Expert: Harriet B Jacobster, Au.D. - 5/28/2009

Question
Hello, I have a low frequency hearing loss as follows:

Freq-R/L
500- 50/60
1k- 60/70
2k- 50/70
3k- 50/55
4k- 45/60
6k- 40/40

The test wasn't very good, as my left ear is chronically congested, which I'm currently being treated for in hopes of clearing it up. I'll be retested when I return to the states. I've contacted an audiologist at home (I'm in Iraq) sent her the results, and asked if I could be fitted with the Audeo YES IX. She said that I met Phonak's fitting criteria, but had "some concern as to whether they would be the most appropriate choice" considering my loss.  She didn't comment further on her recommendation.

With my results in hand I've been trying to educate myself on low frequency hearing loss. Most of the examples involve a significant reverse slope. I've always had poor hearing, but never a significant slope... more linear and slightly better in the high freqs.

With my pattern of loss, can I hope for a satisfactory improvement? Should I expect to encounter the same difficulties associated with fitting a reverse-slope? (my own booming voice, exaggerated loudness of higher frequency sounds, exaggerated difficulties in noisy situations)  I've had hearing aids in the past, but the booming of my own voice and chewing were so severe it would make me physically ill (dizzy, nauseated, and disoriented).  I was told that "everyone experiences that" and that I would "get used to it".  The audiologist spent about 30 min total in fitting.  I find out now that she may have been able to do more for me.  

Are there any HAs that are more appropriate than another for this type of loss? I was under the impression that MOST, if not all, HAs are designed with a typical slope in mind…. That all of the HAs on the market would be challenging to fit a low freq loss.

Thank you in advance for any assistance!  

Answer
Hi Carla,
Without a lot more information, I really cannot answer your questions.  The biggest piece that is missing is: is this loss sensorineural (inner ear) or conductive (middle ear)?  What did your speech testing reveal? Is this a fluctuating loss or a stable loss?

I would not really call this a "low frequency loss."  It is really more flat with a fairly even loss across the frequencies; you do have loss in the high frequencies as well. Certainly I would not really call this a reverse slope. Usually, people with this type of loss do quite well with hearing aids.

I tend to stay away from recommending a particular brand of hearing aid as most aids, with few exceptions, do essentially the same thing.  The digital hearing aids are all programmable to the individual's loss, so the idea that HAs are designed with a typical slope in mind is not really true any longer.  

The key to your success would be in the programming. With the proper programming, you should not experience the booming.  Venting in your case would also play an important role.  I also would choose the Phonak Audeo YES as a choice as it would allow the low frequencies to bleed out a bit and emphasize the high frequencies giving you better discrimination and tolerance in background noise as well as lessening the occlusion effect. This would be typical of most Open Ear fittings.

Again, I would not treat your loss as a reverse slope, but more as a flat loss.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology

Hope this