It is only a ChatGPT answer, with caveats, so it should be treated with a grain of salt; nevertheless, I still think it requires further investigation.:
Itâs not a great audiogram to base any opinions on. With that loss youâre going to start running into the limits of the bone oscillator and/or masking dilemmas, but it would be nice to at least see an attempt at masking. But absolutely I could believe that thatâs actually a sensorineural or cochlear conductive hearing loss. Lostdeaf has had hearing loss since birth, havenât they? EVA, maformations of the cochlea, various syndromes that might be present at birth can all be associated with a third window component.
I wonder what the best option for how to treat that false bone conduction in the prescriptive targets is though. I might actually default to taking it out and fitting it as a sensorineural loss rather than having the calculations in there for a conductive component, but I suppose Iâd just try both with the patient and see what they preferred.
2 Likes
Thanks for your explanation. So, in that case, does it make sense to test a BAHA with a headband?
No. The bone line is too severe for a BAHA.
I guess I shouldnât say âsevereâ as a general term because itâs used as a hearing-specific term. The bone conduction hearing is not good enough to support a BAHA, even if it were to perform in the same way as a true conductive hearing loss, which it might not.
2 Likes
Yeah: thatâs not what your chart shows. Unless you have really high vibrotactile sensitivity, you have a degree of conductive loss. Either the chart is wrong or your interpretation is wrong.
Your loss might be âlargelyâ sensorineural, but thatâs not the whole story.
1 Like
I have sensorineural hearing loss. It was a rubella when pregnancy. So no conductive hearing loss. I know it.
Ok: not to labour the point, but CRS losses âcanâ be conductive.
With my new Oticon Intent 1âs, I used the manufacturerâs proprietary VAC+ as starting point. The result sounded so good, I stuck with that for the last 6 months.
Now that I have read your referenced interview with Gus Mueller PhD, and his comments on NAL-NL2 and DSLv5, I decided to experiment some more to see if I can improve speech intelligibility. Mueller mentions that HA companies stopped using DSL v5 as the customers regarded it as tinny and they lost market shareâŠ
As an aside, I would venture to opine that your first-time HA customers are the worst group of people to judge what normal speech sounds like! Therefore they choose fittings which are not optimal for their prescription.
Yes, I suffer high frequency losses that cause difficulty in speech discrimination. Muellerâs work and comments indicate that NAL-NL2 (and DSL v5) both give better speech intelligibility index (SII).
My understanding of NAL-NL2 and DSL v5 is that they are very similar with DSL v5 giving slightly more boost in the higher frequencies.
2 Likes
Indeed it is, especially to 4 kHz, assuming a ±5 dB deviation. Gus Mueller shows this in his 2017 book about speech mapping and probe microphone measurement (information about it is in the article)âŠ
Iâve chosen DSL 5.0 Pediatric for mainly three reasons:
- I have had hearing loss since age 4, so if I had been fitted with hearing aids using best practices, I would probably have been using DSL 5.0 Ped for 30 years.
- I have a cochlear implant in my left ear, which provides excellent high-frequency stimulation (not amplification). However, I need balanced sound between my ears so the high frequencies from the CI do not overpower my hearing aid ear.
- My high-frequency reception is quite good even without the CI, so it is possible I have relatively few dead regions and could benefit from high-frequency amplification in DSL.
Youâre right. They are used to living for years without high-frequency amplification, so that if they suddenly receive proper gain, they think all sounds âunnaturalâ.
A small caveat: I am not a professional, I simply has some knowledge about it, and work in medical profession.
I am a Phonak Audeo Infinio Sphere 90 user, but I wonder what my hearing would be like with slightly better high-frequency amplification (roughly in 3-6 kHz) with Oticonâs HA and receiver.
that is Oticonâs philosophy. One program and let the technology work its magic! glad that works for you. I just got a pair of intent 1
1 Like
No ot.has been my desires and demand since my first set of aids that did not have but the default progam and no volume comtrols.