Cookie bite hearing loss

Hi I’m new here. I have a cookie bite hearing loss that was picked up in a hearing screening in grade school at age 9. Initially the doctor said this would just be something that I’d deal with and wouldn’t impact my life too much. However over time the loss progressed and has been more of a problem and now there are more available HA technologies. I’ve twice tried to fix the loss with hearing aids. In my 20’s, I got Widex digital in canal aids that did not work. In my 30’s, I got BTE receiver in the canal aids. In my experience, these hearing aids were helpful in some settings, but in most I was better off without. If I’m in a quiet setting they work well enough. Recently the left aid broke. I’m considering looking for a new audiologist and a new aid. My current pair are Widex Passion open fit purchased in 2011.

Welcome to the forum.
8 years out of a set of aids is good. Aids in general have really changed since 2011. Hopefully to the better for your cookie bite hearing loss. You really need to get hearing aids you can wear all the time to keep your word recognition up.
Costco has a good reputation by most here on this forum. Usually great service and great fittings with really good pricing.
Sharing your audiogram would be helpful for us to help you.

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Thanks. I agree it would be best to have a set that I can wear all the time. In practice, I was able to keep them in at max 6-8 hours a day. I need to see an audiologist for a current audiogram. Currently I wear them sporadically in environments I know to be helpful. Thanks for the reply.

If you have access to a Costco, they will do an audiogram at no cost, and you can see what they have to offer. They have a Kirkland Signature 9.0 model which is a RIC type that sells for $1500 a pair. They are premium aids that are very similar to the Phonak Marvel M90, but under Costco’s name. The other thing to consider is the correction formula used in the hearing aid. That can often make more difference than the aid itself. NAL-NL2 is the common prescription used, but a DSL v5 prescription may give better recovery of the higher frequencies for a cookie bite loss.

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Thanks for the response. I’ve been reading a lot in the forum about cookie bite loss. One thing that I was told in the past is that it’s incredibly hard to correct. It’s my understanding that the vast majority of typical losses are ski slope. Mine is a chunk out of the mid frequencies. I’m willing to pay for the best aid for my loss type. The Widex Passion was the best for it in 2011 based on my audiologist’s recommendation. The thing that has been most frustrating with this loss and amplification in the mid frequencies is that other sounds mask the speech that I need to hear. For instance, when I was in grad school the sounds of the fan for heating and cooling the room made group discussion hard to hear to the point I was unsure if they helped at all. I tried to work with the audiologist to fix that issue but it was never great. I think I’m looking for aids that can have several programmed listening environments that I can change with an app. I’m hoping to find a rechargeable set but I realize the most important thing is that they work.

There are some things that don’t work for a cookie bite loss. One would be frequency compression where you take the high frequencies not being heard and shift them down to lower frequencies. Can help those with a severe ski slope loss, but would make things worse for a cookie bite loss.

Speech in noise is difficult for all aids. The reason is that the noise often is at the same frequency as speech. If you reduce noise you also reduce speech. There are a few trick to help though. One is to detect no speech and then simply reduce gain, to control background noise, and then to increase gain when speech is detected. This type of control often has an adjustment as to how quick or slow it acts depending on the situation. But the underlying theory is like the original Dolby noise reduction where one can accept more noise if the speech is loud. Helps but not a silver bullet. The other trick is to use microphone focus to select the speech you want, but reject the sound (noise) from other directions. Hearing aids with two microphones in each aid, and the ability to talk to each other from left to right, can help a lot in achieving microphone focus. Focus can be controlled automatically or manually, when automatic does not work. A third trick which some hearing aids have is an anti reverberation program. The aids detect echo and reverberation like you may have in a lecture theater, and suppress the echo. I have that feature in my aids, but just had it turned on, so can’t comment on how well it works. My fitter claims that her clients that are teachers have found it helpful.

I think the direction that aids are going is to use more and more information to automatically determine what the environment is, and then adjust to it. Phonak uses what they call AutoSense techology. It uses audio data to try and detect the situation and then switch programs automatically. Signia and Rexton have what they call a 3D Classifier technology. It works a little differently by considering not only acoustic data, but also detects whether or not the user is speaking or not, and also uses motion data from the sensor in the smart phone (or built into the new X version aids). They claim this can distinguish between 24 different listening situations and adjust to each. My aids are of this type, and I would like to say it is the silver bullet, but it is not. I can say that I seldom have to adjust out of Automatic to a specific program, but certain situations can still be difficult.

