My mum gonna upgrade to Phonak Sphere 90s in both ears for first time to use RICs HAs with power receiver…
So, the hearing care professional told her to use power dome…
But as i know and based on the attached audiogram, if there is a loss in low frequencies, it’s better to use custom ear mold on the receiver to cover that loss…but they said “it doesn’t matter”
What do you think about that situation ? 
I agree with you.
Her loss is very much in the custom earmold range.
So you see it’s better to make custom ear mold for both receivers ?
There are generalized rules but not absolute.
When the lower hearing frequencies are 40+ DB earmolds are recommended.
I have brand new molded inserts. Hind sight? I should have got them long ago.
I hope this helps.
I see you’re from Egypt. I’m from Canada. I’ve found that where I live affects decisions made. And the most important part of being hard of hearing for me is finding an excellent audiologist or care provider. I’ve used hearing aids for over 20 years. It’s not been easy for me here.
So I wish you great success; I should have used earmolds for a long time. Hope this helps.
Yup. Both receivers Make sure you know how to change waxguards. I find that hard with my own earmolds.
Private message–hope that’s ok.
EDIT: in my line of work I work with experts. What I’ve learned is that if I ask 6 of my experts to solve something, I get 10 solutions. Up. Down. All around.
It’s like asking, “What car should I buy” And answers range from “a Vespa Scooter to a Motor Home” to “they haven’t made the right one yet”
I admit that I could have got ear molds years ago, and regret that i didn’t do that.
I had a dome stuck in my ear for about 3 weeks and didn’t know that. I posted here saying how dumb I thought I was. Someone had 3 domes stuck in their ear. Darn.
Being hard of hearing is like being at war. Many battles. Many stories. I just want to hear better. And maybe hear cymbals if I listen to music again. 78 and counting! Still working. Just an old guy.
I’d vote custom mold unless there was a very strong reason not to.
I have been going through my own journey with regards to this and don’t yet have a clear answer or preference. I got my Phonak Spheres about 8 months ago, started for about 1 month with power domes (after previously having been in closed domes with my previous aids), was having issues with feedback and inconsistent fit in my left ear, so decided to try custom molds. My audiologist chose skeleton molds which immediately improved sound quality in my left ear, but then I started having feedback in my right ear. The skeleton part was also not super comfortable for me. So we had the molds remade, now as canal lock and increasing the size of the right mold a bit to hopefully seal better. There was improvement, but it hasn’t been perfect. I’m still having some feedback issues and still find the fit slightly less comfortable than domes.
Because my Spheres ended up being almost entirely covered by insurance, and I’ve been having some ongoing issues with sound and the way Classic Bluetooth connects with my iPhone I have just picked up a pair of Jabra Enhance Pro 30s from Costco to trial. I’m back in power domes, and I’d say the same pros/cons apply. Overall for me the domes are more comfortable (I can forget they are there), seem to work well in my right ear, but less well in my left ear. Sound quality is probably slightly worse with the domes than the molds and definitely less consistent (the domes seem strongly affected by positioning whereas molds are more stable). I have found that experimenting with different dome sizes (and even manufacturers) I’ve been able to improve the fit in my one ear. Clearly most people seem to prefer molds, but for me it hasn’t been quite as clear cut. I will probably opt to try some custom molds from Costco and hope that they fit/work slightly better than my other molds.
They told that part “Honestly, she gonna forget she is wearing HAs with domes”…
Molds are sometimes easier to handle.
Not me. I became obsessive compulsive.
I learned that sometimes my domes let the sound out, not in. So I’d stick an index finger in each ear, trying to look cool. Volume stays the same? Success! Volume is louder? That’s a problem. I heard better So I’d do that 20 times a day.
You see my ear canals are a funny shape and different sizes.
But over 20 years of domes they’d hand me a few in an unmarked bag and say, use these. No explanation. Got to Power Domes. They hurt. Tried them a couple of days. No explanation. Went back to closed domes
Domes are a cheap solution. If I knew one of them had come off in my ear I’d phone my audi. Or I would take it out myself. I won’t tell you how I did it. My ear drum is fine.
Reflection. let’s see. Hearing aids are medical equipment. Yet so many people use domes. and waxguards. Those two little items are like microplastic. Cheap. And plentiful. They can mess up my hearing so I might as well not use my hearing aids.
Custom molds. I switched years ago due to feedback issues and never looked back. My audiogram is not as bad as your mum’s.
Based only on my own experience, If your audi does a good job on the custom molding process (its really a simple process), they will be more comfortable than standard domes.
It’s an available option too for me, i can choose it np…
It’s worth to consider choose between P and UP receivers… It could be good to have at least 10 dB headroom below your mum’s audiogram lines:
I don’t know if your mum have the possibility of trialing for a few weeks. It could be done with P receivers + power domes.
However it is harder with UP, because Phonak sells them them only embedded in cShell - kind of canal earmold.
It’s my opinion onl, but the best option (I don’t know does it is financially feasible) is take the risk and trial UP receiver with cShell with small vent (possibly pressure vent e. g. 0.6 - 0.8 mm).
A deeply placed earmold could provide additional “free gain” because of the decreasing volume of the ear canal between the earmold and the eardrum. It is about +6dB for a 50% volume decrease.
Titanium material for earmold/cShell is more expensive, but it can has thinner walls, so it has more space for receiver and can be put deeper than acrylic.
However, if your audiologist doesn’t want to make an earmold, it’s probably because he or she doesn’t feel confident creating a silicone ear impression, especially a deep one, which is more difficult to make.
The ideal silicone impression should end at least 5 mm past the second bend of the ear canal and fully fill the concha.
The open-jaw technique may be used with a bite block before silicone injection to open the mouth to 2.5 cm and keep it open throughout the injection and curing process.curation.
I don’t know about accessibility of Real-Ear Measurement (REM), but after getting the earmold/cShell, REM-based fitting is definitely worth to be proceeded.
Maybe here:
It is a good question but I’m not sure there is a good answer. I have a similar flat loss and have gone back and forth with power domes and molds and don’t notice a real difference in sound quality. Comfort may be a bigger issue and that requires trials.
I heard that domes are more comfortable than molds…
Not always and not necessarily. For example power domes is a nuisance for me compared to the earmold/cShell.
And UP receivers can be fit only with custom cShells.
I higly recommend reading that PDF. This show e. g., that on some cases with bendy ear canal the cShell could be better:
I have moulds.
I do not notice them in my ears.
I wear my aids 20 hrs a day.
I tend to sleep with them in.
