Is it possible my hearing test results are wrong?

Hello.

Are hearing tests sometimes inaccurate?

The reason I ask is that I am having a problem getting my new hearing aids to do the job.

I had CIC hearing aids which were fitted from a previous test and work fine in quiet settings but not in noise. With them I can hear all voices easily in any quiet setting. I don’t have the test results any more.

I now have Audeo Yes RIC hearing aids in the hope they will help with hearing in noise, as well as in quiet. When I first had them fitted from a new hearing test they were nowhere near loud enough (practically useless). This seemed odd. I have had the gain turned up once. They are better but still not good enough to rely on. The most odd thing I notice is that for some females I can’t hear any noise at all when they speak, even in a quiet setting! Absolute silence with a moving mouth!

Compare this to my older CIC’s (fitted from the earlier hearing test) with which I can hear any voice clearly in a quiet setting:
This makes me wonder if for some frequencies my new test results are wrong. Otherwise, surely I would at least hear a little noise for all voices, even if I could not understand their words?

Any thoughts or alternate explanations would me most appreciated.

Thank you for your time.

The short answer is ‘coupling’.

How well or badly the sound is transferred from the device to your ear, including any losses for venting, changes of insertion depth, residual volume of the ear canal etc.

This has a big impact on the output as any real ear measurement system will illustrate.

Thank you very much for the answer. However, I’m afraid I don’t understand. Can you explain in a little more detail including what I could do about it?

Is it also your opinion that it is unlikely that my hearing test is incorrect?

It’s possible that the test is a little out, but unlikely to be that far, as each presented tone is over twice as loud as the previous one. Meaning that for it to be more than one level out it would require a 4x difference in the response from you.

Your hearing instrument my just be set on the default 80% of prescription from the first fitting, whereas with you being an experienced user, you could have had the full 100% prescription.

There is also the slight possibility that your previous instruments have over-exposed you in terms of loudness: but there’s not a massive amount that can be done about that until your brain re-acclimatises to the new sound level.

Thank you.

Are you suggesting that if I continue wearing the aids for a while, my brain will learn to hear sounds that it currently cannot hear?

I’m concerned this is not likely to help me with people like the woman I could not hear at all at the moment. That would require quite a dramatic improvement! How would you account for the fact that I could not hear any noise from her voice at all? What could be causing that other than a level on the hearing aid not being accurate?

If you can’t hear her at all, you need to get the aids adjusted again.

If you can’t hear her clearly, that might just need more time.

The level of the aids is down to a variety of physical factors, the audiologist’s appreciation of the software and understanding of your position as well as your test data.

Thank you very much for your help. I really appreciate your time.

The core thing I am still not understanding, and my apologies if you think you have answered this and I am just being thick, is: how is it even possible that I can’t hear her at all whilst wearing hearing aids in a quiet setting if the hearing test was accurate?

(edit: when I say I can’t hear her at all, I mean I can’t some sections of her speach at all, not that that I cannot hear a single word she says without exception)

To me this makes no sense.

There are two parts to this.

Firstly how the aid is tuned, it may be set to low to pick up the parts of her speech that you are missing in particular frequencies.

Secondly your acclimatisation. If your brain is used to being bombarded with sound at certain frequencies, then it’s action in ‘tuning’ the cochlear to hear these frequencies is dulled down. OK if the aid you are using has high output there, but not so got if the aid is quieter in that area.

The difference between speech recognition in hearing noise is tiny. According to Etymotic Reasearch, each extra dB of signal over noise is capable of improving speech recognition by about 10%. Therefore, if either you hearing aid isn’t turning up your hearing enough at the required point or your brain isn’t ‘tuning’ into it you will not hear as well as you might.

This has relatively little to do with your test results and more to do with whether you are able to adopt the new sound from the aid. In any case, ask your audiologist to up the prescription ‘experience’ level and the sounds will ‘lift’ out of the background.

Thank you so much. I’ll talk to the audio about that and see if they can do anything about it.

In my experience, RIC have poor bass response because 1) the mould usually sits shallowly in the ear canal, leaving a big residual ear canal volume that is harder to amplify, especially at the low frequencies 2) the back part of the receiver or mould is open which means that sound escapes more easily, which leads to poorer response at low frequencies.

I have extremely big ear canals and if I do not get moulds that fit deeply in the ear canal the sound becomes thin because of the lack of bass response, and I also require significant more overall volume from the initial settings.

I wonder therefore if satisfied RIC users have relatively small ear canals.

If I were you, I would go back to in-the-canal hearing aids. You need more bass, and normal hearing aid receivers (loudspeakers) have little ability to amplify bass in the cases I described above with RIC hearing aids in large ear canals.

thank you for your suggestion. I do have relatively large ear canals I believe. are there CIC hearing aids that are good in noisy environments?

secondly, what do you think of the option of trying ‘power domes’? do they offer better bass response?

CICs have the advantage that the pinna can help you to hear where the sound comes from and that helps you to disinguish voices. I use Widex ITE and I like the so-called Comfort program in very noisy places. Otherwise it is my opinion that noise reduction algorithms are generally overestimated. The most important factor is a good fitting.

Power domes will probably offer better bass response, but enough I don’t know.

that’s interesting. i certainly notice my CICs, which are from Precision Ear, are a lot easier to hear clearly with in quiet settings, and have much higher gain, so I can also hear over distance, such as in a big room at a meeting.

I have been quite confused so far about why I can’t hear clearly with the Audeo Yes, given they are a newer model and retail at about 4 x the price. So far they don’t seem to be able to do even the basic job of hearing all voices clearly one-to-one in a quiet setting for me.

maybe a better model of CICs will do the job in quiet and noise for me.

following from your comment about the pinna I did some research and saw this article on “RM” hearing aids, (sorry I’m not allowed to do links as I’m too new)

When I decided to try new aids, I had a terrible time with Phonaks. The newer Spice chips seem to be difficult to program. I am currently wearing Starkey CICs that work quite well. From the facroty, the Starkey aids sounded better than the best programming I had on the Starkey aids.

I would presonally recommend you try a different brand of hearing aid.

i see. well i have three months worth of adjustments included in the purchase of these Audeo aids I have so I’ll see what can be achieved in that timeframe.

I had Phonak MicroSavia’s before these ones and couldn’t get them set right even after 6 trips back to the audiologist. They sound just didn’t come through clearly or loudly enough and after the adjustments they were maxed out to the point of having bad feedback issues. In the end I gave up as it was too much of a waste of time going back and forth to the audio.

I read another post here about it being hard to find audiologists who can adjust the newer Phonaks well so maybe that is a part of the problem. according to their product specs they should be able to be fitted to me.

Oticon and Phonak hearing aids have the reputation to be sharp sounding, meaning that the bass is not strong. These hearing aids are therefore possibly better for individuals with small ear canals. I haven’t had success with Oticon hearing aids. They sound extremely tinny and I cannot hear much with them.

Some audiologist say that choice of hearing aids is a matter of taste and what you are used to. I say it is bullshit.

Arni,
How long did you trial your Oticon’s? My HA sounded tinny too, but only for about 3-4 days. what they have also done is mask my tinnitus extremely well. As they say everyone hears differently.

I trialled Oticon Agil for one year, with hundreds of adjustments.

Could never enjoy music.

Everyone hears differently is especially true if the sound coming from the hearing aids is different.