Reverse-Slope Hearing Loss | Hearing Aid Treatment SUCCESS!
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- Опубліковано 30 чер 2024
- Reverse-Slope Hearing Loss | Hearing Aid Treatment Problems & Solutions. Dr. Cliff Olson, Audiologist and founder of Applied Hearing Solutions in Phoenix Arizona, discusses why it is so difficult to treat Reverse-Slope Hearing Loss with Hearing Aids and what you need to do to achieve treatment success.
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I have RSHL, and it's very frustrating for me. At my work, we have a hearing center, and have tested me with hearing aids. All they do is make everything sound like I'm underwater, and they told me there really isn't much they can do for me. It's difficult for me to hear on the phone, radio, some people talking, which has been causing issues at work. People thinking I'm ignoring them, get annoyed if I ask them to repeat, and not being able to understand them at times. Thank you so much for explaining this, and giving me some sort of hope on being able to treat this.
We are 3 generations with RSHL. My daughter’s hearing is the worst, and she refuses to wear her hearing aids. I never understood why until this video. Thank you for this incredibly helpful information.
I always felt like my hearing sucked, and used to complain all the time. Audiologist constantly tested me and said I was fine but my hearing only kept getting worse. Felt like everyone around me was speaking in incomprehensible vowels all the time.
Got diagnosed with ADHD at 12, and family+school refused to test me for hearing loss after that and blamed it all on focus. I stopped bothering to try and get help for it, because as part of my ADHD accomodations, I was placed in the front of the class and could finally hear the teacher clearly.
Had to put on subtitles for all media starting at the age of 14, and wasn't able to understand virtual lessons unless they had subtitles, and found myself getting headaches when I needed to try and understand someone whose back was facing me or who was calling me from their phone.
I did an online hearing test with an audiogram, and it suggested moderate to severe hearing loss in my right ear and mild to moderate in my left. Now, I don't trust my ability to calibrate technology at all, and the internet isn't always accurate with these sorts of tests.
But what I found strangest and what's driving me to see an audiologist is that my audiogram looked nothing like an n/rainbow shape. It was instead a very distinct / shape, showing I was struggling to pick up lower frequencies.
Hoping that now, as an adult, I can finally get some answers from audiologists. Maybe it's hearing loss, maybe it's APD, maybe it's just earwax 🤷♀️ but I'm just so desperate for answers at this point.
My RSHL went under the radar for years because of my own ADHD diagnosis. I thought I was going insane, so finally getting a diagnosis was a massive relief. Hope things went well for you.
I have one friend who has Reverse Slope hearing loss but I didn’t really understand what my friend meant by that. You explained all that clearly and now I understand better what my friend was trying to say. Very interesting.
Another great video. When treating this type of loss i also take into account the upward spread of masking. Too much low freq sound masks out high freq sound
Hi Dr. Cliff
Can all the major brands of hearing aids be programmed for RSHL or are some better than others?
John
Hey Dr Cliff
I've just gone from a power speaker with power dome to a custom mould fitting and want to know about changing the receiver filter if it fills with wax which is a problem I have. With the power dome it was easy maintenance. The custom mold allows me to hear without distortion or feedback.
Hi Dr. Cliff, do you know of any reverse slope hearing loss simulations or ways to simulate the same kind of hearing loss to family and friends?
Thank you for this video. I have reverse slope hearing loss. I struggle with my hearing aids and it sometimes leads to frustration. I just want to hear. I need to a better job communicating with my audiologist. Apparently there is customization needed for my special gift.
Can you please suggest hearing aid and modal for low frequency hearing loss ?
I have RSHL and it's hard. Are there any hearing aids that you recommend?
Hi,
I have a -30 db low tone loss, but I don't know if they will be helped with hearing aids, I think that It would especially during school, do you have any thoughts on this
What about the reverse hearing loss treatment without hearing aids? Is it possible to stimulate the hair cells in cochlear with low sinus tones from 50Hz up to 150 hz? I compose music and this is a disaster for me, I have a hearing damage on low frequencies.... I would do anything to recover my hearing. I have checked which frequencies I have exactly 'damaged. I am able to pay 100000 USD for hearing recovery if it could be possible.
Dear Dr. Olson,
Have you ever made a video in which you compare the mobile apps related to the various hearing aid makes? If not, that might be an interesting topic to consider. If you have, please let me know when it was published so I can find it.
I did about a year ago. Search on my channel for videos that have App in the title.
