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Audio producers and engineers seek SNR optimization, have the luxury to use audio equipment with exceptionally high specifications running on AC power, and avoid extensive signal processing.
If you are a good musician, it is critically important to hear your instrument well in order to shape your performance with precision.
While pondering his question, I wondered: Exactly what “high-quality audio equipment” could Charles use in order to hear his guitar?
To keep things simple, I decided to concentrate on how a musician with hearing loss might use professional-level audio gear simply to practice. Of course, each hearing loss is different, and some problems—such as a loss of frequency discrimination that will interfere with the perception of melody and harmony—cannot be adequately compensated for with modern technology. Although roles often overlap, record producers typically supervise the entire recording process while recording engineers set up and operate the audio equipment. The best producers and engineers are often excellent musicians themselves, trained to analyze what they hear at a very fine level of detail. Additionally, because their reputations depend on extremely acute listening abilities, top producers and engineers take their hearing very seriously; many use earplugs in loud environments like subways or noisy parties and get annual hearing tests. While both hearing loss and audio recording technology is similar—both fields use microphones, amplifiers, digital signal processing (DSP), and loudspeakers (receivers)—there are substantial differences in how this equipment gets used. By contrast, audio recording technology does not necessarily seek to optimize speech perception.
For our thought experiment, my colleagues and I agreed it was important to optimize the SNR through the use of cardioid (directional) mics and high-quality audio technology. While recording studios take great pains to isolate the studio from outside noise, we agreed Charles simply needed a reasonably quiet practice space, isolated from loud air conditioners and other common noise sources. Since the lowest note (open E) of Charles’s guitar is about 83 Hz, the Sennheiser MKH 40 P48—with its nearly ruler-flat frequency response from 40 Hz to 20,000 kHz—can easily capture the full range of his instrument.
My colleagues agreed that instead of separate (and very expensive) individual components, the better quality “digital audio interfaces”—which integrate mic preamps and digital converters into a single box—would provide more than adequate quality for Charles’s purpose. Although closed over-the-ear headphone styles might prevent feedback, in-ear earphones or monitors (eg, Etymotic Research ER-4PT, Figure 6) will likely work best for this system. It is very likely that, even with his hearing loss, the headphone output built into the audio interface will provide Charles with ample undistorted gain to hear comfortably. So far, every effort has been made to optimize SNR and sound quality by using a quiet room, a “close-mic” technique, and some of the finest audio equipment available.
If we now add audibly significant amounts of signal processing like equalization or compression, we risk distorting the beautiful sound while adding little (if any) additional perceptual clarity to the music. A modern DAW, such as Digital Performer (Figure 7) or ProTools, typically includes a breathtaking amount of control over gain, sound placement and phase, as well as numerous styles of equalizers, compressors, limiters, reverberators, and other specialized signal processors. For protection against unpredictably loud noises (which modern hearing aids address through various types of compression), he should place a limiter with a fairly fast rise time, a hard-knee, and a high compression ratio on the DAW’s final output fader (Figure 8).
Once levels are correctly adjusted, however, Charles should be able to sit in front of the mics, remove his hearing aids, put on his earphones, set a comfortable listening level by turning up the volume on the headphone output of the interface, and hear his guitar as well as his ears will allow with extraordinary sonic clarity.
It is quite possible to set up a beautiful-sounding practice system similar to the one I’ve described here; in fact, I use a modified version of this setup (substituting digital synthesizers and samplers for microphones) to compose (see Einhorn9). The purpose of this thought experiment, however, was not so much to “spec” a real setup as it was to focus attention on the differences in approach between the professional hearing loss and audio fields. Practical, high-quality hearing aid systems designed for musicians with hearing loss might find ways to incorporate aspects of this approach into a similar one, perhaps by combining significant recent improvements in music perception via hearing aids10 with the ability to connect easily to high-quality external mics and other equipment. After considering your history and performing a visual inspection of your outer ear, we will perform a comprehensive hearing evaluation composed of a series of tests. Pure-tone threshold audiometry is the measurement of an individual's hearing sensitivity for calibrated pure tones.
Tests of speech threshold and speech discrimination are used to assess comprehension of complex speech signals.
You will be asked to listen to and repeat a series of familiar words which become softer and softer. Your doctor will interpret the results of your hearing evaluation and explain them to you clearly.

