Oticon OPN 1 or Resound LinX 3-D 9?


#103

Concerning the button: It would depend if they use separate or shared port addresses. My KS6 share the port so what happens on one is the sames as for the other. I believe the Linx2 and above have separate addresses. It a design decision that probably isn’t that cost effective at least compared to the perceived benefit for the user.

For those who don’t understand ports, it is a common way used on computers to allow signals to interrupt or provide information based on how the design specifies. Things like printers and USB have port addresses where they can send or receive data. If it is for real time programming, the design criteria is far more precise. It can go beyond what a normal computer’s service timing typically needs.


#104

Volusiano: I paid a visit to my Audi today and asked if the volume output to my ears could be increased by any means, like raising the MCL or using a Connect Clip. He said the level is already at 100% and Connect clip won’t help but I could benefit by changing the 85 dB receivers to 100 dB ones for both ears. He has ordered a pair and has not mentioned any extra cost.

Since you have great insight into the working of hearing aids, and Oticon in particular, may I ask what difference I may expect by changing the receivers. I wish to make sure I can test them out properly before accepting.

Cheers.


#105

If you’re going to get custom molds then I’d recommend getting the 105dB instead of the 100dB. But if you’re still wearing domes then I think you can get the 100dB with domes.

As for what to expect from a bigger receiver, you may get more feedback due to more amplification. That’s why even though domes can be fitted with 100dB receivers, custom molds may end up being needed to deal with feedback.

If you stick to wearing domes with the 100dB receivers and need more aggressive feedback management to deal with the more severe feedback, the more aggressive feedback management may end up eating up more headroom on the additional gain that you get from the bigger receiver so that may offset the additional gain and become kind of a wash anyway.

But if you’re not having to pay extra for the bigger receivers, then it’s still worth getting them to manage your level of loss better.

Plus with the bigger receivers, they won’t get overdriven as often as the 85dB receivers, resulting in less distortion / saturation, and maybe longer lasting usage before it goes bad.

Custom molds, if needed, may or may not lead to more occlusion, depending on how much vent you can have without any feedback.

Naturally you’ll also get more headroom for amplification, which is what you’re looking for.


#106

Thanks. I will like to give the 100 dB a try with domes - Audi did not mention the need for molds. If I get a lot of whistling (the same as feedback such as when I bring my hand close to the ears?) I will ask him what he thinks of using molds instead if ‘the more aggressive feedback management’ needed with domes may cancel the advantage of a higher output from the 100 dB receivers.


#107

Further to my earlier reply, I would like to add an observation I made with the MIC sound received by my ears. For all my presets, P1 …P4, the default is a single ‘0’ on the ON app but sliding my finger vertically on the iPod screen I get two numbers for the left and right ear. I can selectively mute one or both these outputs. I find that almost all the sound I hear comes from the right ear because if I mute the R ‘number’ I hardly hear anything at all - the left ear mic at its maximum amplification has almost negligible effect.

Is this to be expected because of almost 20 dB (average) higher threshold for my left ear compared to the right ear? This is between 90 and 105 dB at frequencies higher than 3kHz. Will a 100 dB receiver improve the hearing on the left ear where the 85 dB could not?


#108

The 100 dB receiver should give your left ear an additional 15 dB of headroom compared to the 85 dB receiver, so it should help your left ear hear better.

The reason you started out with a single 0 is because this is the default volume. As you raise the volume, your left ear starts hitting its max value first (probably at 2 or something) and stops there, while your right ear still has more volume headroom to go up so it continues to go up to 4 before it stops. That’s why you get 2 numbers in the end.

Your provider should have fitted you with 100 dB receiver right up front, at least for your left ear, because your left hearing loss is already out of the fitting range for the 85 dB receiver at many frequency points, and even for the frequency points inside the 85 dB receiver fitting range, it is barely inside near the outer edge, so there’s hardly any headroom left to go up from. If you have feedback management enabled, I would guess that any little headroom available on your left ear (if any) is probably already eaten up by the feedback management as well.

So yes, it is to be expected that you can’t hear as well with your left ear on an 85 dB receiver. I think you will be much happier with the 100 dB receiver on your left ear.


#109

This is what I mentioned to the Audi when I first met him indicating to him the severe loss for the left ear which was well beyond 85 dB and wondering why he was not offering me 100 dB receiver, at least for the left ear. He said he was aware of the hearing thresholds from the audiogram I gave him and I kept quiet. Clearly he was mistaken in thinking that a 85 dB receiver will work for my left ear. A look at the audiogram makes it evident.

