I came across this backgrounder document from Signia on the Click Sleeve option for their RIC HAs. They present a comparison between the older open and closed click domes to their new open and closed click sleeves. A comparison of the Critical Gain Curves is presented which I understand is the amount of gain that can be used without feedback (25th percentile). The open click dome allows for the lowest level of gain without feedback and the new closed click sleeve provides for the most gain. That is not all that surprising. What I didn’t expect was that the open click sleeve provided for as much gain as the closed double dome. So would I be wrong in concluding that this critical gain curve is a proxy for how open or closed the option is? I will be going in for testing tomorrow and when it comes time for fitting I was going to ask to try the semi-open tulip dome option, but now I am thinking I may be better with the open sleeve option. I expect the test to show I have near normal hearing at low frequencies and a loss of about 70 (right) to 90 (left) at the higher frequencies.
I have the open click sleeves and like them. I’ve heard mixed reviews from others–some like them, others find them uncomfortable. The sizing is different than their domes. The click sleeves tend to run big so you may need a smaller size than if you were wearing a dome. I wear smalls in click sleeves and wore mediums in an open dome. And to your question in the subject line. Open domes are quite full of holes. The open click sleeves have two small vents (maybe a mm?) but supposedly that translates into the equivalent of about a 4mm vent that’s 16 mm long if it were in a custom mold.
Am I correct in assuming one would have to be “refit” when making a switch between the various types of domes and sleeves?
“Technically,” yes, but there won’t be a great deal of difference. No need at all if you’re just trying a different size and if you’re trying different types the difference will be minimal. Once you decided on the style and size you like, then yes, I’d ask to be refit, but the minor differences in fitting shouldn’t affect your decision.
Even the closed click sleeve has a vent and they were comfortable for me. This is only for the KS8 or other Rexton, so hearing test and recommendations first.
Which is technically better “lowest level of gain” or “most gain”?
I have KS8. The domes are sized in mm 10, 12 etc and the sleeves are sized like undies, S, M etc. Is there a size correlation? I went from 10mm dome to M sleeve and they are not comfortable.
It kind of depends on what gain you need for your hearing loss. In general the more gain you can get without feedback the better it is from a feedback point of view. However the more closed the fitting the less natural sound you are getting into your ear. To my thinking if your hearing loss is not that bad and you want more natural sound to come in, and you are not using a lot of gain, then an more open fitting is probably better.
I have only used click sleeves. Both were size small as fitted. I complained that the left one did not stay in place as well as the right one, and I was switched to a medium on my left ear. I still use the small in my right ear. Costco was quite happy to make the switch and give me more sleeves. I now have a card of smalls and a card of mediums. Should be good for a long time. They told me to come back for more when I need them.
I’d try the Smalls. I believe I started in a 10 dome and switched to Small sleeves and I like them.
Thank you both, Sierra and MDB; quick precise feedback.
I had 10mm domes for 8 years before I moved from Rexton to KS8. On install of KS8 she gave me 12mm domes which I quickly junked. Then it was M sleeves which I’ve worn for nearly a year, being constantly aware of and ratchetting my finger in there.
Your input MDB, tells me maybe I should try S sleeves or just go back to tried and true 10mm domes if there is not much difference in hearing results.
If you didn’t have any issues with feedback and were satisfied with the low end, domes should be fine. The click sleeves offer the possibility of more high end gain without feedback and perhaps more retained gain in the low end.
With an M receiver your loss seems to fit very comfortably right in the middle of the range for open fittings. Suspect you can get away with either domes or sleeves.
Thanks for that Sierra.
Based on the previous posts by yourself and MDB, I undertook a backyard DIY hearing test with two online programs, which I dug up in other places, on this forum.
This one poste by d_Wooluf :
https://www.blameysaunders.com.au/online-hearing-test
And this one put up by Coroplast :
Not really all that reliable, I suppose, but served the purpose and produced graphics I could compare.
Since I have both domes and sleeves, I did multiple tests with each, using different names, just in case.
There was very little difference, across the board. So, I’ve gone from M vented sleeves, back to 10mm closed domes. I can’t feel them and my hearing seems but I will schedule an appointment with my fitter to make sure all is well.
Your help is appreciated, thank you.
I am using sleeves and more gain is being applied for my left ear. The technician indicated when I was first tested that I may need custom molds but said sleeves were worth a try. I do get the odd “chirp” mainly in my left ear. It sounds quite a bit like a smoke alarm that needs a battery replacement. I am presuming it is a bit of feedback. It can happen somewhat at random, or more often when eating. The change from a small to medium sleeve in my left ear has reduced the frequency of the chirps.
I did run your loss through a simulation and at the soft sound levels with a NAL-NL2 formula you are looking at gains in the 25-35 dB in the higher frequency range. If you compare that with the critical gain curves posted at the top of this thread, it could mean potential trouble. The sleeves should be better than an open dome. But the proof is in the pudding. If you read the article there is quite a bit of variation from individual to individual on when feedback starts. Costco gives the sleeves and domes away, so it certainly is worth trying different sized and types. Nothing to lose but the time it takes for an appointment.
But my domes are closed and no different from the M vented sleeves except comfort.
Maybe I just don’t know what good hearing is or what I might be missing.
I didn’t pick up that the domes were closed. I think for the best results you should have the fitting redone if you switch from vented sleeves to closed domes. Also I think the Own Voice fitting should be done over too. I think there are closed sleeves also to consider.
I’m away most of April so have an appointment first week of May with the gal who first got me into HAs 10 years ago. She’s the best and will get me back on track.
My regular Costco fitter is on mat leave so it makes it an easy choice to travel a bit to the original fitter.
Probably too broad a question but, is there any connection between occlusion and not so good balance?
To clarify…I mean walking, standing balance not left ear, right ear balance 