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About e2e wireless Bilateral vs. Binaural


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Binaural Vs. Bilateral

e2e wireless™ is a Breakthrough in Hearing Instument Technology

Binaural hearing, hearing with two ears, is what nature intended. It allows us to hear sounds accurately and more naturally. Especially in noisy environments, it gives us a sense of balance and direction.

When there is a hearing loss in both ears, even if one ear is worse than the other, binaural amplification provides the most benefit to patients. True binaural amplification, however, requires the hearing instruments to function in such a way that the left and right ears work together to send sound to the brain.

Until now, Hearing Care Professionals could really only offer bilateral amplification to their patients. While bilateral offers the benefit of amplifying both ears, since the two are not connected in any way, they act independently of one another.

Siemens ACURIS™ with e2e wireless™ hearing instruments are the first hearing systems in the world to offer true binaural amplification.

Benefits of Binaural Hearing:

Improved Signal/Noise Ratio

  • If the brain is permitted to sample input from both ears, it can naturally suppress some of the unwanted signal
  • Binaural listening usually can result in a S/N advantage of 2-3 dB

Auditory Localization

  • Allows the listener to “find who’s talking” in group listening situations
  • If listeners have a symmetrical hearing loss and the hearing loss is not too severe:
    • When fitted with two hearing instruments localization will be almost normal
    • When fitted monaurally the patient can have a new handicap

Loudness Summation

  • At supra-threshold levels, the summation of sounds from two ears adds the equivalent of 3-10 dB of perceived loudness
  • Summation permits reduced amplifier gain, which results in fewer potential feedback problems
  • Without summation, people with more severe hearing loss may have difficulty achieving appropriate loudness for speech

Expanded Risidual Dynamic Range

  • Since summation provides greater loudness perception, you might think that the binaural Loudness Discomfort Level (LDL) would be lower than a monaural LDL
  • However, due to the perceived full ness of the sound, loudness discomfort is unaffected
  • The residual dynamic range at threshold is increased by the amount of binaural summation, making it easier to re-package the aided speech signal into this residual dynamic range

Reduction of Head Shadow Effect

  • High frequency sounds from one side of the head to the other are attenuated by 12-15 dB
  • With a monaural fitting, the listener may not hear these sounds if someone is talking from the “unaided side”
  • The listener does not have to “work as hard” to hear when fitted with two hearing instruments – relaxed listening leads to improved intelligibility

Sound Quality

  • Due in part to timing differences, patients rate sounds as more pleasant when they listen binaurally

Spatial Balance

  • Patients report that the world seems more “normal” when they use two hearing aids – likely related to improved localization
  • Binaural users, when forced to wear only one hearing instrument, say they feel “disoriented”

References:

Hawkins D., Yacullo W. (1984) “Signal-to-noise advantage of binaural hearing aids and directional microphones under different levels of reverberation.” JSHD. 49:278-286.
Ricketts T. (2000) “The impact of head angle on monaural and binaural performance with directional and omnidirectional hearing aids.” Ear Hear. 21(4): 318-28.
Byrne D., Noble W. (1998) “Optimizing sound localization with hearing aids.” Trends in Amplification 3 (2): 51-73.
Chung S., Stephens S. (1986) “Factors influencing hearing aid use.” British Journal of Audiology, 20: 129-140.
Bentler R., Nelson, J. (2001) “Effect of spectral shaping and content on loudness discomfort.” Journal of American Academy of Audiology, 9: 462-70.
Hawkins D., Prosek R., Walden B., Montgomery A. (1987) “Binaural loudness summation in the hearing impaired.” Journal Speech Hearing Res. 30(1): 37-43.
Hawkins D. (1986) “Selection of SSPL90 of binaural hearing aid fittings.” Hearing Journal. 11: 7-10.
Mueller H., Hawkins D. (1995) “Three important considerations in hearing aid selection.” Handbook of Hearing Aid Amplification, Vol II, Sandlin, R. (Ed.) San Diego: Singular Publishing Group.
Byrne D. (1981) “Clinical issues and options in binaural hearing aid fitting.” Ear and Hearing, 2: 187-193.
Feston, J., Plomp, R. (1986) “Speech reception threshold in noise with one and two hearing aids.” JASA, 79: 465-471.
Naido S.V., Hawkins D. (1997) “Monaural/binaural preferences: effect of hearing aid circuit on speech intelligibility and sound quality.” Journal American Academy of Audiology 8 (3): 188-202.
Balfour P., Hawkins D., (1992) “A comparison of sound quality judgments for monaural and binaural hearing aid processed stimuli.” Ear Hearing 13 (5): 331-9.
Eriksson-Mangold M., Carlson S. (1991) “Psychological and somatic distress in relation to perceived hearing disability, hearing handicap and hearing measurements.”
Chung S., Stephens S., (1986) “Factors influencing hearing aid use.” British Journal of Audiology, 20: 129-140.



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