How do I find the right RIC hearing aid for me?


#1

I am a 30 year old male and have conductive hearing loss, about a 30 dB ABG in the lower frequencies, due to 4 failed tympanoplastys (ear drum patches). I am currently evaluating a Phonak Virto B90 and have not been impressed. It does not seem loud enough 90% of the time, I don’t have symmetry between my good left ear and my right ear with the HA in it (especially when listening to music in a vehicle), there is a lot of static, and the AutoSense feature makes it seem like the hearing aid is turning off.

I want to look at a Micro/Mini RIC hearing aid. The problem I am having is, the internet is filled with biased, commercialized information and I can’t find a one stop shop that allows for comparison between the brands that are in the U.S. market right now. How can I find the available options that suit my needs/wants? What I am looking for:

  1. Discrete (Micro/Mini)
  2. Allows for a feeling of symmetry between my two ears. This may be due to the filter that trys to block out sounds like wind noise but also blocks out sounds that I want to hear. It may also be because my current Phonak IIC doesn’t have the juice to give me the volume I desire.
  3. Gives me more control over volume adjustment. I want to be able to make the changes, not the hearing aid since, from what I can tell, the hearing aid doesn’t do a very good job of it
  4. Allows for the gain to increase with the increase in sound or music. It often feels like the HA only works when the sound levels are at a minimum. For example, when listening to music in my vehicle, my HA will not increase in volume as the music increases in volume

Also, what types of improvements can I expect when switching from an IIC to an RIC? Are there technological or equipment differences between them?

Thanks!


#2

Often the CIC aids will only have two mics while the RIC will have 4. This improves directionality and noise controls.

Some have greater volume problems than others. A compression adjustment should address that. Road noise can cause the aids to consider you are in a noise situation and adjust. You can ask for a car program to address that.


#3

Regarding music: It sounds like you’re describing issues with dynamic range. Widex, Oticon, Bernafon and I believe Sonic deal wth this better than most.

RICs tend to have more features than IICs. They tend to deal with noise reduction as they have more microphones and they have better separation. Streaming music and phone calls directly from ipnone is also common in RICs and tends not to be available in IICs.


#4

Thanks for the reply. It seems to me that with music, the amplification stops at a certain volume. Do you know if it is possible for the gain of the HA to increase proportionally as the volume of music/environment increases?


#5

The issue I’m more aware of is that microphones won’t accept input from certain loud sounds. What you’re describing sounds like a “compression” issue. I’ll try to explain briefly: Hearing aids apply a lot more gain to “soft sounds( often <50dB)” (to make them audible) than they do to “loud sounds(often >80dB)” It sounds like you want more of a linear response. Your hearing aid fitter should be able to set up a program for music with more of a linear response.


#6

I am considering getting these to try out.


#7

Let us know how you like them, Daffy. There will be more like these in the future and that’s a good thing.


#8

I placed the pre-order for the Boost. They are shipping from 24th April. I will review them hear once I get them.


#9

Hey @samputrah,
Few things to keep in mind. Alot of what you have mentioned is not directly related to a problem with the hearing aid but a problem with how they were fit.

The fact that they are not loud enough 90% of the time tells me they were likely not verified using real ear measurements to your conductive loss prescription. Conductive losses require significantly more gain than sensorineural hearing losses - the conductive portion also requires primarily linear gain with less compression. Lots of times people fitting hearing aids don’t even take into account that the loss is conductive and then people end up saying exactly what you are saying, “not loud enough 90% of the time”. Lack of symmetry is also a good indicator they were not verified with real ear measurements. Unless your hearing is asymmetrical and you spent alot of time with asymmetrical hearing loss - then when you actually become symmetrical with amplification it can sound asymmetrical because you aren’t used to it - but that doesn’t sound like the issue here.

Hearing aids have alot of adaptive automatic features that are not for everyone. Most of these features are more geared towards sensorineural damage because we need to increase the signal to noise ratio as much as possible. It is very easy for the person fitting to just back off on these features - this goes for any style, make, or model - they all have features that can be enabled or disabled (all with varying degrees).

It sounds like to me that there is a bit too much processing happening for you - noise reduction is probably too aggressive - also the output compression/MPO is probably too low. If the person fitting did not account for the fact that your loss is conductive and fit you like a sensorieural loss (especially if it was “first fit” without real ear measurements) then most likely you are getting too much compression and increasing the MPOs would be very beneficial!

As for IIC vs RIC. Alot of time you do lose some functionality because we are dealing with less space - thus less hardware. But their are pros and cons. Sometimes IICs sound more natural because instead of relying on directionality from the hearing aid like a RIC you get to use the natural resonances of your ear for directionality because the microphone is in your ear. RICs/BTEs have to artificially create some directionality - but when in noisy situations often the directional advantage is stronger with RICs/BTEs because they can process things in a more complex manner due to the array of mics.

As @MDB said about music. Hearing aids cannot handle high levels of input (e.g live music). Certain hearing aids from some manufacturers are way better than others. However, if the output compression is set too aggressively then even hearing aids that can handle a high input with no distortion will sound strange because things will be “squished” more than you want them to. Conductive losses need more linear gain and need much higher MPOs (i.e. less output compression) so that you don’t feel like things are being over processed.