Mixing Hearing Aids

Hearing Aids
1

I’m using Moment 330, right ear, & 110, left ear for the second day now (both RIC).
I don’t feel any difference except for having the sounds louder, especially noises. I still struggle with understanding people, especially outdoors. I was watching TV yesterday and I could hear people talking but couldn’t catch/ understand most of what was said.

Should I think of trying a BTE for the left ear or both? The company doesn’t have a BTE Moment.
What other options could go well with Moment 330?

Thank you!

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I’m no audiologist, but I think your solution could be independent of BTE in both ears. I think the key will be finding some kind of streaming device for hearing on the phone and TV, PLUS program set-up to diminish background noise in any setting.

Not saying the latter (dedicated program) is a total fix, but I have “Speech in Loud Noise” as a dedicated program on my Phonak Lumity Life aids. When I’m in a noisy restaurant or place with LOTS of ambient noises, I put my aids into that dedicated program. I find it turns down the volume on EVERYTHING (too much), but if I turn the volume UP a couple steps on my aids, I can catch what folks are saying if they’re FACING ME.

I hope others will chime in here. I honestly don’t understand the logic or benefit of your having TWO different models by ONE hearing aid manufacturer. Yes, your hearing is different in each ear, but I thought most aids made for profound loss would be able to also accommodate little-to-moderate loss, too?

Good luck sorting this out - it’s an intriguing situation!

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The left ear has practically very little hearing. I might be wrong, but unless the bone conduction result was really well masked it could be spurious too.

With this kind of issue, possibly the best approach would be to go to a BiCros system. Now, this is where your mismatched aids might cause you a problem: if they were the same model the Widex software used to allow them to be turned into a CROS setup. I’m not sure that’s possible with different models.

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@1Bluejay Thank you! : )

5

Hi,
I’m sorry but I didn’t get this part! Could you explain it in other words, please?

The audiologist suggested a Bicros aids. However, through reading about it, I learned that that could make my left ear inactive which is not good if one day, I consider having a CI.

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It means that given the large difference in your right and left levels, the tested result achieved for bone conduction is possibly not correct. Separating which cochlear hears what becomes harder with more extreme asymmetry as the process of isolating one ear from the other doesn’t work so well. Also at high output levels the bone-vibrator is vibro-tactile meaning you can ‘feel’ the sound on your skin.

7

Could the surgery I had in the left ear in 2013 be the reason?

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That might be the underlying reason for the loss, but what I’m talking about is the difficulty in obtaining a ‘true’ result for your actual hearing sensitivity in your left cochlear; given how much difference there is between both ears and how unreliable the measurement of bone condition becomes at higher levels.

Aside from this, you need a BiCROS in any case. Like I mentioned you can get a normal pair of Widex aids to work on this basis.

Maintenance of the neural function is certainly a consideration if you’re looking towards a cochlear implant, but you need that test doubly confirmed (and possibly something to illustrate that there is current neural activity there).

Sorry to be downer on the condition of your left ear, it’s just very difficult to get a confident result for that ear without some more advanced testing.

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9

Could an MRI & CT give some answer to that?

Why do I need a BICROS in any case? Is the left ear a hopeless case?

I’m not sure if audiologists in Egypt could give me an honest answer/ recommendation on all of that!

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Yes, BiCROS until the CI.

The other testing should indicate if there’s a functional cochlear there still.

11

What if I will be only able to get a CI in 10 years or even more? Would a BICROS be still a good choice?

Having a functional cochlear would indicate that I’m qualified for a CI?

12

You’re a candidate for a couple of options now including the Bi-CROS. If you presented this loss at our practice we’d fit one because there minimal usable hearing on the left ear relative to the normal(ish) loss on the other ear.

I don’t know enough about the criteria for CI selection or the requirements for CI care in your area.

13

Why not let the patient try the BTE and let THE PATIENT decide if it provides any benefit?

I have a severe/profound almost flat loss in my left ear, very mild in my right. I’ve been so frustrated by hearing care providers trying to shoehorn me into a CROS or BICROS. Whatever hearing I have left, I want to use, even if I just hear birds or lawnmowers! Hearing professionals are so focused on speech, speech, speech, they forget there’s a world of other sounds that hard of hearing patients might want to hear.

And how about an AmpCROS program for this patient?

It took me three tries to find a provider willing to sell me a single hearing aid and work with me. Unfortunately, that provider was in a location that was horrible to drive to, so when I decided to buy two Phonak Marvel aids, I went to the Connect Hearing shop 10 minutes away, and despite being owned by Sonova, parent company of Phonak, they were incompetent.

This year, wanting a replacement, I interviewed several independent audiologist and HIS providers and not a one is willing to step out of their comfort zone and work with me. My suggestion of AmpCROS was practically met with hostility because they’d never heard of it, and God forbid they learn anything new.

