I wonder if it’s possible to do all three - closed mouth, open mouth and chewing.
I’m sure doing that then scanning those into 3D software to evaluate changes in the shape would provide enough information to work out where the fit issue lies.
Wouldn’t be the most cost effective but in problem cases, I’d expect it to yield results.
Yes, my understanding is that the outer part of the canal has cartilidge around it and will give some if the mould is larger. The inner part is close to the bone, and does not give so much. But, it should not change shape either.
I do seem to fit some the cases listed where an open jaw impression is recommended. So far it seems to stay inserted, but it sure feels like I have TMJ movement and that the mold is loose with some feedback.
I am not sure I totally follow all of those measurements, but here are a couple of pics of what my left mold looks like:
That Resound article is helpful. Thanks for that.
I have thought about doing that. The fitter has said they will make as many molds as I need to get a solution.
I thought the mouth open impression was best for a seal for when your mouth is usually closed. I had
CICs before and they were without issue. They also went past the second bend.
At least in theory a mouth open impression should fit tight with the mouth open, and tighter still with the mouth closed. Again in theory where it fits tighter is the part of the canal that has some flexibility, so it SHOULD not cause discomfort. At least that is the best I can make of it all. The proof is always in the pudding though. I’m still waiting for a good pudding!
Your left mold seems very smoothly and evenly shaped - no undulations in the shape of your ear canal that would help keep the mold in place - just my naïve and untutored opinion.
Yes, that is what I noticed too. The right one does seem to have more of a shape to it, especially near the inside end where the receiver is. It gets a little larger and has a bit of a hook shape to it. I’m thinking there might be some benefit if they were longer. The left one is the one that moves the most, but the right one does also, but to a lesser degree.
I struggled, for nearly 6 months, to adjust to molds made with the closed mouth method. They didn’t hurt. They stayed put. Boy did they stay put. Every chew, every word, every facial movement tugged at both my ears. I hated the sensation and could not adjust to it. That seemed to be the only type of mold my audiologist would consider. It was get used to it or go back to some type of dome…and those hadn’t worked for me. I changed audiologists and he had me talk while the gel was setting. The resultant molds are tons more comfortable and don’t tug at my ears with every movement of my mouth or face.
As for my hearing, I haven’t noticed any difference in the quality of my hearing as between the 2 molds. For me, the change to the relaxed mold (using the term of the opening article) has been a matter of comfort.
@Sierra - Sorry if I missed it but what’s the latest on the remake of your molds and are the replacements working out for you?
They replaced the first custom molds almost immediately because they messed the venting up. The replacements are better but do not fit well. Left one has feedback, and the right one slips out. Went on vacation and will have another appointment for new impressions first week in August. This is a long slow process.
I had my followup appointment today for the molds, and got the open mouth impressions made. The fitter seemed a little skeptical that was going to change anything, but was certainly willing to give it a try. Should have the new ones in 10 days or so. I sure hope they are an improvement. Currently the molds are really no better than the non vented sleeves.
I also found out today that I only have two weeks to make a final decision on KS8’s on whether or not to keep them. It seems to have something to do with our healthcare system and the amount they refund.
I had a good talk about alternatives. She tried a slightly different gain curve adjustment that was recommended by her Rexton support person. It was a change in 1.5 to 2 kHz range where my loss curve is steep. Didn’t help and was in fact probably worse. She also gave me a ReSound aid to try, and did the REM adjustment on it. At first I thought it was better with quieter sounds, but the longer I wore it the more I concluded the ReSound was no better, and probably even a bit worse. So I think I am going to keep the KS8’s. Certainly going to the KS9’s would be an option, but I really don’t think they would be better other than being $100 or so cheaper.
So, I guess I will ride the mold fine tuning option to the end and call it quits on expecting any better. She admitted they could just turn down the gain on the left ear to the point it stops being annoying. I guess it gets back to the early warnings about hearing aids. They are a partial solution to hearing loss, but a far from perfect one…
Would have figured you would have given the KS9 aids a try. Sure wouldn’t cost you anything.
