Domes for Phonak Issue

Can someone explain the domes in the pic below?

I started with molds, but never did get good hearing so I went to a second Audi who enlarged the vents about as much as possible greatly improving my hearing. One of the molds broke when cleaning so I went back to the original (Veterans Admin) Audi who just stuck on domes.

Both ears looked like the one on the left in the pic. He said these are new technology and should work for me instead of molds. I realized too late that one of them was a small and I needed a medium, so I went back the earliest apt I could. There he stuck on the dome on the right in the pic.

I have zero confidence in this Audi. I need to get a set for backup but don’t know if there is a difference between them, which I should get, and what they are called.

If you don’t mind, how do you clean them? I discovered you can’t just run the flexible plastic straw like thing through them, does that mean no wax can get inside? If I remove them from the aid, should I put them in warm water to get any way off the dome part? Lots of questions - obviously the Audi didn’t say one word about it.

The picture on the left is a closed dome which is a replacement for the old tulip dome. The other one is an open dome. They are quite different and I wouldn’t be using this mixture without professional advice. Also, your HA’s need re-programming for a different dome - you cannot just exchange domes and expect them to work without adjustments to the electronics.
They are disposable, which means that you wear them for a period of time and then put new ones on.
You need to get a reputable Audi who will fit the correct domes for your loss and provide you with a box of replacements.


The Left is a tulip dome the right is an open dome.

To clean, mix 1 part 409 to 2 parts water, (Example 1 Oz 409 with 2 Oz of water) put in a spray bottle

Spray a paper towel to dampen it with the solution, carefully clean the domes and HA. I usually do this every night before placing the HA’s in the dryer.


I think I had found the identity of the dome on the left side of my pic above. It’s the Unitron Closed dome in Medium. At least it looks a lot like it. As for getting the open dome in the other ear, the assistant said they were out of the closed dome so I’m sure he just stuck what he had on it. Might I add he may have muttered “There I fixed it” to himself (what a guy).

Unitron Domes:

Now for the big question… For my loss (sig line), which dome type (open or closed) is best?

How about me? What dome for Phonak Ambra? I have already taken off the custom molds. The right one falls out and hurts like crazy… And without a change in adjustment (yet) I am still happy with the sound.

for my hearing loss I use the new closed dome(newly designed tulips)and love how well they perform. They are at the limit of what feedback cancellation can handle with my loss.

I’m still looking for information regarding which type of dome I need. I found what I think is a help in a technical brochure I downloaded from the Unitron site. NOTE: this automatically downloads a 1.2MB PDF file to your computer.

In the brochure I saw that:
Open Dome is okay up to 65dB loss, occlusion free.

Closed Dome is okay up to 70dB, semi-occluded with extended fitting range over the open dome.

Power Dome is okay up to 95dB, occluded with extended low freq response.

Sleeve Mold is okay up to 75dB, occlusion depending on venting, choose for comfort.

Power Shell is okay up to 95dB, occlusion depending on venting, choose for comfort.

Now that I’ve worn my mix of domes a few days, I want my vented molds back. Good thing the Audi made sure I took them with me. I’ll make an appointment with the other Audi, a real pro but I have to pay. I’ll go with whatever he says.

Could I now have the new tulips? Just got them today and audi only had the one pair, so not much choice or identification. They are small, about 1cm. high, very conical and pointy on the top like a nipple and comfortable. They have 2 tiny holes. My loss is greater than alpine1; I get a couple of seconds of feedback when the aids are first turned on and then all is well. OldLincol post a nice photo above.
Does it matter in what direction the holes are oriented?
Are they by Phonak? Are most domes made by the aid manufacturer, or generic?

Sounds like the new closed. The pic above shows both profile and top view, so yours should look very much like one of them. I originally had a small but it fell out of my ear. For the first time in a few days of wearing the domes, I had to not wear aids today because one ear is very sore up wear the cone sits. That’s the deal breaker and I’ll go back to molds, just with a larger vent than before.

