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Couple of questions about occlusion effect and IIC fit

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Well I received my Phonak Virto B titanium aids.

I go back for follow up in 2 weeks. In the interim I am trying to get used to them.

My first issue is occlusion which only occurs in the right ear. When fully inserted I have that very bothersome speaking in a barrel effect. If I pull down on my earlobe the effect disappears. I suppose I am allowing the lower frequencies to exit by pulling down on earlobe,

I do not have this issue with the left ear. I will ask my audi if the vent hole be enlarged but maybe cannot as the iic is pretty small

I recall reading somewhere that in some cases it is NOT true occlusion effect but rather the lower frequencies are too amplified and need to be adjusted. In my case I think it is true occlusion because if I take out the battery and insert the device I still have a relief from occlusion when I pull on my earlobe thus opening up to allow escape of lower frequencies.

My other issue is that the left ad sits deeper than the right and is pretty much IIC while the right is more of a … I was told going in no guarantee of IIC as everybody has different shapes/size canals.
Since the left is deeper and feels tighter in the canal why no occlusion the left side? I would think greater entrapement of lower frequencies with a tighter fit ?

My other question deals with removal. The aids have a short monofilament type thread that you pull with your fingers to remove the devices. My short fat fingers cannot grab the removal thread so I find myself using tweezers. Very frustrating.

Lastly: How long till you earn how to insert. It is a bit of a struggle. I insert partway but then dot know if I should direct aid right, left, up r down. After fiddling I finally get them inserted.

With all these very annoying issuesI am almost ready to go back to Lyric in spite the cost.

Appreciate any comments or suggestions

I have no experience with , but some thoughts. Your right ear would be more prone to occlusion since it has better low frequency hearing. I’ve heard that getting a deeper fit can sometimes help with occlusion. I don’t grasp the reason. How deep you can get the aid likely has something to do with ear canal anatomy–they can vary quite a bit.
Have you considered a ? They can be quite small and inobtrusive and give you great freedom in how occlusive a fit you want by offering a range from open domes to double domes to custom molds. I think “fiddling” is a key, necessary skill for dealing with hearing aids. :smiley:

When you get past the cartilaginous portion (from the meatal aperture to 1/2 - 2/3 the way down the canal) of the canal) you are in the bony portion. There is usually little or no occlusion once the aid terminates in the bony portion. Possibly the right aid could be recased to go deeper into the canal, it all depends on the canal size. A small pressure vent could be drilled in the canal end and faceplate if there is currently no venting. If it is a cast vent, the bottom portion could be ground away and make a trench vent. If the audiologist is good at modifications, there are a few options before trying for new longer canal.

@gorgeguy said:

If the audiologist is good at modifications, there are a few options before trying for new longer canal.

Not on the titanium though…

Ooops, I forgot about the titanium. I did not have to worry about titanium when I was modifying and repairing hearing aids. Plain old polymer and monemer or UV acrylic were all I had to work with. Good catch Neville.

You’re on right track thinking it is physical occlusion as opposed to “Amp-cclusion” which is caused by low frequency amplification. Pulling on your earlobe allows air to travel into your ear and relieves that “barrel effect” so physical occlusion is the likely culprit.

Fit is the issue. Tell your provider you are experiencing “speaking in a barrel effect” in your right ear.

Let your provider find the solution. That’s why you see them! FYI: Enlargening the vent is an option. The other options for your provider are to change the canal length or to taper the canal. If lengthening the canal is not possible- shortening the canal is the other option. You need to find the most experienced provider to get the best result.

You can ask your provider for an extra long removal cord (monofilament thread).

Lastly: practice insertion multiple times a day. If you only do it once a day, that’s only one repetition. Try doing it 100 times in a day and you’ll learn quickly. It sounds like you ear canals have sharp curves. I can’t advise on inserting left or right or up or down because your ears are unique to you. Some of my patients have treacherous curves in their ears and they can insert into their own ears much better than I can.

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