Hearing can fail in many ways, and to some extent, becoming hard of hearing is an unfortunate but inevitable consequence of normal ageing processes. Given how much our society relies on verbal communication, losing the ability to hear clearly can be devastating.
Thankfully, much progress has been made in recent decades in the area of auditory prosthetics: hearing aids and cochlear implants. The science behind these devices is very interesting, and is discussed in chapter 8 of "Auditory Neuroscience" . The following web pages provide supplementary material.

Early hearing aids and ear trumpets

Early hearing aids were often simple "ear trumpets" designed to funnel sound to the ear over a larger area to amplify the sound. But the users of hearing aids have always been concerned about the cosmetic side effects of their devices. The wonderful Becker Collection pages describe a variety of ingenious ways of trying to conceal hearing aids and ear trumpets, among them the chair of King John VI of Portugal shown here and mentioned in Chapter 8.1 of "Auditory Neuroscience." 


The Becker Collection also shows ear trumpets designed to be disguised as flower vases, to be concealed in a hat, or a walking cane, or under a bushy beard. 

Hear it Like Your Grandmother - Simulating Age Related Hearing Loss

As we age, our auditory sensitivity often declines, and the average decline is perhaps a lot more than you might think! Use the buttons below to start or stop a little stand-up comedy video clip, and to select to hear it the way it would sound to an average elderly person some 60, 70, or 80 years old, or someone completely deaf. You can also add "multi-speaker babble" background noise. Hearing the comedian is, unsurprisingly, more difficult in the presence of background noise, but it is even harder with background noise and old age hearing noise.

Background Noise

If you are fairly young and your hearing is good, you may be surprised, even appaled, at how much worse the simulated "elderly hearing" is. Is it really that bad? The answer to that is: it depends.

average hearing loss graph

To make this simulation, we filtered the sounds with low pass filters (solid lines in the plot above) fitted to audiometric data (circles) taken from Figure 4 of a 2010 book chapter by Richard Schmiedt entitled "The Physiology of Cochlear Presbycusis". The audiogram data show the averaged hearing thresholds for male subjects sampled at the Medical University of South Carolina. Interestingly, the decline in auditory thresholds in females was not nearly as severe, a fact that has been tentatively attributed to the fact that South Carolina males may spend more of their time with loud machinery and firearms than females, although the real reason is unclear. What is certain is that there is a great deal of individual variability, which is due to both environmental and genetic factors, so hearing impairment at an advanced age certainly need not be nearly as bad as these data and our demo suggest, but the fact that they are based on an average of hearing thresholds measured in a clinical population nevertheless shows that age related hearing impairments as bad, or worse, than what we demo here are sadly not uncommon!

Cochlear Implants

Cochlear Implants aim to restore hearing by direct electrical stimulation of the spiral ganglion, the part of the cochlea where the cell bodies of the auditory nerve fibres sit. This picture, kindly provided by MedEl, shows a typical modern cochlear implant. Contemporary implants consist of a receiver unit implanted under the scalp, from which a stimulating array electrode is run through the temporal bone and inserted into the scala tympani of the cochlea. Contemproary implants have in the order of 20+ contacts which deliver electrical stimulation along the tonotopic array.

Cochlear implants often represent speech formants quite well and enable implantees to have telephone conversations unaided. However, contemporary implants are unable to deliver sufficient temporal and spectral fine structure information to allow implantees to appreciate pitch and musical melody, or to localize sound sources accurately. These limitations make it hard for implantees to follow conversations in environments with high background noise. These shortcomings notwithstanding, cochlear implants are often remarkably effective in improving the quality of life of the severely hearing impaired.

A cochlear implant patient (youtube video)


This extract of a youtube video shows a 5 year old boy, Trever, who was born deaf but fitted with a cochlear implant early in life. What is remarkable about this video is how unremarkable it is. The things to note are that:


In Trever's case the implant was clearly successful, but the auditory experience of cochlear implant patients is nevertheless poor compared to that of individuals with healthy ears.

What do cochlear implants sound like? - 1: speech

Noise vocoded speech is sometimes used to simulate what speech would sound like through a cochlear implant. These sound files give an example of normal (well, fairly normal, British) English speech, and the same speech passed through an 8 channel vocoder. The speech is somewhat "rough", but comprehensible with some practice, at least if there is not too much other background noise.

As is explained in chapter 8 of "Auditory Neuroscience", the speech processors connected to cochlear implants may operate in a number of different modes, such as "compressed analog" (CA), "continuous interleaved sampling" (CIS) or any number of variants of these modes. What exactly they sound like will depend in the speech processor setting, and some settings are impossible to mimick by sound delivered to a healthy inner ear. The noise vocoded speech presented here is probably best thought of as a reasonable approximation of CA coding. CIS should have a rather different subjective sound quality which is impossible to mimic with real sounds, but it is not necessarily more informative of the sound source.

"Family viewing" - normal:

"Family viewing" - vocoded:

For more demos of what the world sounds like through cochlear implants, check out the next page, as well as this podcast.

What do cochlear implants sound like? - 2: music


For reasons explained in chapter 3 of "Auditory Neuroscience", cochlear implants do a very poor job at conveying musical pitch. Consequently, cochlear implant users can get the rhythm of a piece of music, but have tremendous difficulty recognizing or appreciating melodies. Their enjoyment of music is sadly much diminished as a consequence.

Here we again use noise vocoding to simulate what the world sounds like through a cochlear implant, but this time, instead of a speech sample, we run the noise vocoder over a short snippet of music.  

The piece we use for this illustration is a short extract of Ludwig van Beethoven's"Kreutzer Sonata", a very sophisticated piece for piano and solo violin. Beethoven himself famously became deaf, losing his hearing in adulthood. The cause of his deafness is uncertain. Nowadays he would be eligible for cochlear implantation, but while that would have restored his ability to understand speech in quiet, it would have done little to facilitate his work with music, as you may appreciate when you compare the normal extract of the Kreutzer Sonata with the vocoded ("cochlear implant filtered") one. In the vocoded example, the melody is almost completely lost, and it is similarly very hard to make out which instrument is playing when. 

Kreutzer Sonata - normal:

Kreutzer Sonata - vocoded:

A Cochlear Implant Success Story

In this informative and touching short video, Helen, who has been living with a cochlear implant for over a decade, tells her story. The implant enables her to take part in the hearing world at a very high level, studying at a top university for a demanding science degree, and even taking part in a dance sport team. But in the video Helen is also honest about the limitations of the technology, and reminds us that the implantation is a fairly major surgical intervention - nobody's idea of fun.


Music to Deaf Ears - podcast

This podcast by science journalist Dr Carinne Piekema explores how hearing loss affects people, in particular how it affects musicians, and what modern prosthetic devices such as hearing aids or cochlear implants can and cannot do for these patients. It contains insightful interviews with inspirational deaf musicians, some of the UKs leading hearing researchers, as well as simulations designed to show to normal listeners what it would be like to have to rely on a hearing aid or a cochlear implant.

You can listen to the podcast here,

or you can download it by right-clicking on the "Attachment" link below and choosing "Save link as...".

If you enjoyed the podcast, you may also wish to check out Carinne Piekema's blog, or follow her on twitter (CarinneP).

Sheldonian Theater Ceiling

MusicToDeafEars.mp320.53 MB