I have reverse slope loss. I hear fine in the high frequency but I’m at 60db at the 250/500 frequency on the right side and 55/50 on the left. I struggle at times with speech understanding especially via telephone. Currently I am using open domes on BTE aids. Any input if ear molds would help me for my type of loss?
Open domes are not appropriate for your loss because they allow all the low-frequency amplification to leak out of your ear canal. You should be using either double domes or custom earmolds with small to medium vents.
Thanks for the advice. Is there a difference between the double domes vs the custom molds? Or would either do? I’d prefer the double domes cosmetically at least if it will help as much as the molds.
The earmolds are custom fabricated to your particular ear canal shape and size, so they fit perfectly. The domes are generic and may or may not be a good fit. If there’s too much leakage of sound, you may get feedback issues.
With your loss you should be using custom molds or double domes. Go with the custom molds, I would ask for them to have adjustable vents, so you can find the right vent without having to have the molds remade several times until you find the right size. Once you get used to them you will be hooked and never go back to domes again. Good luck!
I have custom molds and would recommend those very much over double-domes or closed domes. Double-domes will seal and that is just not comfortable to me.
My custom molds are small and were fit very deep. They don’t move and are very comfortable. Mine have the select-a-vent thing where it has a large vent hole but you are given a set of inserts with different size holes. You can find the vent size that works best for you. I ended up with the smallest vent size. They also have a solid insert for no venting.
Mine fit deep, as I mentioned, and cannot be seen from the outside. You just see the wire going in, like you would with a dome. I liked my tulip domes and thought I would always have those, but tried the custom mold and now I’m sold.
Sometimes I think people hear custom molds and think that means a big half-shell plastic thing, but that’s not it at all. You can’t see the mold from the outside.
Thanks for all the advice. I’ll ask for the molds to be made since I want the most improvement for my loss. I did have this notion that the molds were big and clunky but I’m glad that’s not the case.
Related question for myself:
What keeps a custom mold from slipping? I use tulip domes that slip out of place all the time. Somewhat anoying but I live with it. At least tulips are comfortable.
Maybe one of the pros will chime in but from a layman’s perspective, the ear has a couple of bends in the canal so the custom mold can take advantage of that and fit snugly so there is just a little pull needed to get it out, and it doesn’t move out on its own. Mine was fit very deep, which I like, and even though I’m using the smallest vent, there is no occlusion.
I used tulip domes and I liked them but they did tend to move, although less than the regular domes. My custom is about the size of a tulip dome (maybe just slightly larger) but made to fit right inside a bend. I’m happy with mine and will probably always have customs.
When I ordered my custom molds, the audi (Costco) showed me the styles available. Mine are Westone, and you can get them plain (just the part that goes in the ear with a little spike that protrudes to help remove them) or with several types of locks that curl in the outer ear to hold them in place. This is from memory, and it’s been a while, but there was one style with a single part that curled the way a sports lock does, but considerably thicker from the picture and then the “mostest” had almost a figure 8 shape.
When I had tulip domes I had a problem with the right one slipping out constantly. With molds it’s much less of a problem, but it still slips. Not enough to have it redone. My right ear has a pretty straight canal. My left canal has a bit of curve to it and holds things in place better.
So molds fit better to start with, which helps with slipping, and you can order them with locks to hold them even better if necessary. Also from memory I think I had 30 or 60 days to return the molds for a refund, which surprised me, custom and all that, and even longer to have them redone if necessary, maybe 90 days for that.
Thanks for the input on molds. One last question :
Does the receiver pop in and out of the mold like it does in a dome? I know I would want to remove the mold for cleaning like I do with domes now. I have a stock of my tulips and they get replaced with clean ones every night. The dirty ones get washed and dried and put back in stock next morning. I have 20 in stock.
Sounds crazy but it’s actually a very efficient method. Doc thought I was being a little over the top but didn’t disagree with having clean domes each day.
The molds would just get washed and dried each night.
Boy, I don’t know for sure since I’ve never tried to remove mine. Before I got the molds, I asked twice to be sure that if I didn’t like them I could go back to the tulips, and the answer was yes, but from what I saw, the receivers are a tight fit into the molds and take a pretty hefty pushing process to position properly. They don’t snap on like a dome. Keep in mind that’s my Trax 42s with Westone molds. Maybe it’s different with other brands.
I got some wipes specifically made for hearing aids and wipe mine down when I take them off every night. That’s what I did with the domes also, never washed them and only changed them once a month, so I’m more casual about that than you are. Once I got the molds, I also got a PerfectDry Lux with UV light and use that every week or so. That’s my answer to the not replacing them like domes concern.
Thanks Tribalrose. It may be true what you said about the tight fit of the receiver for all of them.
