1. Lab / GTO Work Group: Johnny Hansen Charlotte T. Jespersen
Jan-Peter Rekling
Niels Stengaard Hansen

2. Content Audiological rationale Occlusion Venting Acoustic Mass
Openness of vents
Technical Lab aspects
Custom Open Products
The Conscious Choice
Sample survey
Stepvent advantages
Step Venting
New Techniques
Vent Strips
Flex Vent
The ‘Triangle’
Lab KPIs
Lab Training

3. Occlusion

4. Occlusion

5. Occlusion

6. Occlusion

7. Occlusion

8. Hearing loss & the occlusion effect
The user typically complain that own voice sounds
too loud and or like he/she is speaking in a barrel.
The occlusion effect is commonly experienced by
hearing aid users with low-frequency hearing
thresholds less than about 40 dB HL (Dillon, 2001).

9. 5 reasons for using vents
To allow bone-conducted low frequencies to escape
To allow amplified air-conducted low frequencies to escape
To allow unamplified signals to pass unobstructed to the eardrum
To allow pressure relief
To allow aeration of the ear canal

10. How do Vents work ?
Vents affect the low frequencies
(Dillon, 2001)

11. Why do vents affect the low frequencies ?
Eksperiment:
pick up a cup or whatever you might have in
front of you and move it slowly from side to side in front of you,
then increase the rate with which you move the cup/other thing from side to side.

12. What determines the vent effectiveness
Acoustic Mass determines the vent effect
The lower the Acoustic Mass the higher the vent effect (occlusion relief)
Formula
Vent Length x
Constant
Vent diameter2

13. Acoustic mass illustration
Experiment:
Pick up the long straw and try to blow through it
Then cut it so that the length is reduced to about 50%

14. Effects of Ventilation
Low frequency sounds can enter and leave the ear canal through the vent.
Transmission of low frequency sounds is easier the smaller the acoustic mass of the vent.
The acoustic mass of the vent is calculated from the length & diameter of the vent.
Increasing the diameter reduces the acoustic mass
Decreasing the length reduces the acoustic mass

15. Openness of vents
Non-occluding
Non-occluding
Open
Closed
Closed

16. How open are our instruments
ReSoundAir rating 1
FlexV (L) rating 3
FlexV (M) rating 4
Tmold (2.4) rating 6
Tmold (1.6) rating 7
S.CIC (2.3) rating 5
T.CIC (2.3) rating 5
FV(M):4
FV(L):3
Air:1
IROS
SCIC:5
Here you see the subjective occlusion rating (HI subjects) from the Giessen trial.
Explain why the stepped vent doesn’t alleviate occlusion. Venten kortes af, men kun ud til et hulrum som ikke er åbent, idet resten af apparatet fylder en del af øregangen ud.
Vent length in custom products:
19 x 2 (right and left) CIC devices vent length (stepped vent):
average of 1,48 cm
19 x 2 (right and left) CIC devices vent lengh (traditionel vent):
average of 1,99 cm.
Vent length of tradional earmold vents:
6 Earmolds 2,4 mm:average of 1,9 cm (vent length)
6 Earmolds 1,6 mm: average of 1,8 cm (vent length).
TCIC:5
Tmold:7
Tmold:6

17. Custom Products

18. Problems in the Lab
Custom products with open fittings, especially CIC’s often cause trouble for the Lab.
To get room for the vent canal you occasionally have to compromise.
You can focus on either Cosmetics or Comfort.
You can compromise on either vent diameter or instrument size.

19. Full cosmetic benefits
Custom Open Products
Vent diameter
Small
Large
Full cosmetic benefits
Small
Select cases*
* Cases of larger ear canals
Instrument size
Full comfort benefits
No perceived benefits
Large
Ø 1.6 mm (~2.0 mm2) Ø 2.6 mm Ø 3.0 mm (~7.0 mm2)
<-Closed
Open ->

20. Vents on Custom Products
Non-occluding
Non-occluding
Open
Custom
Closed
Closed

21. The conscious choice Compromise on instrument size.
Risk of Return due to protrusion
Comfort
Limited room for vent
Cosmetics
Compromise on vent diameter.
Risk of Return due to occlusion.
Keep in mind that 40% of users experience Occlusion as the primary problem

