Which in-the-ear hearing aids are best for moderate-to-profound hearing loss? I'm a 45 year-old long-time HA user who must hear well in board meetings and on the phone. Price is not an issue.

Which in-the-ear hearing aids are best for moderate-to-profound hearing loss? I'm a 45 year-old long-time HA user who must hear well in board meetings and on the phone. Price is not an issue.

Christopher Hamilton, AuD

Doctor of Audiology in Asheville

18 May 2016 - 9.01K Views

The hearing aid manufacturer is not nearly as important as the professional you choose. Of the many brands of hearing devices available, many can and will work well, assuming they are programmed properly using standard verification methods. I would recommend focusing on finding an excellent Doctor of Audiology and the everything else should fall into place. 

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Member 19 May 2016
Thanks Christopher. Unfortunately, finding the right audi requires putting them through the paces of a fit. That takes a lot of time, especially when local options don't suit.

Alicia D.D. Spoor, AuD

Doctor of Audiology in Highland

18 May 2016 - 9.04K Views

Good Morning!

I think I have more questions for you to consider before providing an answer.  

The audiometric data provided does not include whether your hearing loss is sensorineural or conductive.  I will presume it's sensorineural (and not conductive- when you would just need volume from a hearing aid.  Sensorineural hearing losses need both volume and clarity, typically).  What are your word recognition scores in quiet and in noise?  How do you perform on sentences in background noise (like on the QuickSIN test)?  

Second, you mention you are a long-time hearing aid user.  What brand of hearing aids do you currently use?  What brands have you used in the past?  Have you noticed one brand is better/worse for you than another?  Why do you want to change hearing aids now?  Do you currently use accessories, like a wireless microphone or bluetooth remotes/streamers?  Why are you pursuing an in-th-ear hearing aid(s)?  What did your Audiologist recommend?  What makes you want a second opinion?

With regards to your needs: you list phone and meetings.  How large are the board meetings?  Are they in-person?  Are you "assigned" a seat for these meetings; if so, where is it in regards to the speaker(s)?  What type of phone are you typically using?  Does it have bluetooth?  Is it multi-line?  Are there multiple phones involved?  Do you want one solution to try to meet all of these needs (and perhaps other needs not listed) or would you be open to the best option for each need?

As you likely know from your experience with hearing aids, the larger the hearing aid, the more options, volume, and better reliability that is typially available.  Behind-the-ear hearing aids would provide more volume for the high-frequency (without feedback) hearing loss and perhaps provide more long-term benefit (so you aren't buying a hearing aid every 2 or 3 years).  Perhaps most importantly, the person fitting the hearing aid(s) need to verify and validate the hearing aid fitting, by using appropriate hearing inventories/questionnaires and real-ear measurements.  

Hopefully this will provide some more information, ensure that you have all of the answers and appropriate testing to make an informed decision, and allow you and your Audiologist to find the best solution for your needs.

