Best Hearing Aids For High Frequency Ski Slope Hearing Losses
Asked by Paul Smith on 01 November 2019
What are the best hearing aids for ski slope hearing losses?
Answered by Geoffrey Cooling
Ski slope hearing losses can be difficult enough to fit, there are a few reasons for this, the first is that it can be difficult to deliver the amplification needed for the high-frequencies without there being feedback. The second is that sometimes, even if we can deliver amplification to the area, the person may actually not get much benefit. There are a couple of considerations we need to take to recommend a hearing aid for this loss. Let's talk about them before I begin to talk about hearing aids that may be of use.
Ski Slope Losses
A ski slope loss is named as such because of the pattern of the loss on the audiogram. Some people have perfect hearing in the low frequency and mid frequency area. Their problems start in the high frequencies, sometimes the dip is severe and the hearing curve looks like a ski slope in the audiogram. Hence, a ski slope loss.
Because the low and mid frequency hearing may be fine, we need a connection to the ear canal that leaves it open in order that the person can hear those low and mid frequency sounds naturally. We will not be amplifying those frequencies of sound. However, we will be amplifying th high frequencies. This is where the issue with feedback may raise its head, if we leave the ear canal open, the high frequency amplification may leak from the ear canal and cause feedback. If we close the ear canal too much, the person may suffer with oclussion.
Sometimes if the hearing loss is severe enough or there is a big drop between sound frequencies, there is a concern that the area of the cochlea may in fact be a dead region. Your response may actually be a response to a stimulation of a surrounding area by a high intensity presentation. If the area is in fact a dead region, well then amplifying to that area will not provide benefit. In fact, it may actually cause distortion making things a little worse, not better.
The Hearing Aids
Depending on the level of high frequency hearing loss we might fit either a Receiver In Canal (RIC) hearing aid or a Behind The Ear (BTE) hearing aid with a thin tube. Both of these hearing aid types are ideal for ski slope hearing loss. The real question is what coupling will we use for the ear. In general, many will use open domes, the generic tips that hearing aid brands provide.
The problem is that sometimes these tips allow feedback to be an issue. More often than not, with steep ski slope hearing losses we would use a custom made tip. The custom tip allows us to seal the ear a little better while reducing the amount of oclussion felt. The custom tip can be used with either thin tube BTEs or RICs.
Even with a decent seal, we still need devices that handle feedback well, most modern hearing aids do that. While some do it better than others, they generally all work well enough in this area.
So much for feedback, what about dealing with dead areas? Several of the manufacturers have different strategies for dealing with cochlear dead regions or possible dead regions. The strategy is to take sounds from the area that may be dead and presenting it in an area of sound that we have no fears about. Different hearing aid brands do it differently, Phonak famously compresses the frequencies, while Widex, Oticon and I believe Starkey transposes the sound onto a lower area.
So to finally try and answer your question, you should probably look at a higher technology level Reciever In Canal hearing aid to be fitted with a custom tip. The reason I would go for a higher technology is because that type of technology level would be equipped to handle noise while still delivering the amplification you need. I would definitely consider one from a brand that offers a frequency lowering strategy.
I have had some excellent success with both Widex and Phonak with these type of losses, however, with both brands, it is really important that you get a well fitting custom tip suitable for you. I believe the new Opn S from Oticon may actually work well with these type of losses as well, again, you will need a custom tip. These are just my preferences and my experiences, to get something that is right for you, go and see a hearing care professional. They will help guide you to a solution suitable for you.
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