Reverse Loss/Low Frequency Hearing Loss

Here is a question:

I have a problem with low tones and I understand that the hearing aids that fit behind the ear are not as good as the in the ear for low tone hearing problems. Also I was told the behind the ear types are not that adaptable if your hearing loss becomes worse. I like your reponce to my first question and wondered if you could comment on this as I am still in my trial period with my first aids. BTW I do go to a Dr. of Audiology (only one in my city)

many thanks

With a low frequency hearing loss, the typical open fit hearing aid may not be the best choice, as they are designed to allow low frequencies to escape out of the ear on purpose.

Thus, hearing aids that occlude or plug the ear completely allow for better correction with these losses. Yet, many reverse slope wearers complain of their voice being booming and loud and hard to guage, particularly if the hearing loss is a sensorineural hearing loss (nerve deafness) versus conductive loss where the voice issues are less frequent.

Thus, vented hearing aids are often used.

To best match this type of hearing loss, a in the ear (cic, itc, ite) type of hearing aid is often used, with varying results.

You can also use receiver in the ear BTE’s, such as the Phonak Micro Power or any other type of traditional tubed BTE’s also. Lots of professional speakers like to be able to control their hearing aids without putting their fingers in their ears, thus the Phonak and Siemens models are very popular.

One point…if you have a SNHL (nerve deafness) type of low frequency hearing loss, it can sometimes take many adjustments to get ANY hearing aid set to be satisfactory, as there are so many variables with this type of hearing loss, such as cochlear dead spots, forward spread of masking (low tones overpowering consanant sounds, etc and these need to be disussed w/ your audi.

Thus you want to work with a professional that is both knowledgeable and patient and patience is usually necessary from the patient also.

Hope this helps you out.

Many thanks for your advice. I have two more months of trial so will be patient. I do like the idea of being able to control them without finger in the ear.

I work for a child sponsorship charity and over the past 10 years have found sponsors for around 12000 children and so I take my work very seriously and need to be the best I can, after all it could mean help for another child.

Many thanks again

Ron J is our web site

I have to disagree with the question a little bit.

Generally in the ear hearing aids are specifically designed to have a bias towards the high frequencies, because this is the most common kind of loss.

Modern digital hearing aids are very flexible for all kinds of hearing loss. Good quality digital aids can be adapted to amplify correctly at the exact frequency areas where you need the most help. This includes the BTE variety. In fact one might argue that you have more flexibility with a BTE because the ear piece is nothing more than a piece of molded plastic or rubber (or similar materials). The mold can therefore come in a variety of shapes, far more than in the ear options, with a variety of venting options.

You should note that my comments refer to ‘traditional’ high quality digital behind the ear hearing aids, as opposed to modern OTE or open fit hearing aids which are primarily designed for high tone hearing loss.

I also have to disagree with your assertion about ITE vs BTE being more flexible for the future. Your comments are really quite out of step with modern technology. If I take one specific model that I fit on a regular basis that digital aid has a maximum gain in an ITE model of 60 dB. But for the most part I have to fix a circuit close to the loss that the patient has. Therefore if their hearing changes too much, I would need to send the aid back to the factory for a power upgrade which would likely be chargeable for the patient. Whereas the exact same technology in the BTE format has a 70dB gain in it as standard. I can fit everything from a mild to a severe loss with that same technology. The worst thing that can happen is that I may need to order some new molds for my patient to allow me to provide more power for them without feedback issues. New molds are around $50. Upgrading an amplifier in an ITE can be five or more times more expensive, if it is even available. A modern BTE can actually be more future proof than an ITE. They also tend to be more reliable. If you look at dispensing trends over the past five years you will see that there has been quite a swing back towards BTE technology. Quite frankly, it sounds like your hearing specialist who told you some of these things is several years out of date in his thinking.

As to the credentials of your hearing professional, he is only as good as his results. There is a doctor of audiology in my area and I’ve fitted dozens of his patients after he failed to satisfy them. Sometimes practical experience is more important that the piece of paper on the wall.