I use open domes. Everyone is different so you will need to try different domes to find what is best for you. As mentioned the aids will need to be adjusted for whatever type domes you try.

I believe that open domes are sufficient up to about 30 DB loss in the 1500 hertz range or lower. This is off the top of my head so maybe one of the pro’s will jump in a clear this up.

Good luck

I am try the closed tulip dome for on Phonak Ambra. They are small, conical and pointy. When I press the phone against my ear (which I have a tendency to do for better understanding) I think the dome slips too far into the canal and presses against the ear drum with discomfort that lasts even after I remove the aids. Is this possible? The discomfort is very central and does not feel like canal irritation. I don’t want to do any damage! Maybe a larger size… Maybe the tube is too long allowing the dome to move more than it should…

In general I like these domes. No feedback, and because they fit deep they feel secure and comfortable. Everything falls out of my right ear (even my recent experiment with custom domes) and I don’t know how many times I had to look in my hair or on the floor for my Oticon Deltas. It’s the left ear that I always use for phone calls.

Anyone else know of similar experiences with tiny domes?

nan2, tubes and domes come in different lengths and sizes. It sounds like you are getting close to the correct set-up but not quite there. Take a look at the website precisehearing to see all the different tube and dome sizes available.

Good luck

The aids need to be programmed for the domes used. For OldLincoln’s loss I would probably fit a closed dome or a custom tip as feedback may be an issue. However I have fit some client’s with open domes with this type of loss. Generally becomes a decision relating to client’s preference for high-frequency sound coupled with the occlusion effect and soundrecover settings (for Phonak products anyways). The new domes have a “T” junction at the top so while the fishing line cleaning may not appear to pass through easily it is still relatively effective. Not a big fan of the water cleaning method posted earlier in the post. I find wet wipes very effective at cleaning dome tips while in place (audiwipes or similar hand-cleaning/baby-wipe product per preference, my preference is unscented).

@Kadougan:Thank you. Now can you explain your reply a bit comparing the open vs closed vs custom molds? I really don’t know much for instance high frequency is like song birds high pitched sounds. What is the occlusion effect? Even if I get part of it, I don’t understand the relationship one has with the other. I just know if you increase one thing it affects everything else.

If feedback is the squeal when I cover both ears, then what is the loud crackle when paper is rattled? Right now, since my VA Audi over wrote my other Audie’s programs (he honestly did not know that would happen!) I’ve kept my aids on music mode and louder by 4db. It kills the loud bangs and crackles but I still hear better.

I think my VA Audi will go back to custom molds if I specifically request them. They were very comfortable and I can’t keep my domes in place. They pop out about half an inch from initial setting which really kills my hearing. Plus they itch if I keep them pushed in all the time.

Sorry to ask so much but I have not found anything written in ordinary language to explain this stuff. Neither of my Audies have the time. The civilian one would but he’s discounted doing my settings so we worked only on that.

Sorry for the delay, haven’t logged in since before Christmas. Occlusion : the feeling of having your ears plugged, often resulting in a hollow/boomy sound in your own voice. High frequency is what makes the paper crackling sound so loud specifically gain setting for louder sounds. What allows us to hear clearly the “s” “f” and “t” sounds is when we have adequate high frequency amplification. If the high frequency is too high (or the brain is not adapted to the new input) this results in crackly sound. The reason all hearing fitters will tell you that you need to adapt is that high frequency sounds DO sound overly crackly at the beginning until your brain becomes more adapted to the new stimulation it is receiving.

So perhaps I should just tolerate the High Freq. I’ve had my aids set to the music program to mellow out everything, but that’s likely delaying my brain training. And it’s precisely those sounds I lost the most.

The VA supplied me with closed domes and I’m used to them now. I can’t tell a difference between these and the molds I had before. I might if I put them back in but the domes seem to be less trouble and if they do the job as well I’ll keep them.

Thanks for your explanation of terms. There may be a glossary somewhere but I didn’t find it when I looked.