And don’t overlook fitting. Some audiologists do not do Real Ear Measurement and adjustment to the desired prescription formula, but they should. And don’t be afraid to try a different prescription formula like DSL v5. It was developed for children with hearing loss, but now has been modified to be suitable for use in all ages. It may work the best for cookie bite.

Hope that helps some,


Thank you for your reply. It helps to know others experiences. There’s a part of me that’s considering holding off because of the new hearing aids/ psap legislation that recently passed. I’m genuinely curious how personal sound amplifiers will disrupt the hearing aid market. I realize for the complex loss that I have I’ll need an audiologist to program mine. I feel hopeful that the market competition will drive hearing aid companies to do better. Maybe it’s not worth holding off but it’s an expensive purchase and I want the best I can get. I’m sure lots has changed in the market since mine were purchased in 2011. But from what I’ve read about cookie bite loss most aids aren’t created with us in mind since we represent such a small fraction of users. So I’m skeptical that they’ll for much better than my current set. I’m trying to motivate myself to see what’s out there but it can feel disheartening to spend an arm and a leg for limited benefit. In any case I’ll be replacing the left one first since it’s broken.

My loss started out as a cookie bite and now I am losing more of my high frequencies. I have been wearing aids for about 15 years and have slowly progressed to the point I cannot live without my aids. I now wear ITE Oticon OPN1 aids and after 8 or 9 different adjustments over 9 months time I hear better that a lot of my friends and family that have normal hearing. It has been a long road but it has been worth it. I have always worn my aids from the time I get up to I go to bed. It has given me much better hearing to do so.

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One aspect of the cookie bite that may have been a problem with older hearing aids is that the loss is a more complex curve, often with a sharp drop and then rise again. Older, especially analog aids would have difficulty dealing with that. However today with aids having as many as 40 or more channels and 20 adjustment handles, there is really not reason for the correction to not be able to follow the loss. And to show the difference between prescription formulas here is a cookie bite loss curve according to the commonly used NAL-NL2 formula.

Compare that to the DSL v5 for the same loss.

This may not be your loss at all, but it shows you how much difference the fitting formula can be while using the same hearing aids. The DSL v5 is prescribing almost twice the gain in the loss area.

On replacing one of your current aids, I think aids should be bought in pairs, and it would seem to me to be better to spend the money on a new set.


Thanks for the reply. I guess wishful thinking that I could replace just one. :wink: Though I haven’t had a recent audiogram, my hearing is close to normal at either end both in low and high frequencies. It drops to moderate and moderately severe in the mid frequencies. For me the bothersome amplified sounds tend to be fans and crinkling plastic. In my current set that’s what they’ve had trouble bringing down for me.

Side note: any advice on finding an audiologist that has solid experience in complex losses? I know at my last practice I was a rarity.

Hi- I am also new to this forum. I suspect we might have the same kind of hearing loss (my audiogram is attached to my avatar). I trialed hearing aids in my 40’s and 50’s when I was working but they were hopeless - like you I found air conditioning, fans, plastic and paper very noisy when amplified and drowned out the voices.

It got to a stage last year when I was really having difficulty hearing at home so I decided to see if technology had improved enough to help me. I trialed a lot of different aids. It came down to Phonak Marvel and Resound with custom ear moulds. I eventually went with the Phonak Marvel 90’s. I have had them since April - I am very pleased with them - it’s taken a few trips to the Audio to get them right. There are still places where I struggle a little - especially if there is music playing in the background but they are way better than what I was like without them. When I take them out at night I realise how bad my hearing actually is.

I am sure you will find that the new technology available now is a huge step up from a few years ago.

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Thanks for your reply. It’s good knowing I’m not alone. Can you explain what a custom ear mold is? Phonak Marvels are on my list to ask an audiologist about. And, yes, your audiogram resembles what I recall mine looking like.

Hopefully you can see this Ok. The Audiologist took a mould of my ear so that they fit perfectly. They are extremely comfortable - so much so that I nearly got in the shower with them in!! I tried the open type of tips that look like a Tulip shape but they didn’t work for me as they let to much noise in.

