Occlusion..... Big Problem

I am currently on my second trial set of hearing aids. I wanted to go with CIC rather the BTE because of the visibility factor and comfort. However after trying the Starkey OTOLens and the Widex models which both produced so much occlusion I couldn’t stand having them in. Everything was great as long as I didn’t speak. Hearing myself talk in my own head is not working for me. By the end of the day I felt exhausted and very happy to have them out.

Next week I am going to try some BTE models and see how that goes. My question is can this occlusion problem be solved? If it can’t I think I will wait until the technology improves in a few years. I have moderate hearing loss in the upper ranges only and would love to hear better but the occlusion problem is huge.

If you go with a BTE that’s a RITE/RIC (Receiver in the ear / receiver in canal) open-fit model, there will be ZERO occlusion. And since you only have a hearing loss in the upper ranges, you could do an open-fit.

The behind-the-ear portion of many of the RITE models are extremely small. And the tube/wire that connects the BTE part to the receiver/speaker in the ear is nearly invisible.

I wear Oticon Acto Pros, Standard RITE with 8mm open domes. People can only tell I have my aids in when the light hits the tube/wire just so. My aids are also EXTREMELY comfortable. :slight_smile:

Not sure about “ZERO” but very, very little occlusion. It does depend on your loss and the size of your ear canals. It sounds like overall you would be much happier with open-fitting hearing aids. There are cases where the ear canal is so small that even an open-fit results in SOME occlusion effect. The other thing to have done is ask your hearing aid fitter to turn down the bass (low tones) especially for softer volume inputs. This is accomplished in most software by reducing soft gain (gain at ~40dB) and sometimes making an adjustment of 3-5 dB for very soft gain (gain at ~20dB or often called TK adjustment). Be a little careful as making this adjustment does also reduce your ability to hear softer sounds in general so it is best to make small adjustments.

I switched to bte aids years ago, and even when they were bigger than today’s models, I thought that they were less conspicuous than the CICs. I suppose it depends on how much hair you have. Todays BTEs seem far less conspicuous to me.

When I see a patient with reasonable low frequency hearing I am always looking to fit RIC in this day and age. Occlusion isn’t about hearing aid technology, it’s about the sound of your voice, the bone structure of your skull, and various other physical characteristics of your head.

So occlusion is never going to go away, so the only trick is to wait until your low frequency hearing gets worse, which is a bit impractical, or fit something that blocks as little of the ear canal as possible, like a RIC.

I finally gave up on any CIC type of aids because of the occlusion problem. However I didn’t give up. I am now using the Widex Passion 440’s which are RIC type of model. I am happy to announce I am experiencing NO occlusion. These things are great! The sound is so good I completely forget they are in. The wire is so small I have not had anyone notice unless I pointed them out. Can’t tell you how happy I am because this long journey was not in vain. I was close to giving up.


I’ve met some newer dispensers who rarely recommend anything but RICs now. As technology improves the type of loss they can fit is expanding dramatically. I can fit someone with an 80% loss with a RIC these days, no problem. Amazing.

You’re right too, the look is great, and they should be very comfortable.

I can attest to the COMFORT factor with BTE’s and RITE’s with open domes. Sitting here reading the posts, I thought to myself “how much can I actually feel of my hearing aids being in?”

Even wearing GLASSES full time, I can sit here and say I absolutely do not feel anything in my ears or on my ears! I can eat, talk, do just about anything and not even know they are there. I hope I don’t forget and somehow accidentally RUIN THEM! :eek:

I was visiting my brother one day and as he was walking along IN his pool, I saw his eyes snap open and he froze. I absolutely knew that he had just thought about his BTE aids still being on his head as he was walking over to play with his granddaughters in the shallow end. OOPS!!

Biggest hazard for me has been the shower, I guess I’ve entered twice in 16 years of HAs.


hi–and it does take time to get used to any hearing aids.I have had CIC for 7 years–(and yes it took a couple of weeks to get used to my voice/and even after that at times i wondered if i was shouting when speaking!).
Recently I started RIC–and sound is better–but took 2 weeks of feeling extremely exhausted.audio started on a low setting.Has been increased to med setting after 3-4 weeks.I need to increase again to last/highest setting sometime soon.I do struggle with sight of tube as seems to be noticeable at times/and i have long hair and often wear it up and I sometimes feel self conscious with tubes showing over ears.I attempt to place whisps of hair to camoflague.but when the light shows them at times I guess i feel like an alien!anyway-they are oticon pro and sound is much more natural to me than CIC.
I did like the ease of placing CIC into my ears.But,when I trialled the newer technology of widex CIC they were bigger.I did have them adjusted 3 times(changing the shape of the shell I am meaning).Finally they got one very comfy for me/but the other needed doing again.i lost patience here/as music did not sound as good as I had hoped.so decided to trial oticon pro,which i read on this forum many were happy with;and enjoying music more.I do believe you must give trial at least 2 weeks to get used to them,plus your voice,plus brain has to adjust to change.take your time to attempt to get used to what ever you trial.Various attachments for RIC aids–some with more occlusion than others,depends on what is appropriate for you–and your loss.I am sure your audio would suggest.
Best of luck.Let us know how you go?

Actually, some aids, such as the offerings from Starkey (RICs) are water proof.

When we were first trained on the current case shape, they would dump a hearing aid into a glass of water at the beginning of the 2 hour lecture, and at the end would pull it out, prove it was still working.

So shop around, I don’t know how many other companies do this, but it is a nice touch.

As an aside, consider too that companies like State Farm are now writing Personal Articles policies on hearing aids, which give you a zero deductible replacement cost of hearing aids if you lose them or ruin them somehow. It’s not that pricey either.

That’s great! I like success stories. I am in a similar boat just starting out with getting the HA’s. I am a returning student and I am not sure exactly what I can afford yet and I am still going to an ENT to resolve some issues. Once it’s settled I am hoping I can fit into one of the introductory lines of open fit aids. I am a serious talker and the occlusion effect would be nice to avoid if possible.