The Ear CompanySan Francisco, CA
Use cases

Where a bionic ear stops working, and what we do about it.

Fourteen situations cochlear-implant recipients deal with constantly. For each one: what actually breaks, a concrete example, what Leo does, and, because this matters more than the rest, what it still will not fix.

Signal-to-noise figures are representative ranges for the setting described, consistent with the speech-in-noise literature cited on the main page. Status labels describe engineering state, not clinical evidence: Leo is a developer kit and no clinical benefit is being claimed anywhere on this site. Off-frame prototype means the software runs today on a laptop against recorded audio. Planned means designed and not yet written. Scoped, not built means we have defined what we would attempt and nothing beyond that. No label on this page means a case has been tested with a recipient.

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Hearing the room

Eight situations where the implant delivers sound but not meaning. All of them are the same underlying problem, too little spectral resolution to separate one voice from the rest, and all of them are attacked the same way: improve the ratio before the signal reaches the implant, and put what is left in the visual field.

01

The restaurant

Multi-talker babble, hard surfaces, no visual line to most speakers

≈ −5 dB SNR Off-frame prototype

What breaks

This is the hardest ordinary environment there is, and the one implant recipients name first when asked what they gave up. Babble is the worst masker because it is speech, it occupies the same spectrum and the same modulation rates as the target, so no amount of amplification improves the ratio.

A recipient needs roughly 10–15 dB more favourable SNR than a normal-hearing listener to reach comparable sentence recognition. A restaurant sits about 15 dB below that line.

Example

Four people at a table. Two side conversations. Someone at the next table laughs. Your dinner companion asks a question and you get the prosody, the timing and the fact that it was a question, but not the words. You say "sorry?" for the third time and then stop asking, and spend the rest of the meal nodding at the right intervals.

Leo: the array steers toward whoever you are facing, suppresses the flanking tables, and the caption line carries the words the beamformer could not fully clean up.

What it will not fix: a beamformer improves the ratio in the direction you point it. Turn your head to the person on your left and the person on your right gets harder, not easier. Group conversation across a round table remains genuinely difficult, and we do not have a good answer for it yet.

02

The classroom

One distant talker, long reverberation, unpredictable turn-taking

≈ 0 dB SNR Off-frame prototype

What breaks

Distance and reverberation together. A teacher eight metres away arrives with a poor direct-to-reverberant ratio, and reverberation smears exactly the temporal envelope cues that implant users depend on most, the cues Shannon's work showed carry most of the intelligibility when spectral detail is scarce.

Group work is worse than lecture: the talker changes every few seconds and there is no podium to point at.

Example

A student follows the lecture adequately. Then the class splits into groups of five, thirty other students start talking, and the room becomes unusable. They spend the session copying a neighbour's notes and reconstructing the discussion afterwards.

Leo: in lecture mode the array locks the podium and holds it through head movement. In group work, captions with speaker attribution mean a glance identifies who is talking without having to find them first.

What it will not fix: a room-mounted or lapel microphone on the teacher, streamed directly, still beats anything a head-worn array can do at eight metres. Where such a system exists, Leo should be complementary to it, not a replacement for it, and we would say so to a school considering the trade.

03

Meetings and open-plan offices

Rapid turn-taking, overlapping speech, high stakes for missing a name

≈ +5 dB SNR Off-frame prototype

What breaks

The SNR is survivable; the structure is not. Meetings turn over quickly, people interrupt, and the cost of missing four words is not embarrassment but a wrong commitment. Attribution matters as much as content: knowing a sentence was said is useless if you do not know who said it.

Example

Six people, one speakerphone, two of them talking over each other. You catch "…can you own that by Thursday?" and have no idea whether it was aimed at you.

Leo: this is the case the spatial map was built for. Each caption line is tagged to the direction it arrived from, so the display can say who, not just what, the single highest-value output the visual layer produces.

What it will not fix: remote participants on a speakerphone are a single mono source from one point in the room. Spatial attribution cannot separate three people dialled in through the same speaker, and no microphone array ever will.

04

The family dinner table

Several people you love, all talking at once, every week

≈ 0 dB SNR Off-frame prototype

What breaks

Acoustically this is the restaurant. Socially it is not. Withdrawal at a family table is cumulative and it is the mechanism by which hearing loss turns into isolation, the outcome the WHO burden figures are ultimately counting.

Cross-talk is constant, nobody waits their turn, and the people involved are the least likely to be asked to repeat themselves for the tenth time.

Example

Three conversations at one table. A grandchild says something quietly, everyone laughs, and you laugh a beat late because you are reading the room rather than hearing it. The joke is gone before anyone could repeat it.

