A Comparative Clinical Investigation of Musician's Preference Between a General Listening Program and a New Music Rationale for Hearing Aids

The intended use of hearing aids is to amplify sounds to compensate for hearing loss. The initial goal is to amplify speech and facilitate speech understanding especially in noise. Research shows that wireless hearing aids are efficacious for older adults , and in general, an increase in satisfaction and substantial benefits are characteristic for the wireless hearing aids brought to market during in the last decade.

Music is proven to enhance the lives of older people, but many people report a reduction in their ability to enjoy music with a hearing loss. Amplification can be used to overcome a hearing impairment and return the joy of music to those with hearing loss. However, for listening to music or particularly, for musicians that play an instrument, the hearing aid settings used for amplifying speech often have adverse effects on music.

Amplification and signal processing within hearing aids are designed to mainly improve speech understanding. It is possible to model the acoustical characteristics of speech because they are defined by the human vocal tract characteristics and the articulation speed. This acoustical model of speech is then used as a guideline for optimizing signal processing within the hearing aid. This approach has shown limitations in terms of perceived sound quality when listening to recorded or live music due to the characteristics of music which show more variations than speech in terms of frequency range, sound level, modulation, and dynamic range. These differences suggest that a specific listening program should be used when music is present in the listening environment. The need to offer a music program for musicians and music enthusiasts is also motivated by 1) the prevalence of hearing loss and associated audiological symptoms among musicians or music listeners exposed to high sound levels (and 2) the benefit (social, cognitive, and physical) of playing or listening to music especially for hearing impaired and seniors.

An optimization procedure based on the participation of the musician during the fitting procedure showed promising results in terms of preference when playing music and in discrimination thresholds of level, duration, and pitch. However, this procedure targets only musicians who actively play music and requires time, some specific knowledge, and the possibility to make the adjustments in the fitting room. A new fitting rationale dedicated to music was therefore developed and made available in the fitting software.

This new music rationale can be offered to any hearing aid user who wants an optimal listening experience when playing or listening to music (live, over a playback setup, or streaming from wireless device). The new music rationale is programmed based on the hearing loss and uses different gain shaping and kneepoints in the dynamic compression compared to the general listening program. Specific settings of signal processing features like directionality, noise reduction, or feedback cancellation are either turned off or set at a lower level than in the general listening program.