1st post - help evaluating KS-9 (Marvel) v Preza (Quattro) after quick demos with both

Merry Christmas and Happy Holidays! A gift to myself is going to be a HA.

Something idiopathic caused single-sided SSNHL so I’m only shopping for a single HA. I think I want an 813 battery model to save size and weight without relying on recharging. I have a musical and engineering background but value intelligence & speed of the HA over features like streaming. My focus is on speech-in-noise performance and automatic & accurate detection of environment. The apps sound nice but ideally I won’t need to tweak it constantly.

Question #1: Are directionality features diminished if I won’t have an HA in both ears?

My ENT’s AuD suggested open-fit (vs occluded) type and demoed Phonak Marvel and Resound Quattro RIC for me. At that time I had not found this forum yet. I forgot to take pictures or note the tips used, but I believe they were open/vented. My notes say I found the Quattro more noticeable when I spoke and others spoke, while the Marvel was neither and so I thought that the Marvel was better. Now that I’ve read this forum and watched Youtube, I recognize that conclusion was premature.

I went to Costco to compare Sonova KS-9 (Marvel) vs Resound Preza (Quattro). HIS#1 did a hearing evaluation and answered questions before running out of time. After going home to read more and digest, I visited HIS#2 who demoed both for me and did a cursory REM on each after exploring various configurations of receiver and dome.

HIS#1 said KS-9 was better for steeper sloping audiogram, uses compression, may sound tinny to me. HIS#1 comes from a Phonak background, yet recommended the Resound for me. HIS#2 comes from a Resound background, and initially recommended Phonak to me, until we demoed different configurations and found the Resound seemed to suit me better.

Hearing test info:

Pictures and notes from Costco HIS#2 (feel free to comment or edit this):

I recognize that I am not a perfect candidate for open domes given feedback risk; however ENT’s AuD demoed Marvel & Quattro using them, and HIS#2 also used them on my Preza demo. I found the closed-domes noticeable in my ear (i.e. less comfortable, or needing more time to acclimate). I also found the Phonak calibration routine more annoying (longer, louder, higher pitched) than Resound’s which was softer and more static sounding. After first-fit, I felt the KS-9 was too loud while Preza was too soft. At some point I believe HIS#2 used 90% of NA-L2 which felt “about right”. HIS#2 commented that the Phonak software initially suggested power receiver + power dome, which he disagreed with. HIS#2 said that I might need custom molded cshell to get KS-9 to work optimally. I didn’t like this idea because I could already feel the closed-domes in my ear.

True/False, please:

  1. Preza with 813 battery lacks physical volume control so that needs to be adjusted via the app.

  2. Preza may never work with Android ASHA for Bluetooth on my Pixel 2, so I shouldn’t expect hands-free calling.

  3. It’d be ok for me to use a medium/regular receiver on the KS-9 and Preza.

  4. It’d be ok for me to use an open-dome on the Preza.

Sorry for the long read. Any feedback on what I’ve been told or how to decide based on these findings is welcome. Thanks for all the information on this forum!

1)Not sure, but a lot of advanced features require both aids to be fully effective.
2) There is no 813 battery. Most common are 312 and 13, with 13 being twice as thick as 312. I don’t know for sure, but I would think the Preza could be set up to use button to control volume.
3) Preza working with ASHA on your Pixel 2 is highly unlikely since it would require ASHA being added to both the aid and the Pixel 2. Neither have it now. To boot, even if they both got ASHA, you still wouldn’t have handsfree calling as you’d still need to speak into the microphone of the phone.
4) Yes, most likely, but I wouldn’t try to micromanage this. I’d encourage you to rely on the professional.
5) Same as number 4.
Pick a criteria and make a decision. You’ve got 6 months to sort it out.