Leo: captions hold the last few lines, so a beat-late glance recovers what was said instead of losing it. Attribution means you know which grandchild.

What it will not fix: reading a joke is not the same as hearing it, and a caption arriving 120 ms late is still late. We think a recoverable conversation beats a lost one. We do not think it is the same thing.

05

Counters, pharmacies and clinics

Glass barriers, masks, background machinery, safety-critical content

≈ +5 dB SNR Off-frame prototype

What breaks

Two compounding problems. Barriers and masks attenuate high frequencies, where much of the consonant information lives. And a mask removes the mouth, which for an implant user is not a minor loss. Rouger and colleagues showed recipients are unusually strong lipreaders and multisensory integrators; covering the face takes away a channel they rely on more than a hearing person would.

Example

A pharmacist behind glass, masked, explaining a dosing change. You hear a muffled sentence containing a number. You are not certain whether it was "one to two" or "one or two", and the difference matters.

Leo: the array steers hard at the counter and suppresses the room. The caption carries the number, which is the part you cannot afford to guess.

What it will not fix: transcription is not perfect and never will be. For anything safety-critical, a dose, a dosage interval, a diagnosis, the right behaviour is to ask for it in writing, and we will not build a product that discourages that.

06

Transit and public address

Vast reverberant spaces, compressed PA audio, information you cannot miss

Reverberant Planned

What breaks

Station and airport announcements are heavily compressed, played through distributed speakers in enormous reverberant volumes, and arrive from every direction at once. There is no single source to steer at, the room is the source. Directional gain, the main tool for every other case on this page, does almost nothing here.

Example

A platform change is announced. Everyone around you picks up their bags and moves. You watched them react before you understood the announcement, and now you are following a crowd without knowing where it is going.

Leo: the caption path matters far more than the acoustic path here. Recognition is run against the diffuse field and rendered as text, because text survives reverberation in a way that audio does not.

What it will not fix: honestly, this is our weakest case. Heavy compression plus multi-second reverberation degrades recognition badly, and we would rather say that here than have someone buy the device for this and be let down.

07

Television and shared media

Compressed dialogue under a music bed, competing with room noise

≈ +10 dB SNR Off-frame prototype

What breaks

Modern mixes bury dialogue under score and effects, which is difficult for hearing listeners and disqualifying for implant users. Broadcast captions exist and are good, but they are on the screen, so you cannot look away, and you cannot use them for the person on the sofa talking to you about what just happened.

Example

Subtitles are on. Someone asks you a question during a scene. You now have to choose between the subtitle and the question, and you lose whichever you did not pick.

Leo: the room and the screen are different sources in the spatial map, so the person beside you can be attributed and captioned separately from the television.

What it will not fix: for the programme itself, broadcast subtitles are authored, corrected and better than live recognition. Use them. Leo's value here is the sofa, not the screen.

08

Driving and passengers

Broadband road noise, a talker you must not look at

≈ +5 dB SNR Planned

What breaks

A passenger sits beside and slightly behind you, and every visual cue an implant user leans on is unavailable because your eyes belong to the road. This is the one common situation where the visual channel, the whole basis of the product, is off the table by law and by common sense.

Example

Your passenger gives directions at 70 km/h with the windows cracked. You either take your eyes off the road to lipread, or you guess at the turn.

Leo: the array steers to the passenger seat and suppresses road noise, which is broadband and diffuse and therefore exactly what a beamformer is good at. Captions are suppressed while driving.

What it will not fix: we will not put a caption in a driver's field of view. The acoustic path has to carry this case alone, which makes it the one use case where Leo is strictly a microphone and not a display.

Being heard

Three situations where the problem runs the other way. These depend on the sign → speech channel, which is the least finished thing we are building, scoped to fingerspelling and a constrained phrase set, not open-domain translation. Read the write-up for why that scope is narrow on purpose.

09

Counter service and transactions

Short, bounded exchanges with a stranger who does not sign

Best fit for scope Scoped, not built

What breaks

Nothing about the acoustics, everything about the direction. A Deaf signer ordering coffee currently types on a phone, writes on a pad, or points. It works, and it also marks every routine transaction as an exception.

This is the best possible match for a constrained system: vocabulary is small and predictable, names get fingerspelled, and utterances are a few seconds long.

Example

You fingerspell your name for the cup. The frame speaks it. The barista writes it down correctly on the first attempt, which is not something a phone screen turned around at arm's length reliably achieves.

Leo: fingerspelling recognition plus a phrase set covering common transactional exchanges. You confirm before anything is spoken aloud.

