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Thread: Important factors in hearing aid satisfaction

  1. Default

    I beleive many who are dissatisfied had a lousy fitter. 50 years ago when they were trying to draft me for Vietnam I failed the physical and the dr told me not to spend a lot of money on stereo equipment. Then maybe 30 years ago I was tested and had a high freq loss and bought an in the ear. I couldn't wear it because it was so annoying. Felt like I was underwater. Again maybe 10 years ago the same.

    NOw i went to costco, tested and tried a BHE worked fine. Many fitters sell you what they want to sell you not what is best for you

  2. #32


    Quote Originally Posted by Neville View Post
    For all that Oticon talks about "brain hearing", the Opn sound is highly, highly processed.
    That's very true. You wouldn't need all that processing power if you don't need to process anything. Also otherwise, the OPN experience would be not too far from wearing a traditional HA in music mode where everything is wide open and the processing is kept to a minimum, or not too far from wearing an analog HA

    I think many of the processing the OPN does it very similar to how most digital HAs do processing anyway, the basic digital processing stuff, namely. The area of processing where it's markedly different is the diversion away from directional beam form processing to a different way of processing for noise reduction.
    Last edited by Volusiano; 03-25-2017 at 08:29 PM.
    HA wearer since the 1990's > Rexton Insite+ CIC (2011-2016) > Oticon OPN RITE (2016)

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    Left ...10...10....10.....30.....70....75....80....95.. ..90....80
    Right .25...30....40.....55.....75....85....90....90...1 00...100

  3. #33


    The concept of hearing aid satisfaction is very complex. Contributing variables include the client themselves, their expectations and interest in the process, the quality of the practitioner and their processes, the rehabilitative plan for each client, comfort vs. effectiveness considerations, and the cost of the hearing devices. Plus, satisfaction is very fluid in that it walks hand-in-hand with rehabilitative goals which also may change over time.

    The Performance-Perceptual Test (PPT), Acceptable Noise Level (ANL) tests, multi-frequency Loudness Discomfort Level (LDL) tests, aided/unaided speech-in-noise testing and validation, multiple hearing aid trials, cost/benefit analysis, and REM verification, adaptation management, open vs. closed fitting, objective hearing aid testing, etc. all exist for the purpose of increasing satisfaction by identifying "red flags" up-front, using evidence-based approaches proven to offer higher satisfaction, and building your confidence in the effectiveness of your hearing solution through both objective and subjective proof.

    Sadly, many of these things are never done and others are done very rarely. Apart from these important considerations, all we have is a hearing aid (that may or may not be selected, programmed, or fitted properly) and a client (who may or may not have a point of reference with which to measure satisfaction or expectations).

    The OPN is a rather expensive hearing aid with a marketed new philosophy of processing speech in noise. I've tested it in my clinic in a free-field directional test and it performs well in front-facing speech tests (traditional directionality). However, at 90 degrees to desired speech it outperforms all others. This may be great news to some, but terrible news to others.

    It's great news for those who sit at a restaurant surrounded by friends, but bad news for those sitting at a restaurant surrounded by strangers (undesired speech). It's directional capabilities are great if closed-fitted, but (not surprisingly) not so great when open-fitted, as noise reduction is voided and directionality is reduced. Comfort almost always comes at the expense of effectiveness. Given your hearing loss, open-fit should not be considered.

    The OPN technical specs state it has up to 10KHz response, like some other premium products. However, if you're a first time hearing aid wearer, you're tolerance for these high frequency sounds may be low so the specialist may lower gain in these frequencies. But, then you need to ask yourself, what am I paying for if I reduce directionality, noise reduction, and high frequency response for the sake of comfort (as the majority of mild-to-moderate wearers do)? Can you achieve satisfaction with a hearing solution when you pay upwards of $3,000 per ear for features you may not choose to use?

    My philosophy is, if you're going to spend money on a premium hearing aid, make sure you have a rehabilitative plan that includes the optimal usage of the expensive features you're paying for. Aim for NAL-NL2 targets in a closed-fit scenario. Be a bit aggressive with the directionality and noise reduction settings, especially if you spend a lot of time in noisy environments.

    Your hearing loss looks to be sloping, sensorineural. Thus, your perception of your hearing aids will be markedly different from those with, say, flat-conductive loss. You will experience a degree of recruitment-distortion (correlative with SN loss) which may disappoint and ruin the sound experience for you. In fact, more expensive hearing aids may cause more distortion for you as you may have more recruitment in the very high frequencies (which only premium hearing aids offer).

    Try an Alta2 Pro or a Nera2. If they suffice, why pay extra? Sometimes the latest, greatest hearing aid does not offer the best cost/benefit value. Judging by independent reviews, I don't see a great deal of difference in reported satisfaction between the Nera2, Alta2, and OPN. What does that tell me? Perhaps that satisfaction is not just a measure of objective quality, but also a measure of subjective cost/benefit.

    Hope that gives some honest food for thought.

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