22. DF

23. Lab samples - survey 7 different labs. Netherlands – Spain – Italy
Germany - UK – Japan - USA
2 impressions (J & K)
K : average
J : more challenge
4 instruments each
K-impression: one 710-OC
one 730-OC
J-impression: one 710-OC

24. Full cosmetic bennefit
Lab sample CIC B B C D F G
Jennifer B B C D E F
Kevin B
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: ~2.2mm ~2.2 mm
Length: 13 mm 17 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
CIC B : Germany
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

25. Full cosmetic bennefit
Lab sample CIC C B C D F G
Jennifer C B C D E F
Kevin C
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: 3.0mm 3.0 mm
Length: 13.5 mm 17 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
CIC C : Netherlands
J-sample: Good fit. Compromised a on instrument size to get room for a large vent.
K-sample: Nice fit, protruding due to large vent.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

26. Full cosmetic bennefit
Lab sample CIC D B C D F G
Jennifer D B C D E F
Kevin D
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm 2.5 mm
Length: 13.4 mm 15.8 mm
Ø 1.5 mm Ø 2.6 mm Ø 3.0mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
CIC D : Italy
J-sample: Fit OK, compromise be-tween instrument size and vent size.
K-sample: Fit nice, no profound protrusion. Could have used 3.0 vent and made instrument a bit larger.

27. Full cosmetic bennefit
Lab sample CIC E B C D F G
Jennifer B C D E F
Kevin E
J-sample
K-sample
Intentionally left blank
Vent canal data:
J-sample K-sample
Diameter: mm
Length: mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
J-sample:
No instrument produced due to misunderstaning of order.
CIC E : Japan
J-sample: No instrument produced due to misunderstanding of order.
K-sample: Fit nice, no profound protrusion. Could have used 3.0 vent and made instrument a bit larger.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

28. Full cosmetic bennefit
Lab sample CIC F B C D F G
Jennifer F B C D E F
Kevin F
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: 1.5mm N/A
Length: 10 mm N/A
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
CIC F: Spain
J-sample: Nice fit , but very smalll vent. Can not be regarded as an Open Fitting. Furthermore the step vent is made so it will be occluded by the ear canal.
K-sample: Fit OK. Vent looks like 2.0 mm, but narrows in in the middle and is almost closed. (Cannot be measured)

29. Full cosmetic bennefit
Lab sample CIC G B C D F G
Jennifer G B C D E F
Kevin
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: 1.5mm N/A
Length: 18 mm N/A
Intentionally left blank
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
K-sample:
No instrument produced due to misunderstaning of order.
CIC G: USA
J-sample: Not a good fit. Does not fit the ear canal well. Protruding and still a quite small vent.
K-sample: No instrument produced due to misunderstaning of order.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

30. Full cosmetic bennefit
Lab sample ITC A A A A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm 2.5 mm
Length: 19 mm 21 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
ITC A: U.K.
J-sample: Fit OK. Little too big considering the 2.5 mm vent.
K-sample: Could have used a lager vent without increasing the instrument size and hereby get a more open fitting.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

31. Full cosmetic bennefit
Lab sample ITC B B B A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm 3.1 mm
Length: 16.5 mm 20 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
ITC B: Germany
J-sample: No big difference between J and K sample. Good utilization of space for the Large D-vent. Alternative layout of faceplate with good access to push button.
K-sample: Same as J-sample.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

32. Full cosmetic bennefit
Lab sample ITC C C C A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm 3.0 mm
Length: 13 mm 15 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
ITC C: Netherlands.
J-sample: Quite large instrument with some. Do not follow ear line which makes the instrument create unwanted shadows and angles in the ear.
K-sample: Same as J-sample. Both instruments could have been made smaller by using a D-vent.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

33. Full cosmetic bennefit
Lab sample ITC D D D A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm 2.5 mm
Length: 10 mm 10.6 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
ITC D: Italy.
J-sample:Small instrument with vent canal in the top. Even if the canal looks big at the ends it narrows down in the mittle decreasing the vent effect. Vent size has been compromised for instrument size.
K-sample: Not a good fit. Presses against Tragus and have a bad fit in the bottom part.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

