Appropriate dome for my level of hearing loss?

Hearing Aids
#1

Hi,

Just got new Jabra 20s (my 3 set of hearing aids) a month ago and in my most recent test I’ve continued to gradually lose hearing to the point where it was suggested I move away from an open dome to a tulip dome but so far I find the results pretty mixed and I’m wondering if I should switch back or if there’s further adjustments I should be considering.

I find the level of occlusion to be too high on my right side (the dome fits tighter on this side) so I feel congested when I’m talking and I’m finding that I’m missing out a bit at the lower frequencies as well. The left side feels ok-ish - it doesn’t fit as tightly as the wire is a shorter length - but I still find the occlusion a bit more than I’d like.

With my level of hearing loss is this just something I have to get used to? What should my audiologist (Costco) be considering to make the fit better for me? Thanks.

#2

Welcome ecbin
You surely can ask them to try the open domes and then run the REM test to see how far away you are from getting a good fit. Going on three weeks now with my Jabra 20.l had to switch from open to close domes from my last pair of HA from three years ago. I do not like the close domes but I know I probably need them to get the best out of the hearing aid. Good luck and let us know how it goes.

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#3

My recommendation would be to try custom molds. With any luck at all they’ll be able to get the venting right and you’ll have something that will supply the gain you need without feedback and stay in place. It might take a few tries to get it right. I think they’re $80 ($40 each) at Costco and if you aren’t satisfied I’m pretty sure they’ll take them back.

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#4

Timely post. I am wondering the same for my right hear HA. My left uses a CI. I have a BTE received with vented dome and while streaming a book I happened to close off my right ear while scratching it. The sound quality of my book immediately improved dramatically. Tried this while streaming music to test, and same result. It didn’t seem to have same impact with hearing speech in normal circumstances, but I did notice my own voice being more prominent - that’s Occlusion I believe? I’ve worn HAs for 15 years and this is the first time I’ve experienced this. My Audiogram is sloped like yours, so I’ll be interested in the responses.

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#5

I definitely agree with MDB!

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#6

When I got my Phonak Audeo Paradise P-90’s, my Audi tried a bunch of fitting with different domes. None worked well. With the addition of custom molds, the vast majority of issues went away. Custom molds are highly recommended. Of course, YMMV.

Good luck,

Dan.

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#7

Thanks for all the tips! I went in for my first adjustment yesterday and my audiologist felt I should stick with the tulip dome and she made some small adjustments that made the right side fit and sound much better - occlusion is much reduced and the right side isn’t too loud anymore. Overall, the adjustments helped a lot so I’m going to give it a try till my next check-in in 6 weeks.

I did raise the topic of a custom mold with her but she felt it wasn’t the right choice (dare I say she a teensy bit dismissive of it? Maybe it’s just her personality as she’s pretty direct with things). If I feel these latest adjustments aren’t enough for me how might you suggest I bring it up next time as I didn’t feel well equipped to talk about why a custom mold might be better for my situation.