My ears seem to produce more oil than wax. When I pull out my tulip domes for the night they will be glistening with oil. Probably why they slip out. In regard to maintenance, I fear this oil will work its way into the receiver if I leave them on and just clean the outside of them. Using a jewelers loop I’ve seen oil inside the opening of the tulip. Removing the domes is just too easy not to for cleaning. So I do. I’ll wash them with liquid dish soap inside and out. The main purpose of course is to insure protection of the receiver. I keep a stock of domes so that I can put on a clean dry pair of domes right away. The pair that I washed goes into the dryer for the night along with my aids.
Is it overkill? Some may think so but it’s truly no more or less trouble than doing any other kind of cleaning and I feel more secure about my $6,200 investment for these aids. I even use HA pull over sweatbands 100% of the time though my aids are rated IP58. I don’t trust they are made all that well. The covers really do keep them clean from dust getting to the mics and dry from salty sweat. Sodium in sweat is the killer, not the water. I consider covers a must accessory for any and all BTE aids. It just makes good sense and the covers are easy to hand wash.
I will be asking my audi about molds here soon.
Thanks again. Appreciate your input on the molds.
.
Can one get micro molds with adjustable vents?
Kerry
Not sure what a micro mold is, but mine are very small, about the same size as a tulip dome, or double-dome. Mine have the adjust-a-vent thing.
I just measured mine and they are 5/8 inch long.
Well, the receiver pulls out of the mold but it is made to stay in there, so there is some effort involved and you are pulling directly on the receiver wire. The more you work it the more likely it is to fail. It is really not necessary to take it off every night. Wiping it every night would be fine, and then maybe cleaning once a week? I clean mine about once a month. On mine, the end of the receiver is about 2/8 from the end of the mold, so it is doubtful anything would get that far in just a week.
I couldn’t have washed the tulips every night because they did not get comfortable until about 3 or 4 days. The new ones always itched until then. 
— Updated —
Well, the receiver pulls out of the mold but it is made to stay in there, so there is some effort involved and you are pulling directly on the receiver wire. The more you work it the more likely it is to fail. It is really not necessary to take it off every night. Wiping it every night would be fine, and then maybe cleaning once a week? I clean mine about once a month. On mine, the end of the receiver is about 2/8 from the end of the mold, so it is doubtful anything would get that far in just a week.
I couldn’t have washed the tulips every night because they did not get comfortable until about 3 or 4 days. The new ones always itched until then.
Thanks Don,
No I agree, you would not want to remove the receiver by pulling it out by the wire. I was a Biomedical Maintenance Technician all my life before I retired. I feel reasonably certain that the receiver is pushed out from the front end of the mold with a special tool perhaps.
If the receiver end is recessed as you indicated, the wax guard may be mounted on the end of the mold instead of the receiver. Is that correct? Pictures of molds seem to appear that way. If not, then the receiver is dead flush with the front end of the mold. Perhaps that varies from different molds, I don’t know but if the receiver holds the wax guard, it would appear that the receiver would have to be pushed out in order to replace the wax guard.
These are just typical thoughts by a maintenance tek such as myself. As for tulips being itchy when new: I’ll get an itch now and then but never thought is was due to being new or clean. For me they hold in better when clean and dry like new but they don’t stay dry for longer than an hour.
I want to know a little bit more about custom molds before I consider. Thanks again
You are correct. Each manufacturer has their own tool to separate the mold from the receiver, my audi gave me the tool for my oticon HA’s; it basically looks like a small punch made out of plastic.
Well fitted ear molds will allow you to hear the low frequencies provided by your hearing aids. Open fitting and vents prevent this. I offer the following earmold option that gives you control and saves about 95% pf your cost. My left ear is similar to your loss, but my right ear is sloping high frequency loss and requires venting, which I easily do by removing some of the silicone rubber, until I am satisfied with the sound quality.
I also wear earmolds. Not only are they more comfortable, stay in the ear, but I fine tune (modify) them to give me the best hearing performance. I have worn hearing aids since 1956 and currently wear Phonak BTE for severe loss. I use DIY ear molds from ebay: 24 Ear-Mold Kit- RIC, receiver in canal, DIY, STAYS IN, f… (141876798441) Note, they have RIC, OPEN FIT and BTE/OE ear mold kits. The one on the link is $29.77, free shipping and makes 24 average size canal molds. For RIC and OPEN FIT ear molds, you use the factory tube/tip/dome. For BTE/OE hearing aids they have 2 kits, offering 2 tubes and 1 tube. You will need their tubes which are unique to their soft silicone process. Plain smooth tubes will not stay in the mold. Their tubes have a dome (3 sizes) and retaining rings to hold the mold and tube together. You can order replacement tubes which last about 6 to 12 months before drying out and turning hard.
My wife also wore these for her moderate flat loss before passing away last November. Her canals were very tiny and no dome was satisfactory, except THE HCPB DIY ear molds on ebay.
I wouldn’t push it from the sound side. You would be pushing directly on where the sound comes out of the receiver. My audiologist pulled it out from the wire side.