34. Full cosmetic bennefit
Lab sample ITC E A E B C D F
Jennifer E
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: mm N/A
Length: 13 mm N/A
Intentionally left blank
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
K-sample:
No instrument produced due to misunderstaning of order.
ITC E: Japan
J-sample: Nice small instrument with a large 3.0 mm vent. Nice layout.
K-sample: No instrument produced due to misunderstanding order.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

35. Full cosmetic bennefit
Lab sample ITC F F F A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Vent canal data:
J-sample K-sample
Diameter: ~2.0 mm ~1.0 mm
Length: 11 mm 12 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
ITC F: Spain.
J-sample: Instrument fit nicely, but vent is small and not stepped back correct. The canal is narrowing down in the mittle.
K-sample: Same as J. In the canal the vent is blocked by the ear canal.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

36. Full cosmetic bennefit
Lab sample ITC G G A E B C D F
Jennifer
Kevin B C D F G A
J-sample
K-sample
Intentionally left blank
Vent canal data:
J-sample K-sample
Diameter: N/A 2.0 mm
Length: N/A 21.5 mm
Full cosmetic bennefit
Full comfort bennefit
No percived bennefits
Select cases
Instrument size
Vent diameter
J-sample:
No instrument produced due to misunderstaning of order.
ITC G: USA
J-sample: No instrument produced.
K-sample: Large protruding instrument with a bad fit. Vent space is not opti-mized considering the size of the instrument.
Ø 1.5 mm Ø 2.6 mm Ø 3.0 mm

37. StepVent

38. StepVent advantages
Greatest potential risk of increasing the vent effect is increased likelihood of feedback - the feedback penalty
Vent Diameter: A wider vent gives more vent effect
Vent Length: A shorter vent gives more vent effect
Shorter vents also tend to reduce likelihood of feedback because the feedback frequency resonance is shifted to a higher frequency range which helps to optimize the Stabilizer DFS. 10 2 3 4
-80
-70
-60
-50
-40
-30
-20
-10
Frequency, Hz
Feedback path response, dB
Stepped
Not stepped

39. Step Venting Process StepVent reduces the canal length.
but not enough to compensate for a small vent diameter.

40. Venting Process 1

41. Venting Process 2
Select the largest possible diameter vent wire for the Canta Open Canal instruments. Press it against the shell wall firmly from one end to the other.

42. Venting Process 3
Apply UV material in two thin lines on each side of the vent wire. Make sure that the material floats gently around the wire. Cure the material completely in the UV-machine.

43. Venting Process 4
Completely cover the remaining part of the vent wire with the UV venting material. Cure it in the UV-machine until completely hard.

44. Venting Process 5
Gently, pull out the vent wire. Inspect the vent for holes and thin areas.

45. Large vent issues
Faceplate Module Battery Hybrid Receiver

46. Large vent issues
Faceplate Module Battery Hybrid Receiver

47. Large vent issues
Faceplate Module Battery Hybrid Receiver

48. New Techniques - Large vent procedure 1
Drill holes at the expected end position of the step vent.

49. Large vent procedure 2
Insert vent strip through the drilled holes

50. Large vent procedure 3
Fill up. Apply two times. Be sure to fill up solid at the tip at second apply.

51. Large vent procedure 4
Cure vent material and remove vent strip.

52. Large vent procedure 5
Grind down from each end until the entrance of the vent canal is reached.
Mount faceplate and components.

