Hi, I need some advice on what kind of domes to use—open, vented, closed—or whether ear molds would be better, based on my hearing loss.
These are my first hearing aids, and I’ve been trialing the Unitron Moxi Vivante 9, Starkey Genesis AI 24, and now the Philips 9050.
I’ve noticed that when I use closed domes, I experience more annoying background noise/white noise, which is more noticeable in my right ear than in my left, along with some occlusion. With open domes, there’s more feedback, but no white noise. Vented domes don’t seem to reduce either the background noise or the feedback; they fall somewhere in between.
Unfortunately, my audiologist isn’t very skilled, so I’m not getting much help on this issue at the moment.
I’d really appreciate your advice on which type of dome might be the best fit for my hearing loss.
Do you want to use Bluetooth? If you do, then you can cross off open domes and the Philips’ open bass domes. These types of domes allow too much low frequency leakage.
If occlusion bothers you, then you need venting. So now you are looking at molds or venting a closed dome.
From your testing, you seem to have it narrowed down to vented closed domes. Since you say they fall between the two types of domes, I would try to make them work before going to a vented mold, especially since you seem to be testing different hearing aid brands.
I suspect the white noise is coming from the amplification you need between 1khz and 4khz for the low and medium loudness inputs (50 and 65 db).
With the Philips hearing aid app, there are two equalizers that you can use to adjust the gain, one for streaming and one for non-streaming. Try reducing the mid frequencies in the non-streaming equalizer to see of the white noise disappears or gets reduced.
If reducing the mid frequencies helps, then your HCP has their work cut out trying to find the right combination of adjustments.
I would bring something to generate white noise, and have the HCP adjust the mid frequencies, low and mid sound inputs (50 and 65 db) to where you can just barely hear the white noise at the 80% target setting. Over time you can have the hearing aid adjusted from more gain.
If Costco or a private audiologist doesn’t want to spend that much time making adjustments, then you will have go the DIY route.
Any chance of getting a different audiologist? I have been very pleased with my local Costco and the technicians there. I let them assign the dome style, and I’ve been happy with it. I’m sure they’d change it, if I asked/explained any problem.
Bluetooth: Yes, streaming with open domes has no bass response, as I confirmed myself.
Vented mold: I think it’s the best option, at least for my right ear, but I’ll think more about it when I buy my own hearing aids.
White noise: This noise is always louder in the right aid than in the left. If present in the left aid, I can manage it, but not in the right ear because it’s very loud. With Starkey, there were two different noises: one below 750Hz and another around 2kHz. With Philips, I’ve tried your suggestions with the equalizer, and the noise disappeared when reducing mid frequencies.
Costco: It’s an option, but it’s 200 km from my house.
DIY: Absolutely, my plan is to dive deeper into this world.
My concern is whether, at 80% of the target and without white noise, I will be able to understand people better than without the aids. At the moment, I’m not very happy with the performance of the aids. I will certainly try another audiologist. She is very kind and open to doing everything I propose, but she isn’t very skilled.
Costco is too far for you to do multiple adjustments, unless your Costco is willing to program them over the Internet. DIY as an option since you seem interested.
Double check the trial period with the Philips hearing aids at Costco, since it appears you don’t live in the USA. If you have a long enough trial period, go to the DIY section. The folks there will help you get what you need.
I would try the 80% with a low level white noise, especially since the right ear has so much loss. Then increase the gain over time.
As far as being disappointed, I can see why since your brain is over whelmed with the noise that you haven’t heard for a long time, and frankly that noise is making it harder to understand folks.
Stated again, you need to start low and gradually work up to your target gain.
I’m from Spain, so sorry for my English. Costco’s trial period is 180 days. I’ll consider that option if I’m not successful with my current audiologist.
Regarding brain overload, it’s possible, as I’ve had this hearing loss since childhood.
Right now, I’m at 100% of the target with the Fit4Comfort prescription. In the right ear, the feedback manager is cutting off the top of the curves around 2kHz, though I’m not sure if this is related to the noise.
What type of frequency compression would you suggest?
Since my right ear has significant high-frequency loss, I wonder if it’s better not to amplify frequencies above 6 kHz, I mean, not amplifying the 6-8 kHz range and avoiding compressing those frequencies.
Hm. Tough because 1) there is no threshold marked for 1500, which would be valuable in this case and, 2) I’m suspicious that they did not test below 20 dB in the lows. It just looks. . . suspiciously flat. With the lowest thresholds being 20 you could get away with a closed dome, but not so much if those thresholds are actually 0 dB.
