Sunday, April 5, 2009

Profoundly deaf man scores over 90% speech recognition with hearing aids!

(Case study, year 2008. He did get a CI eventually in right ear.)

This just goes to show that hearing aids most certainly are not inferior, well unless you happen to have a 115db or 120db hearing loss. My audiologist doesn't recommend CIs for me or anyone hearing equal or better than me, but did say that no HA will ever aid a 120db loss or if there's no residual hearing left, such as with cochlear dead zones.

He didn't mention what HA he was wearing but it's possible he wore the Phonak Naida V UP HAs(and if not, an equivalent from a different brand). I wear those too and got them in 2008. Right now I am able to understand 70% to 80% of what my dad says in the car and that's with much worse aided scores than what ive shown in the chart below(im getting my HAs reprogrammed for max gains and to enable transposition) so it's not too much of a stretch that he could score 90% in noise(and I might be able to match his scores). He did say it took alot of training, but nothing wrong with that and besides a CI would still require alot of training!

His hearing loss is progressive but he held off getting a CI for a very long time, instead doing the right thing by trying all the best HAs and maxing the gains. He did mention that he was taking a big risk getting a CI, but figured that he always has the better left ear and also even if CI was worse than HA, in a few years itll become better than HA because his HL was progressive and HAs won't benefit him after a few years. He probably felt that today's CI technology was "good enough" to risk the worse ear and hope he gets lucky with the CI results.

Well he did get lucky but how much can you improve when you are already hearing great with the best HAs with max gains? His speech recognition improved a few percent and is now over 95% while it was over 90% with both HAs together. He did get the biggest improvement with CNC but CNC doesn't usually reflect real world converstations, HINT would most closely reflect this which he was already over 90% to begin with.

There is way too much hype with CI recently. It is being pushed as the "latest and greatest" by audiologists, ENT and surgeons. They are probably forcing insurance companies to pay at least 80% of the $50,000 tag that CI carries. I really wish insurance companies would pay for HAs and for audiologists to work with the person to program the HA so he or she hears the best. The man who got the CI even mentioned in his case study that everyone should be training themselves to understand speech with HAs first and that it's no different from CI, both are simply tools to give the deaf access to sounds and speech.

Then this begs the question, why take the risk with CI and it's associated surgery? As long as you are getting benefits from HAs, stick with them! Even the profoundly deaf can benefit just fine with today's HA technology. It's simply a matter of choosing the right HA, having a skilled audiologist program and reprogram your HAs and getting speech reception training. This is possible even with unaided hearing as bad as mine and his. Of course if your unaided hearing is something like 115db or 120db at 1000Hz and NR above that and still 90db or worse in the low frequencies, it's going to be very difficult if not impossible to be able to score better than 40% speech reception which is the cutoff for CI candidacy.

I will repeat that I am not against CI, but only advise that you be realistic about what CI can do and can't do. It's not a cure or a miracle, but just another tool to aid the deaf in sounds and speech. Over 90% of the profoundly deaf still have some residual hearing left that would be amplified with HAs and thus provide access to sounds and in most cases, also speech. There's always other options such as lip reading, ASL and writing for anyone that ever has any difficulty understanding others.

Update: I did the math for his audiogram and he's missing alot of low frequencies and all of the highs. I am surprised his speech is around 70% in just his worse ear alone! But this should give the profoundly deaf new hope that with the best HAs on max gains(blue dots) you just might get enough usable aided hearing to have fairly decent speech and hear environmental sounds in the 30db range. A CI would not be much better, but id respect your choice if you had an extra $50,000 to spend.

Doing the math, he has access to about 67% of the lows and 85% of the mids. That's an overall of about 65% so that's great he can understand 70% of speech despite having access to only 65% of the speech banana. With both HAs in, he is able to access over 90% of speech! I should be able to score similar to him, in fact I can understand 70% of what my dad says without lipreading.


  1. I just find that my hearing aid doesnt really give me much sound. It is a spirt 3 sp by oticon

  2. I am fine thanks, i am not sure what my hearing loss is without ci and HA. with my ci i can hear as low as 30 decibels. it may not be great but i do hear a LOT with my ci

    i am going for a hearing test in may so ill be able to tell you then what i hear with HA

  3. I think my HA is at the maximum gain because when I got it, she turn it up and i still couldnt hear so she turn it up until i could hear and it was at the max gain

  4. Hi,
    I'm not sure what the deal is with cochlear Implants. Here in New Zealand there is a long waiting list and funding for just a select few.

    I had 41 years of perfect natural hearing , The suddenly lost the lot is just 4 months. I had 56 days in hospital battling for life, raging high fevers, seizures, endocarditus (heart infection) and septicemia, then rapid, total and permanent hearing loss as a result of aminoglycoside antiobiotics with a very devastating ototoxic effect. But at the same time so lucky, my precious wife of 21 years has stood by me in every experience, and my pet bichon knows I'm deaf and often becomes my ears when I'm home by myself.

    I'm on my third implant. Second on one side lasted just 8 months then electrified my face, neck and brain until finally it got an electrical short and failed. So the one CI I currently use is just 7 months old.. I have tinitus is so loud I think I can feel my head vibrate, then comes raging headaches, and out of control vertigo, .why? Some days it scares me that much I think, no more, I just can't continue, ............why?

    Patience, Ive learn't that, not once since that devastating time in 2007, but 10,20 maybe more times. So I guess I haven't learn't it at all..........why? My wife has gently told and retold me that 'in acceptance lieth peace' I'm still learning that too.

    I have had quite a bit of success with using a personal FM transmitter /magnetic induction neck loop. I set my processor to T-Coil setting and then fine tune with volume and sensitivity on my processor and the controls on the neck loop as well. I can eat in a noisy cafe' and understand every word my wife says without need for visual cues (mostly) and the FM coupled with my processor filters out all the unwanted noise pollution. The system can be used in meetings and in vehicles etc. Check my last post on my blog as I have links to the FM site etc.

    Today I talked on the phone to my wife and brother. It was my first phone call since 2007!

    I appreciate your view of hearing aids / cochlear implants. I think you should consider your experience is quite likely much different to other hearing aid and cochlear implant recipients. I have no options but to be implanted as soon as possible. Its far from easy for me but I can now relate to my family from which I was suddenly ostracised from for a few months. I had three different sets of hearing aids in just four months, finally I could hear nothing even at 135dB. I attach my processor in the morning and I'm back in the world of 'sound'. Its wonderful not to have ear impressions as well!

    Cochlear implants do not aid hearing, they provide direct neural stimulation via electrical impulse and therefor substitute hearing. I think you would do well to exercise patience with others less fortunate than yourself or those who make choices for differing reasons to your own.


  5. Great information.

  6. That is a very great result. I can say that the operation is very successful. I can wait for more amazing results.

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