Phonak/Resound/Oticon comparison

Hello – I am fairly new to this board insofar as I have lurked a lot and posted a little.
I am looking for thoughts about why one hearing aid had performed so much better for me than 2 others – and also where I go from here. Apologies for the length of the post. <O:p</O:p
I am a 52 year old entertainment lawyer – so in audiology terms I have a demanding lifestyle. I attend one on one meetings, small group meetings and lectures in the course of my work – and I need to go to the cinema and theatre as part of my job. It would help to use the telephone (see below). In addition, at work and at home I have a lot of resonant surroundings (hard floors, lots of windows etc).
I have a predominantly low frequency loss (see audiogram below) which is genetic. I understand that this loss is difficult to fit etc. I have worn aids for just over a year – all day and every day – and my worst fear (no improvement) was exceeded – my functional hearing was worse with aids! This was because sounds were louder (and often uncomfortable – eg footsteps, paper rustling) but speech was less intelligible (and I could no longer use the phone at all).
I was originally fitted by the NHS with Phonak Eterna 411 aids – BTE with a custom mould. I believe that this are similar to a Phonak Eleva. These aids have never been successful for me – the ambient noise is too loud and there is no clarity of speech. Lifting soft sounds helped a little – and the left ear in particular benefitted from vented moulds. But generally - despite reprogramming – useless.
I don’t mind wearing hearing aids – I don’t care how big they are etc so long as they are not flesh coloured. I don’t mind moulds – they are not uncomfortable and I have no occlusion. However, without vents I seem to lose my residual high frequency hearing.<O:p></O:p>
In despair, I went to a private audiologist. He recommended Resound Aleras – either the 7s or 9s – BTE units with RITE rather than moulds (and explained that the feedback management is excellent permitting the RITE). I decided on the 9s to give myself the best chance of a good result.
The Aleras were immediately better in relation to ambient, background noise – much more comfortable generally. BUT the aids seemed effective only in close range (18 inches) – beyond that no clarity at all so that I remained reliant on speech reading and sub titles. I have had one reprogramming – and the audiologist added small caps to the receivers for additional gain. However, this has had useful effect – background noise is marginally worse without any gain in clarity.
In the meantime, the NHS has provided Oticon Spirit Zest aids – again BTE with the same vented moulds as before. The difference is amazing. The aids are comfortable in all noise scenarios (perhaps not as good as the Aleras as originally programmed but pretty close to the Aleras with the covers on the receivers) – but most importantly I can hear and understand speech – the news on the radio, announcements on station, people who are a few feet away.
It was my intention to use the Aleras rather than the Oticons for the next 2 weeks – but this has proved impossible because the Oticons are so much better.<O:p></O:p>
So my questions – any idea why the Oticons have performed so much better for me? Before this experience, my conclusion was that performance was in the fitting rather than the brand.
Also what might be the advantages of the Agile (which I believe is similar in hierarchy to the Alera) over the Acto? I know this is dealt with in another post but I haven’t found that very specific.
My present inclination is to return the Aleras. I am willing to try the Agile but should I also look at an appropriate Widex in case that brand is even better for me? <O:p</O:p

Or perhaps someone has another suggestion for my situation?<O:p</O:p


Read your post with interest. I too wear Oticon Spirit Zest aids, fitted by the NHS. I believe they are rebadged Oticon Epoq aids, but without the bluetooth capability. As the Epoq was Oticon’s premium aid round about 2 to 3 years ago, and as Oticon is probably one of the best hearing aid providers, along with Phonak, Siemens and Widex, it is going to be a very good aid.

The sound fidelity is excellent. It performs ok in noise, there is no perceptible switching delay, and the aids are powerful. I wear the Spirit Zest P model.

I would imagine though, that there are better solutions now - the Oticon Agil Pro, and the new Phonak Audeo S/Ambra models.

The NHS audiologist said that I could get a streamer for the Oticon Spirit Zest - but not through the NHS. But not bluetooth. The Alera has good kit from that point of view - but the advantage of getting sound direct to the hearing aid is vastly diminished if it seems distorted from the get go.

The private audiologist deals with Phonaks as well - but part of my query is whether I should stick with Oticons because I have had a good result with the Spirit Zest.

It’s all a bit of a minefield …

IIRC they are more like the Vigo Pro C.

HOWEVER, the reason why the person above finds the NHS aid better than the others he tried is more likely to be due to the plumbing than anything else. With a reverse slope loss, the degree of occlusion that most people experience with NHS aids is removed, but the delivery of clarity is much improved over more ‘open’ style fittings.

This means they are highly effective in providing clear sound that not everybody likes.

If the private audiologist had appreciated that fully, it may have been a consideration to provide an aid that similarly sealed the ear…

Thanks Um Bongo - I have seen and appreciated your advice on these forums.

And I understand that occulsion is a problem for some - but I don’t think it was a problem for me with either the Phonaks or the Resounds. I didn’t feel blocked up - but the clarity of sound was crap.

I had read that moulds could cause problems for reverse slopers in cutting out the residual high frequence hearing. I didn’t think this was a problem until one of my aids failed - and I noticed more bird noise (singing?) with only one aid. Hence the vented mould - and presto improved (but not good) clarity in the left ear and garbage in the right.

With the same moulds on the Oticon Spirit Zest I have clarity on both sides (ie if one aid is turned off I can hear speech in the aided ear).