But yeah, tough loss either way. There’s not going to be a huge degree of benefit in the right ear.
I’ ve never done well with domes. I’m very comfortable with full shell vented molds.
You have a challenging loss, especially in your right ear. Was it a sudden SN loss? Have you been evaluated for a unilateral CI? You seem to have sufficient residual hearing in you left ear for a HA to work well.
My SN hearing loss has been present since childhood, and I am currently 52 years old. The loss has remained relatively stable over the years.
I receive my audiometry results from my ENT specialist, and at my next audiologist appointment, I’ll request a more detailed audiometry.
The ENT specialist told me that I don’t need a CI and suggested I try HA.
In general, I can manage conversations quite well without hearing aids, but I have difficulty hearing from electronic devices like the TV, as well as in noisy environments, such as cars, restaurants, and other similar situations.
I am not a pro for take this for what it’s worth. It sounds like you’ve had a significant uncorrected loss since childhood that you’ve somehow compensated for pretty well (likely through lip reading) I’m guessing your word recognition scores are not good. I suspect getting benefit from hearing aids is going to be quite challenging because your brain has not processed certain sounds for a long time. For TV can you understand if it’s loud enough? If so something like TV Ears or other private listening device could let you listen while others listen at more comfortable (for them) levels.
I agree with the last comment that you have apparently learned to compensate for a pretty serious loss, especially in your right ear. Most hearing impaired people have difficulty in background noise. My HAs usually work well, except in restaurants.
You can always listen to music or TV through earphones. I’m not sure why your audio told you that you don’t need a CI. The issue is whether you can benefit from a CI. I suspect that you can, certainly in your right ear.
It’s curious because most of the time I don’t need hearing aids to watch live TV shows at a comfortable volume for everyone. However, watching TV movies is impossible for me; I usually rely on subtitles to understand what I don’t hear, or I use Bluetooth earbuds.
Another challenge for me is understanding foreign languages.
I can say that with hearing aids, I’ve now discovered that my coffee machine beeps when I press a button.
These are my first hearing aids, and I’ve been trialing them for 45 days, so I hope to have enough patience to train my brain to adapt to the new sounds. I’m constantly asking my partner if a sound is supposed to be like that, or why someone sounds so loud…
Somehow you have to have a good audiologist and trust them to set up the aids properly for you. Then you need to wear them as much as possible for you to acclimate.
In the end you will hear better and be comfortable wearing hearing aids. This may take a few months, we are all different when it comes to hearing loss.
Your right @Neville. The audiogram needs more data, I’ve updated mine with more accurate information. My hearing below 1kHz is around 10db or less, that’s the reason why I’m not confortable with closed domes.
Now I’m using an open domes with no white noise, with not much general gain. From here, I need to gradually increase the gain to get more benefit from HA. The challenge will be to achieve the target without feedback and without white noise.
Thanks, that looks more understandable. Probably your hearing loss is genetic progressive since later childhood? You would have had trouble learning language if you were born with this loss. It’s also not really a loss configuration I typically see in infants.
With open domes, the audiologist will be lucky to get you up to 3 kHz targets in the left and 1.5 in the right. I expect that hearing aids will be a benefit, but less than one might hope. Streaming will be useful. In a noisey situation at your age you might still do pretty well with the hearing aids plus lip-reading.
My audiogram is not too different from yours. I wear a BTE with custom earmolds. But I wear the earmolds because domes allow to much moisture to build up in the ear canal. I had an eardrum replace eons ago and there is what they call weeping from that. I have never had a problem with the earmolds but I had a lot of problem with domes. I cannot offer anymore information than that from my personal experience. I hope you find the right fit.
Thanks for your comments,
What about occlusion with custom molds? Without vents you have occlusion and with vents you are in the same situation than with vented domes.
I wear custom molds because of the conditions inside my ear canal. I get a great deal of moisture build because I had an eardrum replaced and this type of surgery tends to “weep” over time. The custom molds I have are vented. Not entirely sure if the vents are intended to allow some air circulation but they apparently do. I had a very bad experience with domes at one time and will never ever wear another type of HA. The molds I have are called “skeleton molds”. There are many types of custom molds. I had a link to a picture but deleted the picture and now cannot find a good one again. But if you do a search you may be able to see the different types. Hardly anyone notices my hearing aids.