Hi! Long time lurker here! To shortly introduce myself, I have a mild-to-moderate cookie bite that I’ve had since birth. I’m currently wearing Oticon More 1s, and they’re my very first pair of aids.
I received my More 1s in April with OpenBass domes and I liked the sound of them, but absolutely hated the retention (even with the ear grips, the domes managed to back themselves out). Retention is an absolute must for me, since I’m quite young and active as a college student. I asked my audi about custom molds in early June, and I finally got them last Thursday.
The problem is, I’m fairly certain the vents on my molds are very inappropriate for my type of loss? I’m not sure what size it is, I’m going to guess it’s between 1-2mm?
There’s a picture of it. From what I’ve researched and read online, wouldn’t a 3-4mm vent be better suited for my loss?
The sound is actually pretty terrible, and I can’t tolerate the occlusion. Low frequency sounds (like the humming of kitchen appliances, car engines, air conditioning) are SO irritatingly loud to the point where I can’t hear speech clearly. My dilemma is that I’m extremely satisfied with the retention these custom molds are giving me, but I miss the open fit on my old domes.
What can my audi do to fix this? Could she try to modify it by drilling the vent larger? Could I also ask for a REM fitting to verify the volume I’m getting is correct? I’m actually a bit dumb for not asking for REM as soon as I got my aids LOL. I know for sure she has the equipment to perform one, but I’m a bit shy to ask. I’m going to try to call her tomorrow morning to get me in the office asap.
I notice that with the MicroMold (long or short version), the Genie 2 software displays vent options of small vent size of 0.8mm, medium 1.4 mm, and large 2.4 mm, and extra large of >2.4 mm. So I think you should be able to request a larger vent hole. Maybe all they’ll have to do is keep the same existing mold and just drill out a bigger hole for you.
They have these plastic tips with holes of different sizes so that you can plug up a bigger hole to convert to smaller size vents if you find the bigger opening not working out well for you after all.
With your level of hearing loss, I don’t see why you can’t try out larger vent sizes to alleviate your occlusion. You can always experiment with different vent sizes using the plastic plugs anyway.
I had “Select A Vent” built into my ReSound custom molds as Volusiano mentions (the concept is available with a variety of different mold manufacturers, including at Costco, I think).
I guess it depends how sensitive one is to occlusion but I have been wearing completing occluding inserts for several years. I recently decided to try to switch to ~1 mm vent holes and found most of the sense of occlusion went away. So it didn’t take much venting for me to alleviate most of the sense of occlusion but I definitely notice less noise suppression even with a slight amount of venting.
When you try different vent sizes, if you can get your HCP to provide a Select a Vent option, I’d also pay attention to bass level, noise suppression, directionality, and speech recognition. I used to wear open domes and I thought all of those things improved drastically when I went to a more occluding fit as my HA’s became more solely responsible for the sound reaching my ear drums and I had less sound bypassing my HA’s and going directly to my eardrums and less bass produced by my HA’s while streaming escaping out of my ears. Obviously, since your high frequency loss is a lot less than mine, YMMV. The good thing about Select a Vent is that you can experiment to your heart’s content.
I notice that when ReSound built my Select a Vent bore holes, they created a bend in the bore hole (I think ReSound’s custom molds are 3D-printed). That’s convenient as the springy insert tubes are straight and have to bend as they are inserted. The tension of wanting to straighten out again while inserted helps keep the inserts from falling out of the bore hole. If your HCP just drills a straight, larger hole in your molds, you may have a problem, potentially, on keeping the insert tubes from falling out.
REM based fitting - live speech mapping SHOULD be done whenever hardware is changed, especially such huge changes. Fitter who didn’t do it without you asking for it is a bad fitter. So, you either change your fitter or bring a whip and put them in order.
1mm vent is probably perfectly fine but aids aren’t fitted for it.
I wear such mold and vent on my normal hearing ear (for symmetry and because of direct streaming in both ears), and I have zero issues with occlusion and such after proper fitting.
So yeah, don’t touch vent until you have proper fit for it.
And if proper fit still isn’t working for you (occlusion or something), then ask for increasing the vent. But not the other way around.
I agree that REM should have been performed. But I have drilled out many vents over the years with great success. Unfortunately, many audiologists don’t have the experience or skill to physically modify and earmold any more. It is sort of a lost art.
Hi, I also have mild to moderate (more moderate) flat hearing loss… im not sure if its just me or if the vent size looks a little small or if it’s supposed to be that way… i had REM’s done and it literally had met my prescription target… so im assuming if the vent was too small i would be getting too much volume? It doesn’t particularly feel super occluded but its mainly like if im biting down or chewing but not as much in my own voice,… or do i just not feel it in my voice as much,… but it’s probably normal im assuming but with my domes it was a bit less but i the sound quality of the domes wasn’t as great and they feel horrible in my ears…
I’m not sure I’m clear about what your question is. If it’s something to the effect of “is this vent size correct”, then I can only repeat what @Zebras has posted.
The fitting software for your aids will have calculated the optimal vent size for your hearing loss.
Wear them for a while, and make lots of notes on performance that you can discuss with your audiologist.
Sometimes slightly enlarging the vent can have quite a positive effect on comfort. But if you do enlarge the vent you should have another feedback test test run in the software. Vent sizing can be a very personal thing.
I have had other earmolds as well,… I have the cshell embedded earmolds on my Phonak Audeo Lumity and absolutely love them so far,… I had domes but they were no good, as my hearing loss is a moderate flat hearing loss,… I found the domes quite hard to get in to my ears, but the molds are great,… I have had the skeleton ones like yours and had occluded feeling,… switched to the original cshell tip and they’re great and I have absolutely zero occlusion issues with them! Ask your audiologist if they’re is a better type of mold or vent size for you, and certainly have REM’s done as well
while I was trailing Signia, I tried 1mm vent size and also 1.6mm size.
Both sizes weren’t good for me.
Anyone here with experience can tell me what siZe do I need?
Why did they not work for you, what didn’t you like about the set up with those sizes.
One thing is only you would know for sure which you prefer, what size did Connexx recommend.
connexx recommends 1.6mm using nl2
so 1.6 was ok, sort of and my voice didn’t sound that bad but I could not manage to lower loud sounds without sacrificing the speech.
also speech in noise was bad for me
Yeah it’s hard to find that sweet spot to get a good balance, no doubt you had a play around with Own Voice Processing (OVP) settings to see if that would help, otherwise it’s a bigger vent to lower those low frequencys, I think you’ll find most “speech in noise” is not very good with any HA, getting that is the holy grail of all HAs!
