Domes or try custom molds

Hi,

Recently changed up to size 12 dome. I was having trouble understanding certain words/ conversations, especially in busier places. After several days I’m finding I’m hearing better. However, still having a trouble with certain words and finding it still a little struggle in conversation.

Audi, mentioned that although she didn’t normally fit custom molds (for my loss) that if these domes helped but weren’t perfect maybe we should try them.

I’m wondering if anyone was/is in a similar situation. Don’t want to spend the money unless I think there’s a good chance of them helping.

Being only 40yrs old, I find it embarrassing asking people to repeat themselves. I believe it’s a clarity issue not a volume one and having trouble knowing what to do.

Any feedback would be greatly appreciated.

In my experience a custom fit will always provide more clarity. I tried domes once and in comparison the sound was quite muffled. Getting a custom fit gives increased clarity, a bit like when you focus binoculars, the speech becomes sharper and more defined. Depending on what aids you have, you should have your hearing settings redone whenever you change the fit. With Widex the software will recalculate the best prescription for you when the fitter inputs the new hearing aid type.

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Looking at your audiogram, in my opinion you do need to be in custom earmolds. The rule of thumb 40 dB loss applies to you.
Good luck

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In my case, custom molds noticeably improved speech recognition (and in general the “palette” of sounds became richer). Because with them, more frequencies reach the ear, and not “run away” in the opposite direction.
Another plus of custom molds: they are inserted into your ears the same way every time, and therefore the sound is always the same.
In my case, domes sat in my ears a little differently each time, this greatly affects the sound. Sometimes it’s a little better. Sometimes a little worse. Sometimes it’s terrible.
P.s. In my opinion, custom molds have only one drawback: they can interfere with chewing.
Or maybe not.
Depends on the skill of the earmold manufacturer.
But with domes a similar problem: they can squelch when chewing or move and cause discomfort.

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Raudrive is right. The problem is loss at low frequency and being able to raise the gain without feedback. Your loss is such that you can accept a vent of 0.8-1.0 mm without feedback issue. The vent helps reduce inclusion and makes the sound more natural.

I have always had molds and recommend the hard acrylic ones. If you wear them a couple of weeks and they irritate you, just have them ground off to fit better. You can keep the domes as spares.

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I’ll give a somewhat different opinion. I’m a big fan of molds, but to me their three big advantages are 1) getting enough gain without generating feedback, 2) comfort and 3)getting enough bass sound for music (bass doesn’t tend to be a big issue in word recognition)

So, if your current domes are comfortable, you’re getting enough gain without feedback and music sounds ok, I’m not sure there would be any big benefits of going to molds.

@MDB: :thinking:Hmmm - Comfort may be in the ear of the wearer.

I was always conscious of having domes in my ears, when I wore them. I couldn’t get used to them, because they felt like bugs in there.

Since my hearing worsened to the point of requiring moulds (acrylic), I’ve had 3 out of 3 great sets of moulds that could be worn comfortably for 16+ hours at a stretch.

Sorry to disagree on comfort.

MDB is also right about the word recognition issue being a higher frequency problem. Very difficult to get perfect advice from afar. If your audi can’t solve it with tuning to improve word recognition, then you might simply have to experiment with molds. I do know that I hear better with molds than domes.

Word recognition in noisy environments is a problem that may not have a solution. I avoid noisy environments.

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Note: I said IF your current domes are comfortable. I was trying to give specifics of how molds might help (or not)

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I guess I didn’t understand the context. My point is simply that one need not be put off hard moulds for fear of discomfort. Before, I thought moulds would be uncomfortable, and they’re not.

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I do remember my first hearing aids, they were ITE aids and it took about 2 weeks before they felt comfortable. But after wearing aids for over 16 years I feel uncomfortable without my aids.

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Molds have definitely helped in my case as we were able to move the gain up to my prescriptive target. that has helped me a lot with speech.