Anyway, it is better late than never. I am keeping my fingers crossed!


#110

Don’t feel bad. My provider did the same thing to me. My right hearing loss is also borderline for the 85 dB receiver in the mid frequencies and out of range on the higher frequencies. Yet my provider went ahead and fitted me with 85 dB in both ears. I later also had to upgrade to 105 dB receivers, to the tune of an additional $350 out of my pocket for both receivers and custom molds. So count your blessing that your provider at least hasn’t charged you for the higher power receivers.

I asked her why she fitted me with 85 dB receivers on my right ear in the first place. She said that she wanted to try that first to see if she could get away with it before ordering the larger receivers for me.

In my case, however, most of the low frequency loss in my right ears are mild enough that she actually could almost get away with it as long as I’m not picky about my high frequency amplification. But in your case, your left ear has pretty severe loss across the board, so it should have been more obvious that your provider wouldn’t be able to get away with it.


#111

I visited my Audi today - luckily the 100 dB receivers arrived by overnight delivery :-). He fitted the receivers with double closed domes. The overall sound is definitely louder but when I increase the volume by sliding my finger on the ON app screen on the iPod I again see the volume for the left H/A not going above 0 or 1 like before. Also, muting the volume for the right H/A almost silences the system, that is, I hear very little with the un-muted left H/A. Audi said this is the best that can be done with the 100 dB receivers and the 105 dB will hardly make any difference. He also mentioned he did not have to reduce power to stop feedback because there was hardly any feedback at the frequencies involved - whatever that may mean.

When I asked if there were more powerful H/As with Bluetooth (MFI) facility he mentioned ENZO 2 9. This is a BTE and definitely needs a mold, which he said will cost $160 for a pair (this is not a concern). I have an appointment to see him next Friday when I have to tell him if I will keep the OPN1 with the 100 dB.

I will use the H/As as much as possible over the week to see if the ‘almost ineffective’ left ear H/A could be a cause for returning the H/As if I can still hear speech, streaming etc without stress. Maybe, I will not get a real feel of the direction of sound because of this problem but will it really matter?

I will appreciate comments both (1) whether an ineffective Aid on one ear is a serious problem and (2) if ENZO 2 9 is a better Aid.


#112

If the 100dB receiver still doesn’t help then the next logical thing is to try out the BTE variety. There is a BTE version for the OPN as well. But I think it only has 105dB receivers so I’m not sure if it’s going to be any more powerful than the mini RITE 105dB version. Maybe the Enzo or other BTE brands or models have bigger than 105dB receivers.

There’s a possibility that perhaps since your hearing loss had been severe for so long that your brain has been desensitized to hearing on the left side than the right side as well. I would give it some time to see if you can become more used and sensitized to the more powerful receivers. If you have a certain trial period, I would take full advantage of this trial period to see if you’ll adjust instead of hurrying and return it for something else too quickly, especially if this is a brain adjustment issue. Also considering that trying out a BTE will require a custom mold so you don’t want to rush into it until you give the double dome scenario a full chance first.

But no, you should not settle for hearing well in just one ear unless you exhaust all possibilities, which you haven’t.


#113

Many thanks for the prompt reply.

Just to give some background: I had a stape mobilization operation to correct otosceloris in my right ear in the early sixties in London which worked very well until recently. Then the renowned Harley St. surgeon said that he could do even better for my left ear by doing a fenestration operation. This operation failed miserably.

Thanks to the near normal (restored) hearing in my right year I managed without any Aid at all on my left year for many years. But to have better hearing during the last twenty odd years I have been using a spectacle bone conduction hearing aid for my left ear as the bone conduction for this ear had been much better than that for the right ear. I have been using this Aid until I started this trial. So my brain has been used to sound input via the left side.

I am not sure if my Audi is using Genie 2 correctly. Am I to assume that even if I use a very high powered receiver I will always have an ineffective left ear? Why should it be so? Of course I expect to hear much less with my left ear alone than with my right ear alone with the maximum settings. Since this is what I am experiencing even with the 100 dB receivers (but the situation may improve over the next week or so) I am wondering if the fitting is being done correctly. In that case, the situation will not change even if I use ENZO 3D 9 BTE Aids which is for seriously/profoundly deaf people.

Oticon BTE Dynamo does not have Bluetooth/MFI capability which is what I do like to have.

If the situation does not improve I may just return the Oticon through my Audi but not order a new Aid through him. I may ask the Agency who ordered the Aids for me to reorder the Enzo aids but to be serviced by another Audiologist in my area even if I have to drive a few extra miles. I will take this route if I feel convinced that my present Audi is just not good enough. Even today he explained away the reason for not ordering 100 dB even for an ear with hearing threshold worse than 90 dB by saying that my brain was supposed to add 10 dB or some such thing that I could not follow!!


