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Just got Phonak Audéo EON Sphere i90s and looking for fitting advice, especially from anyone who actually had these verified with probe-mic . I’ve been through a few audiologists and keep getting Target first-fit or the in-software “feedback and real ear test,” not real REM.

Setup

  • Open vented domes, M receivers
  • Some fine-tuning at the first visit, no REM
  • Came from Phonak Marvels
  • Not in loud restaurants much. Main problem is meetings and quiet talkers.

What’s bugging me

  • Hard to follow most people in meetings, especially the soft speakers
  • Quiet speech in general is tough
  • Music program sounds off. When AutoSense flips to Music it almost boosts background noise too much
  • Some hiss in quiet
  • A lot of feedback with noise-canceling headphones (didn’t happen on the Marvels)

Questions

  1. With open vents + M receivers on Sphere i90, what usually needs changing after first-fit for meetings and quiet talkers?
  2. If you had REM, did matching soft-speech targets (~55 ) help quiet voices without making the hiss worse?
  3. I only hit loud noise once in a while. Better to keep Spheric Speech Clarity milder in AutoSense and use a manual meeting program, or leave Sphere more aggressive?
  4. Any music settings that beat the default (more linear, less NR, less Sphere, different compression)? And how do you stop AutoSense from over-boosting room noise when it jumps into Music?
  5. Is headphone feedback common on Sphere with open vents? Did molds, a tighter dome, feedback manager, or cutting mid/high gain fix it?
  6. Would it be better to get the equipment to program these myself?

Thank you for any info!

8 people in this conversation10 min readJump to latest

My advice is to find a new audiologist who follows audiological best practices. With your level of hearing loss you need someone who is going to do a proper job to get great results. It isn't possible for us to provide fitting adjustments for you without measuring what the devices are actually doing in your ears.

Where do you reside( e.g country and if it's a large country province/state or city)?

I don't think you're going to be able to get enough gain with open domes and I think you'll still have feedback issues. Either find a better fitter or if you're technically savvy consider self fitting.

I truly don't understand the rationale some use to prescribe these expensive aids with open domes. If you let all sound go into the ear canal, how can the spheric functions (or other speech in noise functions) work? It's like stopping water with a colander.

And why the fitter prescribe open domes with the OP's ? That's kind of insane.

OP: Return those aids to your provider and find someone else. The questions you are asking are a consequence of a bad fitting job and, fitting is part of the price you pay for the aids . If they are new, there is no reason that you should be trying to figure out this yourself. Everything you say points to a poorly made fitting.

@OcramSagev said:

some AuDs

Just to make it clear for everyone, an (Doctor in Audiology) is a totally different thing to an Audiologist (which could have a Masters or Bachelors degree in Audiology) which is a different thing to a hearing instrument specialist or an audiometrist.

Manufacturers have adopted the term "hearing care professional" () and I think it is appropriate to use this term when we don't know who someone is working with given the wide range of levels of qualification that exist for people working in this space which even in Australia where the level of practice is higher overall can be as little as a 1 year diploma for an audiometrist whose other highest qualification is a high school diploma.

The level of training and expertise is going to differ widely between these groups. It's also going to differ considerably based upon experience level and where people have worked.

In reply to @ndirish147

@ndirish147 said:

Would it be better to get the equipment to program these myself?

This is the route I went after 3 failures from audiologist selling top of the line aids and not being able to fit them properly. My hearing was more challenging than yours and it worked out great for me. is not for everyone. You have to be curious, a good troubleshooter and have time to learn the software.

Otherwise I agree with most posters, return those aids, get your money back and move to a new fitter that uses best practices. If all else fails try a Costco if one is in your area. They use best practices and have great hearing aids. The Sonite Rise is a nice move up from your Marvel aids.

In reply to @Hearing_Potential

@Hearing_Potential said:

an AuD (Doctor in Audiology) is a totally different thing to an Audiologist (which could have a Masters or Bachelors degree in Audiology)

In the US, the Doctorate of Audiology (Au.D.) became the mandatory entry-level degree, for clinical practice in the United States, about 20 yrs ago. Those who got the degree before that, with an MS, are allowed to keep practicing with that degree (grandfathered). I'm not aware of any B.S. degree in the US that allows the clinical practice of audiology. I can't speak for other countries.

You are right, I should have used the term to include the hearing instrument speciialists like the ones that work at Costco. So many acronyms these days.

But the question remains: Why use open domes with a Phonak Sphere?

@OcramSagev said:

But the question remains: Why use open domes with a Phonak Sphere?

With this hearing loss? The may not have a lot of confidence when it comes to counseling about occlusion, or they could simply be incompetent and not know that they are. We just don't know.

@ndirish147, thanks for sharing your location. Check out hearingup.com for a list of providers that follow audiological best practices. Read through the best practices check lists and have a look at the questions to ask your audiologist. For first time hearing aid users it's especially important for your success that you work with an experienced professional that can help you navigate each step of the hearing journey. This makes up a greater proportion of whether you succeed or fail than the devices you use all other things being equal.

In reply to @OcramSagev

@OcramSagev said:

, I should have used the HCP term to include the hearing instrument speciialists like the ones that work at Costco.

You do realize Costco has both audiologist and hearing aid specialist in the US. I do know the San Antonio Costco I used in the past had a real deal audiologist and two hearing aid specialist. Seems I remember Canada only having audiologist at their Costco's, no hearing aid specialist.

