Effectiveness of Directional Microphones and Noise Reduction Schemes in Hearing Aids: A Systematic Review of the Evidence

Department of Speech Pathology and Audiology, University of Iowa, Iowa City 52242, USA.
Journal of the American Academy of Audiology (Impact Factor: 1.58). 06/2005; 16(7):473-84. DOI: 10.3766/jaaa.16.7.7
Source: PubMed


A systematic review of the literature was undertaken to find evidence of real-world effectiveness of directional microphone and digital noise reduction features in current hearing aids. The evidence was drawn from randomized controlled trials, nonrandomized intervention studies, and descriptive studies. The quality of each study was evaluated for factors such as blinding, power of statistical analyses, and use of psychometrically strong outcome measures. Weaknesses in the identified studies included small sample size, resultant poor power to detect potentially worthwhile differences, and overlapping experimental conditions. Nine studies were identified for directional microphones, and the evidence (albeit weak) supports effectiveness. Two studies were identified for the noise reduction feature, and the evidence was equivocal. For the researcher, such a systematic review should encourage the careful consideration of appropriate methodologies for assessing feature effectiveness. For the clinician, the outcomes reported herein should encourage use of such a systematic review to drive clinical practice.

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Available from: Ruth Bentler, Feb 28, 2015
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    • "Modern hearing aids often incorporate directional microphones that can provide a substantial signal-to-noise ratio (SNR) improvement—and typically a corresponding speech-intelligibility benefit—over omnidirectional microphones (Bentler 2005). To obtain the maximal benefit, however, requires an ideal set of conditions (Valente et al. 1995): the listening environment should have no more than moderate reverberation (i.e., the level of the direct and reflected sound should be at least equal), the background noise should be at the side or the rear of the listener, and the listener should be more or less facing the signal of interest (Ricketts & Dhar 1999; Hornsby & Ricketts 2007). "
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    ABSTRACT: Objectives: Although directional microphones on a hearing aid provide a signal-to-noise ratio benefit in a noisy background, the amount of benefit is dependent on how close the signal of interest is to the front of the user. It is assumed that when the signal of interest is off-axis, users can reorient themselves to the signal to make use of the directional microphones to improve signal-to-noise ratio. The present study tested this assumption by measuring the head-orienting behavior of bilaterally fit hearing-impaired individuals with their microphones set to omnidirectional and directional modes. The authors hypothesized that listeners using directional microphones would have greater difficulty in rapidly and accurately orienting to off-axis signals than they would when using omnidirectional microphones. Design: The authors instructed hearing-impaired individuals to turn and face a female talker in simultaneous surrounding male-talker babble. Participants pressed a button when they felt they were accurately oriented in the direction of the female talker. Participants completed three blocks of trials with their hearing aids in omnidirectional mode and three blocks in directional mode, with mode order randomized. Using a Vicon motion tracking system, the authors measured head position and computed fixation error, fixation latency, trajectory complexity, and proportion of misorientations. Results: Results showed that for larger off-axis target angles, listeners using directional microphones took longer to reach their targets than they did when using omnidirectional microphones, although they were just as accurate. They also used more complex movements and frequently made initial turns in the wrong direction. For smaller off-axis target angles, this pattern was reversed, and listeners using directional microphones oriented more quickly and smoothly to the targets than when using omnidirectional microphones. Conclusions: The authors argue that an increase in movement complexity indicates a switch from a simple orienting movement to a search behavior. For the most off-axis target angles, listeners using directional microphones appear to not know which direction to turn, so they pick a direction at random and simply rotate their heads until the signal becomes more audible. The changes in fixation latency and head orientation trajectories suggest that the decrease in off-axis audibility is a primary concern in the use of directional microphones, and listeners could experience a loss of initial target speech while turning toward a new signal of interest. If hearing-aid users are to receive maximum directional benefit in noisy environments, both adaptive directionality in hearing aids and clinical advice on using directional microphones should take head movement and orientation behavior into account.
    Ear and Hearing 09/2014; 35(5):e204-e212. DOI:10.1097/AUD.0000000000000053 · 2.84 Impact Factor
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    • "The authors noted however that the fixed directional mode of the hearing aid used in the study was not optimised for diffuse noise, but noise coming from behind the listener. A systematic review of nine studies by Bentler in 2005 found evidence to support the effectiveness of directional microphones in current hearing aids [18]. McCreery (2012) identified seven paediatric studies, again indicating that directional microphones improve speech perception in controlled settings [19]. "
