Inner Ear Hair Cell Regeneration — Maybe We Can Know More

[Nick Pyzik]

I believe it is a kind of post traumatic stress disorder which could eventually diminish, without any drugs, but if natural supplements seem to help you continue with them if they are harmless. I say that because I suffered exactly the same. After many months overnight I listened to music again with the same former good feelings though punch, sharpness in what I listen is bad compared to the past. My ears break like glass if I don't take care and my hearing is muffled compared to the past along with difficulties to hear in noise. I was told by all the doctors I was mentally ill when telling the same issues you have currently but years after I finally notice it's themselves who were mentally sick with their deny and ignorance.

If you manage to listen to music again like before though bad quality, you could do music again and listen to it like before concerning feelings. Btw I learned how to produce music and how sound is build after acoustic traumas. But I fear my tinnitus and hearing goes more and more bad with time. And lack of high fidelity with lack of punch makes me sometimes desperate. But since the paradigm in hearing knowledges might change, I hope future therapies will give us back inner ear high fidelity again along with ability to play live with moderate level and listen to headphones, again with moderate level.

I believe your emotional issues are linked to the fact that you felt very accurately the music since you are a musician. A few weeks before my first trauma (loud loudspeaker noise in student event) I often listened to vinyls and felt how punchy and sharp the sound was. And after the trauma when I listened to them, it sounded lofi and for a few months I did no felt anything when listening to music along with a very bad mood. Since then, my hearing became worse because even moderately loud noise causes trauma, we must take care, capitalize what's remaining before a cure exists.

I'm sorry to say that I don't believe in the names of mental disorders that doctors or any sort of practitioner can give you. I care more about the functional systems inside our brain that can be looked at like a puzzle with the correct information and understanding of how each region works. Depression, Schizophrenia, Bi-Polar Disorder are a few mental disorders that are categorized differently yet are all involved in the same loss of gray matter in the brain. I don't mean to sound rude but truthfully, I stubbornly know exactly what has happened to my brain from my hearing issue. I just don't know what changes will be continually taking place over time through the structural foundations of cells and neurons in my brain. I seem to still be making memories each day, but they are fairly faint even with me taking supplements recommended for mental health.

Our consciousness is made up of only the memories created through chemically (emotionally) composed neurons as we aged from birth and up until present day. Our senses are what created those memories. As I'm sure you understand, new neurons are said to be created everyday while we lose older ones over time. The stronger your emotions are or "chemically neurotransmitting functions" through your senses, the stronger your memories will be from those moments. Although our sight, touch, taste, and smell all can bring back memories through your past life of growing up, I can't get over the fact that I believe our sense of "hearing" is so incredibly emotionally informational that it has to be one of our biggest emotional influences on how we perceive this world and store memories in our brain.

Now speaking about my actual hearing, there are a few things going on with it presently. Mainly, If I try to focus on a sound and there are other louder noises going on around me, then that sound gets drowned out and I can't process it. I've also basically lost my ability to process high frequencies even though I can still pick up in a absolutely quiet room the highest possible frequency a human can hear. Lastly, I can still enjoy music, but I feel no change in emotion while "hearing" it. I can't listen to music on headphones because I have no threshold to sound anymore. It's almost distorted sounding when I play it that close inside my ear. Even loud speakers give me a distorted sound. I can pick up what instruments are being played in any song I listen too, but the timbre, quality, and loudness inside my head of what I hear is gone.

 

[tomytl]

I'm sorry to say that I don't believe in the names of mental disorders that doctors or any sort of practitioner can give you. I care more about the functional systems inside our brain that can be looked at like a puzzle with the correct information and understanding of how each region works. Depression, Schizophrenia, Bi-Polar Disorder are a few mental disorders that are categorized differently yet are all involved in the same loss of gray matter in the brain. I don't mean to sound rude but truthfully, I stubbornly know exactly what has happened to my brain from my hearing issue. I just don't know what changes will be continually taking place over time through the structural foundations of cells and neurons in my brain. I seem to still be making memories each day, but they are fairly faint even with me taking supplements recommended for mental health.

