Oticon More - my first experience

Hearing Aids
1

I have been testing Oticon More 1 (I currently own Oticon OPN 1) in the last weeks. My audiologist added 4 programs:
P1 – General
P2 – Comfort
P3 – Comfort with Directionality
P4 – Speech in noise

I asked him that I specifically want to address my main issue - speech in noise environment. He claimed that other clients of his preferred Comfort program over Speech in noise program in those situations. Also, I followed Volusiano’s advise and replaced open domes with something more close – double vented domes. I was glad to find out that I do not experience any occlusion effect.

We went to two restaurants in the past week, one medium noise and one very loud. I was pleased to find out that More is indeed superior to my 5 year old OPN. I sat with a group of people, it was not perfect, my wife with normal hearing still understood more than I did, but it was an improvement. Also, I have to say I agreed with my audiologist – I liked the Comfort (both with and without directionality) program the most. Speech in noise program amplified non-speech high frequencies too much, I found it exhausting. Does anyone have a similar experience? Should I ask the audiologist to tweak the Noise in speech program?

2

I have the More1 aids with the default, tinnitus and T-coil programs. I find the default program all that I need. Yes a very noisy restaurant does make me somewhat tired. But in most cases I hear very close to as good as my normal hearing wife in noisy environments, but I do struggle with hearing people with face mask on, but not as bad as I did with my OPNS1 aids. With the OPN1 I had the same programs as you but I told my Audiologist that my goal was to only need the default program and we worked very hard to get to the point that I only need the default program 99% of the time. I had to really work at retraining my brain to get use to new sounds and noises.
My word recognition is my weakness and the More1 has really been the solution that has changed my hearing life.

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Thanks cvkemp. I too have a low word recognition, always did.

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4

I haven’t tried the comfort mode with these but I’ve been to multiple very loud restaurants and speech in noise has given me great hearing for the most part. I agree that the high end can be a bit sharp and almost hurts at times but the clarity is amazing and it’s almost like having normal hearing again.

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5

This may be a mistake with your hearing loss. Your lower frequency hearing out to 2000 hertz is very good. Open domes might give you much more lower frequency sound than the aids which would improve your speech in noise.

Might be worth a try.

Good luck

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Same here - haven’t tried Comfort, but Speech in Noise is great when used judiciously (it gets tiring).

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@Raudrive - you are right about my hearing and low level freq, but I think the general consensus is that open domes are not so great for loud environments as they allow all sound in. That is also the reason why Phonak just released ActiveVent receivers - they close when it gets noisy.

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[Wouldn’t it be more factual to say “they are supposed to close when it gets noisy”?]

Phonak announces ActiveVent receiver and CROS Paradise

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I personally think that the bass dome with double vent is a great compromise. Remember that we’re not talking about completely closed domes here.

I find that the double vent lets the natural lows through just enough for me to hear, but attenuates some of the ambient noise if it gets too loud. After all, they’re not closed domes, and they don’t have just 1 vent, they have 2 vents. Thanks to the 2 vents, I feel that occlusion is minimized, except perhaps when I eat, then I may hear my chewing more.

If you go with open domes and have trouble dealing with noise, the assistance you get from the hearing aids to reduce the noise, even if you have a top of the line premium HA that does a fantastic job with noise reduction, is greatly negated simply because the noise can easily enters into the wide open vents anyway. So the noise-reduced speech from the HA gets mixed up and polluted with the nature noise coming through the open vent again.

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10

I find that the double vent lets the natural lows through just enough for me to hear, but attenuates some of the ambient noise if it gets too loud.

Your hearing loss is very different than the OP’s. Not a good idea to compare. Acoustics should be different.

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I’m not comparing my own fitting vs the OP, and I don’t need to, either.

That’s because it’s not about me, it’s about another poster who started a different thread who wondered why he was still having so much issue with noise despite using the More 1 and expecting that the More 1 to do a good job reducing the noise for him. So I opined that it looks like he uses open domes and that’s probably why → the noise enters in through the open domes’ vents, so no matter how great a job the More 1 does at noise reduction, it’s probably all for naught.

It looks like the OP in this thread (@bumbrlik) is in the same boat, so he wanted to try the double vented bass dome because of what he read in the other thread mentioned above. It seems like it’s an acceptable compromise to him because he didn’t feel too much occlusion with the double vented bass domes.

When you pointed out to the OP that he made a mistake in using the double vented domes and should have used the open domes, perhaps you missed the point he made that he was willing to make a trade-off of foregoing the advantage of the open domes in order to gain more benefit from the More’s noise reduction. It was a deliberate choice from the OP.

