Phonak Audéo B versus Starkey Muse — CROS type hearing aids for single-sided deafness — a review

© 2017 Peter Free

 

13 May 2017

 

 

A photograph showing the hearing aids' sizes

 

Phonak's Audéo B is on the left. Starkey's Muse is on the right.

 

(The circular batteries are showing because the hearing aids are in the off position. To turn them on, push the battery compartments into the hearing aid bodies.)

 

 

Here is a picture of the cases:

 

 

I like the Phonak containers (top and right) better. The Audéo B came with a home case (top), as well as a small traveling case (right).

 

Both Phonaks were arguably more practical than Starkey's one container — which is (a) too small for the accessories that you will need at home and (b) too large and too heavy to be notably convenient traveling.

 

The Starkey does have the virtue of a lid that stands upright (unsupported), which makes it easy to use the case as an "airing" container for both hearing aids.

 

 

Hearing aid expectations — a caveat

 

Severe hearing impairment is psychologically isolating, hearing aids or not.

 

 

Which system will work better for you — will depend upon the nature of your hearing loss

 

For me, Starkey's Muse hearing aid worked noticeably better than Phonak's Audéo B.

 

Were the qualities of my hearing loss different, the Phonaks might have been superior.

 

 

Is my deafness like yours?

 

I am single-sided deaf and have profound high frequency hearing loss in the remaining ear.

 

My hearing went "south" in two stages. High frequency loss developed bilaterally over decades, probably in part as a response to the very loud environments I used to work in.

 

Chronic tinnitus developed more than 10 years ago. Mine consists of a constantly very loud, seemingly high-pitched electronic whine. It sounds similar to high velocity winds whipping through high tension wires. I can hear this phantom noise even in very noisy environments. It is impossible to mask it.

 

Recently, a respiratory virus (and the immune response to it) took out the hair cells in my then better ear. Now, I can only hear very low frequencies above 90 decibels in that ear. I cannot hear words at any pitch or volume.

 

The audiogram of the hearing side — which used to be the noticeably worse ear — falls off a cliff at about 4,000 Hertz. I cannot hear high frequencies. And I even struggle with accurately interpreting some women's higher pitched words.

 

 

Phonak and Starkey — do they differ?

 

The Swiss company and the American one take opposing routes to the goal of enabling hearing-impaired people to hear better. Phonak empasizes smooth clarity. Starkey concentrates on amplification, even at the price of introducing artifacts.

 

 

We started with Phonak's Audéo B on the hearing side

 

And added Phonak's CROS aid to the deaf side. These hearing aids are actually identical, except that the CROS unit does not transmit into the deaf ear. Instead, it wirelessly sends incoming sounds to the Audéo B unit on the hearing side.

 

Although the deaf side aid's contribution will sound as if it is coming from the hearing side, it provides information that a hearing-impaired person can use to determine what is going on in her 360 degree environment.

 

For example, let's say that someone yells, "Look out!" on your deaf side. Without the CROS aid, you may not hear this. With it, you probably will — even though you will not be able to tell where the warning is coming from, without looking around.

 

In short, for single-sided deafness patients, CROS units provide a sense of surrounding spaciousness that single aids do not.

 

 

How well did the Phonak system work?

 

Not very well for me. I found that it aided me about 5-10 percent in some situations and worsened my hearing by that amount in others. Pretty much a wash.

 

At the end of weeks of testing, I concluded that I probably would not reliably wear the Phonaks. They did not contribute noticeably enough to my hearing to make the hassle of putting them in, avoiding losing them and keeping them charged with fresh batteries worthwhile.

 

The problem was that the Phonaks did not amplify sound enough to notice. Even after the (genuinely expert) audiologist had adjusted its available programs 3 times. Although the Phonaks were generally good at filtering — or at least not dominantly amplifying — unwanted sounds, I still could not hear people talking to me (across a wide range of environments) significantly better with them than without.

 

The wirelessly transmitting deaf side aid did expand my sense of being able to hear surrounding sounds. But the unamplified volume on the hearing side meant that deaf side's wireless contribution was usually drowned out by background noise.

 

 

Phonak's annoying problem with microphone direction

 

One of the Phonak's oddities was that its microphones are oriented to pick up what comes from behind and 45 degrees laterally to the wearer.

 

Imagine me as a clock face. If I am facing in the 1200 o'clock direction and wearing these Phonak aids, I can hear people at 4 and 8 much better than I can hear people at 12.

 

This was annoying. I could be sitting at a table, talking to someone either on my good side or directly opposite me, and I would hear people talking 10 meters behind me (at 4 and 8 o'clock) much more clearly.

 

No amount of program adjustment completely got rid of this problem. The audiologist told me that this is a well-known criticism of Phonak hearing aids. Their microphones are oriented in the wrong direction for most users.

 

On the other hand, being an ex-cop, I was impressed with the Phonaks' ability to warn me that someone was behind me. Some users, including me in my police days, would find this valuable.

 

 

What the Phonaks did well

 

Phonak's emphasis on filtering stray sounds is impressive. The only way to fully appreciate this is to use Starkey units immediately after testing the Phonaks.

 

For example, the Starkey units pick up (and amplify) wind noise across a surprisingly full portion of the circle around us. This amplified sound also becomes a roar. The Phonaks, in contrast, are vulnerable only in a very narrow portion of the circle of sound. Move my head slightly, and the Phonaks' wind noise completely disappeared. And because the Phonaks are not much amplified, wind noise is more subdued.

 

 

Phonak Audéo B — my overall impression

 

Even with the Phonak units cranked up in amplification, I had to strain to hear people in most of the situations that we face every day. With the Audéo B system, even in watching television in a quiet room, I noticed no improvement in either volume or clarity. And, talking to people, I too often had to "speech read" to get the gist of what they were saying.