Our consciousness is made up of only the memories created through chemically (emotionally) composed neurons as we aged from birth and up until present day. Our senses are what created those memories. As I'm sure you understand, new neurons are said to be created everyday while we lose older ones over time. The stronger your emotions are or "chemically neurotransmitting functions" through your senses, the stronger your memories will be from those moments. Although our sight, touch, taste, and smell all can bring back memories through your past life of growing up, I can't get over the fact that I believe our sense of "hearing" is so incredibly emotionally informational that it has to be one of our biggest emotional influences on how we perceive this world and store memories in our brain.

Now speaking about my actual hearing, there are a few things going on with it presently. Mainly, If I try to focus on a sound and there are other louder noises going on around me, then that sound gets drowned out and I can't process it. I've also basically lost my ability to process high frequencies even though I can still pick up in a absolutely quiet room the highest possible frequency a human can hear. Lastly, I can still enjoy music, but I feel no change in emotion while "hearing" it. I can't listen to music on headphones because I have no threshold to sound anymore. It's almost distorted sounding when I play it that close inside my ear. Even loud speakers give me a distorted sound. I can pick up what instruments are being played in any song I listen too, but the timbre, quality, and loudness inside my head of what I hear is gone.

I know exactly what you are describing!
Two years ago aftermy last big hearing impact all acoustic perception was like listening to a big pink noise, especially listening to something with many harmonies and frequencies like music or environmental sounds. I just could't focus and metally follow one of this sounds or melody.
Everything sounded like same level, like a homogenous mass.
In consequenc of this, my feelings also eased out, I could't feel joy nor deeply sadness especially for things to share with other people....
Now, about 800 days later things changed a bit to the better, I can hear more clear and with more dynamic again, it's still far from healthy hearing, but it improved to a level I can sometimes live with it. Tinnitus still overlays a lot of the sounds and sometimes is the dominant factor...
The hyperacusis or phonophobia got a lot better.
So hearing what we hear frequency wise is just peripheral, the processing engine behind the perception of hearing is a big factor.

I hope this part can improve with something who improves thnerve connections owhat ever.

 

[Reinier]

"Genetic predisposition found for noise-induced hearing loss"

I am not at all surprised. With the many processes this complex for hearing alone I can relate to this.

 

[Reinier]

Now, about 800 days later things changed a bit to the better,

I am glad to hear that after such a long time you still noticed improvement. That gives me hope. After almost one your post noise trauma I am still experience major problems with my hearing. The same you and nick are talking about. Especially the intolerance to normal sounds (person speaking to me) throws me back into this deep black abyss. Oh.... I hate the not abating distortion

 

[cornelius]

I'm sorry to say that I don't believe in the names of mental disorders that doctors or any sort of practitioner can give you. I care more about the functional systems inside our brain that can be looked at like a puzzle with the correct information and understanding of how each region works. Depression, Schizophrenia, Bi-Polar Disorder are a few mental disorders that are categorized differently yet are all involved in the same loss of gray matter in the brain. I don't mean to sound rude but truthfully, I stubbornly know exactly what has happened to my brain from my hearing issue. I just don't know what changes will be continually taking place over time through the structural foundations of cells and neurons in my brain. I seem to still be making memories each day, but they are fairly faint even with me taking supplements recommended for mental health.

Our consciousness is made up of only the memories created through chemically (emotionally) composed neurons as we aged from birth and up until present day. Our senses are what created those memories. As I'm sure you understand, new neurons are said to be created everyday while we lose older ones over time. The stronger your emotions are or "chemically neurotransmitting functions" through your senses, the stronger your memories will be from those moments. Although our sight, touch, taste, and smell all can bring back memories through your past life of growing up, I can't get over the fact that I believe our sense of "hearing" is so incredibly emotionally informational that it has to be one of our biggest emotional influences on how we perceive this world and store memories in our brain.

Now speaking about my actual hearing, there are a few things going on with it presently. Mainly, If I try to focus on a sound and there are other louder noises going on around me, then that sound gets drowned out and I can't process it. I've also basically lost my ability to process high frequencies even though I can still pick up in a absolutely quiet room the highest possible frequency a human can hear. Lastly, I can still enjoy music, but I feel no change in emotion while "hearing" it. I can't listen to music on headphones because I have no threshold to sound anymore. It's almost distorted sounding when I play it that close inside my ear. Even loud speakers give me a distorted sound. I can pick up what instruments are being played in any song I listen too, but the timbre, quality, and loudness inside my head of what I hear is gone.

