Are there any new options for profound loss?

I’m about due for a refresh of my aids and was wondering if there has been any interesting new models released lately in the Ultra power range? I currently have a set of Oticon Dynamo SP-8’s which have been serving me fairly but I find it very difficult to be able to hear voices in very noisy settings like a party or a restaurant, and unlike the Naida Q90’s I had back in 2014, they do not have a directional mic to help in that situation. I miss that option. I see there are Naida V90’s now. Are they a jump up in technology?

Of the two models, I think I prefer the Oticon streamer over the Compilot, but they are fairly similar. I cant imagine life without one of these streamers though, they’re so integral to being able to take phone calls properly and to be able to listen to music.

Are there other options I should look into? I’m in Canada.

Did you see/read the other thread, From Widex Inteo/Super to Unique/Beyond?

What kind of phone do you use? If you use iPhone, Resound Enzo 3Ds allow direct streaming. They also have a remote microphone option (MultiMic) that supposedly works well. I think the Nadia Vs and the Resounds are top contenders although I’m sure some would argue the point.

@pvc Thanks for the pointer, checking that thread now!

@MDB Android here. Way back in 2009 I had Resound Azure’s, which might have been before I hit the profound loss level.

Hi the Naida V hearing aids are slightly old, my audiologist said all of the Phonak “v” models are older and to just get a Phonak “b” hearing aid because they have newer technology. You should probably wait until the “b” model is released in the naida hearing aids.

b over v has little improvements, they mostly focused on the recharable function in the b generation. Same platform and Chip otherwise.

I think Naida V came out 2016 and has Sound Recovery 2, same as audeo B. So Naida V is pretty much up to date, no worries.

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@Neville Is the main advantage of Sound Recover 2 it’s ability to lower high frequency sounds to lower frequencies (start frequency as low as 800hz) than other FL systems because it does it only when it needs it, or does it still have advantages for people that have aidable hearing in the 3khz to 4khz range?

Anyone with severe or profound thresholds at 6 and 8 kHz could possibly benefit. You are correct that people who wouldn’t benefit from other frequency lowering strategies due to having a profound corner audiogram (i.e. unaidable at 3 and 4 kHz) may be benefitted by SR2 because of its ability to drop things lower than most other strategies can. However, I’m seeing a lot of success from its adaptivity* for users who are aidable at 3 and 4 khz but are pushing aidability at 6 and 8 kHz either because of hearing loss or because of the limits of the feedback manager given their acoustic coupling. Many of my patients rejected SR1 (and other similar lowering strategies that other manufacturers are still using) because of the sound distortion, whereas they accept SR2 and therefore get better access to high frequency consonants. (Note, many others had SR1 turned on but weren’t benefitting because the Phonak default value was often incorrect and some practitioners aren’t comfortable with fitting and verifying it. The SR2 defaults seem to be correct more often, so may be more likely to be useful if just turned on with no verification.)

We are independent and so fit all manufacturers, although realistically I probably only fit six manufacturers heavily. Given that, SR2 is a feature that will make me lean towards Phonak, depending on the hearing loss, in the great game of cost/benefit analysis that exists where there isn’t a single hearing aid that does everything I want it to do.

Disclaimers here: I have not run any serious research on this, I am simply having good outcomes with it in my patients. Additionally, I know and trust the independent researchers who worked with Phonak to develop it.

*For those who don’t know, SR2 only lowers during high frequency phonemes and turns off very quickly to preserve low frequency phonemes. So the /c/ and the /t/ in the word “cat” will be lowered while the /a/ is maintained.

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Agreed with this. For those would wouldn’t benefit from frequency lowering, the Audeo V and Audeo B are barely different. That being said, there were some changes in the Naida V relative to the Audeo V and so it’s possible that there will be changes in the Naida B that we haven’t seen yet in the Audeo Bs. Seems unlikely that the Naida Bs will ever be rechargeable given the need for them to be compatible with FM boots, so what WILL be the change? If the only difference is that they have the adaptive expansion and asymmetrical automatic gain adaptation for users with asymmetrical loss, I will see no reason to fit the Naida Bs over the Naida Vs.

Plus, there are new things coming out twice a year at this point. You could say “wait for the next thing” forever.

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I really appreciate answers like this from the professionals on the forum. It may not be research, but having opinions born of seeing lots of patients is more meaningful to me than individual opinions. Definitely agree with no perfect hearing aid. I’d like one with Sound Recover 2 from Phonak, the connectivity, ability to customize response to noise and MultiMic of Resound, and the “je ne sais quoi” of whatever wows so many about the Oticon Opn. Thank you again for the thoughtful response.

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Oh yeah. Widex’s wind noise management, Signia’s tinnitus options, Unitron’s spatial sound. . . if only I could pick my favourite thing from every manufacturer and stuff it all into one hearing aid.

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Enzo 3D.

Been the best power aid for a while and now on the latest platform, good App and loads of accessories too - what’s not to like?

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IMHO, the only way to go these days is to buy hearing aids that allow direct Bluetooth streaming and without the use of any intermediate streaming device or remote.