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Member 18 May 2016
Hi Alicia, and thanks for the thoughtful reply. My loss is congenital and sensorineural. I have worn Phonak's for as long as I can remember, and have never tried any other brand (maybe as a kid, I don't think I ever knew). A few years ago my perception of spoken communication started to get worse and now, despite strong output from my Exelia Arts, I am having trouble understanding people in many situations, most notably at work. My SRT scores are 60 in both ears, speech % recog 72% (L) and 68% (R); "dB/Masking" 85/90 in both--I can send you my last audiogram if you like. It has some other markings I don't understand. I don't use accessories, preferring a minimalist approach. I've tried a loop but cannot stand unreliable technology that works only sometimes and intermittently. I even turned off my telecoil because in the seconds it takes to autoswitch, I lose all ability to hear and that is super frustrating. I am not confident about the advice I'm getting, hence my post here. I am hoping to learn what other audis might recommend and why, and in the process gather considerations with which to make my decisions. The mantra of most audis is that you work with someone to find the best solution and *that* leads to good enough solutions, and I want a great solution. The advice I get from my current audi is always to ask me which aid I want to go with and frankly, how the heck would I know without trying them all for much longer than 30 days with whatever accessories I'd have to use? I'm told each is different without any clarity about how they are different. The last time I went through this finding process I tried the latest Phonak and was told its the best there was. It was marginally better than what I had so I took them and paid $5400. More recently I've spoken to other audis in town and out of town and some are confident about one brand or another but I never get a sense of why. Audi's stick them in my ears in a quiet room and say "how does it sound?" Why do audis do that anyway? It makes no sense at all. I'm spending more money than I would on a car (over time) so I'd like better advice and not have the standard to be "is it better than what you have now?" I get that profit is a motivating factor to how much time is spent with each "patient" but just how does the profession justify measuring success by "is it better?" To your other questions, meetings can be from two to a room of hundreds and seats are never assigned. I meet a lot with people I've never met before or only rarely. In the large meetings speakers are all around the rooms as "interactivity" is encouraged and sometimes it's me who is leading a discussion. I avoid phone meetings like the plague because it requires so much effort to hear that I can't think about anything else. I have a high quality single-line IP Polycom phone but it doesn't have BT. I hardly ever use a cell phone for the same reason. One solution would be ideal, though I don't know what you are thinking about "best option for each need." Size is not an issue, I've prefer the cic for sound quality but I gave up my best cic aids for my current ITE and don't care anymore about how big they are. Hearing fully is a paramount concern. I am very active and wear glasses so BTEs (in my experience) are uncomfortable, awkward and worrisome. I usually go about 5-6 years between aids and would keep the ones I have if not for the perception problem. I can't realistically meet with someone new and ask them to hold onto a microphone or such, so the wireless mic concept is not an option. I am a tough judge of fit so I push until I get the best fitting I can. My audis get to know me well. However, I find that their practices dictate fit far more than how well they get to know me, by which I mean: I know my current audi very well and that person still asks me what brand I want and how aids sound in a quiet room. If you and the other audis here have educated opinions, I'd like to consider them in my response about which aids to try.

Christopher S. Frink, AuD

Audiologist in Salem

19 May 2016 - 8.99K Views

And here is yet another answer for your consideration!  All of the previous answers provide great information, but the primary considerations based on your question would be related to feedback control and quality of fit, specifically because all the other features really don't matter if you don't like how it feels in your ears or if it's constantly whistling.

This being the case, I have found Phonak and Starkey lead the market in both of the categories, with GN ReSound being a distant third.  The other manufacturers I have found to have more problems in these areas than these two companies.  Oticon and its spin-offs (Sonic Innovations and Bernafon) seem to particularly have problems with feedback control, so I'd never consider them for your degree of hearing loss.

Another consideration that was mentioned by others relating to both feedback control and physical fit of the instrument is the experience and dedication of the provider.  The expertise that can be provided by your hearing professional by far outweighs any manufacturer consideration, as their knowledge will be important to making suring that neither of these problems arise.  This is particularly important for custom in-the-ear models, as the newer generation of practitioners have primarily focused on behind-the-ear models (with good reason, since they are lower maintenance).  Your older, more experience practitioners, who probably also favor behind-the-ear models, will have more hands-on experience in dealing with in-the-ear models.

After these primary considerations fo hysical fit and feedback control, then the considerations of other features in the hearing aids should be made.  Alicia's Spoor's answer to your questin provides an excellent list of considerations when determining what's the best technology for you to consider, but none of it matters if your practitioner doesn't get the fit right.  Nevertheless, the vast array of feature sets she describes gives you an excellent list to select from.  Referring back to my original manufacturer consideration, either the Phonak Virto V90 or the Starkey Muse i2400 who be great choices for you.  ReSound could be another consideration if you have an iPhone and would like direct connectivity between it and your hearing aids without any additional accessories (but Phonak and Starkey can connect as well, yet require an additional device for interfacing).

Sean O'Brien's recommendation to go to a multi-line office is a very good one.  If you instead went to an office that only sells one product, then the fitters choice for you will be inherently biased.  Ask for multiple options from your provider, and between them discuss what's better for each.  If you were to come to me and tell me you're strictly interested in the top products but want to know the strengths and weaknesses of each manufacturer, I would mention the Phonak, Starkey, and ReSound options for you, and then explain where each is better or worse than the other so that you can determine which of these strengths and weaknesses are relevant to you.