Actually I have exactly the same issues as you though my brain has more or less compensated over time. Sorry I used the term post traumatic stress disorder which has made a mild misunderstood in the conversation because I don't know the scientific words to explain these emotional modifications in sound processing resulting of inner ear damages involving our body memories. It is demanding when trying explaining that to doctors, in my case it was 15 years ago, and I no longer talk to physicians since they all told me I'm mentally ill, along with their pitiful audiograms. Emotional alteration in sound processing, distorsion, lack of fidelity... if only one doctor had told me I must avoid moderately loud noises and my feelings were true, I would have avoided all the successive traumas.

Again, though making music production and reasonably able to feel it with chills, I still feel altered and hope one day our cells and nerves will be brought back. It's like high level legless sprinter with high technology prosthesis, they enjoy their sport but if they had limb (re)generation they would feel it normally since their limbs would give them (again) the pain and an amount of intense emotions linked to it during the effort.

 

[cornelius]

I know exactly what you are describing!
Two years ago aftermy last big hearing impact all acoustic perception was like listening to a big pink noise, especially listening to something with many harmonies and frequencies like music or environmental sounds. I just could't focus and metally follow one of this sounds or melody.
Everything sounded like same level, like a homogenous mass.
In consequenc of this, my feelings also eased out, I could't feel joy nor deeply sadness especially for things to share with other people....
Now, about 800 days later things changed a bit to the better, I can hear more clear and with more dynamic again, it's still far from healthy hearing, but it improved to a level I can sometimes live with it. Tinnitus still overlays a lot of the sounds and sometimes is the dominant factor...
The hyperacusis or phonophobia got a lot better.
So hearing what we hear frequency wise is just peripheral, the processing engine behind the perception of hearing is a big factor.

I hope this part can improve with something who improves thnerve connections owhat ever.

So do I, therefore for music production I use a lot of reference mixes made by other bands since I lost a huge amount of dynamics with this sensation of flat porridge sound which also increases tinnitus.

 

[Reinier]

I still feel altered and hope one day our cells and nerves will be brought back.

The fact that after 15 years you are able to still hope for a cure also makes me more hopeful.
Did you just recently started to look for this on the internet?

Look at this link: actiononhearingloss.org.uk/community/blogs/our-guest-blog/making-our-funding-go-further
Here it is explained how unbelievably refined healthy hearing can be.
Quote: " They are especially interested in a phenomenon that allows people with normal hearing to effectively listen to speech in background noise, called 'spatial release from masking', or SRM. SRM occurs when the speech sound and the interfering background noise come from different directions – as a result, the two ears of a listener receive slightly different information from each other. For example, the ear nearest the speech sound will perceive it as being a little louder than, and will hear it a little sooner, than the other ear. Likewise, the other ear, being nearer to the source of the background noise will hear it as a little louder, and hear it a little sooner, than the first ear. The brain is able to use the tiny differences in information from the two ears to filter out the noise and focus on the speech, making it easier to hear and understand it".
End quote.
This was what I was talking about in one of my earlier posts. The fact that I used to be so impresses with what we are able to hear with healthy hearing.
So it is not surprising that we experience so much more than "only" tinnitus, distortion and hyperacusis.
And it is very sad that still a default hearing assessment at your ENT is so course. I suppose that just reflects the level of knowledge about hearing. Luckily for us that seams to be slowly changing as insight increases.

 

[cornelius]

The fact that after 15 years you are able to still hope for a cure also makes me more hopeful.
Did you just recently started to look for this on the internet?

Look at this link: actiononhearingloss.org.uk/community/blogs/our-guest-blog/making-our-funding-go-further
Here it is explained how unbelievably refined healthy hearing can be.
Quote: " They are especially interested in a phenomenon that allows people with normal hearing to effectively listen to speech in background noise, called 'spatial release from masking', or SRM. SRM occurs when the speech sound and the interfering background noise come from different directions – as a result, the two ears of a listener receive slightly different information from each other. For example, the ear nearest the speech sound will perceive it as being a little louder than, and will hear it a little sooner, than the other ear. Likewise, the other ear, being nearer to the source of the background noise will hear it as a little louder, and hear it a little sooner, than the first ear. The brain is able to use the tiny differences in information from the two ears to filter out the noise and focus on the speech, making it easier to hear and understand it.
This was what I was talking about in one of my earlier posts. The fact that I used to be so impresses with what we are able to hear with healthy hearing.
End quote.
So it is not surprising that we experience so much more that "only"tinnitus, distortion and hyperacusis.
And it is very sad that still a default hearing assessment at your ENT is so course. I suppose that just reflects the level of knowledge about hearing. Luckily for us that seams to be slowly changing as insight increases.

I started to seek answers already 15 years ago, but forums and public reports were rudimentary. It was more talked about - understandably - the raw sufferings resulting from tinnitus, hyperacusis and hearing loss on audiograms. On forums, if one explained clearly and millimetricaly his or her issues, there was comprehension but we knew very very little about this contrary to today where we know very little. And doctors... one told me with a sneering laugh I have to read on lips since we know nothing about inner ear, another said I feel hearing impaired because I don't want to listen etc, though I explained it like Nick does here but without any scientific terms and difficulties, it was in 2002.

 

[Reinier]

@cornelius So, do you see more research. Perhaps even promising research the last, lets say, 2 years?

 

[cornelius]

@cornelius So, do you see more research. Perhaps even promising research the last, lets say, 2 years?

If I talk about my immediate feelings, I would say that starting from the early 2000's, the amount of information is exponential every 3-4 years but again, it's only studies on paper, and sometimes clinical tests on animals, but nothing significant about humans yet. At least one thing is sure, complaining about lack of fidelity, distorsion and loss of punch / sparkle is taken more seriously. It is even admitted that hearing aids might be destructive for some persons' ears (genetic predisposition to risks even with moderate noise). These last 2-3 years along with stem cells and genetics I read many reports about the increasing hearing aid market but I don't see it as a good thing since it's like an infinite loop which helps for sure but doesn't resolve wounds at the root. I'm almost sure that in 5 years a smartphone could do the same job as a 2016 hearing aid with frequency setup and noise compression, hopefully it would make the hearing aid market switch to a more biological market.

 

[Reinier]

I'm almost sure that in 5 years a smartphone could do the same job as a 2016 hearing aid with frequency setup and noise compression, hopefully it would make the hearing aid market switch to a more biological market.

That is an interesting remark you make here. It is not as small (integral microphone, speaker and amplifier/processor) but you could very well be right regarding software. (Options/applications). It is still remains very limited for the simple fact that the weak link in the whole process is not addressed. The weak link being our damaged ears. I wonder how much improvement therefore is possible with clever software. Perhaps (depending on the level of damage in ones hearing) already the end of possibility's is in sight and not much more is possible with clever software. Let us indeed hope that the market will shift towards more biological approaches.

 

[cornelius]

That is an interesting remark you make here. It is not as small (integral microphone, speaker and amplifier/processor) but you could very well be right regarding software. (Options/applications). It is still remains very limited for the simple fact that the weak link in the whole process is not addressed. The weak link being our damaged ears. I wonder how much improvement therefore is possible with clever software. Perhaps (depending on the level of damage in ones hearing) already the end of possibility's is in sight and not much more is possible with clever software. Let us indeed hope that the market will shift towards more biological approaches.

It is the same for music hardware devices like synthesizers, mixing desks, effects etc. Softwares are currently nearly reaching the same sound quality as hardware for quiet cheap, though purists still notice a difference for sure. In the early 2000's virtual instruments and devices were still quiet rough sounding but nowadays the interest of hardware is slowly becoming more the ergonomics than the sound. A laptop with good softwares can reasonably imitate a hardware studio which costs a lot more. It might be the same for at least hearing amplifiers and maybe current hearing aids : handy but expensive devices VS less handy devices (smartphones) reaching at least 85% of hardware's performance for a very small price. Nowadays even with free softwares we can do much better customised audiograms and tinnitus / hyperacusis evaluation than by a doctor. Smartphone sound applications, though not fully reaching high processor computer quality are dramatically cheap. In fact a hearing aid is a software packaged in a tiny box. I believe that simple hearing amplifiers will become obsolete, and that hearing aid industry will survive if its next technology (laser diode making vibrations in the eardrum) will be efficient enough to sell well. Until now, lots of hearing impaired are not satisfied with hearing in noise and general processing - though helpful, better than nothing - but I believe that apart from deafness and severe hearing loss, heavy and deep bionics won't be used for mild and moderate hearing loss. And since many have tinitus or hyperacusis as well, amplification as we know it today might become a deadlock.