So I wasn’t comparing my hearing with the OP. I was just reaffirming that the double vented domes is not completely closed, so it’s not a mistake to forgo the open domes for the double vented domes like you pointed out to him. You said:

Open domes should not be the de facto fitting choice for people with normal hearing in the low ends for all cases. If all they want is amplification to compensate for their hearing loss in the high, and they can manage the noise just fine without needing any noise reduction support, then yes, open domes makes sense. But if beside amplification for hearing loss compensation in the highs, they also need assistance with noise reduction, then they will not get that noise reduction assistance from the HAs if all the noise is let in through the open domes’ vents just the same.

You opined that “open domes might give you much more lower frequency sounds than the aids which would improve your speech in noise”. I find a number of things wrong with this statement:

  1. Being able to hear more lower frequency sounds than the aids can deliver does not guarantee speech in noise improvement. Not if the lower frequency sounds are not just solely the components of the speech, but also included a lot of noise. And in a noisy environment, there are for sure plenty of lower frequency sounds that are noise.

  2. The other fallacy of your statement is that the aids cannot deliver the lower frequency sounds the OP would need to get the sufficient SNR for speech in noise improvement, and only the natural low sounds through the open dome’s vent can deliver this. For sure the aids can deliver low frequency sounds, maybe not as low as 20 Hz, but hearing aids are designed to go to as low as 125 Hz, or 250 Hz at the worst case.

And whatever low frequency sounds between 20 Hz and 125 Hz that the aids can’t deliver, don’t forget that the 2 vents in the bass dome should let them through. Maybe the 2 vents can’t let them through as completely wide open as the open dome’s vents, but it should suffice. And guess what, the sounds between 20 Hz and 125 Hz that can’t be amplified by the aids, they’re most likely not components of speech sounds anyway. They’re most likely components of HVAC fan noise or something like that. Nobody can talk that low, even folks with a low voice.

  1. As long as the OP’s HCP specifies the correct fitting (double vented bass dome) when doing the programming, Genie 2 will take this into consideration and boost the gain in the lows and mid slightly to compensate for whatever gain the OP might have lost from the difference between fitting an open dome and a double vented bass dome. So it’s not an automatic that by switching from open domes to double vented bass domes, that the OP would lose out on some of the low and mid hearing. Genie 2 will compensate for this such that whatever arrives into his ear canal (the combined amplified HA sound and the ambient sound) would be very close in terms of output gain between the 2 fittings.

The bottom line is that the main concern of going from an open dome to a double vented bass dome is NOT loss of gain in the lows and mids. Like I said above, Genie 2 will make sure the HA will compensate for that. The main concern going from an open dome to bass dome is how much worse occlusion may be to the wearer. Is the wearer going to be able to tolerate and accept it as a trade-off for other things (like improved noise reduction)? If yes (like the OP has mentioned), then in theory, using the double vented bass dome is usually more advantageous.

So it’s not about comparing my hearing loss and acoustics to the OP’s. I’m not saying that if double vented bass domes works for me, it should work for him. I’m only telling the OP that if the theory of the trade-offs between bass domes and open domes (as discussed before) sounds right, and if he tried it and found it to work, then stick with it.

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Thank you @Volusiano for excellent and very detailed explanation. I believe replacing the open domes with double vented domes helped me in noisy environment.

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13

I’m testing the Oticon More for a week now and have been wearing the Widex Evoke for past 3 -years. So far the Mores are marginally better for speech. iPhone and TV streaming are about the same. I have custom domes with Widex and Oticon. Maybe I’ve gotten use to it but not bothered by occlusion with either HA’s. I do have a problem when chewing but have gotten used to that, too. I was hoping for better out of the Mores. I will have Comfort and Speech in Noise programs added to Oticon because like everyone noisy restaurants are a challenge. Masks are terrible!

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@joesan: I find it difficult to process your comments without having access to your audiogram.

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I don’t recall your ever having said this before, and we had a whole discussion about noise-reducing headphones vs. hearing aids a while back! I currently have open domes.

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@happymach: I just looked at your audiogram. Boy, would I love to have your hearing! Why are you even wearing HAs with a 'gram like yours?

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I have a lot of difficulty understanding speech in noise, perhaps more difficulty than my audiogram would suggest. Also, because of the high frequency loss, my whole environment sounds duller, more muted without HAs.

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That’s another reason to use HAs, isn’t it?

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Your position runs counter to everything I’ve ever read in the professional literature about hearing aids and hearing loss, Jim.

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25

@jay_man2: IIRC, @happymach’s word recognition is 96% @ 35dB in each ear. I was interpolating, trying to imagine the degree to which such an objectively minor impairment might impact their daily life.

However, this is very subjective (as are all matters related to hearing) but - if if were I in this position - I’d be trying to get my brain to do as much of the compensation as possible, before resorting to assistance.

I may be dead wrong in my approach, if so, I stand to be corrected, if that’s not the case.