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Frank is in his 70's he has been wearing hearing aids for over 20 years. Frank has a severe hearing loss and was becoming increasingly frustrated with the performance of new hearing solutions his current providers were getting him to try, as he was offered more and more powerful instruments in attempt to help, he was actually finding conversations more difficult to understand.


When we first met up to assess Frank's hearing, beside the routine hearing health questions we ask we also use COSI. COSI stands for client oriented scale of improvement, it is a questionnaire that helps a client document their goals and needs quite specifically so we may revisit them during rehabilitation appointments. This tool gives us a subjective measure to improvements in the clients hearing ability.

Through the COSI questionnaire I learnt that Frank‘s great passion in life is music, he is, despite his hearing loss an active participant in his local brass band and loved classical music. Frank played an active role in his local church and longed to be able to join in conversations during coffee mornings after services as well as to take part in church group meetings.

During the test procedure it was established that there was a high probability that Frank had what we call dead regions within the cochlea of his right ear. This means that no matter how loud sound was played at particular frequencies during a hearing test or through a hearing instrument the tiny hair cells within the inner ear were to all intent and purpose dead and unable to process some particular frequencies which left sounds distorted. Frank's left ear was performing in a normal manner albeit exhibiting a severe hearing loss.


I recommended that Frank be fitted with an Audibel A4IQ Silver BiCROS, Receiver in the Canal system. It was decided that we would not attempt to amplify the right ear and try a CROS system. CROS stands for Contra Routing Of Signal, a microphone equipped device would send sound from the right ear to a compatible hearing instrument on the left ear that will pick up the sound from the right wirelessly.

In Frank‘s case the fitting was actually called a BiCROS as we were amplifying the sound from both sides. This gave Frank the benefits of directional hearing, improved quality of speech understanding in difficult listening situations and helped with his meetings at church. I also recommended that we should fit the Lithium-Ion Rechargeable version as the constant streaming of sound data from one ear to the other is extremely demanding on conventional battery technology.

We routinely use Real Ear Measurement when fitting a hearing system, this means that instead of a hearing aid fitting being based on average data, we are measuring precisely how the hearing system is performing in the ear against a highly personalised prescription.

For many clients we will often set up a hearing system with one program for the initial two week trial. We had planned at Frank‘s first follow up visit to introduce a dedicated music program, Frank brought in a CD of his favourite violin concerto. Once this program had been activated and we played the music Frank became very emotional as he had not heard and enjoyed the concerto for many years.

Frank‘s hearing aids are not top of the range instruments but it shows how by thoroughly assessing a clients hearing, their needs and expectations and then accurately fitting with Real Ear Measurement, a life changing outcome can be achieved.