Reading most of the information out there on the Resound and Jabra hearing aids with M&RIE, you can get the impression that you have to use tulip domes or some other type of occlusive domes to avoid feedback. This can lead to an occluded canal sensation and less than normal hearing experience. I have been using the Jabra with M&RIE since July. I like them a Iot but I wanted to see if an open dome would improve my experience. I took off the tulip dome I was fitted with, and I swapped it with a Phonak open dome. I have absolutely no feedback issues and the sound is more natural.
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I think a lot of “occlusion” is perceptual and you can adjust to it and completely habituate to the new sound of your voice, if you’re willing. For most of us, the sound of our voice changes as we age. The change is so gradual, we grow into it. Especially if you’re male and have gone through puberty, how much time do you spend lamenting the loss of your “little boy’s voice” and trying to get it back? I think the same thing is true of molds offering some degree of occlusion. If you just go with the flow, it becomes the new normal for your voice and after a while (unless you like talking wearing no HA’s), you forget what you used to sound like (just like when you were 5 years old) and are used to what you sound like with molds. There are many advantages to wearing custom molds, it’s hard to lament losing the sound of your “old” voice.
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I hated the tulip domes they gave me with my jabras. Suffered with them over a month, went back and got regular open domes. Changed everything and no way will I allow tulips in my ears again. The regular open domes gave me better, clearer sound and are easier to put in/take out and easier to clean.
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This is a personal thing. Personally I much prefer not hearing sounds coming naturally to my ear that sound muffled by a closed dome. Could I adapt to it? Sure, but why should I if there is an alternative I prefer? I grew up with B&W TV but I prefer color now that I have it. The whole point of the M&RIE is to make sounds sound natural. The open dome allows you to accomplish just that.
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I can say from using the jabras for about 5 months and having a significant loss in that time, that it does greatly depend on the loss. My initial loss, which maxed out about 35-40 dB in the upper ranges was fine with tulips or small closed domes. However, with my left ear and the current loss, it will not allow me to use the mic in ear without using power domes (I ordered molds and will see how they go). It is a matter of how much gain is needed. So it is certainly possible to use them with tulips but it can only really be effective with a smaller loss.
With a small vent size (around 1 mm), you can avoid most of the sense of occlusion but still have close to a closed fit with all the advantages it offers for noise reduction and improved directionality. Especially when the major bugaboo of hearing loss is difficulty with speech in noise, I don’t find it beneficial to go for naturalness and throw away improved ability(for me) to deal with speech in noise. But as you say, to each his own. But it is possible to adjust to a new natural. I think however much one sees oneself getting out of a particular configuration has a lot to do with how acceptable and eager one is to adapt it as the new normal
A discussion started by MDB quite a few years ago on open fits vs. closed fits is here: Article on open fit vs closed fit. A particular Widex paper that I found helpful is mentioned by me in the thread started by MDB: Article on open fit vs closed fit
Don awhile back also vouched, as I have found by following his example, that it’s possible to enjoy the benefits of a closed fit, while minimizing occlusion: Noise reduction and open fit
I think it’s great for everyone to experiment and find out what works best for them individually and carefully weigh what the good and bad points of any configuration are
I also have a 1mm vent in my right side and can stream music and phone calls and have no issues with background noise.
Sounds just as good as my left side that has no vent.
That is a very interesting comment - it relates exactly to what I am going through. My HAS at Costco was hesitant to do molds at first as I still have quite a bit of hearing left in the lower ranges, however, my speech in noise, and even speech in general, has gotten worse on my left, and I would rather be able to understand people. That is my priority… I ordered molds last week and will see how they go. She ordered them with vents that can use inserts to change the size to see what works. I don’t remember what it was called, but it sounded to be something useful…
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A mold will probably be better on the left ear than a dome, but maybe not on the right. But it is perfectly fine to have a dome on one ear and a mold on the other.
Molds for the M&RIE receivers are clear silicone with Select-a-Vent vents. You can use different sizes of plugs to size down the vent.
I hope you have good luck with them. I personally hated the molds and how impossible it was to remove the receiver from the mold to replace wax guards or mic filters. I pulled on the receiver and pushed in the mold so much that the vent plug fell out, but never was able to get the receiver out of the mold.
I went back to 7mm medium closed domes after that and returned the molds.
Actually mine are going to be one red one blue just for kicks 
I have power domes right now but the problem is that they don’t vent and my ears build up pressure very quickly. I’m hoping the molds with the vent solve that. And yeah - select a vent was what the were called. Couldn’t remember.
Personally, I’ve never been a fan of earmolds with RIE products. I find earmolds to not be flexible enough as I guess my TMJ might contribute, there’s too much movement that inevitably causes the earmold to come out. I did try a canal lock with earmolds but just found power domes to be what I preferred.
I was so thrilled when I was able to switch from a BTE with full earmold to a power dome for the first time, years ago! I’m used to occlusion so it doesn’t bother me personally. But I find domes are more flexible to movement.
But each person has their preference!
I found it helpful (with audiologist’s blessing) to try different dome sizes as well as those from the different manufacturers. Some are larger or smaller in certain ways that make so much difference. Of course, making sure the dome isn’t ever blocking the output is important. But these days, that’s not as much of an issue as with older styles that had differently sized tips.
I also have found that over time, sometimes one dome will be better than another!
I recently switched from a medium size to a large and was shocked as previously, the large was too large for my ear and hurt a little. But not anymore. It helped with feedback and is perfect.
I have heard our ears get larger as we age, lol, so maybe that’s why?
Actually I think the canal may just get more flexible and adjust. I had small domes when I started and tried medium at the time and they were painful. 4 months later the medium power domes fit without any pain… Now the pressure - that’s a different issue
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True! I do have perhaps more occlusion and remember how in addition to a bit of physical discomfort, the large dome was too occluding. But I’m a lifelong hearing aid wearer, having previously worn BTEs with full earnolds. So I’m not sure if it’s even occlusion or rather the excellent “sound in quiet” setting. Lol.