Why are hearing aids so bad at doing the job they are made for?

Hey that’s my left ear.
A broken speaker.

Adding to Bimodal_User, but not extending too much, there is also all the neurophisiology behind. Hearing has a very complex path going through several “stations” (Nucleus) so they add a lot of variables

Also Add the neural adaptation of getting a hearing loss, normally you don’t go and get a hearing aid when your hearing loss is mild or just starting, but get the hearing aid when is causing trouble to you and the ones around you. So, you gou through a full adaptation to your new hearing loss, developing mechanisms to create a new standard, and then you have to destroy all that adaption to build a new one.

I can share more info if you want, papers, books, or trustable videos if you want to know more, i’m a otoneurology examiner and hearing care professional

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Couldn’t find it earlier, but I finally did it. Here is the somewhat easy scheme:

Yes, I have described it very briefly here (from a healthy hearing person’s perspective):

@Neville, @JORGESILVA, thanks for elaborating more.

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Oh, I had a very similar experience. But it was only when I took matters into my own hands that I truly got what I needed from my devices. In my case, though, no audiologist was willing to put enough effort into getting it right.

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I have an audiologist that is willing to go the extra 10 miles if necessary, and has done so more than once.

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There’s 2 issues here imho.

The failure of the stereocilia in the cochlear is similar to macular degeneration rather than other eye disorders. Glasses don’t rectify this kind of issue. Retinal failure is pretty irreversible.

Also fundamentally the diffusion physics of light and sound are fundamentally different (despite what you see in the Daredevil films) - there is no definition in the sonar ‘picture’ from the two points of reference available at our eardrums. All we get to build the picture is decaying pressure waves from noise sources reflecting and collapsing on each other depending on their intensity. It’s like sitting in a hot-tub and trying to work out the circulation of water at a particular point: you’ll tend to feel the pressure from the dominant jet in that area, but you’re going to struggle to identify the ‘picture’ of where the other jets are pointed.

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Thanks! That’s super interesting. The aspect of the brain being able to direct the noise filter in your ear to what we want to hear is super cool. Unless a H/A could tap into your brain and do the same it will have to make that selection for you. I assume eventually those things might get to the point that they’ll learn what that might be. Though I presume the biggest problem would be how to get the H/A negative or positive feedback…

Wasn’t actually aware that the neural cells die or atrophy. So waiting to get H/A until you can’t function anymore is not a good thing. @JORGESILVA, yes if you have some resources papers handy, I think those would be of interest. Maybe the forum needs a channel for “Hearing Health?” or something like that. Great discussion everyone!

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Yes, very cool. Recent research has actually shown that to a very minor degree our eardrums also adjust to attend to sound in a particular direction. On the one hand, we are all sorts of animals orienting their ears so maybe it’s not that surprising that we have at least some sort of weak vestigial mechanism, but in the other hand… Wow I wish I’d don’t that research. It was such a satisfying little science question for someone to do.

In terms of auditory attentional skills, one of the ways this shows up for me is that in young children auditory attention isn’t developed yet, so when you’re doing a hearing test you can just hit threshold and then pop right across frequencies at the same level and they will respond consistently. Whereas if you jump frequencies for an adult they’ll often miss it at threshold because they are attending to a different frequency and then you have to increase the volume until they realize they’re listening to a different tone and then go back down. Small little thing, but sometimes relevant to clinical time efficiency.

Yes, bad. We have some evidence in cats that after a period of auditory deprivation the auditory cortex will reorganize, and then when you return audibility it will try to go back to its original architecture but doesn’t quite make it. One question that I’m interested in that we don’t have the answer to is how many hours a day would you need to wear hearing aids in order to maintain appropriate frequency organization of the auditory cortex. We know that for vision, a relatively small daily amount of normal visual input can maintain appropriate binocular organization against a longer period of abnormal input, but we don’t have data on how this works in the auditory system. It’s relevant to clinical practice because for somebody who has experienced a sudden sensory neural hearing loss clarity is often very poor and wearing a hearing aid is aversive, but if they aren’t ready for a cochlear implant yet but want to keep the nerve active, how many hours a day do they need to force themselves to wear a hearing aid to promote better outcomes after cochlear implantation? Right now we just say as much as possible, but it may be that a couple of hours a day would be fine. The brain has a bias towards normal input supporting normal architecture.