What it will not fix: step outside the phrase set and it will fail, visibly, in front of someone. The confirm-before-speaking step exists precisely so that failure is yours to catch rather than something the machine announces on your behalf.

10

Medical appointments without an interpreter

High stakes, unbounded vocabulary, an interpreter who did not arrive

High stakes Scoped, not built

What breaks

Interpreter provision is inconsistent, and appointments proceed without one more often than they should. The vocabulary is open-ended and clinical, the consequences of a mistranslation are real, and the power dynamic in the room already discourages people from stopping to correct the record.

Example

The booked interpreter does not show. The appointment happens anyway, through a combination of writing, gesture and a family member who signs a little and is now hearing your medical history.

Leo: can carry the inbound side well, captioning the clinician is squarely within what the visual layer does. The outbound side is where we are cautious.

What it will not fix: this is the case people will most want us to solve and the one we are least willing to overclaim on. A constrained sign recogniser is not an interpreter, and a device that appears to work well enough to justify not booking one would make this situation worse, not better. Leo captions the clinician; it does not replace qualified human interpretation.

11

Workplace stand-ups and short-form updates

Predictable structure, familiar vocabulary, daily repetition

Bounded vocabulary Scoped, not built

What breaks

A daily stand-up is a bad fit for booking an interpreter, too short, too frequent, and a bad fit for typing, because it is your turn now and everyone is waiting. So the contribution gets compressed into something shorter than it should be.

Example

Your update is three sentences about a build failure. Typing it takes ninety seconds while eight people watch, so you type one sentence instead and the detail is lost.

Leo: a per-team vocabulary makes this tractable in a way open-domain translation is not, the words recur every day and the structure barely changes.

What it will not fix: the discussion after the stand-up, which is unbounded and is where most of the actual work gets decided. We are not pretending the constrained case is the whole case.

Access and fit

Three populations where the fit question is different, either because the hearing configuration changes what helps, or because the person is not a cochlear implant user at all.

12

Unilateral implant users

One implanted ear, and a head in the way of the other side

≈ 6.4 dB head shadow Off-frame prototype

What breaks

With one implanted ear, sound arriving from the unimplanted side is attenuated by the head, around 6.4 dB of head-shadow effect, and the binaural cues that would normally help separate sources are gone. A talker on the wrong side is materially harder than the same talker on the good side.

Example

You choose seats by which ear faces the room, rearrange yourself at every table, and walk on a particular side of whoever you are with. It becomes automatic and it never stops being a calculation.

Leo: the array spans the whole head, so capsules on the unimplanted side still contribute. Geometry does what a single behind-the-ear microphone cannot.

What it will not fix: an external array cannot restore binaural hearing. It can deliver a better monaural signal; it cannot give you two working ears, and true spatial hearing is not on the table.

13

Hearing aid users

Not an implant recipient, same problem in the same rooms

Adjacent market Planned

What breaks

Far more people wear hearing aids than have implants, and speech in noise is their dominant complaint too. The mechanism differs, cochlear damage and loss of frequency selectivity rather than electrode current spread, but the practical outcome is similar: amplification raises target and masker together, and the ratio is what needs fixing.

Example

Someone with well-fitted aids manages one-to-one conversation comfortably and gives up on group dinners entirely, a pattern that shows up long before anyone would consider an implant.

Leo: the acoustic front end is indifferent to what is downstream. Modern aids expose accessory streaming much like implant processors do.

What it will not fix: we have scoped DK-1 to implant recipients and have not done the fitting or interoperability work for aids. Listing it here is a statement of intent, not a claim of support.

14

Late-deafened adults

Lost hearing as an adult, does not sign fluently, between two worlds

Both channels Planned

What breaks

Someone deafened at fifty typically does not have a signing community, may be learning ASL slowly, and has an implant that works better in quiet than they expected and worse in noise than they hoped. Duration of deafness and age at implantation are among the strongest predictors of outcome, and this group sits awkwardly across them.

Example

Implanted eighteen months ago. Phone calls are manageable, one-to-one is fine, and the weekly team lunch is still a write-off. Two years into an ASL class and not yet confident enough to use it with strangers.

Leo: the inbound channel is immediately useful. The outbound channel becomes useful as signing improves, the same device covers both ends of that transition.

What it will not fix: outcomes in this group vary enormously and are dominated by factors no external device touches. We would be misrepresenting the evidence if we implied otherwise.

Missing one?

Tell us the situation we got wrong.

This list came from the literature and from conversations, which means it is incomplete and probably wrong somewhere. If you use an implant and your hardest room is not on this page, that is the most useful thing you could send us.