Hidden hearing aidsWorld's smallest hearing aid

At AudioActive we specialise in hidden hearing. One of the most popular devices we fit is the CIC. Our clinicians have been specially trained to take quality impressions to minimise size and optimise position as well as to program these aids in order to extract maximum performance for every loss. Our clinicians will advise you on which models are most suitable for your needs.

Completely-In-Canal (CIC) hearing instruments were developed back in the 1990s by American manufacturer Starkey and known as “Tympanettes”. They were originally very popular with users seeking a cosmetically appealing device, as they are almost totally hidden deep inside the ear canal. The electronic components are housed in a tiny shell that fits comfortably and completely into each ear canal. The device is removed from the ear canal by pulling a tiny cord.

The original CICs had many shortcomings, and their popularity gradually diminished. However their popularity has surged again over the last couple of years thanks to some remarkable advances in technology.

Technological breakthroughs

Feedback

CIC hearing instruments used to be very prone to whistling, otherwise known as feedback, which occurs when the amplified sound leaving the speaker gets picked up by the microphone and is re-amplified. This results in a high pitched whistling sound. You no doubt have experienced this in auditoriums with PA systems when someone holding a microphone moves too close to the speaker resulting in a loud screech. This problem used to be encountered with all hearing instruments, but more so with CICs because the instrument was so small the microphone and speaker were very close together.

New software has been developed to significantly reduce feedback. It works by identifying the amplified sound re-entering the microphone and then producing an identical signal, out of phase or the mirror image, and then superimposes this on top of the original signal, thereby canceling it out.

CIC instruments can now be produced with great stability and little concern of experiencing feedback issues. It is essential to ensure that the CIC you are fitted with has a “phase inverter” feedback system.

CIC SaviaOcclusion

Prior to phase inverter software, the only way to stop CICs from whistling was to prevent the amplified sound from escaping the ear canal, which meant blocking the ear. This caused several negative effects including reducing the wearer’s natural hearing ability and making the ear feel plugged up. When wearers spoke their voices would reverberate in their heads and they would feel detached from the world around them. This resulted in a high percentage of rejections.

With the introduction of phase inverter software, we are now able to keep the ear open by producing CICs with large vents. This advance alone has resulted in a mass acceptance of these devices.

Lack of Power

CICs used to be prescribed only for mild to moderate hearing losses. Now that more usable amplification can be achieved without feedback, some manufacturers have started to customize every instrument, and fit much more powerful amplifiers and speakers when needed into CICs, achieving success even with severe losses. If you’ve been advised in the past that a CIC is not suitable for your loss, it would be a good idea to have your hearing re-assessed and obtain a new recommendation based on today’s technology. We have successfully fitted CICs to losses as severe as 85dB.

Although components have reduced in size over the years, a good sized ear canal is still required in order to accommodate the more powerful components. Our clinicians will be able to advise you if there is sufficient room available to produce an instrument powerful enough for your loss.

Lack of User Control

Some wearers like to have control over various acoustic aspects of their hearing instruments. CICs typically were produced without volume controls or program buttons. With the advent of automatic program switching and sophisticated noise management systems, most wearers enjoy the convenience of simply inserting their CIC and forgetting about it, while the instrument takes care of the ever changing environments they’re being exposed to. For those who want more control, some models come with remote controls. Program buttons are also available although they tend to add to the size of the instrument.

Comfort

An accurate impression deep inside the ear canal, close to the ear drum, is essential for optimum results. Due to the placement deep inside the canal, where there is only a very small membrane of skin covering the mastoid bone, any excess pressure can result in abrasion and pain. Recent improvements in impression material and shell manufacture using 3 dimensional laser imaging, has greatly improved the fit and comfort of these instruments.

In the ear hearing aidMajor Benefits

The CIC has a number of major benefits that simply aren’t available with other hearing instruments.

Appearance

Unquestionably the number one benefit of the CIC is that it’s hidden. The device quite literally disappears inside the ear canal. Of all the hearing styles available, these instruments are the least visible.

It is important to note that it is the placement of the instrument in the ear that is the determining factor in its visibility rather than its size. A larger ear canal typically will result in a larger device, but normally better hidden as there is plenty of space to locate the device with all its components deep inside the ear canal. Do not be concerned if the aid is larger than expected when viewed in your hand. It is how it looks when in your ear that is important.

Sound Quality

Sound quality from a CIC is enhanced for several reasons.

1. The microphone is positioned within the ear canal, thereby taking full advantage of the external ears natural ability to pick up sound and focus it into the ear canal. The CIC is therefore picking up exactly the same sound as the ear would naturally collect.

2. The speaker is positioned deep in the canal, close to the ear drum resulting in a relatively small mass of air through which the amplified sound has to pass prior to being absorbed by the ear drum. This results in a much more efficient transfer of sound energy and the same power output representing much more volume at the ear drum than conventional instruments.

Sound Localisation

The position of the microphone in the ear canal helps with the ability to locate where sounds are coming from.

Less Wind Noise

The microphone is much more sheltered from wind noise when positioned in the ear canal.

Getting it right

At AudioActive we specialise in hidden hearing solutions. Our Audiologists have had extensive training and experience in taking accurate deep canal ear impressions using a special silicon compound to ensure we create the smallest, most discrete hearing aid possible for you. The laboratories we use to produce the CIC shells use a 3D imaging laser to scan the impression into a computer to create the most comfortable fit possible.

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