Profound High pitch hearing loss and new hearing aids or cochlear implants

Hearing Aids
, , , ,
#21

I wish you well with the CI assessment @craftycrocheter… It has been many years since I suffered with distortion, when MD (Meniers Disease) was at its hight…I do have several dead spots though, but I hear well considering my level of loss, I put this down to always being aided, I never lost the ability to process sound…I have the new Naida Lumity 90 UP BTE on a free trial at the moment, and things are looking up… Good luck with your assessment, hopefully you will get your CI’s… Cheers Kev :wink:

3 Likes
#22

I don’t see how this works with a sloped hearing loss, particularly a steep one. If highs are amplified enough to overcome the loss, wouldn’t lows be too loud, masking the highs or even causing pain? The normal varying sensitivity to sound at different frequencies (SPL vs. HL) doesn’t appear to explain it. @Neville, can you help?

1 Like
#23

Each frequency is adjusted for volume in the booth to compensate for a particular hearing loss during a hearing test. Similar to how a hearing aid is adjusted for an ears hearing loss.

So results from the hearing test in the booth is very similar to what can be expected from a hearing aid.

There are variances on results based on hearing aid experience.

My understanding in simple terms.

#24

I don’t think that’s the case for the standard word recognition tests (perhaps for cochlear implant eval they do it that way (or use your hearing aids?)

1 Like
#25

I am thinking tone tests, my mistake.

Word understanding tests were done with aids on.

I have only done speech in noise with CI.

#26

No, you’re correct, for a steeply sloping loss WRS may not be very predictive. For a more gently sloping loss WRS is typically done (when looking for PBmax) at a sufficiently supra-threshold level that the loss doesn’t impact it much.

Note that WRS is a crappy test overall and we shouldn’t place much value on it. It gives us useful information when highly audible presentation still results in very poor scores, but that’s about it. Test-retest variability can be near 40% in the middle scores and is still commonly 20% at the edges.

3 Likes
#27

Interesting that cochlear implant evaluations are based on word understanding scores.

To me the audiogram just never really answered all the questions about speech understanding. I general it does but there are those that it doesn’t.

Thanks

2 Likes
#28

But CI evals are done aided, ideally at 100% prescriptive targets, and generally use sentence in quiet and in noise materials. It’s a different test.

3 Likes
#29

So have I got this right? A steep sloping loss with good word recognition scores means a cochlear implant is not indicated. A steep sloping loss with poor (50-60 % or worse) word recognition scores means further evaluation is needed. A cochlear implant eval seems to be the way this is most commonly done as word recognition tests with hearing aids is rarely done in routine testing.

#30

Steep high frequency hearing loss has in the past few years been accepted for CI. If a person still has hearing in the mid and lower frequencies it can be borderline for CI candidacy.

In 2000 my audiogram hearing loss was borderline for CI. I still had some hearing in the lower frequencies but my word understanding with aids was very low.

There is a audiogram chart that shows who is and is not a CI candidate. I believe it’s with Medicare but not sure. I will see if I can find it for you.

#31

We’ll sometimes do an aided word recognition test prior to sending for CI candidacy eval, but I think a bit more commonly with borderline pediatric cases as the kids are limited in how they can understand their deficit relative to normal function and advocate for themselves–usually I’m already in communication with the CI team at that point to see whether they think further eval is warranted. Adults generally know whether or not they feel that they are struggling with their hearing aids enough that they might even consider a CI eval.

edit: Let me also mention that a child who showed up with cicada’s loss would definitely be getting a CI. But adults can compensate better than children.

2 Likes
#32

Here’s Medicare’s criteria: NCD - Cochlear Implantation (50.3)
The crux of it is optimally aided sentence word recognition test scores of 60% or less.

1 Like
#33

Interesting.
I read here on the forum 60% and 50% at times. I sure seem to remember 50% when I
got my CI’s but it’s 60% now for sure.

There has been more complaints from new CI recipients lately. I wonder if it has something to do with letting people get CI’s too soon when they still have ok hearing, expectations.

1 Like
#34

I’d guess not properly setting expectations and assessing if somebody is really willing to work for it.

#35

Well most people come to the forum with questions and problems, so what we see here might skewed to the negative. I don’t see that at all on the Facebook groups for current users for each brand.

#36

Thank you @kevels55 very kind of you :slight_smile: although i am still not really 100% sure about it all if i am honest. I have, somehow, managed to live without being aided for so many years but it certainly has not helped me in the long run! Like you said, you have always worn your aids so you know what letters/words sound like but I did not do myself any favours. I am still unsure. I have to get these hearing aids adjusted any way as the set up is worse than what I had before. HF sounds that were loud and clear, are now too quiet… feels like I am wearing my hearing aids without batteries in :laughing:

#37

Thank you @kevels55 very kind of you :slight_smile: although i am still not really 100% sure about it all if i am honest. I have, somehow, managed to live without being aided for so many years but it certainly has not helped me in the long run! Like you said, you have always worn your aids so you know what letters/words sound like but I did not do myself any favours. I am still unsure. I have to get these hearing aids adjusted any way as the set up is worse than what I had before. HF sounds that were loud and clear, are now too quiet… feels like I am wearing my hearing aids without batteries :laughing:

1 Like
#38

You are very welcome @craftycrocheter… Hopefully your dreams & aspirations for a much better hearing experience will come to fruition, in the not too distant future… Good Luck in your CI assessment :grin: Cheers Kev :wink: