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Advices for mixing with hearing loss

matthieuL

matthieuL

Active Member
Hello,

I'm 45 and had recently a sudden hearing loss, at right only. The consequence is a difficulty to mix instruments and have a good stereo balance.

If anyone is like me, would you have advices ?

I think I have to mix only on headphones and apply an EQ at right to compensate my lost frequencies.
But I don't know how to establish a precise and reliable audiogram (the one done by my doctor is not precise). Is there a good plugin out there ?
Then, how to EQ ? I fear to boost too much the lost frequencies and the frequencies around them.
Click to read more...
 
(I should add that I have SoundID/Sonarworks, so a presumably flat response from my headphone, which is a requirement to produce my hearing response curve)
 
I recently had a barotrauma event while scuba diving and will be in the same boat. For now it's not even possible for me tolerate music on the TV, much less expect to mix anything. But I will find a way. It may not be as golden-eared as it used to be, but you can come to understand your hearing loss and compensate. it will not be as enjoyable to listen to anymore probably
 
matthieuL said:
I'm 45 and had recently a sudden hearing loss, at right only. The consequence is a difficulty to mix instruments and have a good stereo balance.
Click to expand...

Sorry to hear.

I work in a hearing clinic and have seen several individuals with sudden sensorineural hearing loss in one ear. Often the cause is unknown (ideopathic), but attributed to viral infection of the inner ear. Other things can cause sudden changes in hearing, such as...

Dewdman42 said:
I recently had a barotrauma event while scuba diving and will be in the same boat
Click to expand...
...but in this case the cause is known.

Noise-related hearing damage is anther things to be aware of (when using machinery, or listening to music at loud levels for extended periods of time, etc.)

matthieuL said:
I think I have to mix only on headphones and apply an EQ at right to compensate my lost frequencies...Then, how to EQ ? I fear to boost too much the lost frequencies and the frequencies around them.
Click to expand...
In principle, what you are describing is how hearing aids are set up to accommodate for a hearing loss; however, they are designed specifically for this (and also include compression with multiple knee points, limiting and individual settings across multiple frequency bands). What you are describing may be possible with headphones depending on the degree of loss; however, if the degree of loss is great, you may be boosting quite a bit and causing distortion in the transducer as a result. Something like Cubase's Control Room allows you to put an EQ in the monitoring path, for example.

Also, the residual hearing you have after a hearing loss means there is smaller dynamic range you have to work with. What I mean is that if you arbitrarily picture hearing ability from 0-100, if you lose hearing (now your hearing is from 40-100) your overall range has decreased as the maximum loudness you can tolerate does not move (it is still 100). The practical effect of this is that you are squeezing the sensation of "soft", "medium" and "loud" into a smaller dynamic range, so it will feel a bit different that having full-range typical hearing.

But I don't know how to establish a precise and reliable audiogram (the one done by my doctor is not precise). Is there a good plugin out there ?
Click to expand...
Audiograms are pretty standardized, but they are relatively coarse and band-limited, as least with respect to the frequency range you will find in music.

Standard hearing-test frequencies are (in Hz): 250, 500, 750, 1000, 2000, 3000, 4000, 6000, 8000

Some clinics will have ultra-high-frequency testing that extends to ~18000 Hz, but most clinics will not do that at is has no real utility when working with hearing aids. Keep in mind that hearing clinics are focused primarily on communication, which is largely encompassed in the range of frequencies outlined above. I have never personally seen anyone test lower than 250 Hz

Standard difficulties that accompany unilateral hearing losses are (a) localization of sound, as interaural time and amplitude cues are thrown off due to the imbalance between the ears, (b) listening in the presence of background noise, as the brain has a natural ability (referred to as "binaural squelch") that helps suppress noise when receiving signal from both ears.

As an aside, I would recommend anyone experiencing a sudden loss of hearing to treat it as an emergency. Often emergency departments or otolaryngologists (Ear Nose and Throat specialists, aka ENTs) will have a sudden-sensorineural-hearing-loss protocol which involves steroid injection (through the eardrum). The window to treat this is quite small, so the sooner you look into it the better chance you have of recovering some degree of hearing, though there is often some hearing loss that remains. It is a bit hit or miss as to how effective this type of treatment will be, but the sooner the better in most cases.
 
Tom_D said:
Sorry to hear.

I work in a hearing clinic and have seen several individuals with sudden sensorineural hearing loss in one ear. Often the cause is unknown (ideopathic), but attributed to viral infection of the inner ear. Other things can cause sudden changes in hearing, such as...


...but in this case the cause is known.

Noise-related hearing damage is anther things to be aware of (when using machinery, or listening to music at loud levels for extended periods of time, etc.)