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Okay, thanks, my current pair looks similar for the bte part but I have the open fit. I feel like the open fit was key for me in the high and low end. My first set of Widex were custom in the canal aids and I couldn’t stand the occlusion (fish bowl) effect. Thanks for sending the photo!

I am a fan of the Costco Hearing aid centers. Assuming you have access to one or more of them, I would try there first. Ask to talk to the manager of the Hearing Center and tell them about your cookie bite loss and your history of being hard to fit. Ask they they have someone experienced with that type of loss on staff. They may not, but it will give you a chance to evaluate how seriously they will take your situation, and how willing they are to work with you. Consumer Reports did a survey of about 17,000 members about their experience with hearing aid retailers. Costco came out #1. There are some upsides to Costco beside beside the low price. They do not get commission and should be trying to sell you the aid that works best for you, even if it is the lowest priced one they sell. They have the best equipment and their standard is to do REM testing, while up to 60% of the industry does not. You can get a bit of information on what they sell at this link, and by clicking on the various manufacturers they represent:

Costco Hearing Aid Centers

As far as the models they sell, I would look at (listen to?) their KS9 which is essentially the Phonak Marvel M90 that @Lorjoh is using. It uses a 312 battery, and does not offer tinnitus masking, or a telcoil. The upside is the price of $1500 a pair. And it will work with Android phones and stream direct to them. I hear the app is pretty basic though.

Their Rexton model is the Adore Li. It is very similar to the KS8 which I have and is no longer available at Costco. The Adore Li is rechargeable and works well with iPhones. It should have the 3D classifier, Own Voice Processing, and Reverb Reducer options that you see on Signia models. It has a pretty good app that is described pretty well in this Signia myControl app document. This is how I have my program menu set up.

The other models they have are from ReSound, and Phillips. I know less about them, other than the ReSound is said to have one of the better apps. If you have an iPhone, I would suggest getting a model that is MFi certified. They tend to work the best for streaming.

Hope that helps some,


Interesting. I would’ve assumed Costco would cater towards helping those with more common losses. Do they employ audiologists in their hearing centers? Not sure if that’s a dumb question but I do know I’d need an audiologist to fine tune the aid. In fact, they weren’t on my radar at all. The price points are much lower than what I forked out in 2011. I believe it was close to 3,500 per aid then. I’ll most certainly look into Costco as there are plenty near me. I’m an iPhone user so would be looking good iPhone compatible.

We don’t have Costco here so I can’t comment on what they provide. I am also a iPhone User (iPhone X) and my Marvels work really well with the phone. I love streaming music and podcasts - they are so clear and the sound is great.

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That’s excellent to know! I also have an iPhone X and the Marvels are on my list. Just need to work up the courage to go through this process again.

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Some have audiologists and some have hearing aid specialists or technicians. Unless you have an underlying medical issue that requires treatment, I would expect either one is quite well qualified to fine tune the hearing aid to your loss. These days the computer does most of the work, and the audi or tech mostly needs to understand how best to use the software. From what I know the keys for you would be:

  1. Getting the correct power of receiver
  2. Selecting the best prescription formula to use. Some hearing aids can accept more than one prescription with each one being in a different program. That can be an easy way to compare which prescription works the best for you.
  3. Willing to take the time to fine tune the gains after the REM is done. Costco does not charge for essentially unlimited follow up fittings. They are as patient as you are, and it is reasonable to expect it will take multiple visits to get everything right. If there is an issue with Costco it is getting appointments on short notice. If you go with them, make sure you make a future appointment right away after anything is changed. It is easier to cancel an appointment than to make one.

Also have cookie bite & will pickup my Costco version Phonaks next wk. Trialed them in the check out line area for noisy environs & match for me was good. By far the Best Value ($1500/pr; excellent return policy; & 4 yr xt Warranty if use Costco Visa to purchase. However, as $ is not necessarily limiting for you, these Phonaks do have Smartphone compatability & but do not have compatability with the Roger remote mic set up like the newest Marvels. The Roger devices are another $1000 & it sounds from readers that Roger is mainly useful in live time when you need to hear one person in noisy environ & can set mic close to them, so may not matter if you’re mostly on phone. Costco rep said they are required to do Real Ear Measurements.

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