Ear mold and speech recognition

Quick question for all you experts out there.

I’m having trouble with basic speech understanding in even slightly noisy environments. If there’s an echo in the room, forget about it. For about 5 years I wore Oticon Deltas with a custom ear mold and larger ventilation hole. Now, I’m on month two of the ReSound Future aid from Costco woth the double domes (no open vent at all). These aids are pretty good, plenty loud, but like I said, really struggling to understand speech in large places and in any type of noisy environment (coffee shop, grocery store, etc.).

I wonder if it has anything to do with the fact that I have no ventilation and therefore no natural sound coming in. Would getting an open fit OR a customized ear mold with a ventilation hole help with speech understanding. I put my old Oticon Deltas on and I seem to understand fine (they just don’t have the power or the features I’m looking for).

Any advice would help. Thinking about turning in the ReSound Future and trying the Widex Clear 440 Fusion. Heard they are great at speech recognition.


Yes, often a ventilation hole is put in to solid custom ear molds for this purpose, so you should ask your audiologist for an adjustment. Without a ventilation hole or one big enough, if I remember correctly, there’s a bottom-of-the-barrel boomy, echoey effect to custom molds. Even a small change in ventilation can make a difference in noisy room performance. However: noisy room performance is the hardest thing for hearing aids to do well (because ambient noise is made up of voices and similar frequencies, so there’s a lot of competition), and it’s also harder than you may remember for people with normal hearing as well. A lot of people are nodding and only getting bits and pieces of the conversation!

Thanks Hamjor. That helps.

I don’t know why they didn’t put vent holes in your ear molds. This typically done for people with severe hearing loss which you don’t seem to have. either the somebody made a mistake or you specifically told him or her that the aid’s speech in noise performance was very bad. by removing vent holes you can jack up the gain in the high frequencies which may help in speech discrimination.

honestly I bet the vent holes will not make a big difference in hearing people in noise. putting vents in ear molds is to resolve occlusion issues and to allow people to hear sounds unaided. unaided sounds that are typically low frequency sounds, which is what noise typically is.

the only aid brand that you’ve mentioned that does well in noise is oticon. you should try the phonak spice aids for their stereozoom feature. it uses 2 aids and 4 microphones (2 on each aid) together to pick out sounds in noise. however these aids will probably not sound as pleasant as the oticon or widex aids.

Ditto. With a hearing loss like yours I’d be looking at a fairly open fitting…
Sometimes larger venting will cut down the amount of background noise reduction but the overall improvement in sound quality should offset that signficantly.

I have had some people report that they do better in noise with smaller vents since it doesn’t allow as much environmental noise through the earmolds. Even though a large vent will roll off a lot of LF gain, some people report that it still interferes with reception of speech. I’d say it’s a handfull in over 100 people though…

Often overlooked is the fact that the Vent size effects not only the sound delivered to the TM (ear drum) but can muck up the input sounds due to the phase difference between direct and amplified sound. The amplified sound is always somewhat slower getting out then the direct sound due to the processing time required to go from one domain and back again.

The key to this effect is an obscure parameter called throughput time which can run as high as 10 to 15ms. Ed

Thanks everyone. I’m actually going to try the Phonak Audeo S next week. The ReSound Futures from Costco are just pretty good but still having trouble in open spaces, meeting rooms, etc. Hearing good things about the Widex ones as well.

In regards to these comments:

  • I don’t know why they didn’t put vent holes in your ear molds.
  • Ditto. With a hearing loss like yours I’d be looking at a fairly open fitting…

Just to clarify, the Resound Future aids I have do not have a custom ear mold. I’m wearing a standard Power Dome (two round circular domes on top of each other). Therefore, there’s no vent built in. It’s not an ear mold in other words. In addition to being mildly occluding, they are itchy as well.

The real reason I ask: Resound Futures cost $2,600 total and I hear well in regular quiet situations, but horribly in echo-y or noisy surroundings.

The alternative, spend an additional $3,000 for the next level up - Phonak, Widex, etc.

I assume most of you will say in order to hear in noise I need to spend more for a better aid.

pdxpete - I have the exact same issues you are having and wear the Phonak Smart IX with Power Dome. I’m strongly considering a custom mold. Are you going to request a custom mold with the Phonak Audeo. I’m curious.

I tried a power dome with the Audeo S IX and found it to be itchy as well. I now have a custom power receiver made from a mold - it gets itchy from time to time too, but I think that’s just an effect of having something “lodged” in the ear.

It takes a bit for environmental noise to settle down, at least in my experience, but while I’ve been HOH in my right ear for 30 years, I’ve been using a hearing aid for only 2-3 months. But even with the challenge of having monaural loss (and it IS a challenge, let me tell you), I’m reasonably happy with the Phonak. I switched from the Audeo S to a Naida because I sweat - the performance is exactly the same, but the batteries last longer since it’s a bit bigger.

I don’t know if our situations are analogous. I wore the Delta 8000 rite for five years and lost one. So I tried the Resound Futures. I found I had problems with word discrimination and speech in noisy situations with them. I tried the Oticon Agil Pros for one week and there was a huge postiive difference. I’ve returned the Futures and will be trialing the Agil Pros for 45 days. Ultimately, I feel that hearing as well as I possibly can, is worth the price difference even though it’s a real stretch for me.

oops you wrote about your power domes in your first post, my bad. your audi should have given you a couple of the power dome buds as they are not meant to be permanent. if not call and ask for him or her to mail you some. you can take one cut triangle holes (base of triangle of course point out) openings out of them, one on top and one at the bottom for one dome and on another dome cut a triangle on the right and on the left. Technically you should reprogram the aid as the aid may feedback more due to the new openings. but this should give you an idea of what an open fit will sound like. if you like what you hear you can go back to the audi and have him/her get you open fit buds and recalibrate the aid.

Honestly, this kind of thing along with a closed custom ear mold is purely for tweaking purposes. The aid should sound acceptable before doing these things, which in your case they do not.

do you clean your buds with alcohol every day? otherwise you will have to do what others on the board do, gold plating.

Widex is not known for hearing in noise. Widex’s are known for sounding pleasant in quiet situations.

Phonak SPICE aids are known for hearing in noise. They use 4 directional microphones, 2 per aid in tandem. However, they need to be programmed well otherwise the soundflow technology or something may treat speech like noise and you will not hear a thing. got to get the phonak rep to program the aid if your audi fails to deliver. If you can’t find a SPICE aid then go for oticon, the former speech in noise king.

That sounds a bit prescriptive to me. The current crop of Widex seem to perform pretty well in noise too.

There’s two things to mention here: Firstly, the trade-off between effective vent size and occlusion/gain is an inexact science - the ability of people to tolerate different levels of occlusion depends on both their experience and low frequency loss. This means that for even the same aid with two different customers, the perception of low frequency background noise loudness will be different. That’s before you even consider the compliance of different eardrum tension and the size of different canals.

Secondly, there are various techniques around to deal with the ‘wobbles’ caused by the different phase of the incoming and canal sound in open fittings. Unitron in particular have been marketing this aspect of their latest platform which ‘re-matches’ the canal resonance and phase.

The Futures are pretty good in noise but you have to ask the audiologist to adjust them. They can adjust speech in noise up and background noise down and it makes a big difference.

what you may need is a hearing aid with more channels. Or a better audiologist, I think the mold may improve a bit the ability to discern speech but just a small part of the story.