Advice about hearing aids and receivers/domes

Hello everyone

I have been having hearing loss for a while (since my early 30s, now late) now and have pulled up the courage to see if aids will help.

I am currently on a trial of the Lumity 50 and 70, with initially with open-dome and now with active-vent. With the main reason for trying the latter being my desire to stream music and pod-casts.

The context for my question, is that during the trial period, I have had one audiologist saw that my hearing loss (refer to my profile) pattern is “tricky”, and tried me on open domes to “preserve” the native low frequency hearing I have. This is the audiologist who has been doing my adjustments. Another audiologist, who I visited to shop around for hearing aid qoutes, said that trying other domes, including the active-vent, would be better.

I personally have noted improvements, albeit not necessarily “wow”, and the 2nd audiologist said that it’s likely due to suboptimal programming and a lack of REM (which were not done by 1st audiologist, unless I actually buy the aids). I am mindful that 2nd audiologist has a vested interest to get my business, although the consult was free.

As such could I ask

  1. what the hive-mind thinks about my situation?
  2. For those who have used active-vents, should the receiver stick out of the ear? I ask because I use stethoscopes, which were fine with closed dome RIC, but not so good with the Active-vent, when used in the ear. I have wondered if it’s just the generic tip that does this or, will a custom do it too.

Extra context
a. I am in Australia.
b. The price difference for the same product between the two audiologists is dramatic (about 4k AUD).
c. I work in healthcare (hospital emergency department) and use a stethoscope. The stethoscope, whilst bluetooth, is tricky to use with the active-vent.
d. I am limited to Phonak, due to pricing and current quotes available to me. I also like the water-resistance (for sweat and rain) of the Life series, as much as I am aware that there is alot of marketing magic behind it.

Thank you for you thoughts.

I don’t think my receivers stuck out of my ears even when I used universal slimtips. My titanium slimtips fit way into my ears. Maybe you need a different universal slimtip?

I listen to a lot of podcasts, a lot of zoom & google meet sessions, and some music. The sound is much better to me than the ordinary ric receivers I was using before.



This is what I had expected with the trial, as the open domes went all the way in. I actually jerry-rigged a pair of sillicone earbuds from my in-ear earphones to fit on the active-vent, which made it comfortable. The universal tip I was supplied hurt after 2 hours. I was the first person who trialled the active-vent at my audiologist, and the audiologist was not very comfortable with fitting them I felt.

I think there is a kit that audiologists can buy for fitting activevents which includes the various sizes a universal slimtips. Did you get the smallest size and it was still too large? Or did they only offer the one size?


I just got the “A” size. The audiologist only had two sizes, but I think that the kit has 4. With my earphone tips, the receiver goes in deep and without discomfort. When I tried open domes, I used a large.

To what extent are you bothered by your own voice when the active vent is in closed position?

The sounds that you are listening to through your stethoscope are typically sub-1kHz sounds, and an open dome will not support that. If you are using open domes, you’ll likely want to use the stethoscope with circumaural headphones and you may or may not need to shut the hearing aid microhpones off to avoid feedback. If you are using your stethoscope via BT streaming, then you need a more closed fit and you’ll likely want to set up the streamed audio program so that your hearing aid external microphones are turned off to block out environmental noise. You may prefer a boost in the low frequency gain in that program as well. If your own voice does not bother you when the active vent is in the closed orientation, if in fact you prefer the sound that way, you might be better off in a custom tip with a static vent, particularly on the left.

However, cardiovascular sounds in particular can be lower frequency than what a hearing aid can support. You may find that even if you are using a more closed tip to improve gain under 1 kHz for everyday listening, using circumaural headphones with an amplified stethoscope will give you better access to those sounds. The trial-and-error bit would be how the circumaural headphones interact with the hearing aids and how much venting you need to maintain to use the stethescope that way.

One more consideration that springs to mind–there are visual stethoscopes out there. If this is a progressive loss, it may be a forward-thinking idea to investigate that. If you start using a combination stethoscope now, then I would imagine that your current hearing will support learning what visual cues match what anomalous sounds and if you ever reach a point where your hearing has declined in a way that makes hearing these difficult, you will already be an expert visually. Also, your patients will think that you are super high tech. Usefulness will be influenced by how unweildy this is in your fast-paced environment. From my complete layman perspective, I might imagine that even a typically-hearing health professional may benefit from the combination of both visual and audio information when trying to diagnose something subtle.