now that the team has demonstrated feasibility of the system-on-chip paired with a sensor and wireless power supply, they are working to fully package the device and prepare for a clinical trail.
  • Moreover, the system presents another benefit; as the sensor is on the other side of the eardrum, it still relies on the natural fitlering effect of the outer ear and teh ear canal.

The Future Of Hearing Technology: From Wearables To Hearables

• A hearable isa wireless in-ear computational earpiece: enhance your listening experience, while also adding additional benefits like biometrics.
• Opticon, Samsung, Google, Heart Math, Zen Sensor, Valencell, BitBiteare developing new hearing tech