Hearing aids - Update
The leading brands of hearing aids in the world are probably
Earsmate and Jinghao. They and other Chinese companies supply the 1.7 billion Chinese, plus many Indians and other neighbors, with hearing aids.
According to incomplete statistics, there are now 466 million people with hearing impairment worldwide. Among them, nearly 34 million children, is expected to reach 900 million people by 2050, according to survey statistics, the largest number of people wearing hearing aids are children. (Earsmate)
Thanks to extraordinarily high production runs, Chinese manufacturers can deliver cheaply, for example through Alibaba.com for Jinghao:
Individualisierbar
Mindestbestellmenge: 1000 Stück
5,50-8,00 $
„Individualisierbar” -- Customizable means that the devices can be supplied with the buyer's logo and lettering, starting from a minimum order quantity. This allows European and American companies to present themselves to customers as the developer and manufacturer of the product. Sometimes a photo comparison with google lens can help to determine the true origin of a device.
If the expected sales figures for a device in Europe and America are high enough, contract manufacturing in China can also be worthwhile, making it possible to equip a device with special gimmicks and features and offer better quality throughout.
Analog vs. Digital
In Germany, there are strange regulations in place that shackle and unnecessarily restrict the audio industry. What's more, these regulations seem to be written by industry representatives who wanted to make their devices as complicated and therefore as expensive as possible:
Hearing aids dispensed to insured persons at a fixed price must be fully digital, have at least three hearing programs and at least four adjustable frequency channels, and be equipped with multi-microphone technology, noise and feedback suppression.
One wonders why the devices can't also brew coffee and warn of a nuclear attack.
In the UK, the NHS specifically supplies certain devices that customers say are quite good for their price.
The National Health Service (NHS) in the UK provides hearing aids to eligible individuals at no cost. To be eligible for an NHS hearing aid, you must have a hearing loss that is severe enough to affect your daily life and communication.
In Germany, the regulations have led to an inflation of chain-connected hearing aid shops present in almost every small town, run by friendly but not very competent ladies who make appointments with a traveling technician who provides expertise to several such shops in the respective area.
Regulations in Germany ensure that analog devices are not offered by official hearing acousticians. If you want an analog device, you have to search the internet and pay for it yourself. The last (and only?) provider of analog hearing aids in Germany disappeared just recently, leaving no trace behind. There are brands offering analog devices which are for the above reasons not available in Germany, eg. Widex (Analog Widex Daily 50 Hearing Aid, In The Ear) or Signia Analog Hearing Aids, Behind The Ear, or Analog Siemens Behind The Ear Hearing Aid
Why analog devices at all?
The granddaddy of analog devices is probably the Phonak Lyric, an implantable device that needs to be replaced when the battery runs out.
A manufacturer of modern analog devices (The Analog Hearing Aid Company) tells us:
You are correct to say that analog hearing aids do have some disadvantages like auditory feedback, amplification of unwanted sounds, etc.
So how do we deal with that.
First it is important to realize that as the market shifted - there became a tendency for analog hearing aids to be seen as cheaper/older alternatives to the modern digital hearing aids. The tendencies were to reduce cost and achieve a lower price. This is especially prevalent in the unbranded and low branded Chinese manufacturers. As digital moved down the Moore's law cost curve, most analog manufacturers either exited or shifted to making cheaper and cheaper products. This was often done by using cheaper - non medical grade - components. We have even seen "hearing aids," using the speakers that come in musical greeting cards.
At the Analog Hearing Aid company we took a different approach. We believe there is a market for premium sound, and we have returned with designs that use the highest quality medical grade transducers. This alone yields huge benefits in terms of sound quality, and a reduction in amplification of undesired sounds - simply by choosing microphones and receivers with response curves which are well matched to the class D amplifiers.
We include exclusive Aer-Tips creating a seal that matches the shape of the ear canal, we are able to eliminate most feedback for most of our customers. These perform at a level that basic circular domes cannot match.
A very convincing presentation. But let’s face it: digital has won over analog and established itself as the almost exclusive market leader because of the unwanted and unavoidable noises produced by analog hearing aids. Their entire body acts as a microphone picking up a myriad of rustling and crackling noises whenever they are moving or are being touched.
However, there is a way of dealing with this problem by locating analog devices only
- In the ear itself
- Behind the ear with the speaker in the canal
- Attached close to the neck
Among the current crop of available analog hearing aids are those well known small red and blue Chinese in-ears sold by several companies. Also, there are numerous Chinese brands offering behind-the-ear analog hearing aids of about the same size and shape as customary digital devices.
Let us face it: analog hearing aids have for a long time been badmouthed by the digital competition (and by sales people thriving on selling expensive digital gear) as being clunky, primitive, noisy, cheap, trashy.