In principle, what you are describing is how hearing aids are set up to accommodate for a hearing loss; however, they are designed specifically for this (and also include compression with multiple knee points, limiting and individual settings across multiple frequency bands). What you are describing may be possible with headphones depending on the degree of loss; however, if the degree of loss is great, you may be boosting quite a bit and causing distortion in the transducer as a result. Something like Cubase's Control Room allows you to put an EQ in the monitoring path, for example.

Also, the residual hearing you have after a hearing loss means there is smaller dynamic range you have to work with. What I mean is that if you arbitrarily picture hearing ability from 0-100, if you lose hearing (now your hearing is from 40-100) your overall range has decreased as the maximum loudness you can tolerate does not move (it is still 100). The practical effect of this is that you are squeezing the sensation of "soft", "medium" and "loud" into a smaller dynamic range, so it will feel a bit different that having full-range typical hearing.


Audiograms are pretty standardized, but they are relatively coarse and band-limited, as least with respect to the frequency range you will find in music.

Standard hearing-test frequencies are (in Hz): 250, 500, 750, 1000, 2000, 3000, 4000, 6000, 8000

Some clinics will have ultra-high-frequency testing that extends to ~18000 Hz, but most clinics will not do that at is has no real utility when working with hearing aids. Keep in mind that hearing clinics are focused primarily on communication, which is largely encompassed in the range of frequencies outlined above. I have never personally seen anyone test lower than 250 Hz

Standard difficulties that accompany unilateral hearing losses are (a) localization of sound, as interaural time and amplitude cues are thrown off due to the imbalance between the ears, (b) listening in the presence of background noise, as the brain has a natural ability (referred to as "binaural squelch") that helps suppress noise when receiving signal from both ears.

As an aside, I would recommend anyone experiencing a sudden loss of hearing to treat it as an emergency. Often emergency departments or otolaryngologists (Ear Nose and Throat specialists, aka ENTs) will have a sudden-sensorineural-hearing-loss protocol which involves steroid injection (through the eardrum). The window to treat this is quite small, so the sooner you look into it the better chance you have of recovering some degree of hearing, though there is often some hearing loss that remains. It is a bit hit or miss as to how effective this type of treatment will be, but the sooner the better in most cases.
Click to expand...
Many thanks for this detailed reply.
I second your warning to treat as an emergency a sudden hearing loss. I myself didn't do that, and regret it. The treatment I took probably too late hadn't any effect !
 


You'll want something like this, and the ability to swap L+R quickly. Not ideal obviously but you should be able to get work done. Having a second person check over your mix is probably necessary.

I'm don't think I'd try to self correct one side too much, it's a bit of a rabbit hole. You'll constantly be adjusting as your perception of frequencies changes hourly. That's not unique to your situation, but since you're going to be hyper conscious of how your right ear is performing you will get sucked out of "work mode" and into "adjust ear freqs" mode too often.
 
Tom_D said:
I would recommend anyone experiencing a sudden loss of hearing to treat it as an emergency. Often emergency departments or otolaryngologists (Ear Nose and Throat specialists, aka ENTs) will have a sudden-sensorineural-hearing-loss protocol which involves steroid injection (through the eardrum). The window to treat this is quite small, so the sooner you look into it the better chance you have of recovering some degree of hearing, though there is often some hearing loss that remains. It is a bit hit or miss as to how effective this type of treatment will be, but the sooner the better in most cases.
Click to expand...
I didn't know this, and thanks for sharing this info. It seems very helpful.
 
QuiteAlright said:
I didn't know this, and thanks for sharing this info. It seems very helpful.
Click to expand...
Many don't. I have met a number of people who had sudden hearing loss and thought "I'll just wait it out". Then nothing changes and I see them weeks or months later for hearing tests and hearing aids.

With all that said, I'll reiterate that the treatment for this can be hit or miss in its effectiveness, and the specific type of treatment or combination of treatments is not necessarily standardized or fully fleshed out in its known effectiveness.

e.g. here are a few copied and pasted excerpts from this review (Published online 2022)...

www.ncbi.nlm.nih.gov

Intratympanic corticosteroids for sudden sensorineural hearing loss

Idiopathic sudden sensorineural hearing loss (ISSNHL) is common, and defined as a sudden decrease in sensorineural hearing sensitivity of unknown aetiology. Systemic corticosteroids are widely used, however their value remains unclear. Intratympanic injections ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

"Background

"Idiopathic sudden sensorineural hearing loss (ISSNHL) is common, and defined as a sudden decrease in sensorineural hearing sensitivity of unknown aetiology. Systemic corticosteroids are widely used, however their value remains unclear. Intratympanic injections of corticosteroids have become increasingly common in the treatment of ISSNHL."