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    ABSTRACT: To investigate the performance of monaural and binaural beamforming technology with an additional noise reduction algorithm, in cochlear implant recipients. This experimental study was conducted as a single subject repeated measures design within a large German cochlear implant centre. Twelve experienced users of an Advanced Bionics HiRes90K or CII implant with a Harmony speech processor were enrolled. The cochlear implant processor of each subject was connected to one of two bilaterally placed state-of-the-art hearing aids (Phonak Ambra) providing three alternative directional processing options: an omnidirectional setting, an adaptive monaural beamformer, and a binaural beamformer. A further noise reduction algorithm (ClearVoice) was applied to the signal on the cochlear implant processor itself. The speech signal was presented from 0° and speech shaped noise presented from loudspeakers placed at ±70°, ±135° and 180°. The Oldenburg sentence test was used to determine the signal-to-noise ratio at which subjects scored 50% correct. Both the adaptive and binaural beamformer were significantly better than the omnidirectional condition (5.3 dB±1.2 dB and 7.1 dB±1.6 dB (p<0.001) respectively). The best score was achieved with the binaural beamformer in combination with the ClearVoice noise reduction algorithm, with a significant improvement in SRT of 7.9 dB±2.4 dB (p<0.001) over the omnidirectional alone condition. The study showed that the binaural beamformer implemented in the Phonak Ambra hearing aid could be used in conjunction with a Harmony speech processor to produce substantial average improvements in SRT of 7.1 dB. The monaural, adaptive beamformer provided an averaged SRT improvement of 5.3 dB.
    PLoS ONE 04/2014; 9(4):e95542. DOI:10.1371/journal.pone.0095542 · 3.23 Impact Factor
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    • "For example, most hearing aids have some type of proprietary digital noise-reduction (DNR) algorithm that utilizes a slow-acting, modulation-based strategy and/ or a fast-acting filtering strategy (Bentler, 2005; Mueller and Ricketts, 2005; Bentler and Chiou, 2006). These technologies all share the general goal of reducing the level of signals identified as noise or other unwanted signal distortions. "
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    ABSTRACT: Transient noise can be disruptive for people wearing hearing aids. Ideally, the transient noise should be detected and controlled by the signal processor without disrupting speech and other intended input signals. A technology for detecting and controlling transient noises in hearing aids was evaluated in this study. The purpose of this study was to evaluate the effectiveness of a transient noise reduction strategy on various transient noises and to determine whether the strategy has a negative impact on sound quality of intended speech inputs. This was a quasi-experimental study. The study involved 24 hearing aid users. Each participant was asked to rate the parameters of speech clarity, transient noise loudness, and overall impression for speech stimuli under the algorithm-on and algorithm-off conditions. During the evaluation, three types of stimuli were used: transient noises, speech, and background noises. The transient noises included "knife on a ceramic board," "mug on a tabletop," "office door slamming," "car door slamming," and "pen tapping on countertop." The speech sentences used for the test were presented by a male speaker in Mandarin. The background noises included "party noise" and "traffic noise." All of these sounds were combined into five listening situations: (1) speech only, (2) transient noise only, (3) speech and transient noise, (4) background noise and transient noise, and (5) speech and background noise and transient noise. There was no significant difference on the ratings of speech clarity between the algorithm-on and algorithm-off (t-test, p = 0.103). Further analysis revealed that speech clarity was significant better at 70 dB SLP than 55 dB SPL (p < 0.001). For transient noise loudness: under the algorithm-off condition, the percentages of subjects rating the transient noise to be somewhat soft, appropriate, somewhat loud, and too loud were 0.2, 47.1, 29.6, and 23.1%, respectively. The corresponding percentages under the algorithm-on were 3.0, 72.6, 22.9, and 1.4%, respectively. A significant difference on the ratings of the transient noise loudness was found between the algorithm-on and algorithm-off (t-test, p < 0.001). For overall impression for speech stimuli: under the algorithm-off condition, the percentage of subjects rating the algorithm to be not helpful at all, somewhat helpful, helpful, and very helpful for speech stimuli were 36.5, 20.8, 33.9, and 8.9%, respectively. Under the algorithm-on condition, the corresponding percentages were 35.0, 19.3, 30.7, and 15.0%, respectively. Statistical analysis revealed there was a significant difference on the ratings of overall impression on speech stimuli. The ratings under the algorithm-on condition were significantly more helpful for speech understanding than the ratings under algorithm-off (t-test, p < 0.001). The transient noise reduction strategy appropriately controlled the loudness for most of the transient noises and did not affect the sound quality, which could be beneficial to hearing aid wearers.
    Journal of the American Academy of Audiology 09/2012; 23(8):606-15. DOI:10.3766/jaaa.23.8.4 · 1.58 Impact Factor
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