I suspect the KS9 aids are really good aids, not that the KS8 aids aren’t.
To get there, I believe I would have had to return my KS8 aids, then go with no aids until the KS9’s are released in Canada (6 weeks or so in her opinion), then start this whole merry go around process all over again. To date I have used two brand new pairs of KS8’s, the fitter’s demo pair of KS8’s, plus the ReSound ones today, and they all have been essentially the same. I think it is probably time to admit it is my left ear that cannot be fully corrected, unless I get a magic breakthrough with the molds. To be frank I am getting a little tired of them. I tried with just a left ear correction, and that was terrible. I tried just the right ear, and that is better, but probably not as good as the right ear along with a gain reduced left ear. If the molds don’t work any better than they have so far, I will probably go back to just the non vented sleeves, and return the molds.
I had flat forgot about Canada not having the KS9 aids yet, sorry about that.
Does your left ear actually hear sounds in the upper frequencies? If not you could be dealing with frequencies that can not be helped. If you can then the right aids and fitting will help you.
No trying to push but Phonaks have a good reputation for feedback control. I was pretty impressed with the KS9 aids the other day at Costco. Almost enough to sell what I have and do the Costco thing.
The one slightly uncontrolled variable - tough to find out if it makes a difference -is that, as you have pointed out, each HA brand gets a different mold custom-made for its receiver. So there might be the slight possibility that if you switch to another roughly equivalent performance HA, you’d get a better mold somehow.
Is there any way of doing something additional - just joking a bit here - like stuffing “putty” in your left ear with the receiver and the mold in your canal. If the additional material cut out the feedback, then you’d know that the mold you have now for that ear is just not good enough - and couldn’t you just keep pushing Costco to make a better mold, change material, or whatever, until they find a way to get a decent, comfortable seal with a mold that blocks feedback? Sorry, this is just off the top of my head.
What my left ear sounds like to me is a fairy faint replication of a clean signal like I should be hearing, with an overlay, potentially with a slight delay, of a sound that is being produced by a $5 AM radio. “S” sounds in particular seem to get turned to garbage. Today the fitter used a stethoscope with an adapter that let her listen to my hearing aids. She said it was loud, but the left or the right did not sound abnormal to her. One would have to think it is some combination of my ear and the HA’s.
Yes, I think there are further options to pursue with the molds. If I push on the mold in my left ear hard enough and get my mouth in the right position the effect I am hearing can be significantly reduced at times. That suggests feedback issues. The fitter says in all her experience she has not seen anyone go to the small pressure vent and silicone material and not stop the feedback. She says 95% of her clients use hard plastic and still get the feedback stopped. Don’t know.
The really weird part of this whole effect is that it is worst when the audio quality of the source is not the best. For example when some reporter in the field is talking using Skype or a satellite phone, or something other than studio quality microphones, the lost sound quality effect of that seems to get exaggerated big time. It was the very first abnormal effect I heard with these HA’s from day one. I made a post here about it calling it the vocal fry effect. Still have it today. Still sounds the same. Not all voices do it, but some, including my own at times, seem to be brutal.
I was asking how sounds were during your audiogram, not from the aid. Sorry if not clear.
The sounds during the audiogram at Costco, or when I do an on line test are not distorted. They sound fine, expect that I need about 90 dB sound level at some frequencies to hear them. I’ve tried various tone generators etc, and same thing. No distortion of the pure tones.
I don’t remember where I read this, but it was one of the Big Five HA companies talking about fittings for asymmetrical losses. The suggestion was to fit the prescription to the good ear on both ears initially. This was based on the concern that, for some patients, amplification of the ear with more loss would create problems, not solve them. The explanation was the one brought up here: audiograms can look the same but the way speech is processed can be different. So amplifying frequencies on an ear with more loss may not produce better results and may actually erode performance. I hope this is a little helpful.
