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First-Time Hearing Aid Trial – Airline Pilot with Reverse-Slope SSHL

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Hi everyone,

Three months ago, I experienced sudden sensorineural hearing loss (SSHL) with a reverse-slope pattern. I’ve since undergone extensive treatment, including oral steroids, 10 intratympanic steroid injections, and 25 hyperbaric oxygen therapy (HBOT) sessions. Fortunately, I was able to recover 20% of my hearing and fully regain 100% word recognition.

Next week, I’ll be starting my first-ever hearing aid trial with the Oticon Intent 1 for two weeks, followed by the Phonak Sphere. Since this is my first experience with hearing aids, I’m unsure what to expect, especially given the challenges of reverse-slope hearing loss.

I am an airline pilot, and my hearing is critical to my job. That’s why I’m investing in the best possible hearing aids to ensure I perform at my best. If there are any pilots with hearing aids here, I’d greatly appreciate your insights and any advice you might have on adjusting to hearing aids in a professional setting.

Also, for Phonak Sphere users, what has been your experience using Sphere in flight? Does the Sphere feature remain active throughout the entire flight, or does it only engage during conversations?

Thanks in advance for your help!

14 people in this conversation19 min readJump to latest

What is far more important than the device you purchase is finding an Aud that is willing to spend a lot of time with you until you get the fitting right. It’s a complicated loss to fit as it breaks many of the rules used to treat more common losses. Expect numerous follow-up visits until it sounds right to you. I’ve pasted a video below that really helped guide me in treating my clients with reverse-slope losses. Maybe you can share it with your Aud if they haven’t come across it. Oticon Intent and Phonak Sphere are both excellent devices that will be up to the task, if fit properly. Best of luck to you.

12.Podcast eleven: Fitting Low Frequency Hearing Loss2

Regarding your questions around the Spheric program, the battery in the Sphere will only power the Spheric peogram for 7 hours before depleting. You wouldn’t run it for the entire flight. The default activation threshold for noise is 70dB but that can be configured as low as 60dB I believe. Otherwise you can manually activate it when required either via the app or via a 2 second press on the volume control on the devices.

In reply to @Louie

Thanks for your response! I’m going with an at HearingLife that my recommended because he’s thorough and really cares. Honestly, I’m not sure what to expect, but I’m hoping for the best!

In reply to @Louie

The last thing I want to worry about is battery life while in flight. On long flights, we typically don’t wear headsets during cruise and talk to each other throughout. That means I may need to rely on Sphere mode for most of the flight. If Sphere doesn’t activate in flight, is the regular mode good enough for conversations?

Good afternoon! I’m not a pilot, I work as a pediatric ophthalmologist. I use Oticon More devices. Oticon is an excellent device, especially if it is configured in the right hands. Good luck and good spirits!!!

In reply to @Ramzi

That depends on a lot of factors. How noisy is it in the cockpit? What is your QSiN signal-to-noise score? The default autosense program would likely handle that situation well enough so long as the aids are calibrated properly. The Oticon Intent is also excellent. The advantage with Phonak is that it utilises Bluetooth Classic, which means more universal connectivity. Perhaps there is some way of pairing the hearing aid to your comms system so it streams directly into the aids? I know very little about the tech in your world and whether that is feasible, but if it is, general connectivity is just more seamless and accessible with Phonak.

Unfortunately, I can’t connect the hearing aids to the comms, it would have been awesome. During cruise, we communicate with controllers using a handheld mic and listen through the speaker. Before the top of descent, I put on my noise-canceling headset. The cockpit is usually the quietest part of the plane since it’s far from the engines.

I will request permission to test both hearing aids while sitting in the jumpseat (as a non-flying pilot).

In reply to @TatyanaKa

Good afternoon Tatyana, thanks for your feedback, my current is more familiar with Oticon products so hopefully he gets it right, that’s why I wanted to test the Oticon Intent 1 first.

In reply to @Louie

The sound levels in an Airbus A320 cockpit typically range between 60 to 75 during cruise but can be higher during takeoff and climb, reaching around 80 to 85 dB due to engine noise, airflow, and avionics cooling systems.

The good thing is I will be wearing my noise cancelling headset during climb and decend so I won’t need the sphere function.

Welcome to the forum.

As mentioned the most important thing is the hearing aid fitter. That loss can be challenging to fit. Custom earmolds will be needed.

You have mentioned a few times how important communication is when the headsets are off. Maybe a portable microphone could be used that is hearing aid proprietary. The person you talk to most could wear it on their shirt collar for example. These devices are excellent for your situation. Roger mics are the best.

