Upward Spread of Masking | Common Hearing Aid Programming Mistakes
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- เผยแพร่เมื่อ 21 พ.ค. 2024
- Upward Spread of Masking | Common Hearing Aid Programming Mistakes. Doctor Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Phoenix Arizona, discusses a common hearing aid programming error that causes an acoustic phenomenon called Upward Spread of Masking that destroys the clarity of speech and how Real Ear Measurement can help.
Real Ear Measurement: • The Most Important HEA...
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And then there’s pandemic masking spread. Multiple times I’ve sent my HA across the room when removing my mask. The struggle is real.
That and hearing / lipreading people wearing masks. And we all lipread to some extent, even if we don't realise we do.
The amount of times my hearing aids have fallen due to the masks. 🤦 They are not functioning properly now but I can't get coverage for two months. I'm due for a new pair.
@@DougPaulley That was so frustrating to have to deal with. In many stores where I live, there's the also the added Plexi glass or plastic barrier along with the cashier wearing a mask. That made things even worse.
Thanks this was very helpful
Excellent, thanks.
Who would have guessed that hearing aids are so complicated! The stuff about the mechanics of the ear bones and cochlea and membrane was interesting.
Very helpful information as I begin my second semester in my audiology program. I am taking hearing tech 1 now and this is great and useful information. I will share this channel to my classmates as well! Thank you Dr.Cliff
Fine tuning the prescription for my cookie bite hearing loss has been a struggle. I have another appointment next week, I'm definitely going to bring this up. Thanks!
Great explanation of upwards spread of masking thanks! I’m relieved because this shouldn’t be happening as long as I’m performing REM’s properly. And I do REM’s on every patient.
Superb. this explains why my speech recognition is awful. I have occlusion too, likely from the ear mould vents beind too narrow
Here I thought you were going to be talking about face masking and what a problem it is for people hearing and understanding others.
Yes! lol
Sir please make a video about auditory neuropathy.
Is it common for minor impact sounds to be amplified when not wearing the aides?
I have developed high frequency senseneurial loss, but ony became aware of the sudden demise, when the amplification became uncomfortable.
Can there be low frequency compensation going on?
Thanks for a great education. A much needed avenue.
Hi. As an Audiologist I have found some hearing aids eg open fit don't show much low freq gain due to venting effects. Yet if the bass is boosted too much and not apparent on Real Ear Measures the aids can distort in the low frequencies and sound terrible.
Good to remove vent simulation on the manufacturer screen just to see how much lows the aids are producing to avoid over amplifying
I just sat here and nodded throughout this video 😋. I’m a stickler for hitting that target as close as I can. There are so many issues brought on by over amplified low frequencies. Great video 😊
Si voy a una clinica a hacerme solo el examen , como puedo saber si el aparato que estoy adquiriendo es el correcto si quiero comprarlo en aftermarket?
REM is necessary absolutely in case of reverse hearing loss to avoid upward spread of masking.
So right
Please tell me how I can wear my behind the ear hearing aid with a face mask without the mask interfering thus possibly losing the hear aid. It is awful.
This is one of the best and most useful videos so far because it addressed and discussed the issue I am facing. Despite getting a new pair of more advanced and expensive hearing aids, I am still facing problem in hearing CLEARLY. It seems that these hearing aids are just amplifying ALL the sounds and noice without helping me understand what people are saying. I have visited the audiologist many times but he has failed to solve the problem and after watching this video I am convinced that my audiologist lacks the experience and knowledge to solve my problem.
I’m a hearing professional, and though I completely understand your frustration, it may not be your audiologists fault entirely. In fact it really depends on the severity and configuration of your hearing loss. Unfortunately the greater the sensorineural loss, the more distorted or “unclear” hearing becomes. It’s hard to say if the issue for you is over amplification of the lower frequencies without knowing your hearing test results, but I hope you find an adjustment that works well for you!
@@laurena4000 You are trying to defend the audiologist based on assumptions and without even knowing the facts. Even if the problem is with my hearing loss, it's the responsibility of my audiologist to tell me about it. It doesn't help patients when professionals start defending each other.
@@azhariqbal1390 I think you misunderstood my intention. I am not defending the audiologist as I do not know them. What I am telling you is coming from experience. Kind of like when you go to a hair salon with black hair and you are disappointed that they told you that they're not able to make your hair platinum blonde in the first sitting. Another hair stylist may validate that as they're trained in the subject as well. If your audiologist hasn't explained your hearing loss and what to expect from hearing aids, then I definitely don't agree with that. Part of our job is to help a client set their expectations based on their hearing loss, their lifestyle etc. You may have not known that a severe sensorineural hearing loss could distort sound, so I was just trying to help. I hope that the knowledge you collected from this video will help you going forward and I wish you the best.
@@laurena4000 Thanks for your advice. Unfortunately, my audiologist over-promised me. He assured me that these new hearing aids will improve my hearing by at least 60% compared to my old ones. But it has been a big disappointment and he has failed to fix the issues despite many visits. I might have to go to some other more professional audiologist.
My Signia HAs have a “mask” setting. It works, sorta. But is also makes the non-masked sounds more intense and tinny.
