Help with HINT testing and Phonak M90s

#1

I am looking for help in whether I have the best option for Hearing aid. I received my 3rd set, starting year 9 of wearing them. I am in law enforcement, and my levels have dropped below what is considered road worthy. In January I received the Phonak M90 R and went to the test about 6 weeks later, not doing well.

Testing consisted of;

-The first part of the testing session consists of a basic audiologic evaluation and includes the following: otoscopy, tympanometry and pure-tone audiometry. The audiogram will serve to assess changes in hearing status since the last audiogram was performed. This step is performed without the hearing aid(s).

-Other tests (sound localization and speech recognition) will be performed twice (aided vs unaided), allowing us to determine the benefit provided by the hearing aid(s) for each specific task. When performing aided testing, the fitting program and other settings of the hearing aid(s) should be those used on a regular basis, unless otherwise indicated.
-Ability to understand speech in quiet and in noise will be assessed through a sentence repetition task using the Hearing in Noise Test. Sentences will be presented through loudspeakers in quiet and in various noise conditions (noise coming from the front, from the right and from the left, with speech coming from the front) and he/she will be asked to repeat what was heard. Using this approach, speech reception thresholds for sentences will be measured in each condition.
-Finally, to test your client’s ability to localize sounds, a sound will be presented through one of 12 loudspeakers and he/she will be asked to identify which loudspeaker the sound is coming from. The loudspeakers will be mounted on a half-circle located either behind, to the right or to the left of your client.

What I am hoping is that someone with experience with the different hearing aid brands and their technologies, can say, yes “you have the best, but tweek it here” or “this brand would be better for those tests”.

I want to get back on the road and hope there is an current answer for me.

Thanks.

Terry

1 Like

#2

Welcome to the forum.
Your audiogram would help us help you.
In general your Phonak M90 aids are classed in the best pending on your hearing loss. There are other name brands that are also very good, like the Ford and Chevy debate.
How well you do with your aids is very dependent on your fitter and your hearing loss.

1 Like

#3

What is the best way to add the PDF…as these are not the usual results

…and how do I removed my posting name? To just my first as it should be in my profile? Thanks

0 Likes

#4

Go to your avatar in the upper right corner of any page and touch/click it. You will find a banner, envelope and gear. Click the gear. There you will find your profile data. You can change it there.

0 Likes

#5

How to add your audiogram from the admin.

1 Like

#6

Thank you…went can I upload the HINT results? As I am still a new user it will not allow me.

0 Likes

#7

I don’t know.
Did you find your profile page?

0 Likes

#8

yes…thanks…got the names working. Maybe I need verification by a mod first before I am able to upload…

0 Likes

#9

Looks like you are all set.
The magnifying glass in the upper right corner of all pages is a search function. There is a huge amount of information in this forum. Just about anything you can think of has been discussed in detail. Asking questions is good too.

0 Likes

#10

SCAN - Copy.pdf (355.0 KB)

Copy of the HINT test report.

1 Like

#11

Interesting challenge. I’d probably recommend trying to locate an audiologist who is ready to work closely with you to try to meet your goal of passing this test. It would be beneficial if they would have access to the HINT or are willing to get the HINT (it needs to be purchased) so that you could run through it with new settings to see if you are able to meet the criteria. You need to find someone who runs REM and you probably need to emphasize intelligibility over comfort.

The marvels might not have the optimum directional strategy for the HINT, but it would be nice if you could try working with them first to see if you can get it before investing in a whole new set. If changing, I might recommend Unitron or Signia.

1 Like

#12

Hearing in noise is the tuffest test of hearing aids. Not many people are ever really happy with their aids in noise.

I did a walk around in Costco with their KS9 aids. They are very similar to your Marvel 90 aids. Something I noticed with these aids is how really good they were in directionality. Like facing sound and hearing it well but other sounds to the left, right and behind were not coming in. That would be bad for you. That’s the question for your fitter.

The Oticon open aids have a good reputation for gathering all surrounding sounds to the wearer. They are a bit challenging to get used to but once you are trained with them I have read they are great.

Your hearing aid fitter is the key to all of this.

0 Likes

#13

I was read a bit on the Ultrazoom added as a manual program. Is there anyone who has experience with using this outside of the autosense?

I will be building a 12 speaker structure that I used and be trying thing out before I get tested again.

Raudrive, you said the Oticon are a bit challenging to get used to…why?

