Oticon programs and algorithms

It is only a ChatGPT answer, with caveats, so it should be treated with a grain of salt; nevertheless, I still think it requires further investigation.:

ChatGPT - ABG with Normal Tympanogram7

Shared via ChatGPT

@Neville and @Um_bongo, I see interesting issue.

It’s not a great audiogram to base any opinions on. With that loss you’re going to start running into the limits of the bone oscillator and/or masking dilemmas, but it would be nice to at least see an attempt at masking. But absolutely I could believe that that’s actually a sensorineural or cochlear conductive hearing loss. Lostdeaf has had hearing loss since birth, haven’t they? EVA, maformations of the cochlea, various syndromes that might be present at birth can all be associated with a third window component.

I wonder what the best option for how to treat that false bone conduction in the prescriptive targets is though. I might actually default to taking it out and fitting it as a sensorineural loss rather than having the calculations in there for a conductive component, but I suppose I’d just try both with the patient and see what they preferred.

Thanks for your explanation. So, in that case, does it make sense to test a BAHA with a headband?

No. The bone line is too severe for a BAHA.

I guess I shouldn’t say “severe” as a general term because it’s used as a hearing-specific term. The bone conduction hearing is not good enough to support a BAHA, even if it were to perform in the same way as a true conductive hearing loss, which it might not.

Ok: not to labour the point, but CRS losses ‘can’ be conductive.

@Bimodal_user said:

Out of curiosity, what made you choose the VAC+ earlier? Perceived comfort?

Adding a point about choosing between NAL-NL2 vs. DSL 5.0—I theorize that it depends on whether you will benefit from more high-frequency amplification in DSL for loudness normalization.

With my new Oticon Intent 1’s, I used the manufacturer’s proprietary VAC+ as starting point. The result sounded so good, I stuck with that for the last 6 months.

Now that I have read your referenced interview with Gus Mueller PhD, and his comments on NAL-NL2 and DSLv5, I decided to experiment some more to see if I can improve speech intelligibility. Mueller mentions that HA companies stopped using DSL v5 as the customers regarded it as tinny and they lost market share…

As an aside, I would venture to opine that your first-time HA customers are the worst group of people to judge what normal speech sounds like! Therefore they choose fittings which are not optimal for their prescription.

Yes, I suffer high frequency losses that cause difficulty in speech discrimination. Mueller’s work and comments indicate that NAL-NL2 (and DSL v5) both give better speech intelligibility index (SII).

My understanding of NAL-NL2 and DSL v5 is that they are very similar with DSL v5 giving slightly more boost in the higher frequencies.

@member45 said:

My understanding of NAL-NL2 and DSL v5 is that they are very similar with DSL v5 giving slightly more boost in the higher frequencies.

Indeed it is, especially to 4 kHz, assuming a ±5 dB deviation. Gus Mueller shows this in his 2017 book about speech mapping and probe microphone measurement (information about it is in the article)…

I’ve chosen DSL 5.0 Pediatric for mainly three reasons:

• I have had hearing loss since age 4, so if I had been fitted with hearing aids using best practices, I would probably have been using DSL 5.0 Ped for 30 years.
• I have a cochlear implant in my left ear, which provides excellent high-frequency stimulation (not amplification). However, I need balanced sound between my ears so the high frequencies from the CI do not overpower my hearing aid ear.
• My high-frequency reception is quite good even without the CI, so it is possible I have relatively few dead regions and could benefit from high-frequency amplification in DSL.

@member45 said:

As an aside, I would venture to opine that your first-time HA customers are the worst group of people to judge what normal speech sounds like! Therefore they choose fittings which are not optimal for their prescription.

You’re right. They are used to living for years without high-frequency amplification, so that if they suddenly receive proper gain, they think all sounds “unnatural”.

A small caveat: I am not a professional, I simply has some knowledge about it, and work in medical profession.

I am a Phonak Audeo Infinio Sphere 90 user, but I wonder what my hearing would be like with slightly better high-frequency amplification (roughly in 3-6 kHz) with Oticon’s HA and receiver.

Hello everyone! It’s been 4 months since I asked a question about algorithms and programs on this forum. I’ve been actively using various settings myself, and I’ve chosen two that are particularly suitable for me. The first one is general vac+, and when I’m at work, I switch to speech in noise. These are the algorithms I use most frequently.

Hi to all, Just an update on my previous post from May 12 above relating to fitting formulas for Oticon INTENT1 HAs. Since that last post I reprogrammed my aids from the original proprietary VAC+ to use the DSL v5 which I have found it to be superior for speech understanding for me.