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Sara Carnevale Fearon, AuD

Doctor of Audiology in Cranston

18 May 2016 - 9.04K Views

This is a tricky question.  Most manufacturers offer a power ITE model.   Are you happy with your current aids?  If you like their processing I would start with that company.  CICs (completely in the canal) are typically not the best choice for someone with a more severe hearing loss.  Your audiologist should discuss all these options with you and give you the opportunity to trial the latest technology.  It is important to remember that hearing is not like vision.  Everyone perceives sound differently and therefore has different preferences.  The only way to tell is to try them for yourself.     

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Nichole Kovel, AuD

Doctor of Audiology in Colorado Springs

19 May 2016 - 8.97K Views

You have received so many great answers already, I can only add a little.

First, as you found with all the questions you received, it's not as easy as "look at numbers, suggest technology."  By experience you know that it's not as easy as, push buttons on the computer and then ask in quiet, "how does that sound?"  Audiology is art, science and should be backed by proof.  Multiproduct practices AND one that uses verification as a true test of improvement is important.

Although there are many factors to consider, I do prefer Starkey for custom (ITE) products and the new Siemens Primax second.  Best of luck to you!

Nichole Kovel

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Member 22 May 2018
Hi Nicole. It was suggested to me that with my moderate hearing loss, I should buy the Premium 8 brand from Costco. This is a rebranded Siemens HA, but Costco technicians cannot tell me its exact Siemens style. You recommend Siemens Primax second. Would this also be suitable for a first time user with moderate loss in the high freqhuency. Are these two Siemens HA equivalent? Regards Graeme Wilkinson (Australia)

Jeff Clark, AuD

Doctor of Audiology in Tampa

18 May 2016 - 9.03K Views

There's just too many factors involved to give you a single product answer.  Best advice I could give you is to find an audiologist that you trust and one that carries several different manufacturers.  That way you will have access to all the different products.  They all have their own advantages and disadvantages that you should discuss with your audiologist.  

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Jennifer Waddell

Hearing Healthcare Provider in Simpsonville

18 May 2016 - 9.04K Views

Hello. I have found that the Widex Unique line to be one of the best for high frequency hearing losses, since it has the ability to provide more amplification in the soft sounds. The aids reach as low as 5 decibels, which means the instruments can pick up the sound of falling leaves. If you want to truly hear well, you will want two microphones on each aid to hear well in noisy enviros, so I wouldn't suggest going with the cic models. The in the ear versions of aids with two mics is more visible than the behind the ear versions. Most have found going with the very small behind the ear is less visible and usually has less maintenance and repairs. If you want super small, take a look at the Widex Unique Passion 440. There are many great manufacturers, I have found these to be easiest to hear speech and actually get the highs you are missing and are completely automatic and amazing with music. Best of luck to you!
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Shanna M Mortensen-Dewsnup, AuD

Doctor of Audiology in Peoria

01 June 2016 - 8.91K Views

Starkey and ReSound have great in-the-ear hearing aids that are made for individuals with your loss. They also make power custom hearing aids with stronger speakers so you do not "outgrow" your hearing aid if your hearing changes over time. Both brands also have additional accessory microphones that can be placed on the desk in larger meetings to help hear the discussion. 

I agree with the previous comments on the provider. The person fitting the device is more important than the brand. Make sure you go to an educated provider with an understanding of all aspects of the hearing organ and hearing loss. Think of it this way... "What is more important...expensive costly tile, or the person installing it? You can purchase beautiful tile for your home and have someone install it who has no training in what their doing. The end results will be a very expensive mess" and in some cases not fixable. 

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This provider is no longer listed.

24 May 2016 - 8.94K Views

All custom hearing aids from the new Siemens Primax line (IIC, CIC, ITC, and ITE) are well within the fitting range for this your hearing loss. If you are interested in smart phone compatible devices, then Siemens would be the way to go, especially if you are looking for a smaller custom aid that still allows for connectivity. 

