What is working well for cookie bite users with RICs in terms of open versus closed domes versus molds or something else? It seem fitters like to try the Bass Double Vent domes (Oticon/Philips/etc.). I’m willing to experiment with what may work better.
Can molds work well? Do they fit all the receivers or do they have to be tailored to each. I do wonder about the MicroShell option as that is compact and could fit better.
Do all molds create more occlusion or not necessarily?
Your audiogram would be useful, but I’ll generalize. The indicator I’ve heard for dome vs mold is the hearing loss at 500Hz. A loss of 40dB or greater suggests a custom mold would be better. Many (I would suspect most) of us prefer custom molds. I’m unsure, but I suspect the mold needs to be made for a certain size of receiver, but until one gets to the UHP (105 dB) receivers, one can at least change out the receiver without needing to send the mold back to the manufacturer. Occlusion depends on the amount of venting, so if the ear canal is big enough to handle a decent sized mold, it can handle a decent sized vent.
Thanks for your response.
DaveL
Toronto
It depends on your hearing loss, I wear custom ear molds, but my cookie bite is become less of a cookie bite as I am losing my high frequencies. I have mostly worn custom ITE aids so my preference is custom ear molds.
Personally even with my mild loss I find a bit more occlusion to be helpful but even with pinhole vents I find that I do not have much occlusion at all,just enough to help with sound leakage. My custom molds are much more comfortable and secure then domes which were very hard to fit due to my extremely tiny ear canals. Although everyone’s ears a different so it can very much depend. I got my custom molds from lloydhearingaids.com and they were absolutely amazing! Answered all of my questions and changes to my molds. The phone number on the website needs to be updated so if you want to call just use the number on the google information page. 
I have used both and both worked well for me in terms of speech.
That said, I do prefer my vented Oticon micro molds for 2 reasons.
The first is retention and the second is bass response. The bass domes would work their way out ever so slightly, even when using ear grips, resulting in loss of bass. Not a big deal in terms of conversation, but obvious when listening to music in which case the loss of bass was enough to make the music far less engaging. Like listening to a streamed mp3 song vs CD or vinyl. Would find myself messing with them and repositioning constantly.
With the vented micro molds, I just put them in and forget em. All day comfort and little if any repositioning required. No occlusion problems for me and the bass is far more satisfying.
This may not be important for you if you don’t have any low frequency loss, but it is for me.
I’m a cookie-biter, too, with narrow canals and hyperacusis. I tried open domes (Phonak) but lost too much sound when listening to music, while other sounds were echoey. I’m trying tulip domes made by Connexx right now. I think tulip domes are considered semi-vented. Sound is much improved, and they’re not bad, fit-wise; I have the 8 mm size. (The larger ones are 12 mm, I think.) Occlusion isn’t bad, either. Would tulip domes be an option for you? Good luck!
What is the difference between tulip and double vent in terms of venting and fit?
I’m not entirely sure how tulip compares to double vent (because I haven’t tried the latter), but in comparison to the open Phonak domes, the tulips are slightly more noticeable upon insertion but I’ve been getting used to them. The tulips are definitely a bit less open, vent-wise, than the open domes I tried, but that helps the sound stay in the ear canal, according to my audi. Perhaps others with more experience can chime in?
