Will Open Fit Help

Just had my 5 year hearing test by my ENT specialist. here are my results:

…L…R
250 50 55
500 55 60
1000 40 45
2000 45 45
4000 55 60
6000 60 65
8000 55 55

PTA 48 48
SRT 50 50
Disc. 88 88

There is also a note “masking dilemma”

Can anybody put this in layman’s terms?
Can open fit aids work?
If so, do I need speaker in the ear model?

Any recommend a good high end aid as I give a lot of seminars in large conference rooms and spend a good deal of time in crowded noisey situations?

Thanks in advance for any help.

dear jjar:

Unfortunately, you can not use a open fit (receiver) with a dome,
you can still use such a product with a custom made mold…

My choices in no particular order are for a high end instruments
would be Oticon Epoq (wireless) and with blue tooth conectivity, another interesting aid is the GN Spot 30, I would also consider the new Exelia from phonak but i dont think it is out there…

If you decide to go by brand ABC it is important to get an audi which is very familiar with their fitting software,

please make sure to ask for REM, (see other postings)… given the speech discrimation i would say you should have good results…

make sure to pick up a dry and store… or a hearing dryer to extend the life of your aid

Well,

Now I am confused. One HAD said an open fit Siemens Centra Active would work fine. A different HAD said the Starky 1200 CIC’s would work fine and my ENT that did the test told me my hearing loss was too much for a CIC to work.

Xbuilder says the open fit won’t work and I need a custom ear mold BTE.

I guess it just shows the need when looking for hearing aids to get 3rd, 4th and 5th opinions before you shell out $6,000 or $7,000.

it is a reciver in the canal or receiver in the ear but with a a vented earmold,

You could also use a CIC but i believe 60dbhl is what most CIC would fit

(i believe siemens Nitro could fit a lot more than that)…

Do remember that if you use CIC, you would not get a 2 microphone (there

is simply not enough space)… With Mini Bte or baby bts you get a higher

fitting range (usually 80dbhl) and also some mini BtE has a autophone

such as the Phonak audeo… By the way siemens is good brand…

Here is why there is all the debate- First off, the more open the ear, the less gain, especially in the low frequencies, you can get. With your loss, you need more gain in the lows than is typically available with a standard open fitting.

If we had a way to close the canal more and still fit a “open” hearing aid, like some of those mentioned above, it is possible that one would work for you. The “closing” options would be to have a custom tip made or use a power dome. Even with one of those options, I would put you in a borderline candidacy for this type of device. It might work for you today if the fit was very good. Unfortunately, if your hearing changed signficantly, you might fall outside of the range (same for a CIC) then you would have to consider buying another aid. This doesn’t mean that a well-fit open device or CIC might not help you. It just means you are at the limit, and I’d use caution before I invested $5000 in something that might not be enough in a year or two.

There are other options: Some aids can be fit both open with the slim tube and with a traditional BTE mold. I’ve fit ReSounds (Azures and Pixels) this way as well as Phonak Savias and Extras. You can start with the small tube and then later, if you need more power, you don’t have to buy a new hearing aids, just a new mold. This is usually what I do with the borderline candidate with losses like yours that really want to go with the open-style tubes.

Hope this helps!

True, this allow greater flexibility. For example the GN sofware has an option
that allows you to change from an open fit product to a hook (traditional BTE)
this allow the customer to have an extended product range… I know phonak has the same thing as well as oticon… Interchangable hook…

One detail that you must remember is that this is an open tube BUT NOT a
receiver in the ear type of fitting… This product will still require the sound to
travel down the thin tube…

Just met with a 4th audiologist today. She was very helpful and recommended Widex Inteo IN-9 (flat to 85db) or the Oticon Epoc XW RITE with a micromold which claims Flat to 80db.

Leaning toward the Epoc as it is smaller than the Widex.

Any suggestions?

advice–

i would get the epoq W which is cheaper…

I’m not a fan of open fit for this loss. You need some low frequency amplification, and open fit is generally more appropriate for high tone loss.

So for me, I’d be suggesting something small and in the ear. See if you can find a professional to demonstrate a Starkey Destiny 1200 or 1600. Very impressive for a more active lifestyle and background noise situations.

to be honest we can not compare the technology of a starkey destiny 1200 vs a epoq xw, or a Phonak Exelia or a Siemens Centra… right?

My audie’s attitude is a bit different, and I agree with her. A less optimal fit that’s worn every day is better than a perfect fit that’s in a drawer. When the Resound Air came out I wasn’t a good candidate, but my audiogram fits just fine in the Pulse’s fitting range. I started with Widex Diva ITE’s 6 years ago, and I’d personally give up some low end for no occlusion.

With Starkey they have venting options that go from no vent, right up to what they call open fit venting, which is larger than an IROS. With your loss, and an IROS vent I’d be amazed if you were occluded. But even if you were, with the devices I have available, I could simply step up to open fit and remain in the ear.

I’ve only ever met one patient for whom occlusion was still an issue with this kind of set up. And they were a very odd and difficult fit (actually the toughest fit of my career).

In all fairness you can’t really put your audiologists opinion up against mine, when I’ve not had the luxury of personally examining you. But of course she’s correct in that you should never go by the book, you have to go with real life experience, and what actually works for the patient.

Are you all just making a statement based on past experience of micro-BTE’s or have you looked at the current specs and made a decision.

The EPOC XW RITE with a thin tube “MicroMold” has a fiiting range that starts at 80db at 125hz and goes to 100db at 10,000hz.

The Widex Inteo IN-m (a micro-BTE) starts at 80db at 125hz and stays flat 80db through 8,000hz.

If my loss is 10db every 5 years, then based on my current audiogram, either of the above should last 10 years.

The only other option is the new Siemans Nitro CIC which fits to 90db flat.

I want a remote control for volume and program changes.