My audiologist strongly advised me to use custom embedded receivers rather than off the shelf domes.
Can several of you look at my audiogram and give me your opinions?
Currently on Quattro
Going to Marvel M90 RT
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Sometimes the recommendation is based upon your ear shape but you could get away with double domes. If there is a conductive component in your loss would be more reason to go for custom embedded. Personally, when it comes to custom receiver in canal moulds if I am able will look to order moulds where the receiver can be taken in and out. Saves a lot of hassle if a receiver goes, as can be changed in clinic - if it is an embedded mould it has to be sent away to the factory for replacement and means you are without the hearing aid whilst it is being repaired
What my audi told me was his experience with the customs with the pop in receiver was that the material around the receiver tends to wear and then the receiver pops out of the mold. I work in a steel mill so I am a very harsh case. Bear that in mind as well. I have never had a receiver itself go bad. I have had the shell break. I have also had them migrate. The full skeleton embedded doesn’t migrate, but tends to break at the weld where the back plate is welded to the front. The small in the canal units tend to migrate. With the Phonaks, I am getting the canal unit made of titanium. I am hoping that it doesn’t migrate. If those don’t work, I am going to get them to do full skeleton molds made in one piece.
I hope i am doing the right thing going from Resound Quattro to Phonak Marvel M90RT. If the SKY Marvels had the telecoil in the Rechargeable, I would get those instead. I am all about connectivity options. I want the 02 Roger protocol so i can connect to everything Roger, both educational and adult.
I don’t understand why the telecoil isn’t available in the sky series. I also dont understand why i cant get the full sky color gamut in the Audeo series.
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I could never understand why people opted for “off-the-shelf” molds/domes rather than custom fit. You get your eyeglasses custom made. Your 4 figure suit custom fitted etc.
I don’t have the Target software or the Quattro, but here is how the Rexton software would handle your loss. This is the gain it would apply using a closed click sleeve. While it is designated as closed it I believe is about equivalent to a 1.6 mm vent - fairly small. I used the DSL v5 prescription formula because your high frequency loss is not so bad, especially in your left ear. DSL tries a little more to restore the highs than the other formulas. Your worst loss is in the 2-4 kHz zone which is the prime frequency for feedback. The high amplification of these frequencies promotes sound leakage out the vent, or around the fitting back to the microphones. When the loop forms there is feedback. On these graphs the lighter trace at the top is the gain for soft sounds, the heavy colored one is the gain for normal sounds, and the lower lighter one the gain for loud sounds. The red and blue shaded areas are zones of potential feedback. If the gains go into those areas you are likely to have feedback. If the full prescribed gain is applied especially in your right ear, you are flirting with feedback big time. The choice the fitter has is to manually reduce the gain in these areas, or to go to a custom mold.
Here is what it looks like with custom molds. The software recommends a vent size, and has chosen 1 mm for the right and 1.3 mm for the left. As you can see the full gain can be applied with lots of room below the feedback zones, which are suppressed by the custom molds.
My thoughts would be to go with the molds. Not sure about Quattro or Marvel, but with Rexton the S, M, and P receivers just click into the molds like an off the shelf dome fitting. The HP or UP receivers are much larger physically and are typically molded right into the fitting. You should only need a M receiver, and should be able to use a click mold. The ones I have are very secure, and I could never see them becoming detached. I use silicone molds. But, to be frank, they are not as comfortable as the off the shelf closed click sleeves I used for a while. This is a very personal thing, and depends on your specific ear canal shape.
Hope that helps some,
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