I am a teacher, so being able to hear speech clearly both in the classroom and in relatively noisy environments is very important to me. I have been using Starkey CIC hearing aids for about 15 years, and the latest model I purchased was the Starkey Muse 2000 three years ago, but I am not satisfied with it because I feel it doesn’t produce natural sound. I am now thinking about buying a better and newer model. In your opinion, which models would be more suitable? I’ve attached my audiogram.
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What is it about them that sounds unnatural to you?
At a guess, is it a sort of muddiness? That’s a difficult loss for a CIC to support.
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I don’t think the issue is muddiness. I was very comfortable with the older Starkey models I used. The unnaturalness comes from the fact that when sound compression is high in the hearing aid’s tuning, I can comfortably hear sounds at any intensity, but high frequencies become muffled. Amazingly, when a high-frequency sound occurs (such as the sound of car brakes), the hearing aid drastically reduces all sounds across all frequencies, which causes speech sounds to lose clarity. On the other hand, if sound compression is low, this issue is mostly resolved, but loud sounds then become uncomfortable for me.
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Compression can be set differently across the frequency range.
But I really would worry that CICs might not support your high frequency gain requirements, unless your ear canals are big enough to fit in a super power receiver really nicely. If the high frequency gain is being limited by the size of the hearing aid, that is going to limit how much you can adjust compression/audibility in that region.
That all said, you might try an Oticon CIC. Historically they had a nice little floating linear window around speech. I’m honestly not sure how the move to DNN has changed that, but I would suspect that it is something that they are still sensitive to. But if they cannot fit the SP receiver in there you might want to try a RIC with a custom tip.
Note, too, that if you have been using a 70/130 dB receiver with Starkey, the newer Starkey CICs use a “mini 70” receiver that is actually not as powerful as the one they had in the picasso line (It’s actually a 65 dB). You can do a special request to have the old one put in, but even so I have not been able to meet the same high frequency gain targets with the newer devices. No other manufacturer currently offers a more powerful receiver in a CIC than that older Starkey one (e.g. the highest Oticon CIC is also that 65 dB receiver).
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Thank you for your detailed explanation. I started wondering how much DNN can truly improve sound clarity if that linear window isn’t functioning properly. My understanding is that DNN helps with better hearing and understanding of speech by reducing noise and enhancing speech clarity.
Additionally, based on your explanation, it seems that in terms of receiver power, only Starkey might be suitable for that high frequency hearing loss, not Oticon.
For newer products without a special request, Starkey and Oticon super power receivers are the same. But Starkey is the only one that can sometimes put that older receiver in by special request, which gives a bit of a boost. But if your ear cannot accommodate even the regular super power receiver for a CIC (which may be okay for you), then it doesn’t really matter and you’d want to look at a RIC.
When it comes to CICs, it can be tough to anticipate how well they will work over the internet, or even tough to know before ordering and checking the fit and gain on the ear. For a lot of people, given average ear sizes, CICs are only able to accommodate a moderate hearing loss. But I’m sure every clinician has that one patient with the perfect large, straight ear canal that has space for a really deeply fitted SP CIC. With those patients you can really get quite a lot of functional gain.
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I wonder if a RIC style would suit you better since they can typically output more power and since their speech in background noise programs tend to work better than ITE or CIC models. The problem you’re experiencing with a high frequency sound slamming down the volume on the rest of the hearing aid tells me you’re almost at the limit of your receiver and therefore you do need something more powerful. It might be worth checking out some newer AI powered RICs to see what they can do for you. The Starkey Edge and the Phonak Spheres might be worth having a look at. Phonaks can also take advantage of Roger accessories including remote mics, which might help you depending where you place them in the class.
Phonak are also coming out with an Infinio Virto CIC and ITE model next year and as far as I know, they allow a more powerful receiver.
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Oticon Own 1 with 90 speakers (or next gen in a few months), Signia Insio IX with 124/60 speakers, Starkey Edge AI CIC with P or UP speakers (if your hearing loss isn’t stable), Phonak Virto I CIC with UP speakers (they struggle to make shells sealed enough though and you’ll have to wait 1-2 months I guess), GN ReSound Nexia CIC with UP speakers.
Basically, you can have any brand with your hearing loss, you just need the one with the better shell and a sound you will enjoy. For customs, I have a preference for Oticon and Starkey.
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It seems wiser to wait for newer hearing aids, particularly from Phonak or Oticon, to become available before making a purchase. Hopefully, the next generations will feature more advanced AI, more powerful receivers, and potentially smaller sizes thanks to advancements in nanotechnology.