Instead, the analog devices – if well implemented – are the only ones offering a satisfactory level of fidelity.
The digital industry is busy explaining that only digital processing permits to “achieve” certain supposedly advantageous characteristics of their gadgets: for instance being able to “boost” spoken word recognition over surrounding noise – a feature seeming attractive to poor hard-of-hearing people who experience difficult communication in noisy surroundings.
However, the digital industry fails to tell customers that for every “boost” there must be a corresponding trough in the response. The more you tailor the response to make it desirable or insert new gimmicks (e.g. noise suppression), the more the response is altered, becomes kinky and unnatural. In the end, only the honest-to-John analog rendering of a sonic event will provide truthful hearing and listener satisfaction
Also, the gimmickry prevailing in modern digital hearing aids implies a drain on the limited capacity of the rechargeable (lithium based?) batteries. Since the brands compete in offering small "invisible" gadgets, batteries and amplifiers are faced with a cruel limit to size. The resulting product is a hearing aid device which performs satisfactorily only under moderate levels of sound pressure. Any loud noise will drive it into clipping and possibly force it to shut off in order to protect its delicate innards from damage.
In Germany, the hearing industry is threatened by the imminent arrival of over-the-counter (OTC) hearing aids coming from America. Chances are that some of the new arrivals will outperform traditional by prescription models.
Hence it is not surprising that the established retail sellers are now busy launching vigorous marketing efforts aimed at luring potential customers to acquire a prescription model as long as the current payment system is still sustained by the health care insurers, and OTC models have not yet upset the market.
Germany is facing rising inflation and decreased disposable income, prompting middle-income consumers to choose mid-tier and refurbished hearing aids as affordable options. Subscription models, like those offered by Neuroth and Iffland hören GmbH & Co. KG (starting at USD 44 per ear), provide companies with stable revenue and improved inventory management, helping them navigate economic uncertainties while catering to budget-conscious consumers
Since analog hearing aids are usually not sold by certified audiologists -- being conscious of insurance regulations -- customers of analog gadgets cannot avail of the services of audiologists. As far as "tuning" the gadget to the customer's (remaining) hearing is concerned, the owner of an analog device must forget this "tuning" exercise. This is not much of a loss because the tools provided to the audiologist for tuning digital aids are too primitive to produce more than a show impressing the customer with "modern" "advanced" technology. The equalizer used by audiologists only offers very broad filters. Any attempt to correct a specific frequency will fail because of the unwanted intervention of two neighboring filters. In the end, the result is likely to be disappointing and exhausting for the customer.
No such problem with analog and OTC devices. No customization, no audiologist, no delusion. It's either o.k. as it is, or it's useless.
UPDATE
In my experience so far, there are two types of listening devices: bad and even worse. My recent experience with upscale models from Starkey is sad. The audiologist was very nice though: he didn't charge for the loaner and the many sessions and futile fitting attempts.
I am currently experimenting with analog devices (which are not available in Germany because the health insurance companies only allow digital devices). In principle, analog devices are the best because they are the most honest in terms of sound reproduction. I have had analog devices sent to me from China and the USA: their technology is simpler than digital and they consume less power. Therefore, a lithium battery lasts quite far. But their crux is the feedback between loudspeaker and microphone: the problem that led to the development and current market dominance of digital devices in the first place. An earmold is needed to prevent feedback. This is done by the acoustician (if you buy a digital device). Since there are/are no analog devices, there is logically no one in Germany who makes earmolds. Not a good enough reason to emigrate: you can make your own earmolds if you buy two-component plastic material, for example AHEAD Custom Molded Earplugs in the USA. One pack is enough for several attempts.
Once you have solved the feedback problem it turns out that the analog devices on the market are no better than the digital devices, which drive acousticians and customers to despair with their few channels and wide-ranging filters. If you still want to try, you can start with the TrueEQ from Analog Hearing Labs (USA), whose boss Sreeny Cherukuri is professionally qualified.
However, if you really want to achieve credible analog reproduction, then there is no way around portable devices and wired headphones. Here, too, the market for modern small devices is thin on the ground. Unfortunately, the ME-200P from AUSTAR (supposedly the world's largest audio equipment manufacturer, in China of course) is out of stock. (An older version was once available for a few euros at the Rossmann drugstore).
Still available, however, is the Chinese More Glory Muguang box-type wired portable hearing AIDS, available in Manila, for example, or More Glory wiederaufladbares Hoergeraet available from FRUUGO which has a mini plug for the earphone -- so you have to re-solder if necessary.
Not every earphone from a top brand will deliver equally good sound. It is advisable to test the sound of the earphones for unpleasant resonances, for example using the online sound generator (https://www.szynalski.com/tone-generator/) and choose the type with the most balanced frequency response (without bad resonances).
