What vent size do I need? Phonak Target doesn’t tell me

[Zebras]

My left ear is purely conductive. (My right ear isn’t.)

When I put my BC levels in to Target (0 dB to 10 dB), it doesn’t change the vent recommendation compared to having no BC levels.

Having such good BC levels means I require more power. I get the high MPO pop up notice when I open it all up.

I really would like to get a vent for my left ear. The audiologist that I go too, uses Starkey.

Starkey in the UK, say there small vent is 1.2mm, there medium vent is 1.8mm and there large vent is 2.55m.

I’ve never had a vent for my left ear before so unsure as to what I should choose.

Target is recommending a 3mm vent.

[Raudrive]

Try selecting different vent sizes in acoustics. Then see what MPO and feedback do.

[Raudrive]

Just took a look at Target. In setup under fitting there is a selection for auto vent size recommendations.
Try checking that box.

[tenkan]

This doesn’t make sense, your loss is only 70dB at 2Hz at its worst, why would that trigger the high 132dB MPO warning.

@Zebras

Having such good BC levels means I require more power.

Do you mean high BC thresholds or very low?

But either way you most likely won’t want venting at 3mm, because you’ll lose a lot in the lower frequencies by doing so, plus if you’ve got that much gain going through (because of the MPO trigger) you’re going to get feedback issues.

What’s wrong or what don’t you like with the set up you have now.

[Zebras]

Having a conductive loss requires more power then a standard sensorineural loss.

The further away the BC levels are on the audiogram from the AC levels, means more power. That’s why I get the high MPO warning.

[Zebras]

[tenkan]

@Zebras

The further away the BC levels are on the audiogram from the AC levels,

How much more are we talking, is the gap more then 10dB-20dB
But anyways what level have you got the left HA set at now?
No doubt you know that you can set/change the % of your fitting on the left side in global settings, without having to change anything else (getting more gain)
I’m really interested in what the outcome is for this, as I’ve never bothered putting the BC thresholds in myself because it never made any difference for my sensorineural loss.

[Zebras]

My BC levels are between 0 dB and 10 dB so yes the gap is quite large in my left ear.

[Zebras]

I tried different vent selections and found I couldn’t hear anything if I changed it. It felt like my left ear was very plugged up. I know I was using an ear mould with no vent which didn’t really help but thought I would try.

I’ve decided once the lockdown is finished to get a Select a vent from Starkey. Then I can figure out what is suitable for me. I think I’ll have to start off small and get used to it first then move to a bigger vent.

I find I can hear things without my left HA in but find Speech very hard to hear.

[Zebras]

@tenkan

This is the difference between a large gap between my BC levels and my AC levels and no gap. Using the same audiogram just one with BC levels and one without.

[tenkan]

That’s a massive difference.
I have 2 questions on this.

1. Can you hear speech with the fitting set up without BC levels as in picture 2 (just speech not noise)

2. Can you confirm that with the fitting set up with BC levels entered everything sounds over amplified?

I suspect that you would have to find some middle ground.

@Zebras

It felt like my left ear was very plugged up.

That’s normal it’s the occlusion effect.

@Zebras

I know I was using an ear mould with no vent

Did you have this mould made for some reason? As in a previous fitting.

@Zebras

I find I can hear things without my left HA in but find Speech very hard to hear.

When you say this, do you mean using just your right hand HA, or do you mean you can actually hear some things on your left unaided?

[Zebras]

@tenkan

That’s a massive difference.
I have 2 questions on this.

1. Can you hear speech with the fitting set up without BC levels as in picture 2 (just speech not noise)
2. Can you confirm that with the fitting set up with BC levels entered everything sounds over amplified?

I suspect that you would have to find some middle ground.

I can’t hear from the settings with no BC levels. I can hear the start up tune on my HA tho but it’s super quiet.

With the BC levels, I found things slightly too loud so put my AC levels 5 dB better and left my BC levels as what they are. Things sound a lot better now.

EDIT - I should add that my right not being conductive it uses more compression then my left ear. Reducing my left ear by 5 dB helped balance my ears to sound equal.

Sensi - neural losses are amplified 1/3 of what you need.

Conductive losses are amplified 1/2 of what you need.

I think that’s why my ears didn’t seem balanced.

[Zebras]

@tenkan

Did you have this mould made for some reason? As in a previous fitting.

I have ear moulds with no vents as that’s what I’ve had all my life. I wear a dome in my right ear but my left ear is getting quite wet due to the weather so I want an ear mould with a vent to get air to my ear.

EDIT - In the past, no vent has not caused issues but I’m now on medication that makes me sweat more so my left ear is suffering.

I’ve also changed to Stay Dry tubing as well.

[Zebras]

@tenkan

When you say this, do you mean using just your right hand HA, or do you mean you can actually hear some things on your left unaided?

I can hear without my HA in both ears. I pick up quite a lot in my right ear but I only pick up limited loudish sounds in my left. I can pick up Speech in my right ear without my HA but not with my left ear at all.

[Zebras]

How would fitting software use Bone Conduction (BC) audiogram results?

Phonak’s fitting software, among possibly others, allows entry of BC thresholds in the audiogram along with AC (air conduction) and UCL (uncomfortable loudness) thresholds. If both AC and BC results were input, how would the software differentially use the BC data?

Found out that conductive losses require 30% to 40% more then just a SN loss.

[Raudrive]

If I understand you correctly you are changing the vent size in Target, not the actual vent size in the mold. That will not work. Target needs to see the actual vent size in the mold to prescribe properly.

Do you have accurate BC measurements? From everything you are writing I would do a fresh Audiogram Direct, enter the real vent size of your mold and enter your known correct BC. See where that takes you.

Target can recommend vent sizes while setting up a prescription. Is that different than what you now have?

English Dispenser was a great help back in the day!

[Zebras]

@Raudrive

If I understand you correctly you are changing the vent size in Target, not the actual vent size in the mold. That will not work. Target needs to see the actual vent size in the mold to prescribe properly.

Ah I didn’t know. Still learning things after 9 years of self programming.

[Zebras]

@Raudrive

Do you have accurate BC measurements? From everything you are writing I would do a fresh Audiogram Direct, enter the real vent size of your mold and enter your known correct BC. See where that takes you.

Target can recommend vent sizes while setting up a prescription. Is that different than what you now have?

I haven’t had up to date BC levels done for a good few years, well I should say, I haven’t had them done since starting to self programming. My BC levels have not changed from all the tests I had done so hopefully it’s still just about the same.

When I go to the hospital, they test the right side because of the surgery that I had. As my left hasn’t changed for years, they’ve stopped testing that ear.

Thanks, I’ll do an up to date AudiogramDirect and go from there.

[Raudrive]

@Zebras

Ah I didn’t know. Still learning things after 9 years of self programming.

Me too!
Sometimes I wonder if I am relearning things forgotten.

[Zebras]

Ok I’m very happy! I just played around with the software and I can wear a thin tube and power dome on my left ear. That’ll help quite a lot with getting air to my ear, even tho the power dome is fully closed, no vents.