Authors' conclusions​

Most of the evidence in this review is low‐ or very low‐certainty, therefore it is likely that further studies may change our conclusions.

For primary therapy, intratympanic corticosteroids may have little or no effect compared with systemic corticosteroids. There may be a slight benefit from combined treatment when compared with systemic treatment alone, but the evidence is uncertain.

For secondary therapy, there is low‐certainty evidence that intratympanic corticosteroids, when compared to no treatment or placebo, may result in a much higher proportion of participants whose hearing is improved, but may only have a small effect on the change in hearing threshold. It is very uncertain whether there is additional benefit from combined treatment over systemic steroids alone.

Although adverse effects were poorly reported, the different risk profiles of intratympanic treatment (including tympanic membrane perforation, pain and dizziness/vertigo) and systemic treatment (for example, blood glucose problems) should be considered when selecting appropriate treatment."
 
matthieuL said:
Hello,

I'm 45 and had recently a sudden hearing loss, at right only. The consequence is a difficulty to mix instruments and have a good stereo balance.

If anyone is like me, would you have advices ?

I think I have to mix only on headphones and apply an EQ at right to compensate my lost frequencies.
But I don't know how to establish a precise and reliable audiogram (the one done by my doctor is not precise). Is there a good plugin out there ?
Then, how to EQ ? I fear to boost too much the lost frequencies and the frequencies around them.
Click to expand...
Have you tried boosting the right monitor to compensate for the volume loss, or is it only specific frequencies affected?
 
For about 7 years now, I've had asymmetrical hearing. It's not extreme, but still impacts my workflow. After a sinus infection moved into my right ear, it lost about 2-4 db of volume plus the ability to hear anything above 6khz. That, coupled with tinnitus in that same ear, plus general hearing damage from years of loud rock 'n' roll abuse during my youth, and natural hearing deterioration due to age, means my hearing is pretty f***ed up. But that hasn't stopped my ability to make music and commercially viable mixes.

In terms of volume imbalance and stereo image, I shifted my position so I sit closer to the right monitor. But honestly, if the overall mixing volume is loud enough, there's enough sound in the room for me to evaluate the stereo image from the normal mid position.

I use headphones only to check mixes, and flip the image as others have suggested. I also boost the right channel slightly to compensate for the hearing imbalance.

EQ is a much bigger issue for me because diminished high frequency response affects both ears due to age, plus the complete deafness above 6k in my right ear. The technique described by Greg Scott in the video above (attenuating the high end, then selectively bringing back desired frquencies) has been very helpful.

But I've also come to rely on frequency balancing plugins to ensure my high end is in check, namely TEOTE coupled with smart:balance. There are other similar plugins, but I find these two to be the most helpful and accurate.

The most important thing to bear in mind is our brains learn to compensate when our senses are compromised. I had a friend in high school who was completely deaf in one ear - he became a professional sound engineer (true story). When our hearing becomes compromised, we don't just hear our own music differently, but ALL music differently, so the brain develops new adjusted reference points for when we work on our own mixes.

Good luck.
 
NekujaK said:
For about 7 years now, I've had asymmetrical hearing. It's not extreme, but still impacts my workflow. After a sinus infection moved into my right ear, it lost about 2-4 db of volume plus the ability to hear anything above 6khz. That, coupled with tinnitus in that same ear, plus general hearing damage from years of loud rock 'n' roll abuse during my youth, and natural hearing deterioration due to age, means my hearing is pretty f***ed up. But that hasn't stopped my ability to make music and commercially viable mixes.

In terms of volume imbalance and stereo image, I shifted my position so I sit closer to the right monitor. But honestly, if the overall mixing volume is loud enough, there's enough sound in the room for me to evaluate the stereo image from the normal mid position.

I use headphones only to check mixes, and flip the image as others have suggested. I also boost the right channel slightly to compensate for the hearing imbalance.

EQ is a much bigger issue for me because diminished high frequency response affects both ears due to age, plus the complete deafness above 6k in my right ear. The technique described by Greg Scott in the video above (attenuating the high end, then selectively bringing back desired frquencies) has been very helpful.

But I've also come to rely on frequency balancing plugins to ensure my high end is in check, namely TEOTE coupled with smart:balance. There are other similar plugins, but I find these two to be the most helpful and accurate.

The most important thing to bear in mind is our brains learn to compensate when our senses are compromised. I had a friend in high school who was completely deaf in one ear - he became a professional sound engineer (true story). When our hearing becomes compromised, we don't just hear our own music differently, but ALL music differently, so the brain develops new adjusted reference points for when we work on our own mixes.