Unfortunately we are not on our 4th try with attempting to get a pair that both stay in place and are comfortable. Either they don’t stay in place or are painful. Can’t seem to have both at this point. I do have small ear canals apparently which is presenting a real challenge.

Jim

I thought I had read from a couple of sources that the recommendation for custom earmolds was 75 dB losses. Where does the 40 dB rule of thumb come from?

Perhaps I misunderstood, and this may then be why the Kaiser Audiologist (not the source of my HAs btw) recommended I consider closed domes or molds. At his advice I was looking into it, but stopped after I read about the 75 dB threshold.

Chiming in with my own 2-cents’ worth of experience, having used both CUSTOM molds and the softer silicone domes. Don’t think that CUSTOM is the total answer! Indeed, they can slip around in the ear canal and start to extrude due to moisture, humidity and even your own articulation as you laugh, smile and YELL throughout the day.

Custom molds can also HURT if they aren’t done right or if you have a tendency for swelling in the ear canals as I do when waking up. Dang things would not FIT until about 10am.

Now it’s also true that silicone domes will extrude throughout the day, and I’ve resigned myself to pushing them IN like folks would push their glasses up the nose to keep them on. It’s just part of the nature of wearing aids. Even the so-called leash, which I had on a pair of aids to help the aids stay in place are pretty useless! The aids may not FALL out of your ears, but they will always still extrude or slip slightly out of the canal throughout the day.

So! My idea (based on my own experience) is go back to the audi and tinker with the settings to boost whatever range helps you hear those words you tend to miss. That’s what I ended up doing, and that alone made the key difference. GOOD luck in getting this total solution to work for you!

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The 40 dB hearing loss out to the 2000 hertz area has been talked about by more than one of the pros on this sight. Between their advice and my own experiences I feel like it’s a good rule of thumb. I can also say that power domes on some people can be used beyond this rule of thumb. Power domes will work but properly fit molds made of the correct material will be better for hearing.

As mentioned, improperly fit molds are a pain in the butt. Take them back as many times as needed to get the best fit possible.
Good luck

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Thanks. Since I hit ~40 dB starting at 1500 Hz, I guess they may be worth a try.

I did wear custom molds for hearing protection for a number of years, so I’m pretty certain I could get a good fit and used to them without too much trouble.

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Don’t hesitate to do this, custom made molds are the only way to get the best fit, plain and simple for your loss, not everyonnes canals are the same, so domes just don’t always work for everyone,just use uncle Google to see for yourself why molds will work for your loss, so much more fitting possibilities will be available to you. Remember your hitting 70dB in the higher frequencys, so you could eliminate feedback issues as well, Soft silicone ones are pretty good too, really nice fit, you don’t even notice them.

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I agree with you! I did try domes with my first RIC hearing, and immediately ordered a custom acrylic earmold. I could not keep the dome in one place. It was either too far in my canal or moving more out. The number one thing for me is keeping the sound source exactly in the same place always! One dome moving can change the stereo effect of having 2 hearing aids. With Custom molds, the hearing aids can be programming without the possibility that one will move and change my perception of hearing. I will never try a dome again! That is my 2 cents worth…

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Thanks. I am in fact feedback-limited from reaching target gains in the higher frequencies, at least according to the fit prescribed by APD2. Another nudge toward the molds.

I’d initially been worried about not having enough gain, but (I think) I hear properly with the aids, and actually DSLv5a Adult prescribes much lower gains in the relevant regions. This made me think feedback in my original fitting wasn’t as limiting as I’d thought. I’m still interested though in hearing how the aids would sound with the gains more closely fitted to APD2 targets.

Hi, Fitting a closed dome gives me a “tunnel” effect so I am looking to have a mold made. Is a mold better suited to BTE h/aids as apposed to RIC h/aids. Also which is the best material for the mold. I understand there is rubber, plastic and acrylic.
On a personal note I am amazed by the number of people who are embarrassed at being seen wearing h/aids. These people no doubt have no such reservations about wearing glasses which are to rectify defective sight. Surely h/aids are to likewise rectify defective hearing, so what is the difference.

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