In my case, open fit, NAL-NL1 done with REM plus further reducing lows yielded best comprehension
Everyone who saw me insisted that I have to have closed mold. That yielded significantly lower comprehension. Because of distortion. Don't know for sure if from upward spread of masking or cochlear dead regions or something else.
But working together with a fitter who wants to really help me, was really important. I was open to his suggestions, he was open to mine (my idea was open fit and NAL-NL1, we tried NAL-NL2 and DSL V, too much lows, too much distortion)
Thanks for raising awareness!
I thought that cookie bite is the hardest to fit?
You could make the argument either way between Cookie Bite and Reverse-Slope being the toughest. I notice that most cannot go with a completely closed mold as well. Good idea going with a NAL-NL1. Virtually anything is worth a shot with RSHL. Glad your provider was awesome enough to spend the time to figure it out!
Hey Dr Cliff, I believe I may have reverse slope hearing loss, as several online audiograms state I can hear 250 hz at 30 db, 500 at 20 db, and the rest are at 10 or less. I also have recruitment since loud sounds bother me severely. I feel as if people only speak to me in s sounds and wonder if I will need hearing aids. Please get back to me if you can. Much appreciated
Hi Dr Cliff. Thank you soooo much for this video! Last December I developed SSNHL in my left ear due to a head cold plus conductive loss due to fluid in my ear and an ear infection. I was finally diagnosed with RSHL this April. Do you have any suggestions for a professional violinist who has developed recruitment? I teach students and their playing hurts my left ear. Nor can I play without an ear plug, further lowering my ability to hear clearly hearing my violin tone. My hearing in the low frequency range slopes down to 60 dB. My audiologist just ordered a top-of-the-line Starkey as that HA sounded the most natural of the three I trialed.
I am also a musician with reverse slope sudden loss (although bilaterally, with the worst being around 45 db). Did you end up having a positive outcome?
Hello , I also a have this Sam issue. Have u got any solution
Im trying to figure out if tmj can cause high frequency loss or sudden hearing loss?
My right ear exposed to hi frequency loud sound, now can't hear low frequency, what are the treatment for the hearing prop
Hlw Dr.Cliff This is Abhisek Laha, your regular youtube follower and fan..I am facing automatic ear locking and hyperacurasis problem and can't listen a certain thing in a particular freequency tone.I often have to increse volume....Sir can you suggest what is exact problem of these symtoms?? I will be waiting for your kind reply.....☺
Hi, I have one ear with normal hearing and one ear with reverse slope hearing loss and hyperacusis. The problem is sensorineural and happened overnight. Maybe my experience will be helpful to you. My bad ear can't hear very low frequencies at all, but can hear high frequencies very well. Intermediate frequencies (on the slope) sound extremely loud and distorted to me. Even quiet sounds at these frequencies are extremely stressful and borderline painful. I believe it is because hair cells in my cochlea are damaged, maybe Dr. Cliff can explain that more. I didn't expect a hearing aid to help me, but it did! I use a custom ear mold to basically prevent any sound from entering my ear normally. A behind the ear hearing aid picks up all sounds, but it is adjusted to only reproduce high frequency sounds, over 2 kiloHertz. It has given me back my life!!! Wearing the aid has given my brain and me a break from the stress of hyperacusis. I can finally go for walks, to stores, and (after Covid is under control) to restaurants and movie theaters. Plus, I can understand conversations better now, because I can listen with my good ear, without struggling to ignore horrible loud sounds from the bad ear. I hope you find a solution that works well for you. Good luck!
Hi I m 25 years old I m not able to listen low sound and what can I do can I go for operation or for hearing aids because I m very much disturb not concentrate on study also can u suggest some suggestions
Hey Doc! You got any more news on frequency therapeutics and their drug FX-322? I haven't heard or seen much from them as of recently but I'm still hopeful in their work to create A cure for SNHL/NIHL
The Clinical Trials are still progressing despite Covid. Not sure we will have results by the end of the year or not. It is still possible.
I have RSHL. I’m using a tulip dome. Do you think it would be better a costume-made dome with a vent?
Possibly, just depends on your personal preferences.
I heard an low echo in my one ear while watching tv what is the cause for this
I’ve struggled in my search for a hearing aid that works for me. The absolute best sound quality for my RSHL was the Phonak Lyric. Unfortunately my ears did not tolerate them well. The 2 others that I tried did not come close to the Lyric hearing improvement wise. Do you have any suggestions?