This reduces what you need to function on a daily basis to:

  1. Your Hearing Aids.
  2. Your mobile Phone.

Oticon OPN 1’s allow direct Bluetooth streaming from Apple iPhone and Apple devices (but I as I understand it, not from Android).

So if you are an Android man, you should go for hearing aids that direct Bluetooth stream from Android devices as well. I understand that Siemens/Signia (px or the new nx platforms) 13 BT’s would direct Bluetooth stream from Android devices.

Many hearing aids are still being marketed and being sold brand new that do not have direct Bluetooth streaming capability, thus requiring an extra streaming device. So choose wisely and throw away your streamer.

Yes, accurate.

How many of those are suitable for a profound loss as requested in the thread title? with sufficient headroom for proper fitting longevity?

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The way it now seems to be going is that a few manufacturers have already produced premium top end direct Bluetooth streaming aids and highly likely, they will soon be followed by everyone else.

But a great question about whose aids will provide the best solution to profound hearing loss with sufficient headroom is yet another facet which I think requires a solid technical analysis of the specs followed by a user trial.

But, all being equal, having the ability to directly stream Bluetooth directly into your aids and listen and hear within your own head-space to received speech and sound has moved everything up a notch at least as far as my experience has shown.

That’s not particularly accurate.

There are MFi hearing aids. There are a couple of direct BT solutions. There are also 675 Powered, UP hearing aids.

Most MFi product sits across the entire range of the platform so you can get a Resound 5 series or Opn3 which stream BLE 5 directly from Apple product.

If you want a hearing aid for a profound hearing loss, you need a decent UP/675 aid - that’s not really up for debate - the add-on of streaming is certainly a bonus. So, you choose this form factor, then look at the technology level, then see what you can plug it into. If you drive the process the other way around you’ll still have product like the Opn in your list, which clearly isn’t suitable for profound losses.

That’s why I suggested the Resound Enzo 3D.

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I don’t believe the Signia 13 BT or Signia nx will stream directly from Android devices. I believe Phonak’s Audeo B Direct is the only professionally fit hearing aid that allows that. I specify “professionally fit” as there are some OTC devices that will as somebody pointed out previously. But back to the OP’s original post. If one wants a Super Power hearing aid for losses greater than 105dB AND wants direct bluetooth streaming from iPhone, the Resound Enzo 3D is the only current choice.

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You may agree that your statement isn’t always true. As you said…
“If you want a hearing aid for a profound hearing loss, you need a decent UP/675 aid - that’s not really up for debate” -

and
“you’ll still have product like the Opn in your list, which clearly isn’t suitable for profound losses.”

In my case that UP 675 power aid would drive me nuts having the aid deliver that gain in the highs because of Recruitment. So I have been using power receivers in the ear for many years. The plus is, they are discreet. I’m coming from a Agile Pro 100 receiver to a trial of the OPN 105 db receiver.

What do you think?

Recruitment

Recruitment refers to a condition related to some hearing loss.

Recruitment causes your perception of sound to be exaggerated. Even though there is only a small increase in the noise levels, sound may seem much louder and it can distort and cause discomfort. Someone with recruitment can have problems only with specific sounds and frequencies or may have problems with all sound in general.

The theory of recruitment is that as the hair cells in your cochlea become ineffective, they “recruit” their (still working) neighbor hair cells to “hear” the frequency the damaged hair cell was supposed to hear, in addition to the frequency the still working hair cell was supposed to hear. This increases the signal from the still working hair cells.

The sounds reaching our brains appear to be much louder that normal. This is because the recruited hair cells still function in their original critical bands and also in the adjacent one(s) they have been recruited into.

The net effect is that people who have recruitment along with their hearing loss will experience an increasingly narrow range between the softest sound they can hear (caused by the hearing loss) and the loudest sound they can comfortably tolerate (caused by the recruitment).

Not everyone with hearing loss also has recruitment. It’s a condition of the hair cells and their nerve endings in the cochlea. So, people whose hearing loss comes from other sources (such as conductive losses or nerve losses not involving the cochlea may not experience recruitment.

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Thanks for the helpful replies so far. I can see things have changed a lot in the past few years, especially with bluetooth and streamers. I also use a hard-wired setup with my current Oticon streamer for making VOIP calls from a laptop, to eliminate the intermittent bluetooth issues such as delayed or buffered speech.

I have an appointment on Friday morning to go over my shortlist of possibilities to see which is the best option for me, and to pick one to try. I think my two main options are the Naida V90 and Resound Enzo 3D at the moment.

I do recall the Sound Recover option in my old Naida Q’s, helping, so I’m particularly interested in hearing what Sound Recover 2 does.

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Why would you not be able to control the MPO on a 675/UP aid to deal with a recruitment issue? Thanks for the explanation, it sounds like the one I learned.

Just because the 105dB receiver runs out of power at the right level doesn’t necessarily mean it’s the best choice, just in terms of distortion at the limit. A more powerful solution with proper limiting would hit the target more effectively- cosmetics aside.