Phonak Virto V has a new Speech in 360 program that seems like the you would take advantage of due to the severity of his loss. They describe this as "automatically selects the direction of speech and streams this to the other ear, improve speech intelligibility without the need to face the speaker." This feature is only available in premium (v90) and advanced (v70) levels of technology.

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Sheri Gostomelsky, AuD

Doctor of Audiology in Deerfield

18 May 2016 - 9K Views

All of the big manufacturers have custom products powerful enough to accommodate your hearing needs, however, it is more important that you find a provider who will care for you properly. Most practices carry a wide variety of solutions. You can have the best device in the marketplace and in the wrong hands it can turn into the worst experience . Just my humble opinion.
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Member 19 May 2016
Hi Sheri, I really agree with that. Your opinion is a good one. Finding the right audi is a challenge requiring a lot of visits and time.

Seth Dank, MA

Hearing Healthcare Provider in New Hyde Park

18 May 2016 - 9.01K Views

My # 1 choice would be Starkey.  Not only are their custom hearing aids powerful, they can also be streamed with the Surflink Mobile which can be paired to your Bluetooth cellphone and the Surflink Mobile can also be used as a remote microphone making this a great solution for a 45 year old.

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Barbara H. Jenkins, AuD

Doctor of Audiology in Centennial

18 May 2016 - 9.01K Views

Dear long-time user,

Most of the manufactures have in-the-ear hearing aids that are appropriate for your loss.  The important thing to focus on is the level of technology and the areas that you are having most difficulty hearing with.  Since cost is not an issue, I recommend trying the new Signia Primax hearing aid.  It has an eight microphon which not only reduces background noise, but can actually enhance the speech of the person you are listening to.  You can also use any smart phone to adjust the volume, amount of noise, treble and base, and direction the sound is coming from, even without an extra blue-tooth device.  It also has 48 channel fidelity for increased clarity.  I own a private practice in Denver, Colorado, and provide hearing aids from multiple manufactueres, so I have no financial interest in promoting this device.  I have just found it to provide the best clarity of speech and flexibility available presently.  

All the hearing aid manufactures have wonderfult devices now, so if you have a provider that you like and money is not an issue, go ahead and try their favorite and then this one.  My best to you.  Good luck and God Bless.

Dr. Jenkins

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Member 18 May 2016
Nice, succinct response. Thanks! I'll look into them.

Rena Jacobson, AuD

Doctor of Audiology in Dartmouth

18 May 2016 - 9.03K Views

The most recent innovation in hearing aid technology is the availability of wireless accessories.  As a veteran hearing aid wearer, you know there are many factors which contribute to your success with hearing aids. As other experts have written, your thresholds are just a piece of the puzzle. If your chief issues are with the phone and at meetings, you should be looking at hearing aids which will stream input from your cell phone and which will stream input from a remote microphone at a meeting.

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Discussion

User 18 May 2016
Ten people may give you 10 different answers. I would DEFINITELY goto a multi-line hearing professional. I have been fitting over 20 years, and have accounts with all big 6 and their sister manufacturers. You need to take advantage of the trial period in your state, make sure they do NOT have return fees, make sure they verify using real ear, or at the very least in-situ and they have many years experience fitting aids. You will want to go premium level to access the best available noise reduction and automatic directional microphone technology. I really like the Unitron Pro, Resound Linx2 and Signia (Siemens) Primax. Starkey just released their new Muse and Halo2 on a new platform, and Oticon is getting ready to release a brand new platform in the next few weeks. Make sure to talk to your professional, and explain to him that your livelihood relies on your ability to hear and communicate as well as technologically possible, and make sure he will let you try a few different manufacturers due to the fact they all have their own proprietary technology, and simply some people do better with one over another. If I can be of any more help, let me know. Good Luck!
Member 18 May 2016 Replied to User
Thanks Sean. The news about Oticon is especially nice to hear. I've read some of the research supporting their "brain hearing" approach and it resonates with me. I've never considered the Signia Primax and will look into them. As for my professional, he knows my hearing well but leaves it to me to decide. I do plan to try a couple of brands. Your suggestions are appreciated.
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