Nach meiner bisherigen Erfahrung gibt es zwei Arten von Hoergeraeten: schlechte und noch schlechtere. Meine juengsten Erfahrungen mit upscale Modellen von Starkey sind traurig. Der Akustiker war allerdings sehr nett: er verlangte nichts fuer das Leihgeraet und die vielen Sitzungen und vergeblichen Anpassungsversuche.
Zur Zeit experimentiere ich mit analogen Geraeten (die es in Deutschland nicht gibt, weil die Kassen nur digitale Geraete erlauben). Im Prinzip sind analoge Geraete die besten, weil am ehrlichsten in der Tonwiedergabe. Ich habe mir analoge Geraete aus China und USA kommen lassen: ihre Technik ist einfacher als die digitale und sie verbrauchen weniger Strom. Daher reicht ein Lithium-Akku ziemlich weit. Aber ihre Crux ist die Rueckkopplung Lautsprecher-Mikrofon: das Problem, das ueberhaupt zur Entwicklung und jetzigen Marktherrschaft der Digitalen gefuehrt hat. Um die Rueckkopplung zu verhindern braucht man eine Otoplastik. Eine solche macht der Akustiker (wenn man ein digitales Geraet kauft). Da es keine analogen Geraete gibt/geben darf, gibt es logischerweise niemand, der einem Otoplastiken macht, in Deutschland. Kein ausreichender Grund auszuwandern: man kann die Otoplastik ja selbst machen, wenn man sich zwei-Komponenten-Plastikmaterial besorgt, zum Beispiel in USA AHEAD Custom Molded Earplugs. Eine Packung reicht fuer mehrere Versuche.
Hat man das Rueckkopplungsproblem geloest, so zeigt sich, dass die auf dem Markt befindlichen analogen Geraete auch nicht besser sind als die digitalen Geraete, die mit ihren wenigen Kanaelen und den breitflankigen Filtern Akustiker und Kunden in Verzweiflung treiben. Wer es trotzdem versuchen will, kann mit den TrueEQ von Analog Hearing Labs (USA) anfangen, deren Chef Sreeny Cherukuri fachlich qualifiziert ist.
Will man jedoch wirklich glaubhafte analoge Wiedergabe erzielen, dann fuehrt kein Weg an tragbaren Geraeten und kabelbewehrten Kopfhoerern vorbei*)
. Auch da ist die Marktlage,was moderne Kleingeraete anlangt, duenn. Das ME-200P von AUSTAR (der angeblich weltgroessten Hoergeraetefabrik, natuerlich in China) ist leider vergriffen. (Eine aeltere Version davon gab es mal bei KIND und um ein paar Euro beim Fachhaendler Rossmann-Drogerie).
Noch erhaeltlich ist hingegen das ebenfalls chinesische More Glory Muguang box-type wired portable hearing AIDS, zum Beispiel in Manila erhaeltlich (https://www.lazada.com.ph/products/pdp-i5071320148-s29853373854.html?), das allerdings einen Ministecker fuer den Ohrhoerer aufweist -- man also notfalls umloeten muss. Das More Glory wird leider nicht (mehr?) auf der Website der Firma gefuehrt, man muss also in China suchen, wenn man nicht in Manila bestellen will.
Nicht jeder Ohrhoerer von einer Top-Marke wird gleich guten Klang liefern. Es empfiehlt sich, den Klang des Hoerers auf unangenehme Resonanzen zu testen, beispielsweise mit Hilfe des Online-Tongenerators (https://www.szynalski.com/tone-generator/) und den Typ mit dem ausgeglichensten Frequenzgang (ohne boese Resonanzen) zu waehlen.
Zur allgemeinen Information: hearing aids - update (https://germanpages.de/style/hearing-aids-update.html)
*) Die Mini-Kopfhoerer ("Lautsprecher") in allen gaengigen Hoergeraeten entsprechen in der Klangqualitaet in etwa den Gratis-bipack-Kopfhoerern, die man geliefert bekommt, wenn man ein Taschengeraet kauft, oder wenn man fuer ein paar Euro Kabel-Kopfhoerer in Diskountlaeden kauft. Wer hohe Verstaendlichkeit und Klangqualitaet will, darf die Im-Ohr und Hinter-dem-Ohr-Geraete vergessen und bekabelte Marken-Kopfhoerer (Sennheiser, Beyer usw.) fuer einen drei- bis vierstelligen Betrag erwerben, plus einem clip-on-Hoergeraet. Weitere Qualitaetsprobleme lauern in den Class-D Verstaerkern und in den Mini-Mikrofonen dieser Geraete.