Phonak ActiveVent^TM Receiver: The World’s First Intelligent Hearing Aid Receiver

Audiologists often have to make a compromise between the comfort of a more open fitting and the performance in noise provided by a more occluded fit for patients with mild to moderate hearing loss. This is a challenge all audiologists face no matter what hearing aids they fit.

Mild to moderate hearing losses are the most common that we see and often their main concern is hearing well in noise. Often these patients have an audiogram that suits an open or vented dome, however they report a lot of difficulty in noise and have speech in noise test results that back this up. This poses the question – do you fit them open or more occluded?

More recently, with the introduction of hearing aids that stream music, calls, and TV directly to your patients’ ears, having an open fit also leads to direct sound entering the ear when listening to streamed media. This coupled with the streamed sound escaping from the open ear means that the quality of streamed media is not as good as it could be if it was occluded.

ActiveVent was developed to directly address these questions – you can have the best of both worlds! The previous compromise between an open and a closed fitting for mild to moderate hearing loss is no more. Your patient can have an open fitting when they want it and a closed fitting when they need it most – to hear speech in loud noise.

How does ActiveVent Receiver work?

It’s both simple and complex. The idea is simple however the execution is complex. The receiver has a series of holes in it that amount to a 3.5mm vent which can either be open or blocked. The ‘blocking’ is done by a moving gasket that is positioned to the front or to the back of a small chamber. When the gasket is forward, the venting is closed, and when it is back, the venting is open – sounds simple. Making this all fit within a 12mm long by 4mm diameter body is more challenging.

The automatic vent switching is possible because of the unique way Phonak AutoSense OS™ 4.0 works. AutoSense OS 4.0 is continually scanning the environment to select the optimal blend of settings for the wearer.

The vent state (open or closed) can be programmed in any of the non-blending programs in AutoSense OS 4.0. The best example of this is the Speech in Loud Noise program which is activated when in a loud noise environment. Controlling the vent state is not possible in the blended programs within AutoSense OS; however manual versions of these programs can be created with the vent open or closed.

The vent state can also be controlled for streamed signals which means if your patient has a phone call, wants to listen to music, or watch TV they can benefit from the sound quality of a closed vent.

Identifying the ideal candidate for ActiveVent

As an audiologist, I would start with 2 simple questions:

1. Does your patient report difficulty in noise?
2. Does your patient have trouble hearing streamed media well?

If yes is the answer to one or both of these and the patient has a mild/moderate hearing loss then they will likely benefit from ActiveVent and should be considered a candidate.

Once you have answered those initial questions, there are a few other considerations around suitability and longevity of ActiveVent. Ideally, the wearer should not have excessive wax production, have good dexterity to regularly change the wax filter, and no significant issues with tinnitus or sensitivity to loud sounds.

From an audiogram perspective, you’ll want to offer ActiveVent to patients with mild to moderate sloping losses, such as the one below. These are the audiograms you see and debate which dome or custom earpiece to use…open or closed!

In terms of lifestyle, you’ll want to think about active patients who are often in background noise, and do a lot of streaming of music and TV throughout the day. Of course, you’ll want to consider ear health and excessive amounts of wax, similar to many RIC devices. In general, the more the patient is in background noise or streaming (especially streaming in noisy places like on the train to work), the more benefit they’re going to find with ActiveVent.

The great thing about ActiveVent is that it can be added on to any rechargeable Audéo P device, even those that have been previously fit with a simple hearing instrument firmware upgrade. It’s a great opportunity to provide an upgrade to existing patients, and can be an interesting add-on in the hearing aid evaluation process for a new patient. The cost of the receivers can either be bundled into the hearing aid price, or purchased individually; this flexibility allows ActiveVent to easily integrate into your existing clinic structure.

How often does ActiveVent Receiver need to be replaced?

ActiveVent contains moving parts and anything that moves risks no longer being able to move at some point. The good news is that we tested the mechanism of the vent cycling between open and closed over 200,000 times and it still worked well. We then tested it in real ears over the span of six months. This showed that if ActiveVent needed to be replaced, it was almost always due to cerumen entering the body of the receiver. How the cerumen got into the body of the receiver was either due to the wearer not cleaning and changing the wax filter often enough or poor handling when changing the filter.

We developed a cleaning reminder function in the myPhonak app to help wearers remember to change their wax filter. This reminder can be set at weekly intervals from 1 week+ to ensure your patients know to change their filter at regular intervals.

Integrating ActiveVent Receiver into your practice

Demonstrate ActiveVent to anyone suitable! It’s that simple. Phonak has developed the Universal SlimTip AV to allow for instant demo. An effective demo includes three key steps – discover the need, explain the benefits and prove the benefits.

Understanding your patients’ goals is vital; if any of these are focused around hearing better in noise and/or quality of streaming media then their needs align with the benefits of ActiveVent. Following their needs assessment, test their hearing and if they have a mild to moderate hearing loss then you have a candidate!

Once testing is complete and you begin discussing solutions, it’s time to explain the benefits of ActiveVent. Use a goal identified earlier in the appointment, and explain to the patient how ActiveVent will address their specific needs in that situation. This personalizes the experience for the patient and helps them understand how ActiveVent can lead to meaningful improvements their hearing.

Finally, proving the benefits means demonstrating the benefits of ActiveVent. Program the hearing aids (remember to have rechargeable Audéo Paradise Trial hearing aids ready) and using the party noise sound files in Phonak Target fitting software, get them talking to their family or friends present with ActiveVent open and ActiveVent closed to show the benefits to your patient.