 

[tomytl]

Research from John Hopkins

 

[Reinier]

I can understand why trying to trigger supporting cells to differentiate into haircells is the way to go.
Watching the clip from Johns Hopkins medicine only strengthens my believe.
I think it is very well summarized by Angelika Doetzlhofer and the clip makes so much sence.
Such a robust concept. It works for birds.
Watching the clip makes me think science is almost arriving at this point. That is probably not true. Too complex.

and that hearing aid industry will survive if its next technology (laser diode making vibrations in the eardrum) will be efficient enough to sell well.

I have heard about this new technique. I can not understand how it can be beneficial for a damaged cochlea. The damaged cochlea is not processing this better managed vibration of the eardrum (I would imagine). Could it be that the hearing aid industry is preparing customers for this wonderful new technique as a sales pitch?

 

[cornelius]

I can understand why trying to trigger supporting cells to differentiate into haircells is the way to go.
Watching the clip from Johns Hopkins medicine only strengthens my believe.
I think it is very well summarized by Angelika Doetzlhofer and the clip makes so much sence.
Such a robust concept. It works for birds.
Watching the clip makes me think science is almost arriving at this point. That is probably not true. Too complex.

I have heard about this new technique. I can not understand how it can be beneficial for a damaged cochlea. The damaged cochlea is not processing this better managed vibration of the eardrum (I would imagine). Could it be that the hearing aid industry is preparing customers for this wonderful new technique as a sales pitch?

The eardrum becomes itself the loudspeaker and reports say patients gained a wider range of frequency and word comprehension but I agree the root of the disability is not managed. It is like current bionic limbs, more and more efficients in movements, probably reaching human capabilities in two decades, but the evolution of sensory sensor building is more difficult and then - until now - slower than mechanics though recent breakthroughs in this field.

 

[Reinier]

It is like current bionic limbs, more and more efficients in movements

I remember seeing paralympics. People with proteases are able to run faster than people with there own legs.
I do not see something similar happening with hearing. Where people are able to hear better (and most of all more accurate) than people with human hearing. When I was young there was this television series "the six million dollar man".
We can make him better, faster and stronger. His bionic ear(s) could hear better than "ordinary" ears.
Unfortunately even with 6 billion dollars this is not yet possible.
It took millions of years of evolution. How can we expect to get near this level of refinement. The industrial revolution started not that long ago. The human body is an amazing "machine".

 

[spingee]

I remember seeing paralympics. People with proteases are able to run faster than people with there own legs.
I do not see something similar happening with hearing. Where people are able to hear better (and most of all more accurate) than people with human hearing. When I was young there was this television series "the six million dollar man".
We can make him better, faster and stronger. His bionic ear(s) could hear better than "ordinary" ears.
Unfortunately even with 6 billion dollars this is not yet possible.
It took millions of years of evolution. How can we expect to get near this level of refinement. The industrial revolution started not that long ago. The human body is an amazing "machine".

Not that amazing if cant regenerate hair cells

 

[Reinier]

Not that amazing if cant regenerate hair cells

I didn't say perfect
Birds have the better deal when it relates to hearing.

 

[Foncky]

When it relates to wings, too.

What we don't know is : ok, the regeneration in birds makes them able to pick sounds well all their life. Would that be also useful for them to understand speech clearly ? (I know birds don't speak our language, but you get the point)
We have people here who pick every possible sound but don't understand speech quite well.

 

[Reinier]

Would that be also useful for them to understand speech clearly ?

I read that they are able to recognise other birds again. I wouldn't have a clue how accurate this hearing needs to be in order to regain this recognition. I wouldn't be surprised if the regeneration is complete.

 

[Silvio Sabo]

I didn't say perfect
Birds have the better deal when it relates to hearing.

Humans got the better deal when it relates to brain. You can't have it all

 

[cornelius]

I read that they are able to recognise other birds again. I wouldn't have a clue how accurate this hearing needs to be in order to regain this recognition. I wouldn't be surprised if the regeneration is complete.

Common sense makes me believe that it is like salamanders regrowing lost limbs. Not fully identical, a bit weaker but fully operational.