My hearing loss is in the low ranges but I also have auditory processing disorder and some tinnitus to deal with as well.
I lost some more of my hearing after mumps last spring. I had complications. My ears were in pain for two months. I couldn't even put my hearing aids on due to swelling.
Because of the pandemic, I couldn't get this properly addressed.
I have just high pitch loss. I am new to hearing aids and only been using since march this year so 3 months. I still miss a little when people speak especially in noisy places like the bowling alley. But not as bad as before. To be honest most the time I do not know I am using them. But music is much richer as their are often little bells or real high pitch sounds I never could hear before. Like I had a dog whistle ring tone 15 years that my wife and daughter would cry. They said it hurt. I could not hear nothing. So it was one of the first things I tried when I got them, and I heard it, and it was not pleasant. 😆 When I take them off if they are close to each other and turned on the chirp in a high pitch so my wife will tell me to turn them off because I can not hear them. LOL. But most the time I place them in the charger and they go off automatically. I still feel like I am missing some of the lower high pitch sounds and maybe that is why. But my insurance is making me use truhearing so the office I must use does not even have licensed audiologist. The dude that diagnosed my loss was but My insurance would not pay for his equipment. If I wanted to go to him instead and have him double check my programing can I or do I have to go to a truhearing agent? Mine are a BTE truhearing devise. Like is the software to program them shared? They are of high quality and smart and small. I have no complaints with the devise I just want to make sure I am getting the most. But my low levels are not amplified.
Hi Dr. Olson, Have you had success with hearing aids improving distorted hearing aka Dysacusis?
What is dysacusis
Dr. Cliff - I'm tempted to travel to Phoenix to visit you for correct programming. Coming from Chicago. Would you be open to helping me? Just purchased the Oticon More/Advanced. Moderate to Severe bilateral hearing loss. Getting genetically tested at the Mayo Clinic in July to find out why my hearing just started to deplete in my 20s. I'm 38. I love your content. It's truly a blessing. Thank you so much.
I have several great Audiologists in the Chicago area. Check out my website www.drcliffaud.com
Thanks so much!
Than you so much doctor for your videos I have Ménière disease I have hearing loss comes goes and hopefully I can some help soon 🙏 bless you doctor
Hey how did u found out it was menieres disease which test
@@vajras4769 diagnosed by an ENT
@@steverliu1886 yes
Your ENT should be helping you manage it. Low salt diet, hydrochlorothiazide and diuretic, that’s as far as I know. The goal is to reduce the number and severity of the Menieres episodes. And hearing aids too if recommend by your audiologist. Meniere’s is a horrible disease, best wishes to you.
@@steverliu1886 yeah thank you
How do you wear a face mask with behind the ear hearing aids? When I wear my mask my hearing aids come lose, luckily I not lost one, yet. The straps on face masks are not compatible with my behind the ear hearing aid.. thank you
When I performed REM to my patients and then I measured their functional gain with hearing aids, sometimes I need to give them extra amplification. Because in some frequancies their aided tresholds can't reach the speech sounds. This point, what do you recommend? Should I stick with only the REM (maybe give patients some time to adaptation for their auditory perception) or is it OK to make some changes after REM?
Totally okay to make changes after REMs based on perception and performance.
Agreed, I apply the science first (REM) but will make further adjustments per patient feedback, applying the Art second
What do you think is the cause of extreme distortion when I hear something that is loud, such as when a person shouts and I hear what sounds like static, or if I change the channel on the TV and can't understand anything until I turn down the volume on the TV? I'm using Stakey Muse IQ2400 RIC hearing aids with closed domes. I've been struggling with terrible sound and feedback as well (feedback during loud sounds) for almost a year now. Previously, my hearing aids sounded good and I had no issues with distortion or feedback.
Sounds like a compression issue, too low of MPO issue, or input dynamic range issue with the hearing aids. Feedback should not be an issue. If the closed domes are not adequate in preventing feedback, then you need to consider custom earmolds.
@@DrCliffAuD thanks! I'll mention that when I go in after making my appointment.
If it wasn’t doing it before, but now it is, maybe it needs to be cleaned or repaired. Otherwise I agree with Dr Cliff’s comments as well.
I trialed my “new” oticon More HAs with my old molds and there was a definite improvement in my word comprehension. Ever since having new molds the HAs have not been nearly as satisfactory. It sounds as if the vent may be causing this, correct?
Is the vent size prescribed by the audiologist or just done by the technician at oticon?
I plan to call my audiologist tomorrow to make an appointment to see if she can do something for me. I had planned to do that before watching this video but now I may have something specific to ask about.
I live close to MA so if I get desperate I will go to Mass Eye and Ear for a consult. I know that will probably be costly but if it helps it’s worth it.
This video was excellent.
The size of your vent could have been audiologist selected or "factory select" based on your audiogram. Your audiologist might be able to modify the vent in-office to open or taper the vent, not all offices do this, or, if within the manufacturer designated remake days, you can ask the manufacturers to modify or remake the molds.