1 Like
  1. It would be helpful if you filled out the My Audiogram for both ears. See the link on the right end of the blue bar at the top of the page. There are some advantages to two aids, but it would depend on what your loss is in the right ear.
  2. I am afraid, I don’t follow what you are talking about here. The battery type should have nothing to do with adjusting volume.
  3. You never know, but it would seem unlikely that the Preza will be upgraded to use ASHA.
  4. Either the standard (S) or medium (M) receiver should work.
  5. If you go with open dome, gain will most likely have to be cut back to avoid feedback. You can use the open dome, but you just won’t get the same correction.

These are both good hearing aids. The KS9 will work wirelessly and hands free with Android and the Preza most likely will not. The KS9 will be cheaper providing Costco will sell you one of them. I don’t see anything in your loss that would favour one aid over the other. Both of these aids will use a number of different prescription formulas like NAL-NL2, NL1, DSL v5, or their proprietary one. You can alter the sound by switching formulas more predictably than by switching from one aid to the other.

The Target 6.1 software recommends a vented dome (not an open dome) for your loss. Here is what the insertion gain chart looks like. The dashed magenta line is the feedback threshold. Gain will have to be cut back in the higher frequencies to avoid feedback.

image

Here is what a custom slim tip would look like. Still feedback issues but less gain would have to be cut back. This would be with about a 2 mm vent, which is not real small. The Power Dome apparently has no vent at all. The other advantage of a custom mold is that there is essentially no leakage around the mold, while off the shelf domes are more likely to leak around the fitting.

image

Sorry I’m a newbie. I meant 312. All else being equal I prefer smaller/lighter. I thought the HIS said that the 13-battery Preza had volume control + mode toggle, however 312-battery Preza just had a mode toggle and volume would need to be adjusted via the app. Meanwhile the 312-battery KS-9 had both physical controls, like the 13-battery Preza.

I’m trying not to let streaming and hands free calling be the deciding factor. Since the Preza is more Apple friendly and the KS-9 has a hassle switching between multiple devices, I don’t see a clear favorite here, for me, especially when you add in that the Preza has a better app, and the KS-9 may never get the new Phonak app.

My right ear is 5-10db flat across the audiogram, SRT 5dbHL, Word discrim 100%. I’m only needing one HA and thus wondered what features wouldn’t work as advertised without using one in each ear (e.g. directional stuff).

My apologies because I’m probably not properly communicating the type of tip. Best to look at the picture in slides #1 and 9. I’d rather start with something that’s less noticeable in my ear (to me, moreso than to others). After HIS#2, the Preza is using a “less noticeable” tip than the KS-9, and seems to be a good preliminary fit on REM. I shall go back and see if HIS#1 can get the KS-9 with vented dome to work for me.

Do you guys have any insights on the charts in slides 2 through 8 that would help me choose between the 2 HA’s?

Thanks. I believe this, which is why I’m trying to figure out which has better odds of long term satisfaction. I plan to stick with full-time HA use for the full 180 day period. It seems hard to decide up-front with limited knowledge and experience. I’m thankful this forum is making it easier.

I think you’re saying the Preza with the 312 battery has just one button? I’m not familiar with the Preza so can’t say for sure, but other aids I’ve encountered with one button the button can be programmed to behave differently depending on how long you hold it. A common way to set it up would be quick pushes are volume control, medium length pushes change programs (or “modes”) and a long push mutes the hearing aid. It may sound complicated, but it’s not hard to master. The downside is with one aid and one button that you’ll need to cycle through the volume steps. With two aids, one button can be volume up, the other volume down. Again, I can’t say for sure the Prezas can be set up this way. I stick with my original advice that you just need to pick one and try it. There is no right/wrong answer. My impression is that you tend to favor the Preza so go ahead and give it a try.

Comments on the slides:

#1 - The ReSound aid looks huge, although that could be the camera angle. I presume that is the one with the size 13 battery. A 312 battery should be fine for your loss. Will not last as long, but that is probably a good tradeoff for a smaller size.