53. Vent strips Small: 1.0 mm (0.040) 9103-059 0.8 mm2
Name Diameter Part # Area
Small: mm (0.040) mm2
Medium: 1.5 mm (0.060) mm2
Large 1: 2.2 mm (0.085) mm2
Large 2: 2.3 mm (0.090) mm2
Iros: 3.0 mm (0.118) mm2
Small D-vent: mm mm2
Large D-vent: mm mm2

54. Full cosmetic benefits
Survey Summary
Small
Large
Vent diameter
Vent diameter
Small
Large
Spain
Italy
Japan UK
USA Germany
Netherlands
Full cosmetic benefits
Small
Select cases
Small
Instrument size
No percived benefits
Full comfort benefits
Large
Large

55. FlexVentTM – a complete solution

56. FlexVent™ - a complete solution
“ Canta7 Open BTE combined with FlexVent™ is our unique and preferred choice” – because it;
- provides optimal comfort benefits to the end-user, and
is a true USP (nobody else has FlexVentTM) to the dispenser
FlexVent
(rear)
(front)

57. Benefits & key issues
Canta7Open BTE combined with FlexVent™ addresses 58% of users (Dialogue study)
FlexVent offers Minimal-Occluding Natural sound benefits to the hearing impaired - as well as great wearing comfort (cool, light and comfortable) – with no compromise on gain!
FlexVentTM provides a 100% improved vent effect compared to traditional ear molds (Giessen study)
The Canta7Open BTE offers competitive Minimal-occlusion benefits compared to IROS ear molds – and is fully compatible with IROS ear molds
The Unique GN ReSound FlexVentTM concept must be offered by well trained selected external - alternatively by own labs

58. Lab - Key Performance Indicators

59. Making sure the “Triangle” works
Most labs communicate with dispensers through internal sales
Make the dispenser believe in Open, give him RFC awareness and give him dummies documenting possibilities/restraints
Establish “rules of engagement” both between sales and lab and sales and dispenser
Make sure that Sales and Lab people have common understanding of Open and agree on company policies (do joint training)
Dispenser
Sales
external
internal
Lab

60. Lab KPIs
KPIs will be become focus areas of Management tracking and Lab Continuous Improvement Training
Dialogue on-going with Global Ops how to most rationally collect these data
Final process to be defined

61. GTO / Lab Training:
Cluster Work Shops

62. Lab Training America Asia Europe North Europe South
4 Lab training sessions to be co-ordinated with Product/Mkt/Sales training
America
(Bloomington)
March 3rd
US – CND
Asia
(DanaJapan)
March 9th
JPN – CHI – AUS - NZ
Europe North
(Taastrup)
March 9th
GER – HOL – FRA
DEN - SWE – NOR - BRA
Europe South
(Madrid)
March 12th
SPA – ITA – U.K.
BEL - SWI - A

63. GTO/Lab Training Outline
Mindset building (shared knowledge base)
Audiology
Lab / GTO
Demos
Hands-On training
Advanced StepVent – New shortening techniques
D-vents
New materials
Face plate colors
Full day program
Target audience: lab/quality manager + super operator
Mindset building – same contents as for Sales Team

64. Thank you.
Questions ?

65. Full cosmetic benefits
Lab/GTO: Key Takes
Select cases*
Full cosmetic benefits
Full comfort benefits
No percived benefits
Maximize vent diameter – only way for full Comfort benefits
Compromise instrument size.
Comfort
The conscious choice – Comfort or Cosmetics
Limited room for vent
Cosmetics
Compromise on vent diameter.
New Venting Techniques to support max vents

66. How open are our instruments
ReSoundAir rating 1
FlexV (L) rating 3
FlexV (M) rating 4
Tmold (2.4) rating 6
Tmold (1.6) rating 7
S.CIC (2.3) rating 5
T.CIC (2.3) rating 5
FV(M):4
FV(L):3
Air:1
IROS
SCIC:5
Here you see the subjective occlusion rating (HI subjects) from the Giessen trial.
Explain why the stepped vent doesn’t alleviate occlusion. Venten kortes af, men kun ud til et hulrum som ikke er åbent, idet resten af apparatet fylder en del af øregangen ud.
Vent length in custom products:
19 x 2 (right and left) CIC devices vent length (stepped vent):
average of 1,48 cm
19 x 2 (right and left) CIC devices vent lengh (traditionel vent):
average of 1,99 cm.
Vent length of tradional earmold vents:
6 Earmolds 2,4 mm:average of 1,9 cm (vent length)
6 Earmolds 1,6 mm: average of 1,8 cm (vent length).
TCIC:5
Tmold:7
Tmold:6