No one wants a hearing aid. The generation that prefers to peer at restaurant menus through itty-bitty reading glasses they bought at the drugstore will not go gently into any good night that involves a hearing aid. Nevertheless, the first generation to attend rock concerts is now paying its dues.
A 2000 study by the University of Washington School of Medicine found that early exposure to noise can increase the speed of age-related hearing loss, known as presbycusis. In other words, if you're in your fifties, the damage from that 1974 Led Zeppelin concert may just now be making itself felt, while you twenty-year-olds can expect payback for cranking those iPod earbuds in about thirty years.
But hearing aids, valuable though they are, are almost universally loathed. They're so hard to get used to that a reported 17 percent of people who buy them leave them in a drawer. They don't work well when there's background noise, changing the battery every few days is a hassle, and they don't look pretty.
Robert Schindler and Adnan Shennib thought they could do better. Schindler, chairman emeritus of the department of otolaryngology at UCSF, was one of the inventors of the cochlear implant, the surgically implanted device that allows some totally deaf people to hear. Shennib is a serial entrepreneur and auditory engineer who specializes in extreme miniaturization. Shennib runs a business incubator in Dublin, where he advises start-ups in the medical devices field. When Shennib came to Schindler in 1998, asking him to come on board the newly founded InSound Medical, Schindler knew the time was right.
"I said, 'Listen, let's start by defining the ideal hearing aid. What would it look like if we were able to build it?'" Schindler recalled.
The criteria they came up with were: It should be small enough to fit deep inside the ear canal, the sound quality should be excellent, and people should be able to wear it all the time.
Most hearing aids rest at the outer ear opening; fitting the device deeper inside would not only make it invisible, it would improve the sound quality, especially for high-frequency sounds. In addition, the closer it gets to the eardrum, the less power is needed to drive the device.
"Conceptually, the Lyric is potentially easy," Schindler said. "But it's a much more complicated engineering process."
In fact, when Schindler and Shennib presented their idea to a group of the world's top experts, they said it couldn't be done. The experts insisted that wearing something inside the ear for months at a time would create infections. However, in his work with deaf patients, Schindler had seen many whose ear canals were completely plugged with wax — and uninfected. So he knew it could be done — somehow.
There were plenty of technical challenges. Not only did the battery need to be extremely small and yet last for three to four months, it had to fit inside the ear canal. They needed to develop a special plastic coating for the device, and, although it needed to be snug inside the ear, the microphone and loudspeaker require air on both sides in order to function. In addition to all that, its chip has to have a wireless receiver so that it can be programmed to suit an individual's pattern of hearing loss.
By 2000, they had the first prototype. "We tested it on three people at UCSF and the results were spectacular. It lasted for about seventeen days. More important, people loved the sound quality," Shennib said. Schindler, who has high-frequency hearing loss, began wearing the prototypes in 2005.
The result of InSounds' nine years of research and development is Lyric, a tiny device that became available in Northern California and three other markets in April. It's the size, shape, color, and weight of two kernels of corn, but it feels very soft, even floppy. The Lyric is inserted deep in the ear canal, where it remains for up to 120 days. You can swim, play sports, sleep, and make love without worrying about dislodging or damaging it, according to the company. And no one has to know you're wearing it.
This new kind of hearing aid also needed a new pricing model. The Lyric is fitted and sold by the same hearing professionals who fit traditional aids, but instead of buying it, you pay $2,900 to $3,600 for a year's subscription. That includes replacing the device when the battery runs out three or four times a year, as well as any improvements InSound has made in the meantime.
At this point in the product's development, only about 50 percent of potential users can wear the Lyric: The size and depth of the ear canal has to be large enough. And InSound is still making all sixty components of each device in its own small Newark factory. As production ramps up, the cost and the size may come down.
Shennib and Schindler hope to work with the government to make the Lyric available at reduced cost to veterans, and to make it more affordable to middle-class and elderly people. Schindler says, "It's one of my commitments, to make sure this technology gets to everyone."
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