0 Likes

#14

I have only read about the Oticon aids. The challenge is all sounds are coming in to the wearer. All this sound takes the wearer time to learn how to process. It can be overwhelming at first.
Hopefully some of the Oticon people will chime in.

0 Likes

#15

Oticon’s “open” strategy is still a front-facing directional strategy. There isn’t the narrow beam forming that Phonak uses, but it doesn’t have a backwards directionality for speech other than just turning its opn strategy off.

There’s a lot of talk on these forums about how the opn strategy is just to let all sounds in, and some people talk about using the omnidirectional modes of other hearing aids to mimic it, but these ideas are both incorrect. The opn simply engages in a different sort of directional processing that is potentially beneficial for speech-in-babble situations. People also talk about how the opn trained their brain to filter out sounds, but in reality the opn itself is doing a lot of heavy processing to filter out unwanted sounds. It is not at all like the omnidirectional mode of other hearing aids.

I think it’s actually unlikely that the opn would work out well for the HINT. Its processing strategy depends on identifying near versus distant speech based on modulation rate and then subtracting the distant speech signal to try to clean up the near signal. In the HINT, the target speech and the noise are spatially separated but equidistant from the listener.

1 Like

#16

You don’t mention, or I missed it, what you are using for fittings. My thoughts would be that you could benefit from a custom mold with a very small vent. It is tempting to using an open or semi open because you have such good low frequency hearing, but the problem with that is that much of noise is at low frequencies. With an open or larger vent fitting, your hearing aid has no way of controlling what you hear at low frequencies. But with a very small vent mold, the mold can act much like an ear plug to kill the low frequency sound. This in turn should help you hear the higher frequency speech where you hearing is not very good. Also killing the low frequency sounds can help with directional sensitivity. This is because the hearing aid is more in control of what you hear and where it is coming from.

I only have software for the Rexton (Signia, KS8) aids, but here is what I get with 1 mm micro vents. It seems somewhat reasonable, and you could get away with quite a bit of gain in the high frequencies without encountering feedback. The KS8’s are still available at Costco in Canada, but will be replaced with the KS9’s about mid September which are essentially the Phonak Marvel M90 like you have now. Costco does REM testing and adjustment, which can help some too.

0 Likes

#17

The problem there is that it would likely have a drastic effect on his ability to localize sounds, which is task number two that he has to be able to pass. Hearing aids break sound localization. Open fits do better.

Though frankly, an open fit will not give him enough gain in the left ear anyway. Some sort of balance is required. It’s probably going to take some work.

1 Like

#18

I am using the smallest of the 3 vents…due to “very hairy ears” for the less itching. I did years ago try moulded, but as suggested… it blocked the sounds in the levels I could hear fine in.

But really for the test from the half circle 12 speakers, it is only white noise played. I struggled with mirroring

0 Likes

#19

So, actually, you failed the localization task in the unaided category as well. Front/back confusion is resolved with pinna cues, which are high frequency. IMO, Unitron has the best localization processing out there right now. But it may simply be that your marvel’s are currently providing insufficient high freuquency gain (not that RIC hearing aids have pinna cues at all, but they all at least try to adjust for this with wide directionality. . . eck, I don’t even know if this would do much. I wonder whether customs would be better.)

0 Likes

#20

Yes, for sure having a more open fitting would let your ears identify the source of lower frequency sounds. The down side is that low frequencies can drown out the higher frequencies that you need for speech recognition in noise. So that is one specific purpose of using a closed fitting, to kill the sounds you hear easily. The basic problem is that hearing aids to not even come close to restoring normal hearing in the higher frequencies. So, if you leave the low frequencies alone and do not try to attenuate them, then you cannot hear the the highs. There is a basic rule in hearing which says that if you have two sources of sound, natural sound through the fitting vents, and HA made sound from the receiver, once one is 10 dB louder the other source becomes inaudible. The 10 dB+ louder sound dominates.

One of your advantages is that both ears are almost identical in the higher frequencies. For that reason they will be able to be aided almost the same. My ears are very different, and that causes problems with directional sounds. For example the fairly high pitched sound from my coffee maker is heard by my right ear, but essentially not at all with my left. Or the right just dominates. It sounds like the coffee maker is off in the totally opposite direction to where it really is (on my left).

Yes, closed fittings have down sides, but in your situation the benefits might outweigh the negatives.

Not sure what controls you have with your Marvels but on the aids I have, I can manually change the directionality of the microphones by quadrant. If that is allowed for the test, perhaps you could improve your scores with some adjustment of the HA’s ahead of time…

0 Likes