Phonak and Oticon are both great aids. I am not sure if these aids have disposable battery options which might be best for your work.

You have come to a great place to learn about your hearing and hearing aids.

In reply to @Ramzi

@Ramzi said:

That means I may need to rely on Sphere mode for most of the flight. If Sphere doesn’t activate in flight, is the regular mode good enough for conversations?

Not necessarily; the non-Sphere mode is also efficient, particularly fitted binaurally, especially Speech in Car program, which is for constant noise (e.g., cars, air conditioning, etc.). The condition is proper sealing of the ear canal to prevent noise from reaching the eardrum by venting unprocessed sound.

A better option is what @Raudrive mentioned—a Roger microphone (e.g., RogerOn) clipped near the second pilot’s collar. With RogerDirect, it is very energy-efficient.

However, switching between hearing the partner and the loudspeaker is an issue.

Another issue is whether the 2.4 GHz wireless Roger protocol is permissible in the cockpit environment, but I think this is mainly a problem during takeoff/landing.

In reply to @Raudrive

Thanks for the warm welcome! I’m glad I found this forum.

I have a question, how will I know if my hearing aids are properly fitted? Should I expect them to feel like my normal hearing before the hearing loss, and is that how I confirm the fit is right?

I also have no experience with hearing aid accessories, so it’s good to know about the microphone option. However, since I fly with different pilots every day at a major airline with over 6,000 pilots, explaining it each time would be inconvenient. I’d like to try the hearing aids on their own first and see how well they work. If I feel I need a microphone, I’ll definitely consider getting one.

During the trial period, can we request custom earmolds?

Unfortunately, neither Phonak nor Oticon offer disposable battery options.

I really appreciate your advice!

@Ramzi said:

how will I know if my hearing aids are properly fitted?

This is a great question and difficult to answer. Since these are your first aids you have zero experience about how to know what’s right. Reading this forum will help you big time.
Since you have not had hearing loss a long time you are at an advantage to know when the aids are fit properly. The aids will sound different than normal hearing that you remember. That will take some time to acclimate to. If you get your aids and you can understand speech pretty good that’s a first big step. From there it’s little things that tell you how the aids are fit. In noise can be the most challenging.

@Ramzi said:

During the trial period, can we request custom earmolds

You should not have to request ear molds, the fitter should be the one that knows and they should be asking you lots of questions about your lifestyle and what you need from the aids. This forum will also help you understand how you can help your fitter do a better job. It’s both of your responsibilities. That’s important.

In reply to @Bimodal_user

I will definitely try both hearing aids in the cockpit while in the jump seat (not flying) to see how well they perform. I’m especially curious about how effective the non-Sphere mode actually is.

As I mentioned to @Raudrive, I fly with a new pilot every pairing, so relying on a Roger microphone wouldn’t be very convenient since I’d have to explain it every time I go to work.

The 2.4 GHz wireless signal might be an issue, as you pointed out. If I feel I need it, I’ll probably have to look into getting approval first.

Thanks for your feedback!

In reply to @Raudrive

This is my first time trying hearing aids, and honestly, I don’t know what to expect. I’ve seen many people struggle with their first experience, so I just hope it goes well.

It’s helpful to have the benchmarks you mentioned as a starting point. My biggest challenge is dealing with noise and understanding speech in noisy environments.

I still have a lot to learn, I’ve already gained so much knowledge from this forum.

At the beginning, I’ll have to trust my , and I’ll do my best to work with him. In the end, it’s a team effort, and we both need to be well-informed to get the best results.

In reply to @Ramzi

Good luck! I let only that apart of Phonak (which is the most convenient from Bluetooth side) there is also other manufactures which technologies could help with constant noise:

  1. Starkey Edge 24 in EdgeMode+
  2. Resound Vivia

I am not sure about constant noise with Oticon Intent and newest Signias, which otherwise are good maybe someone could help.

I recommend videos from Matthew Allsop YouTube channel:

Edited

In reply to @Raudrive

I would not jump to the conclusion that earmoulds are required immediately. This is often a big mistake with reverse slope losses. A mould will likely occlude the ear too much and deny natural hearing where you still have it. Blocking the ear to meet typical low frequency targets at the cost of high frequency audibility is not the right trade-off, particularly given the fact that there is more speech information in those highs, and the risk of upward spread of masking. Start with a vented dome. Experimentation may be required. Make sure to watch the video I posted earlier.

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