 

In restaurant-like situations, I almost never could hear someone directly across the table. And I even had to strain to hear someone immediately adjacent to my hearing side. Noisier social situations (like work gatherings and large parties) were hopeless. This last was also true of the Starkeys.

 

 

Starkey Muse

 

Even with their obvious flaws, the Starkey Muse aids worked better for me than the Phonaks had. With the Starkeys, I immediately noticed that I did not have to focus on my audiologist's mouth when she spoke. I could take my eyes off her and still comprehend what she was saying.

 

They key here is the Starkeys' more noticeable amplification of sound.

 

This amplification works well in quiet environments. But when things get noisy, it becomes almost impossible to filter out what I want to hear from what I do not. In loudly busy situations, the Starkeys are just as useless as the Phonaks were.

 

 

A telling contrast

 

I got the full effect of this difference between the two manufacturers, while walking adjacent to the Air Force fighter base "Flight Line" where the audiologist's office is:

 

 

The Phonaks kept the aircraft takeoffs within a reasonable range of volume. I could still distinguish some lesser sounds around me.

 

The Starkeys, however, created a universe of impenetrable, shrieking sound the eliminated any ability to tell what was where.

 

It is not that the Starkeys endangered my hearing during these fighter jet take-offs. The Muse system cuts volume off, when it approaches damaging levels. But the Starkeys' amplification before reaching that point makes the world almost unrecognizable.

 

Walking along a busy street, while wearing the Starkeys, creates a similarly jumbled and overwhelming sensation. It takes a bit to get used to this. That trait made me recognize that amplification has significant drawbacks, even for me.

 

 

The very nice thing about the Starkey Muse system is that its amplification is easily adjusted through a widely useful range, unlike the Phonaks. Even though it is possible to make the Starkeys way too loud, one can tune them to a workable balance.

 

You can also order a wireless volume control (called a SurfLink) for the Starkey units. This remote allows the wearer to change volumes — or mute — as desired. The remote features a "home" button, as well. Pushing it adjusts the hearing aid(s) back to the most often used program and volume setting.

 

 

Programming the hearing aids

 

Both these aids allow an audiologist to program three sound-response patterns. In my case, we programmed both brands for normal, tinnitus-masking and "restaurant" settings.

 

The tinnitus masking programs work by injecting white noise into the hearing ear. My tinnitus is so loud that neither program worked. White noise in both brands had to be amped up so much for me even to notice them, that the audiologist could hear the masking working from 2 meters away.

 

Drawing attention to oneself in this fashion is not something that most hearing aid wearers are going to want. However, if your tinnitus is less loud than mine, these programs might work for you. I kept the tinnitus masking program because, although it is worthless for its intended function, it changes the quality of incoming sounds just enough to be occasionally useful in frenetic, jumbled sound settings. The program appears to take the abrasive edge off some noises in loud environments.

 

Restaurant programs on both brands are intended to suppress sound behind the wearer in favor of sound in front. Neither brand's restaurant setting works particularly well. But both were just good enough to make a subtly appreciable difference in a limited number of situations.

 

 

A note on fit

 

The in-ear "domes" on the Phonaks fit me much better than the Starkeys. The Starkeys' hearing side dome kept coming out of the hearing side's ear canal. I had to reinsert every 10 minutes.

 

We eventually put a bulky retainer on it, like this one:

 

 

These rather noticeable retainers work well, even though they cause some ear cartilage pain. The tradeoff between much improved retention and cartilage ache is worth it. From the visibility standpoint, I don't mind being labeled as hearing impaired. It saves me from having to tell people.

 

 

Expect no miracles

 

Accept that hearing aids cannot fix profound hearing loss. Even with the Starkey units, I am lucky to hear and properly interpret about 15 percent of what's going on around me, across a wide range of daily environments.

 

Severe hearing impairment is psychologically isolating, with or without hearing aids.

 

 

Another point — relearning sounds

 

Single-sided deafness and/or profound hearing impairment can also inject a selection of constantly changing phantom sounds. This means that I spend a significant amount of mental effort trying to figure out (a) what I'm hearing, (b) where it is coming from and (b) whether it's real.

 

If I cannot see what produced a sound, I have to spin all the way around to try to locate it. This is humiliating. And I cannot begin to enumerate the times that I've had to tour the house to see whether something I hear is actually there.

 

Two of my phantom sounds, for instance, have been (i) a radio baseball announcer's background drone and (ii) a broken water pipe. Throw in a surprisingly wide and constantly evolving array of clicks, snaps, buzzes, musical notes and other voices —and you have a recipe for constant pondering.

 

This confusion even spills over into identifying sounds that one would think I would recognize. Some of these sounds change character over time, hearing-aided or not.

 

The Starkeys' distortion just throws in another layer of complexity. Water from a faucet, for instance, sounds like a stream of fragmented glass. The Phonaks did the same thing, but to a lesser degree. You may find (like I do) that there are audible nuances to your footsteps and paper crinkling — among many other things — that you have never heard before.

 

 

The moral? — As of late May 2017 —  if you need noticeable sound amplification, the Starkey Muse system tops Phonak's Audéo B

 

Both brands worked better for me in comparatively quiet situations. Introduce significant noise or background babble, and interpreting speech becomes hopeless. In those situations, if I cannot see someone's mouth, I cannot even begin to interpret what they've said.

 

If you only need assistance with improved speech clarity, the Phonaks are probably a better choice. So too, if you need to hear someone behind you.

 

That said, the Starkeys' enhanced amplification slightly improved my ability to hear in just enough situations to make choosing them over the Phonaks an easy choice.