I appreciate everyone taking the time to give me feedback.

I did update my location in my profile if that is helpful.

Here is a little background on my experience up to this point. I have had hearing aids around 13 years or so. My first aids were starkey halo’s. I was ignorant at that point. That distributor was definitely not an audiologist. I probably went back for adjustments 6 or 7 times before I gave up and quit wearing them. Three or so years later I was in a position with my job that I had no choice but to use them so I could at least pick up some of a conversation.

In early 2020 I found a new . I had done research at that point in time and thought I was making a better choice with who I was choosing. My experience there was better but I was still missing a lot of conversations, specifically in meetings or when I had my kids or wife talking but not facing me. I went through two different HCP’s after the initial one left the office I was going to.

That pretty much brings us to the present. I am trying a new HCP they seem no better than the last. On one hand I am blessed that my insurance will cover the total cost of my aids. The problem is I am limited on what offices are covered.

I mentioned self fitting only because at some point you feel like it can’t be any worse than what you currently have.

@ndirish147 said:

On one hand I am blessed that my insurance will cover the total cost of my aids. The problem is I am limited on what offices are covered.

In this case what looks like a blessing might actually not be to your advantage. Dr Cliff explains why in the video below where he discusses private practices, especially those that are involved in providing hearing aids through insurance in the USA. He's testing a range of different thumbnails and titles for this video, so it may appear/read differently on your device than mine.

Doctor Cliff, AuD2Why Expensive Hearing Aids Don’t Guarantee Better Hearing

Edited

In reply to @ndirish147

I wanted to respond because you’re the first other EON Sphere user I’ve seen post here. I’m using the EONs too, and before them I used the Audéo Sphere i90s, so I thought my experience might be useful.

My own is not exactly an easy fitting either. My low-frequency thresholds are actually poorer than yours, although your loss falls more steeply and is poorer than mine in parts of the mid/high-frequency speech range. I’m currently using medium vented domes with the EONs, and I’m hearing very well with them.

I would be cautious about concluding from the audiogram alone that the OP’s coupling is necessarily wrong, although I should make clear that my own successful fitting uses medium vented domes, not open domes. That gives my fitting more acoustic control than a truly open fitting, so the comparison isn’t exact.

One thing I’ve learned is that the EON does not behave exactly like the earlier i90 Sphere. In my experience the EON processing is more sophisticated, but it also responds differently enough that simply duplicating an older fitting is not necessarily the answer. Mine has taken several weeks of small adjustments to really hone in.

A particularly important change for me was changing the AutoSense adaptation setting to Fast. That made a surprisingly large difference in how naturally and quickly the aids responded as the listening environment changed.

I also recently had a remaining problem with speech intelligibility in calm situations. In Target I used Auto Fine Tuning → Speech in Calm → Speech Unintelligible. Three small steps — two initially and one additional step later — produced a very satisfactory result. With the medium vented domes I now have excellent speech clarity without feeling that the fitting has become harsh or over-amplified.

I’m absolutely not suggesting you copy my settings. Your audiogram and ears are different. I’m only pointing out that these aids can work extremely well once the fitting is actually optimized, and in my case that optimization was not instantaneous.

is a valuable verification tool and I certainly wouldn’t argue against having it done. But verification and fine-tuning are not mutually exclusive, and the appropriate coupling still depends on the audiogram, feedback margin, comfort and occlusion, programmed gain, and ultimately how the person is functioning with the aids.

So before assuming the EONs or the open domes are the problem, I’d spend some time getting the fitting dialed in. These are very capable hearing aids, but my experience has been that they reward careful, incremental adjustment rather than expecting first-fit to be the finished product.

In reply to @Raudrive

@Raudrive said:

Seems I remember Canada only having audiologist at their Costco's, no hearing aid specialist.

This used to be true in Ontario, but it's no longer as they couldn't keep enough audiologists. They will probably lose more audiologists in the future as they start to put the screws on in regards to sales targets and reduced appointment times.

@hearingMac said:

I’m currently using medium vented domes

I don't love a vented dome for your hearing loss unless you have very small ear canals. Have you tried a custom tip? Are you picking up soft speech?

In reply to @hearingMac

@hearingMac said:

So before assuming the EONs or the open domes are the problem

My comment about the open dome was not an assumption, it is based on the fact that open domes can't handle the level of amplification required for the posted.

To confirm this: I entered OPs audiogram in Target ( 4.0,Open domes, M receiver). The result is below (purple line is the open dome estimated feedback curve). In this case, the purple limit severely limits the gains (or going above them will cause feedback). In this case, a mold is likely the optimal tip to use. It doesn't look like the M receiver is the correct choice.

Open domes are only for mild to moderate hearing loss.

You’re right. I made a terminology mistake in my post. I use medium vented domes, not open domes. I was reading the OP’s description of his open domes while writing my reply and carried “open” into the description of my own fitting.

So my successful fitting should not be taken as evidence that the OP’s open domes are appropriate for his . Your Target example makes the limitation quite clear.

The point I was really trying to contribute was narrower: as another EON user who previously used the i90 Sphere, I’ve found that the EON responds differently and that mine took several weeks of incremental fine-tuning. Changing AutoSense adaptation to Fast made a substantial improvement for me, as did small Speech-in-Calm fine-tuning adjustments.

Thanks for catching the dome distinction.

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