What issues were you having with the aids you tried?
Think about the aid you want but also think about the type of audiologist you want. Service orientated or sales orientated
Is it normal for hearing to roll off at about 60 Hz, with 20 Hz being almost inaudible?
Is it still considered RSHL if it’s the low and mid frequencies that are bad, then in the high frequencies (around 4k) it raises to mild? (In the video it said the low frequencies are bad and it slopes up in the mid frequencies)
There are different levels of Reverse-Slope hearing loss. It is possible for the "better" threshold regions to still have a hearing loss like you indicated.
Super interesting and helpful. I have reverse slope hearing loss and my audiologist was basically just like ¯\_(ツ)_/¯ It’s good to understand why it’s so difficult to treat with hearing aids.
Mine is not currently “bad enough” to pursue further but I have a terrible time with deeper voices, especially men with accents, in crowded rooms (nsm a problem right now, thanks Miss Rona), or...over the phone or web conference. This one could be a big problem given I’m working remotely right now, but funnily enough, since everyone pretty much has their own mic instead of gathering in a big room over speakerphone, it’s actually a little better than it was before.
I end up having the experience that someone hears the train coming nearly a full minute before I do, but when my mom’s oven gives a faint, high-pitched ding from the other room, I can let her know that dinner is ready! I once got into a fight with my mom over how annoyed I was by a running toilet, when it finally turned out that I had no idea she couldn’t hear it, and she had no idea that I could!
So funny your comment about the toilet.
My husband recently changed parts in our toilet. I told him it now ‘runs’ every minute or so.
Well, he told me today, while we were standing in the bathroom, that he fixed the toilet. And it was “running” while he was saying that! HE couldn’t hear it run standing right next to it but I could! 😂 (I also have RSHL).
My hearing loss is the opposite of what you explained in your cookie bite video, where my lows and highs are moderate/severe but the mids are in the normal range. Is there a term for this or would it still be considered cookie bite loss?
Called - Reverse Cookie Bite You can Google it.
I have perforated eardrum for almost 4 years. Is there any treatment for this? My doctor said that it was only about 10%.
In some cases, an eardrum can be surgically repaired.
Any HAs you guys recommend for rshl?? I have Oticon Opn1
Wow , I have reverse slope hearing loss and u told exactly that I feel. I’ve been using Oticon OPN1 for a couple years now . I’ve gotten it set according to REM that you mentioned . I use a hadd mold with a vent too . Is there any better newer technology than these Oticons yet ? Any other HAs u suggest that might be better ?
Thanks in advance Doc !!
Great video. A fourth complication with reverse slope loss fittings that wasn’t mentioned is upward spread of masking, but this is a more complicated topic and would add several minutes to your video just to explain. But it also helps to account for why RS patients generally prefer more mids and highs and less lows than you would expect.
So a suggestion to follow up this video would be to discuss USoM and how it can affect fittings-yet another reason why REMs need to be completed.
On another note, I’ve often suggested that the researchers at the National Acoustics Labs (NAL) come up with a fitting formula specifically for RS losses. Call it NAL-RS. It could be worked into software and applied as needed, effectively fitting them better than NAL-NL2 since that’s more oriented towards traditional HF sloping losses.
Thanks Scot! I should have included USoM, however, as I edited this video I'm glad I didn't. I found this video to be potentially difficult for the average viewer. However, USoM is one of my most favorite topics and I agree that it needs it's own video! Love your idea for a specific NAL prescription of RSHLs. Who do we know that works at NAL now?
@@DrCliffAuD USoM would be a lot of additional to cover in this (agreed). It's enough of a topic by itself, and would be a great one to cover from a lot of angles -- like why REMs need to be done, why basic amplifiers can actually make clarity worse than better, etc.
I would definitely be interested in a video explaining the upward spread of masking! Also, someone in a RSHL Facebook group Im part of mentioned cochlear dead zones being suspected with low frequency hearing loss. Can you explain why that is and how you would find it using Audiometry?
Hi Dr. Cliff
I am 37 years old and have a hearing loss in my left ear only since childhood. My audiogram shows reverse slop hearing loss from low to high ( ac 70 - 30) and as per the doctor my hearing loss is mixed problem( bones and nerve ) .. I’ve visited 2 hearing centers and each one recommend different hearing aid type (1st recommend cic (star key 3 series) and the other says that customize hearing aid are not possible for my case and he recommend only models with receivers such as RIC.. i’m confused and i feel it hard to choose specially that i want to go for an option that is not visible as much as possible. Looking for your support and recommendation
Thanks
Ahmed alajmi
It would be hard for me to make a specific recommendation without a full consultation.