#2 - I believe that slide is showing the Preza hitting the feedback limit with only 20 dB gain. That is pretty poor, and must reflect either the poor fit or the large vents/leaks in the tulip style fitting. You could benefit from closer to 30 dB gain in the 3 kHz range.

#3 - Same comment. About the only adjustment they can make is to reduce overall gain, or at least soft sound gain.

#4 - This appears to be a feedback potential screen, and it looks like the prescription is wanting to give you about 40 dB gain, but it is being cut back to 20 dB to avoid feedback. That is a significant limitation.

#5 - This looks like a power dome and it is letting you get close to the prescribed gain.

#6 - It is hard to see because of overlaping lines but I believe the prescribed gain goes right up to 8 kHz, but they dip down to be coincidental with the feedback threshold in some spots and to stay under the power limit of the aid. The power limit could be increased to take it out of the way by going to a P power aid.

#7 - This shows you why REM is essential. Non REM adjusted is way too high in gain in the 500 to 2000 Hz range, and low above that. This is what people get when they just accept the computer first fit, and no REM is done. This is what makes it meaningless to compare hearing aids unless they are fitted to the same formula and REM adjusted. You are just comparing a dog’s breakfast to another dog’s breakfast.

#8 - As a first fit, obviously way better but still in error.

#9 - I think you would have to go with the power dome on the Preza, but may get away with the vented dome on the KS9. However you would probably get the closest to prescribed gain, with the least occlusion by going to a custom mold with an optimized size vent.

Hope that helps some,

I don’t know the answers to your specification based questions but can say that if you really want a hearing aid that isn’t noticeable to you, I’d suggest trying an ITE type. I wore In the canal aids for 25 years and just tried the BTE marvels for the last 8 months but couldn’t ever get used to how much I felt like a person who wears aids with them. I have since gotten a new pair, Oticon Opn ITCs and am very happy so far. The sound is perfect for hearing speech and I have so far been able to hear wonderfully in loud settings and quiet settings and everything in between. To me this is far more normal than anything the marvel BTE was able to provide. These don’t have wireless capability but it doesn’t sound like that matters to you. Just wanted to throw out that suggestion as I wish I’d tried them before the Marvels. Good luck!

Yes this is what I was told by HIS so I’m running that assertion by anyone who can confirm/deny. Thanks for the insight about how a single-button could be configured.

Thanks. I learned a lot from all your slide comments (and in aggregate from your posts on the forum) - especially re: slides 6 and 9. I ran out of time with HIS#2 so we couldn’t adjust each for REM but was trying to divine if one being closer at first-fit (less to tweak) had meaning. As for slide 1, yes the Preza is the 13-battery, while the KS-9 is the 312-battery. There was no 312-Preza demo.

I will go back and see what HIS#1 comes up with for receiver & tip without any prompting. If he’s frustrated or open to suggestions I’ll mention your combos: Preza + power dome; KS-9 + power receiver + vented dome.

Thanks for this advice. I’ll see what Costco offers for ITE/IIC solutions. I presumed that if I could already notice the sensation of a closed/power dome, then a custom mold or ITE/IIC would feel similar or even more noticeable. With BTE/RIC, I thought most of the weight would be borne by the ear and I could feel less of anything inside my canal. That’s all based on assumption and could be disproved. Also I have read that feedback is more of an issue with ITE/IIC.

Question: Either with RIC or ITC, does that mean I can no longer use these headphones because there’s already stuff inside my HA ear?
https://www.amazon.com/Bose-QuietComfort-Acoustic-Cancelling-Headphones/dp/B00X9KV0HU

I don’t think so. It is a reflection on the fitting programming sophistication of the manufacturer, but with REM it should be able to be adjusted to give the result as the formula intended. It is probably more of a red flag for those who try to do self programming without any ability to REM adjustment.

You won’t be able to use that style of headphone with any hearing aid (well, probably Phonak Lyric- but I doubt you’d like it) Options: Use it without hearing aid or get over the ear headphones.