Phonak Audeo: open or vented domes?

Yep I’d go with custom made moulds as well, with the correct sized vent, however have you got a local Costco and try with some updated models.

With your audiogram you shouldn’t have open domes, because it causes you’re probably underamplified and get little benefits. Try different size of domes, maybe medium instead of large?

Personally, I would recommend go firstly all-in:

1. Power domes (for deep placement - probably M size, because ear canal is often narrower when deeper). Deep placement helps greatly in avoid to occlusion effect (boomy own voice when you put hearing aid turned OFF, not on).

2. Which receiver power do you have? If you have M - it is probably too weak. Try P receiver.

3. Changing to another acoustic coupling, like power domes creates more earplug effect which should be overcomed by new fine tuning, with Real Ear Measurement in perfect situation. Choose NAL-NL2, NAL-NL3 or DSL 5.0 fitting algoritm, not manufacturers proprietary.

More closed coupling helps greatly to improve speech understanding but requires patience to getting used to it.

You can step-down from power domes to close domes, but I think you shouldn’t do it regarding your hearing loss.

Custom earmolds are the gold standard, but it’s a bit guesswork to choose proper vent diameter which requires even more patience.

I have cShell with 0.9 mm vent with UP receiver and it’s great. However I don’t recommend Paradise UP in your case.

Hallo everybody!

After a few attempts, I finally have a first — and positive — update on this topic, in case anyone is interested.

I got a bunch of Phonak power domes in two different sizes (S and M), since I wasn’t sure which ones would fit properly.

I started testing them with my Phonak Audeo Paradise HAs, but this resulted in a lot of pain and irritation in my ear canals, because both dome sizes kept popping out after a while and I repeatedly pushed them back in. I was close to giving up, but I decided to try the same domes with my old Resound Lynx 2 — and they worked amazingly well: same domes, same ears, but no popping out!

The sound improved a lot compared to open domes, and two days ago I was able to join a large company meeting in a worst‑case/nightmare scenario (large room, many people talking from their seats, female hosts on stage, no microphones) without missing a single word! And all of this using my old Resound Lynx2 761 HAs — 10‑year‑old technology!

I’ve never (never!) felt so engaged in the last 20 years.

I was very happy with this result, but still confused by the mixed outcome: same domes, same ears, pain and poor performance with Phonak, success with Resound.

I’m still investigating, but I’m quite sure the main factor is the different receiver wire length and shape: on the Resound I have size 4, which is a little too long for me, but it has a longer straight section after the last bend before the receiver, allowing the dome to go deeper into my ear canals.

My audiologist told me that Phonak doesn’t offer a size 4, because their lengths go from 0 to 3, and Phonak 3 is supposed to be equivalent to Resound 4. I’m not sure about that, but I managed to get a pair of Phonak 5.0 3M receivers yesterday evening. I’m testing them right now, but at the moment the domes are still moving back and forth.

What do you think? Is it possible to reshape the receiver wires without damaging them?

Thanks!

Something I forgot: I switched both HAs from proprietary fitting prescriptions (Phonak adaptive 2.0 and Audiogram+) to NAL-NL2, as suggested by @Bimodal_user, so I have a “comparable” scenario now.

1. Which receiver power do you have? If M (SDS 5.0), try P, which is longer (which adds a bit of lenght) and wider, so it will be less wobbly. Perhaps you have larger receiver with Resound.

2. Do you use retention loop?

There is advice, which wire lenght you should use, I have “0” (zero), despite having “2” previously:

@Bimodal_user said:

1. Wire length - too long is detrimental to directionality because two microphones would not be aligned horizontally.

There is measuring piece as shown in the form, but I recommend measuring by rules written in PDF provided thanks to @raylock1:

Here is a Phonak guide which may help. See the chart at the bottom of the page.

This video explains why excessively long wire lengths can be detrimental to hearing:

The best option is custome earmold/cShell with no vent or minimal 0.5-0.8mm if you have no problem with occlusion effect.

@marcobuffa said:

I managed to get a pair of Phonak 5.0 3M receivers yesterday evening. I’m testing them right now, but at the moment the domes are still moving back and forth.

The aids should sit on top of your ears and the wire going to your canal should be flat against your head. If it is off your head the dome is not all the way in or you have the wrong sized receiver.

Try comparing the Resound receiver to the Phonak. The bends could be different too. These bends can be adjusted with the heat from a hair dryer.

You are getting some good advice. Good luck with this. I would also recommend molds with your hearing loss.

Thank you all for very good advices you are sharing.

At the moment I managed to make also the Phonak HAs work using power domes L size. This creates the right sealing in the canals and a good sound quality with no pain, but the booming effect of my voice is quite annoying because of external receiver placement.

Still investigating and searching for some european online dealer who sells Unitron domes.

The huge difference with Resound receivers is because Resounds are thinner, so the dome heads can go deeper in the canal, collapsing better around the receiver. To get the same effect with Phonaks I need receivers L (edit: I meant S: low power), but they aren’t compatible with my hearing loss.

I will post any improvement here.

@marcobuffa said:

At the moment I managed to make also the Phonak HAs work using power domes L size

Try something like in my case - M size and push carefully deeper, which greatly can improve your voice.

Phonak has S (not recommended), M, P and UP receivers.

I think you should have at least P. If I would have your audiogram and have no problem with spending money, UP in cShell would be probably the best, but I am not sure how deeply cShell could reach in yoour case.

Not sure why your really need to change if your that happy with medium, power are also a bigger diameter, have you considered custom moulds, this should make for a more comfortable fit, you’ll need to recalibrate your HAs when you change receiver as well.

Yes, that’s basically correct.

Anyway, I would like to test P receivers because:

• They are also longer, and currently with size 3M, the wire is applying some traction to the receivers, which very slowly get out from the nice spot in canal.
• Target is placing the gain curve for my left ear very close to M receiver limit. I some area, the gain is outside the limit. I don’t know if this can happen, but I’m quite sure I’m feeling some distortion on my left ear is some specific situation.

I never considered moulds. I’m pretty curious about them, but I have no idea about their cost and all the implications. I will try to get some information more from my aud in the next visit.

Thank you!

Yes if your just outside based on your audogram, you should go for power if your getting a bit of distortion, and yes ask your Audiologist about moulds with venting.

my mother in law has the same hearing loss as you and was fitted with phonak RICs from Boots with open domes originally. she couldn’t hear SHIT with them. i only met her when the warranty ran out so I made her go to the NHS who fitted her with Oticon Optim power BTE with skeleton moulds but with huge vents. she heard ok with these but struggled in even mildly noisy places.

recently i took her to my audiologists and they fitted her Sphere Infinio with titanium custom moulds with only small vents and what do you know she hears quite well now even in moderate noise.

why the obsession with open domes and massive vents when they’re not indicated ?? in NHS *and* private?? makes no sense to me.