Doctor Cliff, AuD .. Kindly let me know how we can do an online consultation if it is possible
Thanks
this is only about hear aids....
i hope this is fixable without the hearing aids that has to go in my ear....
just a week ago i was at night awake i just had a ITCH in my ear put my finger in my hear and when i put it out my ear i heard a loud POP noise witch was painful for moment and now i realize that i start to have difficult hearing from bellow 80hz
Now i just have to accept that my right ear is destroyed just because of my finger of doom?!?
What if you have mild hearing loss in your left ear but still hear pretty good out of it? My left ear dropped to 35db at 250 frequency and 30db at 500 frequency where my right ear was 20 and 10.
But I can still pick up sound and bass from songs, talk on the phone find out if that ear, I mean I can hear background noise good and what direction it’s coming from etc. like I can hear pretty good out of it, only thing I’ve been experiencing is this pressure and fullness sensation and low pitched ringing sensation, or ringing from the pressure I don’t know how to explain it. It’s not high pitched ringing and it does ease up at night it seems like. I’ve also noticed sensitivity to some sounds like scratching the wall I can feel it in my ear, closing lids hard I can feel it, sometimes my voice or other peoples voice I can somewhat feel it in my ear as well… it was worse at one point, but has improved atleast gradually. The humming test I have a hard time distinguishing which ear is better, most of the time it feels equal and other times maybe slightly louder in my right ear?
My symptoms at one point were pretty intense with the pressure and sound coming from my ear, that’s really the only time I notice a little difference in my hearing? When it eases up it almost feels normal. But it seems like for a week now my symptoms have gradually improved? Not 100% but better than it was gradually.
I’ve been getting treated for middle ear fluid for about a month and half now, and been dealing with these symptoms on and off for 2 months exactly. I haven’t had vertigo or any other serious symptoms, just the pressure and fullness and low pitched ringing. I got sick with a bad head cold and congestion, stopped up, sinus headaches etc and lasted for like 10 days ATLEAST and somewhere between the 7th and 14th of November I woke up and noticed my left ear just felt like, full? Pressure? And that sound (low pitched ringing or whatever) thought maybe I just slept too long on that side and all that mucus and congestion went to my ear, and I just kinda shook it off because I’ve dealt with this similar experience in my right ear years ago and it got better over time so I didn’t really think anything of it, well November 28th was my first visit at this clinic and that’s when I started getting treated for middle ear fluid and slight mild infection idk. Never would have thought of hearing loss, never would have crossed my mind. I don’t do anything to super loud excessive to cause damage, I don’t have any diseases. But maybe it was whatever virus attacked my sinuses I have no idea. Maybe my body is just taking longer to heal and get over this.
Just curious if anybody out there has dealt with similar symptoms that I’m dealing with and if they think my situation will get worse or these sensations in my ear will last forever??? It’s been 2 months now and my symptoms haven’t gotten worse, I mean for a while it seemed like it was on a routine, where it would ease up at night and then flare up bad when I wake up and midday.
If anything like I said maybe some slight gradual improvement.
How are things now? I am also having similar hearing loss
Dr. Cliff, do you see patients remotely? I’m not quite sure hearing loss in my family is Reverse-Slope. Last time I checked, hearing is almost normal on high and low pitches, but not in the middle, which constitutes speech. Maybe this type of hearing loss doesn’t apply, but your recommendation for the patient to make adjustments via an app and testing various domes is appealing and self empowering!
If your middles are missing, that's called cookie bite loss. If that helps for searching for more information :)
Ines C thank you! Never heard of cookie bite loss!! I’ll Google it!
Ines C is correct, it sounds like you have a Cookie Bite Loss. Fun Fact: I have a Cookie Bite Loss as well. I will likely make a video discussing Cookie-Bite in the next few months.
Doctor Cliff, AuD can you work with me remotely? I’m in Chicago. Pretty please!! If not possible, can you please share what hearing aid you’ve selected for your own cookie bite hearing loss? This would help me to research.
Hi Dr Cliff
This was really interesting for me I have RSHL and have struggled immensely to get the HA profile adjusted to my liking. REM was helpful but did not provide the perfect solution for my Oticon Open S 1 with closed domes, grip tip.
