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Innovations in hearing aid and cochlear implant technologies, and an update on NIDCD’s September advisory council meeting

October 10, 2024

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Hearing loss can make it difficult to participate in daily conversations, which can lead to frustration, social isolation, depression, anxiety, and other issues that negatively impact quality of life. Assistive technologies such as hearing aids and cochlear implants can improve communication for those with hearing loss, but these devices are used by only a small percentage of those who could benefit from them. Among the reported barriers to the use of both hearing aids and cochlear implants are performance issues, including sound quality and inadequate personalization to meet a user’s unique needs.

In this director’s message, I outline NIDCD-supported efforts to encourage collaborations that accelerate advances in hearing aid and cochlear implant performance. In addition, I describe research on alternatives to help restore hearing for those who cannot benefit from traditional devices. I also summarize topics discussed at the September meeting of the National Deafness and Other Communication Disorders Advisory Council.

Different Designs, Common Challenge

Hearing aids and cochlear implants work through different mechanisms, yet they share a common challenge: difficulty performing amid background noise. People with hearing aids often have trouble focusing on specific conversations in noisy rooms because the devices amplify both speech and background sounds. Cochlear implants may fail to isolate conversational speech from other noises because the implants provide an oversimplified representation of the complex signal processing that converts sound into electrical signals during natural hearing.

One way to address these challenges is to test signal processing algorithms and conduct investigational studies with hearing aids and cochlear implants in real-life settings that better reflect the typical listening environment. This research is constrained, however, by several barriers related to commercial systems. For example, commercial digital processing chips for cochlear implants and hearing aids are designed with specific hardware constraints—such as fixed processing power, memory, and pre-determined algorithms—that limit research into testing more advanced sound processing algorithms. In addition, signal processing chips and algorithms may be proprietary, which further restricts development of new algorithms.

Portable Hardware and Software Solutions

NIDCD-supported research is addressing these barriers through several approaches. For example, researchers have developed a portable speech processor, CCi-MOBILE, which replaces the commercial digital sound processing portion of the cochlear implant with an interface that provides modifiable, open-source code to implement the complex algorithms needed for a cochlear implant. Using this platform, researchers can map parameters for cochlear implants—such as sound level, number of channels, stimulation mode, gain, and amplification—in real-life environments. They can also develop, modify, and test algorithms and signal processing techniques; conduct subjective experiments; and explore new methods for enhancing cochlear implant performance.

A complementary effort is focused on expanding researcher access to signal processing algorithms and other applications through open-source platforms. Open access lowers the technical barriers and allows researchers to bypass the limitations of proprietary systems and commercial digital processing chips. In addition, these open-source devices are portable: researchers and clinicians can modify the base software and create novel sound processing algorithms that are then tested outside of laboratories, thereby providing real-life data across different environments.

One such platform, Open Master Hearing Aid (openMHA), provides access to open-source software that allows users to conduct hearing aid research using several signal processing plug-ins and tools for noise reduction, amplification, dynamic range compression, and feedback cancellation. The openMHA platform can be used with all established operating systems and with various types of hardware, including small portable devices, which makes it accessible for both academic research and commercial hearing aid development.

Another open-source hearing aid development platform, Tympan, offers a wearable, customizable hardware platform. The platform’s specialized microcontroller system and software allow the development and testing of custom signal processing algorithms in a real-time audio processing environment.

Alternatives to Hearing Aids and Cochlear Implants

NIDCD-supported research is also exploring options to restore hearing in those who cannot benefit from traditional hearing aids or cochlear implants. For example, researchers are collaborating through the NIH Brain Research Through Advancing Innovative Neurotechnologies® (BRAIN) Initiative to explore the use of the Utah Slant Electrode Array to improve the precision and effectiveness of penetrating electrode auditory brainstem implants (ABIs) in targeting the cochlear nucleus. Researchers are also studying the use of penetrative ABIs in stimulating midbrain regions for conditions involving other compromised parts of the auditory system.

If you are an aspiring innovator within the fields of hearing aid or cochlear implant development, I encourage you to explore the open-source and portable platforms described in this message. I also recommend that you monitor NIH's Small Business Education and Entrepreneurial Development (SEED) website for additional funding opportunities.

National Deafness and Other Communication Disorders Advisory Council Meeting, September 12-13

On September 12-13, the institute’s advisory council convened. Portions of our council meetings are open to the public, and I invite you to watch the archived videocasts of the September 12 open session. I also encourage you to join us online for our next meeting, to be held January 23-24, 2025. A few highlights from September’s meeting are summarized below.