#114

After your audi fitted you, did he do a Real Ear Measurement test? The result from it should tell him and you whether he fitted you correctly and the hearing aid delivers like it’s supposed to or not. Without a REM, it’s hard to say if you’re being fitted correctly or not.


#115

No, he did not. He does not have the REM outfit. He said (and this is what Oticon somewhere also said) that REM is not necessary if using Genie.


#116

The REM test is a universal test to confirm that a hearing aid and the subsequent fitting delivers the amplification it’s supposed to or not. I’m surprised to see that your audi does not have the equipment to perform REM tests.

I’d like to see where Oticon said that the REM is not necessary if using Genie 2. I think the interpretation of what Oticon said might have been taken out of context somehow.

If I had to guess why it might have sounded like Oticon said that, although I still don’t believe they do, the latest version of Genie 2 has added the in-situ audiometry feature (back?). Although it’s not the same as the REM test, at least it’ll give you kind of a sanity check to see if your OPNs deliver the kind of amplification they’re supposed to or not.

You can ask your audi to at least run the in-situ audiometry for you from Genie 2 to see if the resulting audiogram from it matches with the original audiogram he ran for you independently or not. It’d be very easy to see if there’s a difference because both the original audiogram and the in-situ audiogram will be overlayed one on top of the other.

If it’s different than the original audiometry result your audi did for you, you can choose to re-prescribe the OPN for the in-situ result instead of for the original audiometry result. At least that way, it’s kind of a re-calibration to amplify based on what you actually hear out of the OPNs and should deliver more accurate amplification for you based on what you’re actually being fitted with.


#117

By the way, I wasn’t referring to the Oticon BTE Dynamo. I was referring to the Oticon OPN BTE PP13. As part of the OPN family, it has the MFI Bluetooth feature and all of the technologies used by OPN, I think.


#118

Resound Enzo 3D ultrapower aid is mFiphone and fits lossess up to 120 dB. Personally, I’d be inclined to ask audiologist’s opinion. If you don’t trust him/her, get a second opinion. There’s a fine line between trying to be active in one’s care and taking over. That said, I would think you would benefit greatly from custom molds and that comparing different gain receivers without them is of questionable benefit.


#119

Volusiano, a quick reply: The video explains what REM Autofit is.

I am not sure if my Audi did exactly what the video describes. From my experience with him I do not think he will be forthcoming with a helpful response if I ask him to do what you suggest. I feel sure that he is not going to redo the fitting at my behest and then provide me with a better fitting acknowledging his mistake/oversight. Noting how he explained away (glumly) why he chose a 85 dB speaker for an ear with a threshold worse than 90 dB I think my query will only make him think I doubt his professional skill. I will like to avoid any unpleasantness.

I will check up on the Oticon opn BTE model you mention.

MDB: If the 100 dB receivers needed molds I would have accepted that, but the double dome is considered adequate. So, comparing the outcome of the 85 dB and 100 dB with domes is valid, in my view.

ENZO has five BTE models, Mini BTE 67, Standard BTE 77, POwer BTE 88, High POwer BTE 88 and Super Power BTE 98. All are MFI. ‘Closed’ powers are respectively: 120/56, 124/57, 132/67, 132/73 and 141/83. I do not know what the second numbers are. Of course I have to consult an Audi to decide what is appropriate for me but I am not sure I can trust my present Audi for doing it.


#120

The maximum power is 105 dB.


#121

This video doesn’t say that you don’t need to run the REM test anymore in Genie (2). All it is saying is that the REM Autofit in Genie (2) is designed to be better integrated so that you don’t have to run both the REM system and the fitting software independently in parallel and make the necessary adjustment manually. REm Autofit communicates with the REM system to run the tests all within the fitting software (Genie (2)). And Genie (2) will automatically adjust the hearing aid gain to match the target so that the provider doesn’t have to do it manually. That’s all.

But the REM test is still conducted, and the audiologist must still be equipped with REM system to run it. The REM Autofit feature in Genie (2) simply makes the REM test easier by better integration and automation of gain adjustment, that’s all.


#122

I did not realize the function of this software. In any case, my Audi does not have the REM equipment and I will not gain anything by raising the need for REM which he is not capable of doing.

It seems I may have to end my trial because of this and ask the people who buys the aids on my behalf if the other Audi they work with in my area has the equipment. If not then I am in trouble!