The private audiologist thought that the RITE would allow me to hear high frequencies - and also allow him to reduce amplification of the lows (which travel further - and which were drowning out the speech frequencies). And that seemed to work insofar as the aids were more comfortable - but speech recognition was still very poor (both from my point of view and so far as those living with me were concerned). I hoped that some additional programming would help - but it didn’t.

And then the Resounds were blown out of the water by the Oticons - which surprised me but not you. So would you think that I should stick with the Oticon brand and perhaps try a higher range product (Agile)?

I would be happy to do that if I could better understand what the differences are and improvements might be.

I’ll tell you my experience with Oticon and Phonak.
I tried the Oticon Agil Pro ITE for 3 weeks. I did not like a lot of the sound I was getting from these and asked to try something different. I next tried the Phonak Ambria MicroP BTE for both ears. From the start these were much better for me. I got them adjusted one time then wore them another 2 weeks, then bought them. They have met all my expectations for excellent quality sound in what I do. I have a very wide variety of sound environments from very quite to loud. These really knock out the background noise and work great on the phone and good for music too. I do a number of small groups and must hear every word spoken, including the little old ladies that speak very softly.(I’m 77) These are replacing 7 year old ITE ReSound and are by far the best aids I’ve ever had. These are my 5th pair of aids. My audio has a reputation for working with a client to get what they need, no matter how long it takes. She has lots of experience and handles 5 different brands of aids.
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The RIC mechanism is wrong for your needs because it has a built in power peak in the same spot as your normal canal resonance (about 2.6KHZ)- he’s adding to that and removing the sound where you actually need it. It’s not likely to work, especially with the in-house Resound algorithm tailored for softish delivery. So, the aid doesn’t suit, the algorithm doesn’t suit and he’s moved them away from what you actually need due to a preconception about the upward spread of masking.

Not the Phonaks either BTW, they will also emphasize the HF area and soundrecover is just going to worsen the effect of your audiogram.

And the real stinger: not the Agils - the floating point linearity does nothing for your loss and you wont get much perceptible benefit from the HF poncery with directionality and the like.

IMHO, if you can try an Acto(Pro) against the Agil and REALLY tell a degree of difference, go for the more expensive one, if you can’t, save yourself a couple of grand and I’ll have a Magners with ice :wink: - Many thanks.

Jerry: in fairness, look how your numbers go in relation to your loss - they are the reverse of the original poster. Glad you are getting on with the Ambras - if people around here could afford them they would be my weapon of choice for a forward sloping loss like yours.

Thanks again - I hope I am allowed supplemental questions!

Is the upward spread of masking the same as my perception of background sounds distorting speech? My understanding is that the gain on the lows has been deliberately reduced for this reason.

If the Resound factory fitting is predisposed to amplify soft sounds, that might explain why they work well in very close proximity (where someone is naturally speaking quietly/softly) - but pretty hopeless everywhere else.

But you would expect Oticons to perform better for someone with my kind of loss - which is interesting. [I realise that statement is a vast over-generalisation and perhaps a misrepresentation of what you have said - but I feel that I need to fix a starting point for the next stage of investigation.]

So a reasonable course of action might be to contine with the NHS Octicon Spirit Zest as they can probably be improved from a good starting point - next appointment there is in about 8 weeks.

And in meantime, return the Resound Aleras - but try the Acto (Pro) and Agile in the Oticon family? Btw is the Acto (Pro) different to the Acto?

Um Bongo, I hope you continue to read to read and respond on this thread. I currently have Oticon Epoq that are beginning to have problems and are going to have to go back to Oticon for out of warrenty repair. I am trying a pair of Phonak Naida and am looking at the Resound Futura, and Siemens Aquarius. Price ($7,000) eliminates the Oticon Pro). Can you give me your opinion as to which aid is designed for my extreme loss?

Naida don’t work fantastically well for a precipitous loss like yours (then tend to be better on flatter severe/profound loss). My first thought would be the Ambra/Solana MicroP - this would give you a decent aid in a small package which used Soundrecover to bring some of your higher tones back online. You can go to the SP model if you really need some more welly.

You might have to do a deal with your audiologist to accept that you probably have dead-spots at 4-8KHz and not bother amplfying this region so much. Agil Pro may work quite well, but hearing in background noise isn’t going to be better than the Ambra: especailly with the Stereozoom function,

Of the other two, I’d chuck the Resound in the bin and only wear the Siemens when swimming.

Hope this helps.

Yes to an extent, but you shouldn’t be experiencing distortion anyway: you don’t on the Zests. Lots of manufacturers have forgotten about people who do need LF improvements, and certain ones pretty much ignore/reduce the receiver response below 1Khz in order to reduce ‘ampclusion’. However: LF gives us good environmental info, loudness appreciation and warning signals etc)

More and more it’s the hearing company where the promotional pens last longer than the products. Other peoples’ mileage may vary though.

Largely going on what you are saying about the Zest: yes, particular instruments just ‘sound’ better to some people - like certain stereos etc, but Oticon developed a lot of the bass side when they put out a power instrument a couple of years ago - IIRC some of this development was carried into their current algorithms which allow for relatively normal loudness growth across more frequencies than other manufacturers.

Aleras aren’t worth the cost IMHO.

Acto vs Acto Pro is just a bit more refinement of channels over directionality - more moveable null points, slightly enhanced noise management. The reason I’d said Acto pro is that I would push anybody to find a real difference in a double blind listening test between them and the Agil. Though there will be a considerable difference in the cheque :wink:

As a final thought: get the Acto pro ordered up as a BTE so that you can do a proper side by side test against the Zest you are wearing. Best of luck with them.