We often get comments on here about what the appropriate receiver is for a certain audiogram. I think lots of factors come into play. One guideline I got from a Rexton Connexx video was to place the audiogram readings at 500hz, 1000hz and 2000hz in the middle of the fitting range chart. I still think that’s a decent place to start. To me it avoids the temptation to go with really powerful receivers if one has profound high frequency loss. There’s just no way you’re going to be able to get or tolerate enough gain at those frequencies if you have a mild or moderate loss at 500-2000hz. That’s where some form of frequency lowering may be useful. Also, what if you don’t tolerate loud sounds (there’s little difference between your loss and UCL) Even though you may “need” more gain per your audiogram, you might not be able tolerate it. I’m sure other factors come into play. I suspect most of us are better off letting the professional decide which is the best receiver. I know I questioned initially if I had a powerful enough receiver and it’s worked out fine. If you’re having problems getting adequate gain, ask why the professional chose the one he/she did and if there would be benefit to trying a different receiver before dictating what he/she do. Basically throwing out to stimulate conversation. Hoping to hear some other guidelines for choosing power levels of receivers and other criteria to consider.
Even with my 105dB receivers, I simply don’t hear the 6 and 8 KHz tones anymore even at max amplification. I only hear a low buzzing noise associated with it during my in-situ audiometry testing, which I attribute to the vibrating sound of the receiver due to the powerful high frequency amplification. So I consider my hearing at those frequencies as goners and use frequency lowering to hear in those bands instead.
Because of that, although it looks like I should be fitted with 105dB receivers, 85dB receivers are adequate for my loss as well because I’ve given up trying to amplify at 6-8 KHz.
I actually own 2 pairs of receivers, one pair of 85dB and one pair of 105dB. I can get my with the 85dB receivers just fine thanks to the frequency lowering.
My aids came without receivers, but I had some of the low, or normal power ones already from some old aids I already had. I tried those first, just to make sure the aids worked. I bought some high power receivers to actually use. Using the same settings as before, they were louder than the medium power receivers. I decided to keep the higher power receivers because they had longer wires, which I thought I needed, and just because they can put out a lot of sound, doesn’t mean they have to. I have given up on hearing anything above about 3 KHz. I don’t think you could get enough sound into my ears at the higher frequencies without actually doing damage.
For my the left ear the threshold is at 80-90 dB in the 500 to 4000 Hz range. I don’t think there is any RIE receiver which will put these losses in the middle of the range. The super power BTE ENZO 3D 9 has a range 60 dB -120dB, which meets this criterion.
Does it mean that for profound loss in one ear one has to use a high/super power BTE aid?
I don’t think there are any hard and fast rules. I’d stare out with what kind of aids you have now and how do they work? Do they give you enough gain? I would suspect you’d do best with custom molds, but I’d almost bet that there are people with similar loss that would say domes work better for them. If you don’t tolerate lound noises, you might get by with a considerably less powerful aid. If you are constantly wanting more gain, then possibly an ultrapower aid, (or maybe even cochlear implant)