Q&A | A conversation with Dr. Thodi - Audientes
Ask an Audiologist
Meet Dr. Chryssoula Thodi, the Chairperson of Health Sciences at European University Cyprus with over 30 years of experience in the audiology field – and now the resident audiologist at Audientes. We’re thrilled to have her join the Audientes team, and she is ready to help you.
To kick things off, we have gathered all the most common questions, and Dr. Thodi shares her expert opinion on everything from hearing loss to the Ven™ solution. Discover the answer you’ve been looking for in our first-ever Ask an Audiologist interview series.
What do you see as the benefits of Ven™?
There are several benefits for Ven Users. Ven provides:
A very reliable and high-quality sound to support people with hearing loss.
Auditory input to communicate better.
That means people can perceive sounds from their environment clearer and be more efficient in their overall auditory function. The other huge benefit is that Ven is accessible – it is a device that people can get without crippling expenses. People with lower income can now have high-quality amplification. People with hearing loss who barely cope and might hesitate to go buy hearing aids can now access and receive support earlier. And this has a lot of very positive implications, both for quality of life but also for memory and health benefits.
How do I know if I am suffering from hearing loss? What are the signs?
The most basic sign of hearing loss is the difficulty in perceiving speech. And since most hearing loss is very gradual, people don't really realize that they have hearing loss until it reaches a level where it's very detrimental to their communication. Signs that somebody may have a hearing loss include:
The need for others to repeat themselves. That means a person who says, “What?” “Can you repeat this?” or “I didn't get this.” If a person says these phrases multiple times during a day, that's a surefire sign that this person possibly has hearing loss.
Individuals who accuse others of mumbling of not speaking clearly. These people will say they “don't understand what you're saying because your speech is not very clear.” This involves a sensation of gargled or mumbled speech.
So, the first and most common signs are either the person realizing that they ask others to repeat a lot or the family realizing that this person cannot really follow conversations effectively, and they need repetition and special attention to communicate.
How can I tell what range of hearing loss I have?
The only way to classify the type and degree of hearing loss is with an audiogram. If we want to classify the type of hearing loss, in terms of where the damage is and where the problem occurs, we need an audiogram performed by an audiologist or an ear, nose and throat (ENT) doctor. This professional will do a comprehensive measurement of hearing sensitivity with the sound being put through headphones or through vibrators behind the ear.
With these tests, we can assess the hearing capacity of this person depending how loud the sounds needs to become for a person to hear. We classify the degree of hearing loss into the categories:
• Moderately severe
Depending on where the breakdown to sound processing happens, i.e. the outer, middle ear or inner ear and the auditory nervous system, the hearing loss is classified as conductive or sensorineural.
Do I need a professional hearing test before buying Ven?
The “self-fitting” audiogram measured by Ven™ is a reliable starting point for fitting the device.
However, hearing loss is still a disorder of our hearing mechanism. As such, it is recommended that people who realize they have hearing difficulty or find indications of hearing loss with informal hearing tests should consult their doctor, even after they received Ven, to determine causes of the hearing loss and receive medical care if required. Ven is a very high quality and accessible amplifier, but it does not make a diagnosis on the causes of the hearing loss.
How effective is Ven amplification for different types of hearing loss?
Amplification is effective for all types of hearing loss – sensorineural, conductive and mixed.
If the person has conductive hearing loss, that might be an indication for medical intervention before amplification as a first step. Conductive hearing loss may be temporary and could be rectified with medical intervention such as removal of excessive earwax or treatment of middle ear infections. Sensorineural hearing loss in older adults is most commonly caused by normal aging; it may also be caused by diseases that could potentially threaten the person’s neurological integrity and life. Some types of hearing dysfunction require medical attention. We only intervene with hearing aids and amplification for permanent hearing loss that cannot be medically rectified.
However, if we have established that a person has a hearing loss that is permanent and does not require medical attention, Ven will be hugely beneficial for all types of hearing loss. As people with conductive or mixed hearing loss usually have less damage to the auditory nerve and the processing mechanism, they might gain better sound clarity. For sensorineural hearing loss, high-quality amplification like Ven is the best accessible and affordable way to improve quality of life.
What's the main difference between Ven and traditional types of hearing aids?
There are three important differences between Ven and traditional types of hearing aids:
The aesthetic difference. With its lightweight neckband and ergonomically-designed earbuds, Ven looks more like a modern headset for a smartphone or noise-reduction system.
The accessibility difference. Ven is a lot more affordable and accessible than traditional hearing aids – it's a lot easier to get!
The sound difference. As far as sound quality goes, Ven is exceptionally good. Our hope is that it will rehabilitate hearing and support those with hearing loss even better than traditional hearing aids.
Should I always consult a doctor or can I just buy Ven online?
Consultation with a specialist is preferable before embarking on hearing amplification. As an amplification device, Ven helps tremendously to improve communication; however, to avoid amplifying temporary hearing loss or neglecting more serious disease, it is always advised to consult with a doctor.
Let me give an example – if you have an older person who has no symptoms other than mild to moderate difficulty in communicating, and their general practitioner has verified that there is no wax build-up (a common cause of conductive hear loss), then it might not be necessary to see a specialist. But for any more serious symptoms of hearing loss (such as difficulty to understand speech even if it is of adequate volume and clearly enunciated), it is important to consult a doctor.
How can Ven improve my hearing?
The neckband and earbuds, together, are very highly specialized amplifiers. Based on the hearing measurement Ven will amplify sounds for optimum communication based on your individual needs.
Ven considers that even though somebody may not hear very well, a person should never be exposed to damaging levels of sound. This means Ven will adequately amplify soft or low intensity sounds to make them audible, but it will provide lower or no amplification for sounds of higher intensity. Depending on the frequency and the level of sound input, the amplification provided by the device is dynamically modified.
How does the Ven hearing aid work?
Ven considers two main things:
Individual hearing contour: this defines the increase in loudness required for a person to hear sounds in each frequency
Ven provides customization based on input sound levels. For anything from a soft or louder speaking voice, music, or background noise – Ven separates sounds in discreet frequencies and amplifies each frequency. The final amplification is thus based on the need that was determined by that person's hearing contour, the sound input level, and the output level limitations to protect hearing.
While this might sound simple, it involves a lot of:
(a) Instrumentation designed to receive, analyze and amplify sounds.
(b) Calculations to decide how much to amplify each frequency.
(c) Instrumentation, again, to deliver that resulting sound to the VEN user.
Using the algorithm of someone’s hearing, Ven creates a personalized sound that is both audible and comfortable for each ear.
What if I only have hearing loss in one ear? Can I still use Ven?
Absolutely. Even with hearing loss in one ear, our communication is impaired in many ways, and Ven is perfectly suited to address unilateral hearing loss. Hearing loss in one ear affects sound perception and communication in several ways:
The very first thing affected by hearing loss in one ear is that the person cannot determine the sound source. This is because our auditory system is designed to integrate the input from both ears and compare intensity, timing and frequency differences to determine the location of the sound source. Localization allows orientation towards the sound. For example we may turn towards the speaker or determine that a car is coming from behind or from a side, , and we need to move out of the way! A person who has hearing loss in one ear is unable localize; amplifying the ear with hearing loss will help to localize sounds again.
Hearing loss in one ear negatively affects perception of speech in noise. To suppress environmental noise we use input from both ears. This means our brain learns to ignore a steady sound, like a heating or cooling hiss or rainstorm that it detects at about the same loudness from both ears . A person with hearing loss in one ear cannot compare inputs from both ears to reach this conclusion. Amplification for those with hearing loss in one ear can help overcome this problem, and can help to significantly improve communication in noisy environments.
Can hearing loss be a sign of other underlying health issues?
Yes, hearing loss can sometimes be linked with other health concerns. Some key examples:
Hearing loss in only one ear can be a sign of a space occupying lesion or tumor. While infrequent, a significant difference in hearing between the ears is a red flag for a professional and warrants further investigation.
Hearing loss may be related to disease affecting other systems. For example, hearing loss is associated with kidney dysfunction, especially with chronic kidney disease.
Circulatory problems and heart conditions: hypertension and heart disease are associated with hearing loss. Diabetes, is associated with peripheral neuropathies, which can affect the auditory nerve. These and other health disorders can result in hearing loss independent of age.
It is always advisable to discuss hearing loss in the context of overall health with a doctor to see if further testing might be required.
Hearing loss has also been associated with memory loss: it was identified as one of the 9 potentially modifiable dementia risk factors, (Livingston, 2017). A significant decrease in cognitive function is associated with every 10dB worsening of hearing (Loughrey et al., 2018). Several studies are showing that timely hearing amplification may slow the progression of memory loss and improve quality of life for the individual and the family.
Do I need a prescription for Ven?
No, Ven has been designed as a stand-alone amplification device where there is no prescription needed. Through the online shop and wholesaler partner stores, our main goal is to make this device easily and quickly accessible to anyone who needs it.
How do I use Ven to perform a hearing test?
Ven includes a hearing test. You are guided to respond to sounds that are presented directly through the device – first in one ear, then in the other. In just a few simple steps, Ven determines the individualized hearing contour and creates an audiogram. If you use the accompanying mobile app, you can view your audiogram and adjust or fine-tune programs at any time.
Is a phone needed to use Ven?
No, Ven works perfectly as a free-standing device. The standalone device allows you to measure hearing and create a basic amplification contour based on individual needs. Different programs designed for different sound environments can be accessed with the push of a button. The Audientes team made sure to design Ven so that even the standalone device has the flexibility to modify responses based on the acoustical environment.
Do I need to adjust Ven for different situations?
Not always. After the initial hearing test, Ven automatically adapts to noisy environments . The amplification that we get from the device is a dynamic process.
For those who want more functionality, the phone app provides ever-more possibilities to adapt to the sound environment. Whether the user is in a noisy restaurant, a busy street, or at home, sound is processed by are noise processing algorithms within the device. The Audientes app allows to add, delete and adapt different amplification programs.
Is tinnitus related to hearing loss?
Tinnitus is usually a reflection of dysfunction in the outer, middle, or inner ear or the auditory nerve. In many cases, hearing aids are quite helpful in suppressing that annoying “ringing” noise. While not a blanket solution, amplifying sounds and providing input to the hearing mechanism suppresses or masks the tinnitus noise, providing relief.
Does Ven provide relief for tinnitus?
Yes. Ven will provide relief for people who have tinnitus that can be suppressed by auditory input or presence of an auditory signal.
Why do you recommend Ven?
I believe a big advantage of Ven is that it will be many people’s first step towards amplification. What we know is this: –people who discover they have hearing loss and require amplification may take five to seven years to seek help for that hearing loss. Five to seven years is a long time for a lower quality of life and diminished communication.
My hope is that the time barrier between the indication of hearing loss and the first step to do something about it shortens drastically with the availability of Ven. In other words, I think that Ven can be a very accessible and less stressful first step to amplification.
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