  • I introduced our new Executive Officer, Mark Stevens, D.P.A., who serves as an advisor to all NIDCD senior officials, providing strategic guidance on the institute’s administrative and financial management functions. To view this segment, start at the 02:01:01 mark of the videocast.
  • Bruce J. Tromberg, Ph.D., Director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB), summarized NIBIB-supported efforts to accelerate developments in innovation and technology across the fields of engineering and medicine. Examples included an optical coherence tomography (OCT) device that provides in vivo imaging of the middle ear; the integration of OCT and machine learning to diagnose otitis media  (ear infections) from bacterial biofilms; the potential of combining OCT angiography and focused ultrasound as a treatment for tinnitus; and an OCT center for technology development. He also described two data repositories, the Medical Imaging and Data Resource Center and NIH Common Fund’s Bridge to Artificial Intelligence Voice Project; the potential of the Zoom-in Partial Scans technique for enhancing computed tomography scans of the middle and inner ear; and genetically encoded fluorescent indicators to image synaptic zinc in cortical sound processing. To view this segment, start at the 00:00:08 mark of the videocast.
  • Roger Miller, Ph.D., an NIDCD Program Director, provided details on NIDCD-supported research advancing hearing aid and cochlear implant technologies. He described advances in brain-computer interfaces, such as the BrainGate Neural Interface System, that allow people with paralysis to control a computer cursor with their thoughts, as well as research that decodes words directly from cortical activity while reducing the need for frequent model recalibration. To view this segment, start at the 01:07:55 mark of the videocast.
  • Kelly King, Au.D., Ph.D., an NIDCD Audiologist and Program Officer, summarized the results of the 2024 Working Group on Accessible and Affordable Hearing Health Care (AAHHC) for Adults, which was co-sponsored by NIDCD, the National Institute on Aging, and the U.S. Food and Drug Administration. The goals of the workshop were to revisit recommendations from a 2009 NIDCD AAHHC workshop, evaluate current needs, and develop a research framework for increasing the accessibility and affordability of over-the-counter hearing aids for adults with mild to moderate hearing loss. The full workshop summary will be posted on the scientific workshop/meeting reports section of the NIDCD website. To view this segment, start at the 02:03:40 mark of the videocast.
  • Dr. Kelly King also presented a concept for clearance, “Continuing to Advance Accessible and Affordable Hearing Health Care for Adults,” as a future funding opportunity. This concept, which aims to address AAHHC issues and several themes that arose from the recent AAHHC working group and a related request for information, will be discussed in greater length at a future council meeting. Concepts describe the basic purpose, scope, and objectives of proposed initiatives and represent an early planning stage for potential funding opportunities. NIDCD uses the concept clearance process to gather input from the NDCD Advisory Council about the merits of the concepts and to enhance transparency by making the NIDCD research community aware of potential initiatives that may be developed into published funding opportunities. Council approval of a concept does not guarantee that it will become a funding opportunity. To view this segment, start at the 02:17:34 mark of the videocast.
  • Lisa Cunningham, Ph.D., NIDCD Scientific Director, announced that the efforts of NIDCD’s Division of Intramural Research (DIR) within the taste and smell mission areas have greatly expanded under the leadership of NIDCD’s Clinical Director, Joshua Levy, M.D., M.P.H., M.S. She also provided updates on the NIH Fellows United-UAW union and on DIR training and diversity efforts, including:

To view this segment, start at the 02:33:52 mark of the videocast.

  • Joshua Levy, M.D., M.P.H., M.S., NIDCD Clinical Director, provided updates on programs under the Office of the Clinical Director, including the Clinical Trials unit within the NIH Clinical Center, the newly launched National Smell and Taste Center, and the NIDCD Otolaryngology Surgeon-Scientist Program. He also announced the hiring of Valerie Asher, M.D., as chief of the Otolaryngology Service. To view this segment, start at the 02:51:56 mark of the videocast.
  • Janet Cyr, Ph.D., an NIDCD Program Officer, provided an overview of NIH’s upcoming simplified review framework for research project grants, which reorganizes five criteria into three factors: importance of the research; rigor and feasibility; and expertise and resources. Katherine Shim, Ph.D., an NIDCD Scientific Review Officer, described how the new framework will impact fellowship applications and review and mentioned an NIH webinar that explained the changes. To view this segment, start at the 03:43:00 mark of the videocast.
  • Judith Cooper, Ph.D., NIDCD Division of Scientific Programs (DSP) Director, introduced three recent additions to DSP: Mary Ejiwale, Ph.D., Data Science Program Officer; Samah Jafari, M.D., Medical Officer; and Troy Hackett, Ph.D., who will oversee the Temporal Bone Registry. To view this segment, start at the 04:20:32 mark of the videocast.
  • Several of the newest council members described their research:
    • Laurence Trussell, Ph.D., Professor in the Department of Otolaryngology-Head and Neck Surgery at Oregon Health & Science University’s School of Medicine, described his work exploring information processing in the cochlear nucleus of the auditory brainstem. To view this segment, start at the 04:34:25 mark of the videocast.
    • Jay Gottfried, M.D., Ph.D., Vice Chair of Research in the Department of Neurology and Professor in the Department of Psychology at the University of Pennsylvania, described his work exploring the natural forms of sensory stimuli (odors, sound, etc.) encountered in the environment and how our brains adapt to the stimuli. To view this segment, start at the 04:45:23 mark of the videocast.
    • Mario Svirsky, Ph.D., Professor in the Department of Otolaryngology-Head and Neck Surgery and the Department of Neuroscience and Physiology at the New York University Grossman School of Medicine, described his work exploring frequency mismatch in cochlear implant users. To view this segment, start at the 04:56:35 mark of the videocast.
  • I recognized the exemplary service of the following council members, whose terms ended this year. The institute benefited immensely from their time and expertise. To view this segment, start at the 05:10.38 mark of the videocast.

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