If the only change was the molds and no change to the programming and you are experiencing occlusion or your own voice being distractingly loud, then opening the vent could possibly be the solution.
Without enough venting you might experience a plugged feeling when you eat, talking, or for some, even breathing. Some programming in the low frequencies might alleviate this as well to a degree.
If it's sharper tinny or more high pitch interference then it could be something much different and more programming based.
@@ClassicDarling Thanks, Amy. The volume may be a tad too loud but mostly I am experiencing a real harshness in sounds. It helps if I turn my aids to "Comfort" but then the volume goes down too so I can't hear as well. My audi had put the old molds on the new aids until the new molds came in but I think when she changed the molds she didn't give them back to me because I checked my old aids and they just have the smaller attachment on them. I've had these since around January and been back for adjustments a couple of times so if it's the molds I suspect I will need to pay for new ones. I think my audi is very good but as I said, if I get desperate I will go to an audiologist at Mass Eye and Ear.
Great comment, but have you told your audiologist about this yet? If you haven’t, don’t be afraid to tell them, the feedback you give them is very important. They may re-do the real ear with your new molds if they haven’t or re-order your EM’s as a remake with larger vents. There’s usually a 90 day remake period so be more picky about your EM’s the first three months until they get it perfect for you. It’s not uncommon to have the EM remade several times until the patient is satisfied with it for various reasons
@@jkgrasso I wonder why they kept your other earmolds. Maybe you can request them back? I've had times where I sent the old molds in to have the new ones made identically to it. That can help a lot.
Harshness in sound quality can sometimes come from sensitivity to high frequencies. you'll also notice harshness in other sounds like paper or jingling keys.
@@steverliu1886 Thanks, Steve. I know, I should have been more proactive. I guess I was really hoping it was an adjustment thing on my part. She did do real ear measurement and it seemed to be correct but it's not to me.
Dr. Cliff, do you have any idea why would an Oticon More 1 HA cause fluttering in vowels? And how can this be fixed? 🙏🏻
I’ve heard a fluttering on long e sounds when the gain for loud sounds is too close to the maximum power output (MPO). I fix it by separating the two, either by increasing MPO or decreasing gain for loud sounds at the point where they overlap. That could potentially fix your problem, if that’s what’s causing it. Good luck!
(I’m not Dr Cliff, but thought I’d chime in because that fluttering is annoying. If it’s the same sound I’m familiar with, it is not specific to the Oticon More. All hearing aids can do it.)
@@believe53787 thank you very much I will share this with my audiologist 🙏🏻
Hai
How can we amplify precipitously sloping hearing loss to the right amount
What I mean is normal hearing at 250 and 500Hz and around 80-85 db at 6 and 8khz
Do you have any special tips for this pattern of hearing loss while programming
I think this type of loss is tricky for everyone. Basically try both strategies one at a time and see what patient likes best. 1) open fit, no custom mold 2) EM with large venting, like the Oticon LiteTip type EM. Kinda depends where you’re at from 750-1.5k. Either choice is reversible so you’re not stuck with the wrong decision.
I would recommend acoustically optimized vents that allow enough containment of High frequencies to prevent feedback without causing occlusion.
Can you explain acoustically optimized vent?. Here in India we don't use that term
Excellent video! Now I understand why tried no-vented earmold didn't help me despite occlusion was no problem. I took a trial with that earmold because I wanted to mask external noise completely.
Eventually I have taken AOV earmold and it works perfectly ;) (I have normal hearing to about 600Hz)
I have had REM of course :)
Good timing... now that most people are over the mask thing. Might have been more helpful a year or so ago.
Any news about the injections to "cure" tinnitus?
Not since my last video about it.
@@DrCliffAuD thanks, doc.
Hey doc 😌please do reply 😌 What might be the reason for tinnitus ear pressure and ear pain? Is it symptoms of sensonueral hearing loss
Btw u look too hot 😌❣️
Tinnitus and ear pressure are different things. Although you could be experiencing both at the same time. These are not symptoms of SNHL. Have you gotten tested yet? Did you get normal tymps?
@@steverliu1886 Am at hospital let me let you know my hearing test came out normal 😌i need to do tympanometry
@@vajras4769 they didn’t do tymps with your test? Tymps is like a standard part of the hearing test…😅
@@steverliu1886 need to do it soon 😌They felt am okay 😂i dont know why 😂they are just recommending some vitamin tablets 😌 Haa i couldn't attend the first appointment date that's y 😌 do you have tinnitus 😌
Hey, are you growing a beard, Cliff? Or just not enough time to shave? 🤣🤣🤣
lol I thought... we are talking about mask. A real mask. Everyone wearing mask these day. Due to COVID. Its frustrating.
Those attachment on the ear of this woman's ears looks painful 😖😣 for me to go hearing testing . Are all those attachments necessary for me to hear 🙉 ? 🦻🦻👂🤕🤔
They aren’t painful and are on about 5 minutes. The REM is just confirming the settings by the audiologist are matching the prescription as much as possible.
Not painful at all. The tube can tickle a little bit at the beginning, but that is about it. Fortunately, we don't force you to get a bunch of piercings like she has. 😃