So I went to Costco, got a pair of Philips, and doing DIY for AmpCROS.

The Philips doesn’t completely cover the loss in my left ear, and I’m tempted to buy BTE, one for my left ear or both, on eBay and going full DIY. The only thing stopping me is that I have no idea about tubes or whatever connects the BTE to the ear.

And, no, there’s no way I’m going to get a CI or BAHA. I’ve made it to almost 70 years on this planet without surgery, and I’m not going to have surgery now unless it’s for something life-threatening.

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14

Happy to.

I’m sure that they’re able to consider a range of options from their local professionals.

15

I meant to include this in my previous rant, but awhile ago, in a fit of “I can’t be the only one,” I went on an internet search and found this article:

https://www.audiologyonline.com/articles/asymmetrical-sensorineural-hearing-loss-fitting-12222.

The takeaway, “Don’t say no until you know.”

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Hi @Kaytee,
Thank you so much for sharing your thoughts!

I also don’t want to give up on my left/ weak ear that easily. I am checking what other options I have.

I have been educating myself on my hearing impairment for a couple of months now despite being hard of hearing since childhood.
I have never heard about AmpCROS. If the specialists didn’t hear of it in the US, I suspect any would know about it in Egypt. However, I’m going to check whether this option is available here.
On another note, I’m not very good at dealing with electronics so I can’t do DIY unless I get a kind of training.

I had surgery in my left ear before and I wouldn’t mind having a CI, today before tomorrow. Unfortunately, I can’t afford to pay it and “my case” is not covered by medical insurance.

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17

You can learn about AmpCROS here:

Starkey and Signia have instructions online on how to set this up. I was able to figure out how to do it with the Philips by hunting around in the software and following the same concepts.

Best of luck finding an open-minded hearing aid provider!

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Do you have a link to the Starkey site that shows how to setup ampcross? I have a Starkey Genesis bicros but would like to try that. Thanks!

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I am with you @Kaytee… I get very little contextual information from my left ear, but I sure as hell notice, if that aid is switched off! I wouldn’t even consider a Cros aid, nor will I consider a CI… I recall many years ago, working with a profoundly “Deaf” young man, he was born with Ushers Syndrome (tunnel vision, in conjunction with profound hearing loss) his vision was in rapid decline! I asked him one day (via sign language) why did he wear hearing aids, as he obviously couldn’t hear any spoken language, he had no speech… His reply was, “he liked to hear something, be that traffic noise or whatever”… I believe, any ambient sound gave him some reassurance, and the world wasn’t such a frightening place, if he could hear something!!! That young man left a deep, and lasting impression on me, I actually taught him to play pool, he became quite good, given the fact, he couldn’t see all the table, what a player he would have been, had his vision been 20-20… It taught me a valuable lesson, just because someone wears glasses, it doesn’t mean they can see you, and likewise, just because they wear hearing aids, that doesn’t mean they can hear you… Cheers Kev :wink:

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20

Not wanting to labour this point Kev, but your asymmetry is massively different.

I’ve historically used both Widex and Starkey power ITE to achieve a transcrainial CROS result, it’s nice that someone has coined the term AmpCROS and written a paper for it.

The problem is here, is that we can’t say for 100% that the worst ear has actually been measured AT ALL. Once there is more than 30-40 dB asymmetry across the head and you start punching loud sounds at the level needed for the Left, the (not so bad) hearing in the right gets to hear these too. This is all well and good except for a few factors:
1, The shapes of the loss are entirely different.
2, The skull/power aid interaction introduces its own transfer function - significantly more LF bias, an acoustic delay and signal modification.
3, The power distortion of the receiver, skeletal and environment sounds are in the mix too.
4, Feedback/battery use on the sending ear can be a nightmare as you’re deliberately trying to shake a mass (the skull), much larger than the intended mass of the eardrums.
5. Just because you’re using the skull to achieve the CROS, doesn’t mean you’re actually ‘hearing’ on that side, it’s just doing the same thing as a wireless CROS but doing it really badly in terms of the good ear.

All of this yields a degradation of the signal to the better side, which might not be an issue under some circumstances. However, if you look at the OP’s loss at 500Hz, you can see that there’s a 20dB result - that’s practically ‘Normal’ hearing. We already know that she does well with a RIC on that side - throwing an uncontrolled/distorted signal across the head is unlikely to improve the situation.

The reason why transcranial CROS methods are out of favour, and that is wireless CROS systems have been around for about 2 decades. Given that (especially with the latest models) the output can be perfectly controlled and you get a good mix of the contra-lateral and ipsi-lateral signals, you can see why this method of delivering sound is better (especially noting point 5 above).

I would encourage anyone to ‘do their own research’ but I would caution against looking at it emotively. Once you talk about ‘abandoning’ one ear, not everyone understands the concepts of why it might be better: especially as an AmpCROS essentially does the same thing, just to an inferior level.

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