Some commercial wireless headphones used with smartphones compare favorably to conventional hearing aids and therefore have the potential to be repurposed as assistive listening devices in people with mild to moderate hearing loss, a study reports. conducted in Taiwan.
In an electroacoustic test, a pair of headphones that came with a smartphone (AirPods Pro) met four out of five standards for Personal Sound Amplification Products (PSAPs). PSAPs are a category of wearable electronic device intended for people with normal hearing, but have been shown to help compensate for hearing loss in terms of listening effort and speech perception in noise in patients with mild to moderate hearing loss. [iScience 2022;doi:10.1016/j.isci.2022.105436; JAMA Otolaryngol Head Neck Surg 2019;145:516-522;
AirPods Pro had the smoothness and bandwidth of frequency response, total harmonic distortion, and maximum output sound pressure level at 90dB. The only exception was that the headphones had equivalent internal noise that exceeded the regulated standard, meaning the device may impact users’ speech perception.
AirPods Pro vs hearing aids
The performance of Airpods Pro was further assessed in 21 adults (mean age 42.9 years, 57.14% female) with mild to moderate bilateral symmetrical sensorineural hearing loss (SNHL) and no prior experience with hearing aids . The device was then compared to its predecessor, the Airpods 2, and a pair of premium and basic hearing aids.
During the test, participants were asked to verbatim repeat a short sentence read by the authors under the following conditions: without any assistive listening device, as well as wearing AirPods Pro, AirPods 2, a premium hearing aid and a standard hearing aid.
The AirPods Pro did as well as the basic hearing aids, but fell slightly short of the premium hearing aids when used in a quiet environment; AirPods 2 had the weakest performance among the four devices, although the device helped participants hear more clearly than when they weren’t wearing hearing aids.
In a noisy environment, on the other hand, AirPods Pro provide similar performance to high-end hearing aids when noise travels laterally. However, the wireless headphones failed to improve hearing when noises came from the front.
“Two reasons may explain the difference between the two scenarios,” noted Ying-Hui Lai, study co-author and bioengineer at National Yang Ming Chiao Tung University in Taipei.
“This may relate to the trajectories with which sound waves travel, as well as the advanced signal processing algorithm used by high-end hearing aids. This discovery will hopefully inspire engineers to design more hearing aids and PSAPs. sensitive in certain directions,” Lai said, adding that the AirPods Pro’s noise canceling feature gave it an edge over the AirPods 2.
Cheaper and more accessible
“To our knowledge, this study is the first to use headphones bundled with a smartphone like PSAP tested to compare hearing performance in patients with mild to moderate symmetrical hearing loss. We found that the AirPods Pro met most electroacoustic criteria and could be considered a competent PSAP,” according to the authors.
In 2016, Apple introduced “Live Listen,” a feature that allows its AirPods wireless earbuds to be used for sound amplification and subsequently function as a PSAP.
“Globally, the wireless earphone market is growing rapidly. Some companies want to explore the possibility of designing headphones with sound-amplifying features. Our study proves that the idea is plausible,” Lai said.
Lai and his colleagues see the AirPods Pro as a potential hearing aid device for adults with mild to moderate hearing loss. These wireless headphones can be a decent alternative to hearing aids, with the added benefit of being less expensive.
The cost of hearing aids is largely responsible for the low usage of these devices. Between $3,000 and $6,000 a pair, hearing aids are expensive enough to prevent many people from correcting their hearing problems. By comparison, the AirPods Pro cost just $249. [Am J Med 2016;129:245-250; Disabil Rehabil 2021;43:436-446]
A previous report revealed that around three-quarters of people with hearing loss do not use hearing aids. This number is worrying, according to the study authors, because hearing problems will eventually impede effective communication, leading to lower quality of life and increased healthcare costs, if left unaddressed. [Arch Intern Med 2012;172:292-293]
Dr Yen-fu Cheng, corresponding author of the study and an otolaryngologist at Taipei Veterans General Hospital, acknowledged that convincing patients to use hearing aids can be difficult.
“These wireless headphones are of course not perfect, but they would be a good starting point for many patients who do not have access to professional hearing aids. They will see an improvement in quality of life even with these headphones,” Cheng said.
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