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hearing aids for profound hearing loss?

Jeffrey Sirianni audioman at hctc.net
Fri Jul 10 01:00:47 EST 1998

At 11:05 PM 7/8/98 -0700, David Barnkow <barnkow at wsu.edu> wrote:
>Good Morning All,
>I have to say that I believe Langche Zeng is, in fact, a good hearing
>aid candidate. Perhaps not the easiest technical fitting in the world,
>but certainly a candidate. I think the level of success and satisfaction
>with a hearing aid fitting on this audiogram is more related to
>appropriate and realistic expectations (for both the patient and the
>dispenser)of the hearing aid fitting than the particular type and level
>of technology used.

I agree here.  From the audiogram, there apprears to be a very sharply
sloping hearing loss, including loss at 1500 and 2000 Hz, frequencies
important for speech understanding.  I also recommend at least a trial of
some devices.

>I would encourage a trial hearing aid fitting with a dispenser who has
>spent more time defining your needs and expectations and educating you
>about the potential benefits and disadvantages of each of your style and
>amplifier options than one who "sells" you the most expensive thing in
>the office. Since you asked for suggestions, I personally would not start
>you off with instruments like the Senso. Again, this is a personal opinion,
>Senso is a bit like repairing a dripping faucet by replacing all the
>plumbing in the house; overkill. (This statement should generating a
>dissenting opinion.) I'd start with a Class D/AGC-I with active low cut.
>My rationale: low internal circuit noise and ability to account for your
>potentially reduced dynamic range in the high frequencies. Cost:
>depending upon style chosen, $700-$1000 each in our market. Where you live
>the price could be significantly different. If the Class D/AGC-I generated
>complaints that the Senso could address then I would reconsider a
>fitting using that level of technology.
>Finally, to account for the differing advice you have received, skill
>level and sophistication among dispensering varies widely. Additionally, I
>believe that hearing aid fitting is as much "art" as it is science and
>some hearing aid fitters are better "artists" than others. Thanks for the
>opportunity to give input.
>David Barnkow

>At 11:44 PM 6/29/98 -0700, Langche Zeng <lzeng at fas.harvard.edu> wrote:
>>Greeting! I recently had a hearing test and the audiogram is like this:
>> Hz 250 500 750 1k 1.5k 2k 3k 4k 8k
>> left 5 5 10 15 65 70 90 90 80
>> right 0 5 10 35 70 85 100 105 105 
>>I function well in one-to-one conversations but are totally lost in group
>>(even extremely small group) situations. The audiologist told me that NO
>>hearing aids, regardless of how expensive or fancy they are, would help
>>and advised me not to wear any. However when we called around and ask
>>hearing aids dispensers we were told that something can be done to bring
>>my hearing to 2k hz. Widex's senso, which would cost $2,500 EACH, was
>>offered as a choice. 
>>I have the following questions:
>>1. Is the audiologist right in saying that no hearing aids can help at

No.  I'm guessing the audiologist has had difficulty with successfully
fitting this configuration and degree of hearing loss (steeply sloping high
frequency loss).  I would guess that they are predicting you may be
difficult to please and may be avoiding any loss of time they may
experience if you return the aids for a refund.  It's not fair to you to at
least try.  I see patients like you as a challange as they help one grow
professionally and a dispensing audiologist.

>>2. If the hearing aids dispensors are right that hearing aids CAN being it
>>to 2k, why the audiologist would not recommend it? Does it mean that the
>>benefit of hearing up to 2k rather than 1k isn't that great? Or, is the
>>benefit worth the $5,000 cost?

Don't always believe what you hear, especially if you sense a person is
trying to SELL something rather than MAKE YOU HEAR BETTER.

I've had one person with a very similar configuration come in wanting the
best hearing aids available regardless of price.  I ordered him the Widex
Senso BTE's and he struggled so much that he returned them.  He ordered
another set of hearing aids (Phonak AudioZoom ITE's) and he is doing much
better with these devices.  Why ???  Read below.....

>>3. As I understand it beyond 2k my ears are pretty much hopeless, and
>>below 1k they are close to perfect. So it's only between 1k and 2k where
>>amplification is needed. Are there simple, much cheaper hearing aids that
>>could do just that? what's the advantage of those digital, programmable
>>aids in my case?

The problem with going with the Widex Sensos is the limitation of the slope
of the filters.  These devices process sound in three bands.  The dispenser
would probably set the filter sets so that the low band amplified low
frequency sounds (500-1000 Hz), the middle band for middle frequenices
(1000-2000 Hz), and the high band for high frequencies (2000-3000 Hz).
With the steepness of your hearing loss, the gain difference between middle
and high band is too great for the Sensos to handle.  There cannot be more
than 30 dB difference in the between any two adjoining bands and 50 dB
between the low and high band.  Your hearing loss would warrant setting the
high band at maximum and the middle band well below that (making it greater
than 30 dB difference between the middle and high bands).  The disenser
will have to lower the amount of gain in the high band and/or increase the
gain in the middle band in order to make the difference 30 dB or less.  You
may not find this compromise acceptable and/or beneficial.

To answer your question, if you decide on trying the Widex Senso's and are
not happy with the performance, be sure you know the time frame in which
you can return the aids for a refund or exchange.  You may want to try less
expensive high frequency emphasis aids which are designed for your
steepness of hearing loss.

>>4. Any recommendation about the type/brand of hearing aids I should get
>>(if I should get any at all)? 

As your degree of hearing loss is pretty severe in the high frequencies and
near normal in the low and middle frequenices, I would go with a mini-BTE,
which will probably be a lot less expensive and may meet your cost/benefit
expectations.  A custom device (ITE, ITC, or CIC) may produce too much
feedback in the attempt to benefit in the high frequencies.

>>I would appreciate your help very much. Thanks,
>>(Please cc to my e-mail address when replying. thanks!)
>>Langche Zeng
>>lzeng at fas.harvard.edu

Good luck...


* Jeff Sirianni, M.A., CCC-A                      *
* Sound Advice / R.G. Delaney, M.D.               *
* 710 Water Street / Suite 404                    *
* Kerrville, TX  78028                            *
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* audioman at hctc.net                               *
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* Discussion Leader of bionet.audiology Newsgroup *

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