Wayne’s World examines the unwritten history - people, events, and products - that shaped the hearing aid industry. The selected signals were pulsed pure tones (bars within the audiogram of Figure 1), recorded speech from Cox’s connected discourse, and steady speech noise (bars to the right of the audiogram).  The bar colors represent the right (red) and blue (left) ears respectively. The inter-ear difference convergence at supra-threshold presentation levels brings to mind the familiar loudness growth patterns, the basis for many amplification assumptions, shown as a reminder to the reader in Figure 3[2][3][4].
It is well established that large individual differences exist in loudness growth patterns among listeners with sensorineural hearing loss [5][6].
Part II, scheduled for next week, will show the results from an additional subject, along with describing the test environment and test procedures. How is that for a coincidence; my wife of 23 years developed a vestibular schwannoma three years ago.
As such, I’ve actually developed a significant specialty in this area, our office having fit about 300 systems since 2004, myself doing about 60% of them. I’m curious; with this essentially left-corner audiogram for the left ear, what was this clients aided and masked WRS?
If you have a moderate or severe hearing loss, some kind of electronic amplification will be almost always necessary. I conjured a thought experiment that might provide some insight into the different ways that hearing loss and audio professionals use very similar technologies in their work.
To augment my own background in audio, I sought technical advice from multiple successful classical music producers and engineers, each of whom has worked on hundreds of recordings, including classical guitar.
Fortunately, Charles discriminates pitch well in both ears, so my colleagues and I decided to specify a practice system similar in approach to the way producers and engineers record music. Producers like David Frost, a 14-time Grammy winner who records Riccardo Muti and the Chicago Symphony, must be able to rapidly identify a softly played wrong note or the most minor tuning problem. Modern hearing aids are worn on (or in) the ear and include small, often directional, microphones. Instead, the ideal objective is to accurately reproduce the entire audio spectrum (20 Hz to 20 kHz). Much of the basic equipment and signal flow of the proposed setup will be familiar to hearing care professionals (Figure 2).
Illustration of a small diaphragm condenser mic and its polar plot and flat frequency response from the Sennheiser MKH 40 P48 product spec sheet. Several different brands came up in our conversations, but one model was clearly preferred: a small diaphragm condenser mic with a cardioid (directional) pattern (Figure 3).
There are a number of common stereo microphone angles used in the music industry for yielding optimum sound quality and stereo balance. Producer David Frost suggested that a pair of these mics be positioned very close to the instrument in order to pick up “as much of the guitar and as little ambience as possible.” The mics should be aimed at the guitar’s soundhole and several different techniques for angling the mics (Figure 4) should be tried for optimal stereo balance and sound quality (eg, see Auld3 and Boudreau et al4).
A digital audio interface (DAI) integrates mic preamps and digital converters into a single component. These devices range in price from a few hundred to several thousand dollars, depending upon the number of audio channels and the quality of the electronics (Figure 5). In-ear earphones feature ear tips inserted into the ear, which effectively block ambient sound, provide excellent feedback control, and deliver superb audio quality. If not, the unanimous and enthusiastically recommended choice for an external headphone amp was the $1,600 Grace Designs m903.
Having gone to such lengths, many of the acoustical problems a musician with hearing loss might encounter during a typical practice session (eg, too much ambience) have been eliminated. Nevertheless, a small amount of DSP may be helpful and is readily available in the digital audio workstation software. Digital Performer or ProTools are examples of modern digital audio workstation (DAW) software that can be used to balance and manipulate multiple digital audio signals. However, in keeping with our approach that less DSP is more, Charles should try only a small amount of high frequency equalization if the guitar sounds muffled to him—about a 6dB boost around 3.5 kHz—but probably not much more. However, because there are several places where signal gain level can be adjusted (or misadjusted), it can be surprisingly tricky to set signal gain properly.

However, such a system can easily cost more than $4,000 (plus computer) and also may be beyond the technical ability of some, but by no means all, dedicated musicians.
Tympanometry allows the audiologist to assess if there is any form of middle ear dysfunction present.
Assessing speech discrimination ability (how "clear" the ear hears) allows the audiologist to estimate success with amplification. This will help determine your speech threshold, the softness level that you can recognize familiar two syllable words, like "baseball" or "hotdog". Threshold and plotted examples of levels to achieve balances for selected signals for an asymmetrical listener.
Illustration of the numbering chart used to locate the perceptual experience for the various signals.
Generalized representation of classical “Growth of Loudness” patterns indicating steeper than normal function for sensorineural hearing impairment.
Behavior pattern for several subjects with unilateral sensor-neural impairment showing a similar nonlinear loudness patterns to those of Figure 3. Practical high-quality hearing aid systems designed for musicians with hearing loss might find ways to incorporate aspects of this approach. We would provide our guitarist with extremely high-quality amplification by using superb equipment and ensure he heard his instrument clearly by optimizing the signal-to-noise ratio (SNR). Hearing instruments use sophisticated DSP algorithms to significantly alter the sound in an effort to compensate for hearing loss and, to some extent, for less-than-acoustically-optimal mic placement in noisy situations.1 The hearing professional selects a fitting method for the patient’s specific hearing loss,2 solicits feedback from the patient, and fine-tunes the sound of the hearing aids. Unlike many real-life situations where hearing aids are used, neither the mics nor the sound sources move around very much during recording sessions.
The digital converters should be set to the industry-standard 96 kHz sample rate with a bit depth of 24 bits.5 Such a spectacularly high frequency response and wide dynamic range, which is likely beyond the discernment of even the most experienced listeners with normal hearing,6 will create an audio system of exceptional transparency. For the most comfortable and effective fit, Charles should visit a hearing care professional to have custom ear tips made. This takes time, experience, and patience to do well, but the basic idea is to have the audio signal pass from the mics through the DAW software to the earphones at a level that is neither too low (adds noise) nor too high (adds distortion). Practical approaches for maximising signal-to-noise ratio for music and other applications. Today, pure tone thresholds of both air conduction and bone conduction are measured to determine the degree and type of hearing loss present. Words will also be played at a comfortable, conversational level to determine your word recognition score - how well you can understand speech if the volume is appropriate for your needs. Fortunately, hearing devices can help most people and today's choices are easy to try, often right in the office or in your own home. Listeners directed the investigator to adjust the relative Left-Right levels until the stimulus was perceived in a position as near as possible to number 15. 2, 3, 4, 5, and 6 have suggested a ‘softness imperception’ aspect of the abnormality, rather than loudness ‘recruitment’.
These professionals go to considerable expense and effort to use world-class equipment and carefully honed techniques to make the best-sounding recordings possible. In my experience, the audiologists and dispensing professionals do not rely on their own hearing to make adjustments. Audio professionals place mics wherever they believe the optimal balance between the instrument’s sound and the ambience of the room can be found.
If necessary, other tests will be performed to evaluate how well you hear in difficult or noisy environments. People who use hearing devices report an improved quality of life and a new dimension in hearing and belonging.
In classical and jazz recordings, producers and engineers try to minimize audible alterations to the natural sound while DSP is typically adjusted not by algorithm, but by ear.

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