Good luck.
Click to expand...
This imo is a really good approach,I sincerely doubt there are too many musicians or mixing engineers that have played or recorded music for several years as well as aged that actually have normal hearing.
If it’s a gradual progression of a decline in our hearing I’m sure it’s not a big deal I think we learn to compensate consciously or unconsciously.
If it’s a sudden dramatic loss in hearing like some of you have experienced it must be uncomfortably jarring & difficult to adapt to.
My hearing is far from perfect I have played drums for about 55 years and I was a really heavy hitter,lol
Ironically I have two sisters who never played music and they both wear hearing aids. I don’t and I really don’t notice or struggle hearing unless I’m in a loud restaurant or an ambient space with a lot of chatter, so I have never felt the need to explore anything like that because I have learned to adapt and compensate accordingly. But I’m sure my hearing is not normal and I wouldn’t be surprised if it’s much worse than I realize.
Like other people have mentioned I generally don’t even bother to listen or look at new EQ’s because frankly I doubt my ability to really notice or use them competently like someone would that has great hearing.
I think Gregory Scott’s video is actually spot on and frankly I doubt most people that have been mixing engineers in studios for years have perfect or normal hearing. I think we all adapt,learn and compensate whether we realize it or not.
An old friend of mine who’s a world renown guitarist lost his hearing in an ear after a brain tumor was removed many years ago,subsequently he’s made numerous records performing with some of the best musicians in the world,he trusted his talent,compensated and learned to adapt.
Utilizing tools and a 2nd set of trusted ears is also worthwhile while you get used to this new auditory reality.
Good Luck 👍
 
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I'm also in the club. To give a little hope: The brain indeed manages to compensate quite a lot and when you keep judging your mixes based on other music you listen to frequently, you will probably be able to come up with decent results nonetheless, as both - your mix and the reference - have the same "filters" (i.e. your ears) applied.
That's what @NekujaK described above, and I can confirm this from my experience.

And, as long as your hearing loss doesn't affect both ears in exactly the same frequencies, you will also be able to realistically assess your mixes by listening on speakers instead of headphones.

A medical note: Anyone who suffers from hearing loss should be treated immediately (meaning same day or the next!), probably with cortisone, as this is often the only way to prevent the damage from being permanent.
 
I am 47, have moderate hearing loss since ages, probably since awhen I was a child. I never actually impacted a lot my life but I definitely recognized the problem around my 20, when I decided to go on recording music hobby. The problem impacted also my work, when I had to start to go abroad and follow conferences and to speak in english. I had to practice a lot to be able to understand what they was saying.
of course the problem did not solve growing old, but it became worse and worse. I had some troubles in loud places to understand what other was saying to me
a couple of years ago i decide to go fo hearing aid.
I admit it was the best decision i could take, everything is more "clear" now. I can hear things like hihat in songs, which i just never heard before.
thanks to some custom setting, I can listen the music in a much more natural way.
I am finishing the recording/production of a solo metal in these days, I think it's not bad in term of sound! :P

btw, also steve lukather or Toto has hearing aids (of the same brand I have)
 
NekujaK said:
The technique described by Greg Scott in the video above (attenuating the high end, then selectively bringing back desired frquencies) has been very helpful.
Click to expand...
I have to admit that I didn't understand this technique
 
Kony said:
Have you tried boosting the right monitor to compensate for the volume loss, or is it only specific frequencies affected?
Click to expand...
Below 2000Hz, I have an almost uniform volume loss of 6-10dB, and after that a drastic loss at 4000 Hz(-70dB) and above (-60dB at 8000Hz).
If I boost the right monitor, my left ear will hear it and it will be a mess. That's why I think I should work with headphones (anyway, my workstation is in a corner of a non-treated room...).

I think I will try and boost the lost/attenuated bands, but roughly to avoid the rabbit hole of measures, plugins, etc. So my brain could compensate itself (like many seem to say here) from a better start.
 
bosone said:
a couple of years ago i decide to go fo hearing aid.
I admit it was the best decision i could take, everything is more "clear" now. I can hear things like hihat in songs, which i just never heard before.
thanks to some custom setting, I can listen the music in a much more natural way.
:P

btw, also steve lukather or Toto has hearing aids (of the same brand I have)
Click to expand...

Thanks for the brand advice !
Forgive my ignorance, as I never tested hearing aids, but isn't the sound too much artificial ? I fear that a sound going through a microscopic mic, then processed in a small device and finally released by a tiny membrane, would be very degraded ? I suppose it depends of the quality of devices, did you try other brands before Widex ?
 
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