 

[RB2014]

Nick, I found this article. I thought you might be ineterested. They talk about the auditory nerve fibers.

https://www.sciencedaily.com/releases/2016/01/160128133035.htm

 

[tomytl]

A lot of the processing makes the brain in how we might understand.
To train my hearing I often listen to following song. It has a fantastic arrangement for listen to different lines of the song...
-follow the lead voice
-follow the down pitched voice
-follow the lead synth
-follow the bass
Because of the beautiful harmonies your brain will love to follow this melody...
I think the dynamic perception can be trained in this way.
Listen to very low level!

 

[Foncky]

I read that they are able to recognise other birds again. I wouldn't have a clue how accurate this hearing needs to be in order to regain this recognition. I wouldn't be surprised if the regeneration is complete.

My concern is that the speech birds use seems less complex than human speech. But I may be totally wrong. Birds hear very high frequencies if I remember well, so their speech might be far more complex than what we think we hear.

 

[Reinier]

My concern is that the speech birds use seems less complex than human speech.

Lately I have been wondering about voice recognition. I think if you are still able to recognise different voices you need a sofisticated hearing apparatus. As an example: The difference between a "normal" voice an a voice from someone that has a cold (sounds nasal) is already amazing. Try to show that in the audio spectrum with a spectrum analyser! So perhaps this level of sophistication is also at work with birds? Interpreting the sound happens in the brain, but the hearing apparatus needs to bring the outside sounds inside the brain. Including the nuances.

 

[RB2014]

https://decibeltx.com/

The more I read about decibel the more excited I get. Their webpage looks good. They are hiring. This looks like a pretty serious attempt to get a company going to tackle hearing disorders. My only concern is the 52 million initial investment. I really don't think thats enough to cover all of the different areas they want to tackle. I'm thinking they have some pretty strong research behind them already to actually get the company going and private enterprise is where things can happen.

 

[Mario martz]

https://decibeltx.com/

The more I read about decibel the more excited I get. Their webpage looks good. They are hiring. This looks like a pretty serious attempt to get a company going to tackle hearing disorders. My only concern is the 52 million initial investment. I really don't think thats enough to cover all of the different areas they want to tackle. I'm thinking they have some pretty strong research behind them already to actually get the company going and private enterprise is where things can happen.

Yes!!!!
it looks great, their web designt is super modern :O

 

[Aaron123]

This looks pretty exciting: http://www.nature.com/articles/srep24907

They administered the NT-3 24 hours after the damage. They note the "long therapeutic window" between damage and the death of cochlear neurons, but an important unanswered questions is whether intervention at any point during that window will be effective or whether intervention must occur quickly in order to elicit regeneration.

(bold added)

Round-window delivery of neurotrophin 3 regenerates cochlear synapses after acoustic overexposure

Abstract:

In acquired sensorineural hearing loss, such as that produced by noise or aging, there can be massive loss of the synaptic connections between cochlear sensory cells and primary sensory neurons, without loss of the sensory cells themselves. Because the cell bodies and central projections of these cochlear neurons survive for months to years, there is a long therapeutic window in which to re-establish functional connections and improve hearing ability. Here we show in noise-exposed mice that local delivery of neurotrophin-3 (NT-3) to the round window niche, 24 hours after an exposure that causes an immediate loss of up to 50% loss of synapses in the cochlear basal region, can regenerate pre- and post-synaptic elements at the hair cell / cochlear nerve interface. This synaptic regeneration, as documented by confocal microscopy of immunostained cochlear sensory epithelia, was coupled with a corresponding functional recovery, as seen in the suprathreshold amplitude of auditory brainstem response Wave 1. Cochlear delivery of neurotrophins in humans is likely achievable as an office procedure via transtympanic injection, making our results highly significant in a translational context.

 

[jeff W]

If I talk about my immediate feelings, I would say that starting from the early 2000's, the amount of information is exponential every 3-4 years but again, it's only studies on paper, and sometimes clinical tests on animals, but nothing significant about humans yet. At least one thing is sure, complaining about lack of fidelity, distorsion and loss of punch / sparkle is taken more seriously. It is even admitted that hearing aids might be destructive for some persons' ears (genetic predisposition to risks even with moderate noise). These last 2-3 years along with stem cells and genetics I read many reports about the increasing hearing aid market but I don't see it as a good thing since it's like an infinite loop which helps for sure but doesn't resolve wounds at the root. I'm almost sure that in 5 years a smartphone could do the same job as a 2016 hearing aid with frequency setup and noise compression, hopefully it would make the hearing aid market switch to a more biological market.