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I had a single widex in the ear HA for 10 years.
It was my stress meter. When I noticed it hurt I took it out. Truth? I seldom used it.

I later qualified for workman’s compensation. EXposure to noise was the cause. Now I’m a believer and know that I should have had 2 good hearing aids from the beginning.

An aside: I knew someone with macular degeneration. She lost her sight. Frequently she commented on the beautiful scenes she saw during car rides. No one else saw them…the beauty was in her manner and wonderful attitude, even though she was blind she saw.

Will they ever discover that tinnitus is the result of our hearing loss? I have tinnitus in each ear. Perhaps our unwanted sound is similar to the visions my dear friend had

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Since you mention the “orienting”. I wonder at times to what degree the fact that the microphone of my hearing aids are behind my ears rather inside affects things like my ability to localize sound. You would think it does. I recall those head shaped microphones that allowed recordings to be really “surround” with just two channels. I haven’t tried any HA that have the whole system in the canal.

@BodyTechEars
The new Phonak’s Infinio will have that. And if I remember well the newest Starkey’s have this too.

All gone very technical on here, but I’ve been looking at my default Music programme in Target it was like this:


This appears to miss out so many bass frequencies, and also doesn’t help the lower end of the speech spectrum.

I’ve since increased the MPOs and G80/65/50 in the Music programme to reflect the “media music + mic” programme:

Wow, the car stereo sounds so much better, much richer. The TV sounds better, with less need for the TV Connector. I can discern speech better in every environment, including a noisy echoey bar!

However, everything’s a lot noisier, but isn’t the world noisier? I just have to use my brain to concentrate on what I want to hear. I now hear my noisy digestion, breathing, shuffling of clothes, and distant winds. It almost sounds like occlusion, but the source of the sound isn’t from inside my head.

Why Phonak decides I don’t want to hear these sounds is beyond me, but at least I can get a better music sound. I’m using Calm Situation (zero noise reduction) as startup and Music, now, as 1st switchable option.

I don’t believe Earbuds and HAs are a like for like comparison.
Peter

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Are you talking about Resound M&rie? It has a microphone on the receiver and this enables the ear, i.e. its pinna, to be used for orientation. This technology has existed for more than 4 years and as far as I can see, no one has introduced it yet.

The same can be said about Phonak activevent receivers, which can block and open the opening to external sound. Receivers have also been around for over 4 years and as far as I can see no one has made one to compete with phonak.

@markoo355
Sorry, probably misunderstood/ wrong interpretation.
I thought @BodyTechEars was talking about the multimics on the surface of in the ears HA’s.

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How come you adjusted the MPO, you don’t need to in most cases, was it clipping? I take it you adjusted for that dip at 4Hz as well, or is that just the result from your feedback test.

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@tenkan
I increased the MPO’s on Music because they were a lot lower than in other programmes. The 4K, as far as I knew is the Naida M70 SP’s limitation.

I have to be honest, I’m a fair way from understanding the relationships between MPO, G80, G65, G50, compression and the specific limits of each HA type.

Peter

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It’s (maybe, not for sure) Charles Bonnet syndrome. Neurology professor, Oliver Sacks, also has that condition in his blind eye:

Oliver Sacks: What hallucination reveals about our minds | TED Talk

I haven’t read much about it, but tinnitus probably develops by a similar mechanism. Someone please correct me if I am wrong.

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Advanced Bionic has also incorporated T-Mic into its sound processors.

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I think you’re right.

DaveL

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I agree that a Costco fitter or a private doctor of audiology would not spend that amount of time on one person.

Thankfully, the audiology department of the VA was willing to spent that much time.

However, you seem to make the claim that a doctor of audiology is better. When from your experience, it was more time of tweaking the hearing aids and trying different combinations with the manufacture and your doctor.