Better fit for behind the ear?

I have Oticon Ino miniRite aids. I’m okay with the sound - now that I’ve realized that they are hearing aids, not “new ears,” but I’m having trouble with the fit. First the dome - the 6mm seems too small and slips out, but the 8mm feels too big. Should I just force myself to get used to the 8mm? Then the wire from the unit to the dome comes in only two lengths. The shorter is too short, but with the longer length, the aid slips around behind my ear, moves when I touch my glasses, etc. I’m thinking that sticking moleskin on the aid might help keep it in place. Does anyone have a solution for this? These might seem insignificant, but now that I’m used to the idea and sound of the aids, I want a good fit.

Explain the issues with the fit, and have your hearing professional resolve them for you. If he cannot, it’s time to return them and order a brand that does fit properly.

There’s really no excuse for aids not fitting right. Near enough won’t do when you are investing so much in your hearing.

Most premium brands have a minimum of five sizes of tube, multiple non-custom buds, and then the option for a complete custom fit too. Demand that, or walk away and try something else.

Until I read posts, here, in detail, I had assumed all multi-thousand dollar HA had custom made domes included. I can’t see how off the shelf components would work for most people. Ears vary too greatly for that to work well. When you pay $2K+ per HA, custom fit should be included.

Open domes, off the shelf in several different sizes, might be more comfortable and more “open”. I’m using the tulip domes and they are super comfortable. If a custom mold is anything like a CIC I will try to stay with the open tulips for as long as possible.

Actually Mike, most people do quite well on the variety of domes available. They come in three or four sizes with three or four levels of occlusion. This couples with 4-5 tubing lengths. The silicone construction means that they give with the movement of the ear canal AND are disposable long term while a conventional mould just gets dirtier, harder and more out of shape for the ear.

That’s before you even consider the occlusion improvement…

And for the original poster: the brand chosen IS a premium one, despite suggestions otherwise.

I find that the domes actually work extremely well for about 85% of the people that get them…they are far less noticeable to the wearer resulting in a much more rapid integration to the point where they hardly notice them after a few days - couple weeks. For the 15% they don’t work for, a custom mold is the way to go…however it is more noticeable to the wearer and takes longer to get used to. Also, they often aren’t able to be as open as the domes…which for many is the whole point of getting the RIC in the first place. For those that do need the custom molds, in my office it is included, it’s just not the first line of treatment.

Thanks, everyone. I’m seeing the Audiology Doc on Friday, and I’ll ask more questions about fit. I can live with what I have, but if there’s a way to make it better, I’d like to know how. They just feel loose behind my ears, and maybe that’s why it seems like the domes are too small, like they are being pulled out. Part of problem probably that I wear glasses and the earpieces rest on the HA. Any help with that issue?

FairFran,
Do you have the temples of your glasses( ear pieces)resting next to your head and then the HA or do you have the HA next to your head and then the temples? I have my temples next to my head and then my HA and this helps secure them in place and keeps them from moving.

I agree. Ear canals are fairly standard in shape as far as diameter goes at the point the receiver needs to sit. And domes are very soft and pliable, so at least 85% of patients who have a loss that would be suitable for a RIC fitting can use them, and find them more comfortable than conventional custom fittings.

I have the same aids, and tried 3calling different wire lengths before finding the perfect fit. I also had trouble with the aids moving. My audi fitted me for custom molds. I have skeleton molds because my ear canals are tiny. These stay in my ears, and are VERY comfortable. They also stay in when I am running : ). I hope this helps.

An “off the shelf” suit works well for most men. A custom fitted tailored suit would be even better. I would think that when you are spending thousands for HA it should include a custom tailored fit.
Even if ear canals are similar, it would seem that those HA users who can’t use open fit would be most in need of a perfect fit. Also, since outer ears definitely vary, greatly, how would the “tail” that is part of the mold that tucks into the bottom crevice of the outer ear work with something “off the shelf”?

======
In answering Don’s reply:
“Open domes, off the shelf in several different sizes, might be more comfortable and more “open”. I’m using the tulip domes and they are super comfortable. If a custom mold is anything like a CIC I will try to stay with the open tulips for as long as possible.”
My HA would be considered “open fit” they have a “hole” in the mold to let the low freq. pass thru. (This is how it was explained to me.

I would think that when you are spending thousands for HA it should include a custom tailored fit.

Hi,

Um Bongo is a very skilled professional has told you his opinion - which I, also a professional, agree with.

‘Custom’ in this case does NOT always mean ‘better’.

I don’t think that UB ever said that it wasn’t available for those who need it…just like you said above. If someone can’t use the standard and recommended coupling method then a custom mold is available and utilized in those situations. I think all us professionals on the forum have our patients interests in mind and want to help people otherwise we wouldn’t be posting here.

Out of hundreds of Open-fit BTE’s I’ve fit, only about 10% have needed custom molds for whatever reason. A couple even wanted them and when I got them, switched back to the domes because they liked them better. Not one to be wasteful I tell patients about it but always try the domes first…9 times out of 10 they do marvelously with those and never need the custom molds.

In answer to your analogy, yes a custom suit will fit a bit better: but what if you need a degree of slack to allow the suit to be worn on a very hot day?

The seal required for most hearing instruments is a trade-off between openness and occlusion - it’s this balance that provides the most comfortable fitting with sufficient gain and minimum inconvenience.

I’ll give you an example if you like: I’ve just fitted a Wide 330Clear RIC Power to a man who was previously wearing solid custom moulds on his previous aid (Resound Metrix). In one step he has gone from uncomfortably occluded and sore within three hours of wear to aids he can wear all day and be in total comfort. That’s before the acoustic enhancements that let him play his piano happily and technology that allows him to answer his mobile without moving.

In terms of the overall cost, he has a set of tips (10) for £10 which will last him a year or more. A basic mould runs to about twice that and would ruin his experience as he has a dynamic TMJ/canal shape. However should his hearing deteriorate further, a soft canal mould is an option.

I’ve had CIC with a vent and it is much less comfortable than an open fit dome. The domes are really comfortable. I have zero occlusion. My voice sounds the same with the hearing aids in or out. If your hearing loss allows it I would recommend open domes over a custom mold.

I am on my first set of HA which I got about 9 months ago. Being a newbie, I didn’t know what to expect. The audi told me I was suitable for open fit (which would allow low freq. to pass thru to my ears) and suggested a mid-level Phonak. ($4k). She then took "impressions of my ears. Now that I think of it, I don’t know if the impressions also included what was needed to make custom fitted “domes”. All I know is when I went to pick everything up a couple weeks she put the units in my ears and they fit perfectly. I had no extra “domes”. I had no trouble getting used to the fit. I was never really conscious of the fact I had “things” in my ears.