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  1. 2.4 GHz digital wireless technology promises to be a novel technology which will impact our daily use of our MED-EL hearing devices. Unfortunately MED-EL has not presented any specifics on how 2.4 GHz digital wireless technology will be implemented. Hopefully this discussion will start something. The SONNET processor is wireless ready which refers to the fact that it has a 2.4 GHz radio band antenna, which receives wireless Radio Frequency (RF) signals, which allow for direct streaming of audio signals to the SONNET processor. The 2.4 GHz platform communicates directly, device to device. The induction/T-coil-based wireless technology does not use the 2.4 GHz platform and thus still requires the user to wear a neck loop to transmit the signal to the cochlear implant. This reduces the sound quality and requires the user to stay within 8-10 feet of the signal transmitter. True wireless uses the 2.4 GHz technology platform, making the sound quality and the signal range much greater and much more stable. Wireless is not a new concept for cochlear implants. The challenge is which technology to use and how to use it. Today we have three main wireless technologies: Near Field Magnetic Induction (NFMI), Bluetooth (RF) and Proprietary radio frequency (RF). Near Field Magnetic Induction (NFMI) is an example of analog wireless technology. Analog wireless is the transmission of audio and video signals using radio frequencies. NFMI systems are designed to contain transmission energy within the localized magnetic field. NFMI requires a gateway device to communicate between the accessory (TV, mp3 player, etc) and the cochlear implant processor. This device is typically worn around the neck and uses an inductive loop to broadcast from the gateway device to the cochlear implant processor. NFMI does not use the 2.4 GHz platform. Bluetooth and Proprietary radio frequency are examples of digital wireless technology. Digital wireless is the transmission of audio and video analog signals encoded as digital packets over high bandwidth radio frequencies. Digital wireless possesses frequency hopping technology which eliminates the need to manage a frequency and is interference-free. It also provides Higher-quality video and audio and increased range of transmission as compared to analog wireless. Bluetooth is an open standard for wireless communications and uses the 2.4 GHz platform. Currently there are nearly 12,000 different products using Bluetooth. Communication protocols for Bluetooth must be broad and flexible enough to accommodate many uses. Bluetooth uses significant computational and power resources to operate. Bluetooth broadcasts to a very limited number of receivers and the audio delay of a Bluetooth system is high. Near Field Magnetic Induction is typically combined with Bluetooth. An example is the MED-EL provided Quattro Bluetooth neckloop. The Proprietary radio frequency system uses a radio to generate an electrical wave and an antenna to send the information and uses the 2.4 GHz platform. In these types of systems all of the transmission energy is designed to radiate into free space. This type of transmission is referred to as a far-field. The electrical wave carries the information and it can be done by using different frequencies. Advantages of using Proprietary radio frequency with 2.4 GHz Wireless Technology include: no gateway device required for media connectivity; long distance signal transmission, robust and reliable connections; high transmitted data capacity: bandwidth, stereo, low distortion; low latency processing delay and worldwide application. Drawbacks include: requires a specially designed antenna and a streaming device for Bluetooth connectivity. One of the key requirements of a wireless system is its ability to transmit with good sound quality and with the smallest possible delay (latency). A latency of 35ms or more is enough to cause the perception of echoes or even lip sync issues due to a mismatch between sound and visual information. Even when the delay is too small to be consciously perceived, there may be a significant negative impact on the television viewing experience. The Proprietary radio frequency system 2.4 GHz technology is associated with a very minor latency (less than 18ms) well below the threshold for lip sync issues and echo effects. However, other wireless technologies, such as NFMI, transmit with latency (delay) from 40 up to 125 milliseconds, which can provide significant issues for the user. In addition, the Proprietary radio frequency system 2.4 GHz system uses high-density audio compression, resulting in superior audio quality transmitted directly to the sound processor, while other wireless technologies such as Bluetooth and NFMI may use a so-called “low density” solution for audio compression. Thus Bluetooth and NFMI are not being considered for direct streaming of audio signals to the cochlear implant processor by the three major cochlear implant vendors. The Proprietary radio frequency system is the technology currently being used by the three major cochlear implant companies to directly stream audio signals to a cochlear implant processor via digital RF transmission. There are two ways to directly stream audio signals to a cochlear implant processor using Proprietary radio frequency system technology via digital RF transmission: 1) via a wireless accessory/streamer, 2) directly to the cochlear implant processor. The two approaches are described below in the context of streaming audio from a smartphone. 1) Via a wireless accessory/streamer. Receive the phone signal via a wireless phone accessory or streamer that connects to the phone via Bluetooth. The accessory or streamer accepts the Bluetooth signal from the phone and converts it to the appropriate wireless signal that can be received by the cochlear implant processor. The accessory converts the standard Bluetooth signal to the 2.4 GHz digital wireless signal for transmission to the cochlear implant processor. In addition, the accessory must be worn or placed such that a built-in microphone in the accessory can pick up the voice of the hearing aid wearer, convert it to a Bluetooth signal, and transmit it back to the cell phone. This capability is current being used in Roger technology. Roger is a Phonak developed proprietary radio frequency system standard protocol which uses adaptive digital wireless transmission technology. Cochlear implant users use Roger receivers as the accessory or streaming device to receive audio signals from Roger microphones. Cochlear Corporation also uses a proprietary 2.4 GHz radio frequency system standard protocol to enable a direct connection to the wireless signal. With the Cochlear 2.4 GHz system, the Nucleus CI or BAHA user may connect directly to three streaming accessories, such as the TV Streamer, and/or the Mini Microphone, plus a Phone Clip. In addition, several users may share the signal transmitted from one wireless accessory. However Cochlear did not develop the technology but instead licensed the proprietary ReSound 2.4 GHz digital wireless system from GN Resound corporation. 2) Directly to the cochlear implant processor. Receive the phone signal directly to the hearing instruments with no wireless phone accessory or streamer. Currently this capability has not been implemented with any cochlear implant processor. The main problems are that the cochlear implant processor has: 1) no Bluetooth connectivity to accept the Bluetooth signal from the phone and 2) no proprietary 2.4 GHz digital wireless system protocol software to convert the Bluetooth signal to 2.4 GHz digital wireless (just has the 2.4 GHz antenna). There is however one hearing instrument which has developed the capability to directly stream to a hearing aid without accessory/streamer, the Made for iPhone hearing aid. Apple has developed a proprietary audio streaming protocol in the 2.4 GHz band (ReSound LiNX) that the hearing aid must be able to tap into in order to receive the phone signal directly. That means that the hearing aid must have a 2.4 GHz radio, and must also have adopted the communication protocol developed by Apple. The hearing aid wearer speaks into the phone itself, so the phone can either be held normally or just placed nearby so that it can pick up the user’s voice. It is the the first hearing aid to allow direct connection to Apple devices. As of today, no cell phone manufacturers other than Apple have made this type of functionality available for hearing instrument manufacturers to connect to. Naturally there are many questions for MED-EL. Which of the two approaches will MED-EL use to directly stream audio signals to the SONNET processor via digital RF transmission? Will MED-EL design wireless accessories/streamers? Will the SONNET have Bluetooth connectivity? What 2.4 GHz digital wireless system will MED-EL use? Will MED-EL create the 2.4 GHz digital wireless system technology themselves or license it from vendors like GN Resound/Cochlear Corp, GN Resound LiNX/Apple or Phonak? Can older FM systems interface to the MED-EL design wireless accessories/streamers? Will other MED-EL processors like Samba or the RONDO be 2.4 GHz ready?
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