The three program options in the Oticon App do not provide any ability for self adjusting any frequencies.
Do you know of any Oticon compatible app which has a type of equalizer similar to the one you show in your video?
Oticon would not be my first choice because their ON App does not give you access to an equalizer. The use of REM is more to measure your preferences based on App adjustments. Otherwise, virtually any prescriptive method over-amplifies Low Frequencies.
What about the correct level of the receiver? Normally this kind of hearing loss need more power...
It is possible that receiver power could be a factor, especially if the individual prefers more Low-Frequency amplification.
Is there a name for a "U" shaped curve, ie bad midrange? That's what mine looks like for both ears and apparently I've had it all my life. Is the treatment different for this too?
That is called a Cookie Bite Hearing Loss. I actually have a weird Cookie Bite Loss in my right ear. It is on my schedule to make a video discussing that loss as well. Stay tuned!
@@DrCliffAuD Thank you! Looking forward to watching it.
@@DrCliffAuD sir I have A normal hearing but Everytime I just think of it but why is my tinnitus so loud instead of a 14db hearing
I need your personal help Can u help me?
I have sudden sensorineural reverse slope hearing loss in one ear, and I have moderate hearing loss in the range of just under 3000Hz to the upper limit (ski-slope) in both ears. AND I am a professional classical musician. Now what? My mid-range hearing is OK.
Could you confirm which app is featured on this clip?
Hi
It's the myPhonak app.
I've been using it for 3 days so still getting used to it. Keeps losing connection to my aids (Marvel 90). The app is good though and I can play around myself which I like. I have reverse slope and the Autosense setting that the app defaults doesn't seem to help me but the ability to change settings myself is very good.
Yes, it is the updated MyPhonak App. I find the stability of the app to be less than ideal, but the goal is to use it to identify your preferred frequency response so we can measure it with REMs and adjust your AutoSense settings or create a stable custom manual program for you to use.
Is it possible that patient is having low frequency conducive hearing loss
Yes. This is not unusual with otosclerosis.
I like your videos but some of the information is very technical and hard to grasp when spoken so quickly. Especially for us hearing impaired. (BTW, I have Bilateral Reverse Slope with distortion so my speech perception is not good.) I was very impressed that you even addressed this rare problem of reverse slope loss.
Hi Tzippi. I was concerned that this topic would be a tough one to explain clearly. As I was editing, I was thinking that it could be difficult for some to follow. I actually had to record it twice because my first attempt did not go very well. Hopefully you still got some value out of this one even though it wasn't my best work.
You can adjust the speed of the video in the settings
A) "hearing impaired" is offensive, and b) adjust the speed of the video
@@dancingpianofairy why is it offensive? What do you suggest. Speed adjusting doesn't help everyone, especially me
@@tzippipollock1937 It focuses on what people can't do. I suggest hard of hearing.
I have a conductive RSHL. Which kind of hearing aid are best in my situation? I have tried Oticon Ponto on a softband, but that didn't work for me.
You are going to have to try several different kinds of hearing aids, and have a competent audiologist to program them to find out what’s best for you. One who listens to your feedback. For myself Phonak Lumity with vented domes work pretty well, but that’s just me.
Advanced hearing care LISA HUDSON. My hearing aids.the name of them is Starkey. My doctor told me real ear measurement was not necessarily he said they used to do that but not anymore my hearing is 55%
Lost in each ear.I have had them for 1 year and a half
The name of my hearing aids are muse i2000.
What do you think about the
Situation.
Hi Mr. Greene, I in no way want to speak for Dr. Cliff, but REM is ultimately the only way for us providers to "guarantee" that we are amplifying you to the correct levels that are needed based on your audiogram and the anatomy of your ear canal. No 2 ears canals are the same so REM is what's needed to ensure you get the most benefit from your investment into your hearing health.
Chenal Hearing, I couldn't say it any better myself. Feel free to speak for me anytime! 😉
It can be difficult to diagnose a reverse-slope hearing loss without a hearing test, because people with reverse-slope hearing loss can often understand speech well.
oohh so that's why I have a 100%-word recognition score, but I have a moderate mild reverse slope loss (hole in eardrum)
It sounds much clearer than hearing with a moderate high frequency sensorineural hearing loss.
Thats what I have.
Bera shows severe to profound hearing loss but audiometry shows less loss
Chad always wins.
Menieres does NOT always have reverse slope graphs !
Otosclerosi