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.

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.

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. 

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.     

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.

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

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!

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. 

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.

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.

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.

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

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.

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.