I’ve got no vents. 
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Correct. Correct. My ears are not identical, but not that different.
The second is my right ear only. I didn’t get a good audiogram with the left as I don’t think I had the mould inserted correctly.
The aids are Oticon Spitit Synergy, NHS issue. The acrylic moulds are the “skeleton” style according to the list posted ny dmrljes
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FWIW, I have c-shell acrylic molds with vent for my Paradise P90 aids and they are great (comfortable, do not try to slip out, etc). I have used custom molds with vents for several years with different hearing aids. Some were good and some were bad. The secret is getting a good ear impression and then having the molds manufactured correctly. What I like about Phonex (I know others do the same) is they digitize the impression to make the custom molds. Also, if need be, the digitized version can be modified to correct impression errors. So much for my three cents (allowing for inflation) worth.
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Thanks for the clarification about audiogram pictures.
If the audiograms are even close I would think you need some form of molds. Too much of your loss is 40 dB or more in most of the speech frequencies. So, getting comfortable molds is important.
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As I said, these audiograms are relative to 1kHz. I have no way of calibrating them to absolute values. At mid frequencies a professional audiogram put it at 20-30dB.
Ok, so the audiograms you showed us are not even close to accurate. Knowing this it is difficult to help you concerning your question about molds.
Good luck
Your situation sounds quite a bit like what I experienced with my first set of silicone moulds. It was so uncomfortable! My audie had me sit completely still while she made the moulds. I changed audies because I’d tried every dome and receiver wire length and then moulds and still couldn’t get comfortable and she said there was nothing more to be done. I learned on this forum about a closed fit and an open fit. My new audie had me talk and move my jaw while the gel hardened. The resultant moulds really increased my comfort and I lost that stuffed up feeling. I’ve had them for about 18 months now and I’m satisfied.
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As I said, they are relative, not absolute, but they don’t need to be absolute to demonstrate a 12dB/octave roll-off below 375Hz, which can’t be right.
Molds work great when fitted/made correctly. My last set were 2 years old fit great. The lanyard to remove from ear broke off. I then used the wire to remove and it started pulling the speaker out of the mold. Had new set made and they are horrible. Now out for 3rd remake. Mine have vents in to reduce occluded stuffed up feeling. Love my molds when they fit correctly.
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If this is correct molds could actually be detrimental to fitting your loss. The audiogram is a very important part of the hearing aid process.
How did you and your Audi decide on the type of custom mold for you? I will hopefully be getting a Phonak P90s this month and would like to get custom molds. For the last 3 years I have dealt with domes (size, type, shapes, open /closed etc) and they still cause me issues. The present ones do not stay on my ear. TIA
I think ideally you’d have a discussion with your audi and state your priorities. Which is more important discreteness or the mold staying put? Which is more important eliminating feedback and getting maximum gain or avoiding occlusion? I think those are the two key questions. If you’re ok with a skeleton lock, pretty sure mold will stay put. Venting and how deep the mold sits in the ear canal affect occlusion.
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I searched the forums for custom fit and c-shell seem to be popular. Also, I think it was Neville recommended them to me. I has the small tip for retention so they would not just be like CIC. Also, my fitter agreed, he had a lot of success with c-shell. Just be sure you get a good ear impression. Phonak mfg methods for custom molds is very good.
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OK, so I’ve got an appointment tomorrow with the technician to switch me back to domes, and I’ll maybe ask for an appointment with the technical audiologist to consider my options. But that won’t be for several weeks, and I can’t stand these moulds that long.
But perhaps someone can explain a couple of points:
- The moulds cause that blocked-up feeling - my voice and chewing sounds are very loud. I couldn’t follow a conversation while eating. Is that an inevitable consequence of a good fit? What causes it anatomically - bone conduction?
- Part of the motivation for trying moulds was that with domes the HAs give poor mid to low frequency response (dropping 12db/octave below 375Hz) making direct input shoes or a neck loop useless for music. The moulds are no improvement. Is that blocked-up feeling something you have to live with in order to get a sufficiently good seal for adequate low frequency response?
It truly sounds like the fit is poor. If they were tight in the bony part of your canal the problems you’re describing wouldn’t be present. I think the squishy part of the mold is too squishy. Needs to be higher durometer material, or just acrylic.
Yup. If your hearing is still too good in the low frequencies, a mold will have insufficient venting for a comfortable sound (plugging/occluding), and appropriate venting will suck for streaming music (crappy bass). It is what it is. Hearing aids aren’t headphones.
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I am going to add my 2 cents here. I definitely prefer moulds. I have Phonak Paradis and the bass is marvelous - never heard that with my Widex’s. I now only have domes - waiting for the moulds to come in next week.
The problem with domes, is insertion. If they are just “in the ear”, I find I am losing alot of sound. I have to take care to precisely insert them into the canal and then the sound is wonderful.
I opt for moulds so that I can get that insertion done easier and avoid sound loss. Of course moulds can wiggle out a bit but a simple tap puts them right back in place. The domes take much more effort.
Its all about the interface. A great aid with a sub-optimal interface , is useless.
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Hello, I did used soft molds coming from just domes, it was an improvement but the occlusion was always an issue. I remember my right ear handle that better that the left because my right is completely deaf, so occlusion is not an issue for the right.
And the left soft mold always was getting out. Today I have a pair of acrylic molds. I am finding that this acrylic molds doesn’t insulated the ear from sounds even you do not have vent opened on it. If I go to gym for example I always will get the ugly music is playing, it overcome my own music. With the soft molds it wasn’t happening.
So, I think if I have occlusion issue it is better go with acrylic molds, because also, this acrylic will let you do sizes open/close vent more easily that soft.
Today I use the very small vent on the left and no vent on right.
You should definitely bug the hell-out these people until they make you feel the benefit of hearing aid without make you feelings you use hearing aids.
This is normal and proper. Telecoils are for speech telephones. If made full-bass you would pick up all the 50/60Hz hummm in the room. They “must” cut bass. Speech will still be intelligible.
There are other technologies for music. I get blutooth down to 90Hz. Trying to deliver deep bass through a dome or non-sealed mould would require massive boost and eat the battery. Your hearing -may- be flatter at high level. I have nearer full-range hearing at medium-loud level, typical of speakers and headphones, and do not need my aid.
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