Challenging loss to fit

Hi,
I’m new to this site, but not new to hearing loss. I was born with high frequency sensorineural bilateral loss. I had 10 dB loss out to 1000 Hz, moderate loss at 1500, severe at 2000, profound at 4000, and no response at 8000 (audiogram from 1967). Hearing aids at the time were useless for my type of loss, so I didn’t try them. I went through public schooling and college without any special treatment since I was able to comprehend speech and speak very well despite not being able to hear higher frequency consonents. As you might expect, I’ve always had some difficulty with speech comprehension in noisier situations. I did try aids in 1992, but they did not help.

I’m 47, now, and this is what my most recent audiogram looks like:

      R     L

250 20 25
500 20 25
750 30 30
1000 80 75
1500 105 100
2000 105 105
3000 105 105
4000 105 110
6000 100 105 (hissing noise instead of pure tone)
8000 no response

This is actually not much worse than my audiograms from 1992 and 2001. Somehow, miraculously, I am still able to comprehend speech very well without hearing aids or any other assistance. I have absolutely no problem carrying on a conversation on the phone or listening to news radio in the car with just the normal volume controls. TV, I now have to supplement with captioning to really follow all of the dialogue. Teleconferences with speaker phones can be a little challenging, but are still doable. Speech comprehension in noise, however, is more challenging than ever and I’m ready to try the latest and greatest digital aids.

Any recommendations? One suggested approach is to focus on fitting my loss out to 1000 Hz, underfit the frequencies above that, and try to take advantage of the new algorithms for better speech comprehension (Oticon Delta 8000). Bear in mind that I should not be able to comprehend speech as well as I do in the first place, so this approach has some merit. Based on my audiogram responses, I probably have cochlear dead zones above 4000 Hz, anyway. Another approach is to perform the TEN test to figure out the dead zones, then use the frequency transpostion algorthims in the Wides Inteo to try to bring some of the speech cues down into a more usable frequency range. The third approach is to just try to fit my loss with a power BTE, but my audiologist and I are not very optimistic about this “conventional” approach because of the dead zones, recruitment, and limited dynamic range.

Thanks in advance for any advice,

Dave

Yes, this is a tough hearing loss. It would be assumed that there are, most likely, cochlear dead spots in this case and amplifying in those areas with a power BTE may degrade your understanding more than help.

There is a PHD doctor, Dr. Ted Venema from Canada that is known as the guy to go to for info in this area. Try a search online. His first name may actually be Theodore, so you may want to try that also.

I have met him several times and attended a few of his classes and he recommends, in these cases, fitting hearing aids to focus on the useable areas. Thus the use of open fit to aid the lower frequencies may be one way to help a bit.

There is also another product from Israel that does frequency shifting, thus shifting high tones to the lower tones where you can hear them.

I forgot the name, but I will be attending the American Academy of Audiology convention this week and will stop by their booth to get the name.

Here is the company:

AVR Sonovation of Israel. The AVR ImpaCt hearing instrument uses a digital speech re-coding algorithm, and is designed for listeners with severe-to-profound losses in the high frequencies. One algorithm is intended to relocate energy from speech in higher frequencies downward to where amplification might be clinically useful for the listener.