Symphonia Virtual Sound Environment Software from Inventis Enables Patients to Experience the Benefits of Hearing Aids in Simulated Real World Environments
AudiologyOnline: What is Symphonia and what is the main goal of the system?
Anna Scala: Symphonia is a counseling tool developed for Hearing Care Professionals.
The main goal is to enable patients with hearing loss to experience the benefits of the advanced features of hearing devices, such as directionality and noise reduction. With Symphonia, the patient experiences a realistic hearing-situation which includes background noises (restaurant, coffee shop, the ocean waves, etc.) and directional sound sources (a guitar playing, a man talking, etc.). The software then allows the operator to change in real time the angle and distance from which sounds are perceived by the patient.
AudiologyOnline: Interesting! What does the Symphonia system include?
Anna Scala: The system consists of a computer with Symphonia software installed; a multi-channel sound card to connect to the computer; and a system with 3 to 8 active speakers (or passive with external amplifier). The Symphonia software includes a simple-to-use configuration wizard to help you set up the system. You can calibrate the system through the software, or using the smartphone app.
Symphonia software - speaker positions in the environment
AudiologyOnline: Can you describe some of the simulated sound sources and controls within the system?
Anna Scala: It is possible to select different soundfields such as coffee shop, restaurant, street, car, ocean waves.
The user can select the signal to reproduce and its level.
It is possible to add up to 3 directional sound sources emitting at the same time, with a different angle and intensity for each source. For example, you can choose from a man's speech, a woman's speech, a violin playing, etc. The user can also import custom sound files (.wav or .mp3) to further customize the experience for a patient.
When a source is added, the polar graph in the main view will contain the representation of the new source and its position. The source position can be easily modified by dragging the source circle around the graph with the mouse. For the sources, there is a direct relationship between distance and level, so modifying one of the two properties will also change the other.
Symphonia software – main view
AudiologyOnline: Dr. Comini, how do you use Symphonia in your daily practice?
Chiara Comini, AuD: I use Symphonia daily, as a counseling tool and for setting the gain of hearing aids.
Symphonia is very useful for helping people understand the need for hearing aids, especially for patients with milder losses. By creating a background noise (which simulates a realistic sound environment), it is possible to highlight the improvement in speech understanding with hearing aids.
I have also used the directional test in Symphonia for patients with unilateral hearing loss, when one ear has normal hearing and the other ear has a moderate-profound hearing loss. In these cases, amplifying the hearing loss ear runs the risk of negatively impacting speech understanding and localization, as well as causing general acoustic discomfort. If you rely exclusively on the target provided by the manufacturer’s software to fit the hearing aid without further testing you run the risk of a negative experience for your patient.
Using Symphonia, you can objectively verify localization. Without amplification, a patient with unilateral loss tends to perceive that all sound sources are coming from the normal hearing side. After at least a couple of weeks of listening training with a hearing aid, we can test localization with Symphonia. We can present sounds through the various speakers, and ask the patient to point to the direction from where they hear each sound. If we get a better balance of correct identifications of sounds from the left and the right, then we have improved localization for the patient (this optimum may be difficult to achieve if the hearing loss is profound). If sound is lateralized mainly on the impaired ear, we are most likely providing too much amplification with the hearing aid, taking away from the patient the natural work done by the healthy ear. Without Symphonia, it is challenging if not impossible to notice or verify this type of benefit. This same task can be extremely helpful when used with CROS fittings.
And, this task can be done with patients who have asymmetric hearing loss where there are different degrees of hearing loss in both ears to optimize the levels in both ears for a more balanced fitting.
AudiologyOnline: How do you use Symphonia to set the gain of hearing aids?
Chiara Comini, AuD: While delivering sound through the Symphonia speakers, I talk to the patient and check how well he/she hears my words. I then adjust gain accordingly using the manufacturer's hearing aid fitting software, as well as check the hearing aid maximum output parameters, compression and microphone settings, and any adaptive features.
I recently saw a 26-year-old patient with unilateral hearing loss, who started wearing a hearing aid on the poorer ear 10 years after diagnosis of the hearing loss.
I’ve noticed the gradual improvement of the balance between the two ears. At the beginning, the patient struggled to recognize the direction of the sound delivered by Symphonia. In particular she had great difficulty in recognizing the sound coming from the ear with the loss.
After a month with the hearing aid, I repeated the test: the patient was able to recognize the direction of the sounds perfectly. She responded with the same confidence whether I sent the sounds to her right side or left side. This was a huge benefit for this patient, and the hearing aid fitting was a success.
AudiologyOnline: Based on your experience with Symphonia, what are the benefits to adding Symphonia to your practice?
Chiara Comini, AuD: It's easy to use. Symphonia is a very intuitive and easy-to-use software to immerse your patients in a simulated but realistic world. The individual sound sources are natural sounds that the patient will surely find outside the clinic.
Patients enter a new world of sounds and noises. Anticipating and counteracting the annoyance generated by noises the patient is no longer used to hearing is essential to a positive outcome with hearing aids
With Symphonia, you can predict the obstacles the patient will face and be proactive in counseling and setting the hearing aids to ensure their success with amplification.
Patients can experience the benefits of advanced hearing aid features such as noise reduction and directionality right in your office! Thanks to Symphonia, all the good work you put into the hearing aid fitting can be realized right then and there. This gives your patient confidence in the fitting from the start.
Using Symphonia sets you apart, and differentiates your practice from others in terms of service and professionalism. Although a dedicated space is not necessary, having a room intended exclusively for simulating acoustic environments, for sound directionality studies and consultancy, creates a very positive impression on patients and shows your commitment to their success with hearing aids.
For more information about Symphonia, please view the webinar, Symphonia - the Software for Virtual Sound Environment Creation, on AudiologyOnline, or learn more about Symphonia at www.inventis.it