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How to decide dome type?

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When I started My Hearing Aids 2.0 Journey I went to my old audiologist, updated my and the gave me new domes. I had been using OpenBass domes on my Oticon More 2s for four years, and they were working well for me, or so I thought. At that time, the HIS switched me to single and double vented bass domes (in different ears), which I didn’t like, and I eventually went back to OpenBass.

Now I have my new Oticon Intent 1 hearing aids, and my new audiologist fitted them with tulip domes. I tried these for a few days, and I don’t like these either. I switched back to OpenBass again, and I’m happy (note: I have not yet recalibrated the feedback response).

So I started researching this whole dome issue, finding information on this forum (thread, thread, thread, thread), but I’m not really finding a guide to help me decide.

What I like about my OpenBass domes: I feel like I’m getting good sound from my hearing aids, I understand people’s speech, and the domes are comfortable and securely fit into my hears.

What I didn’t like about the single and double bass domes: as I spoke or chewed, I’d develop high or low pressure between the dome and my eardrum, and it was very uncomfortable, impacting my hearing. Trying to “pop” my ears by yawning didn’t resolve the pressure issue. The domes themselves felt comfortable and secure.

What In didn’t like about the tulip domes: the pressure issue was there, but to a much smaller degree, and yawning seemed to equalize the pressure, but I had to do it all the time, which is annoying. They itch. I wonder if the corner of the tulip petal (to extend the analogy) digs into my ear canal and causes some irritation. The tulips don’t seem as securely mounted. If often felt as if the receivers are trying to work their way out (perhaps from incessant yawning to equalize pressure).

I understand that the OpenBass domes let more sound escape, exacerbating the feedback problem. Do the OpenBass domes also make the hearing aids less effective? Should I give this more time to adjust, or should I just go back to my tried and true OpenBass domes?

Of course, I’ll also have this same conversation with my HIS, but I always appreciate the wisdom of this forum.

As my audiologist once told me that domes are chosen by size of the ear canals, the receivers and your hearing loss, .

Edited

I use OpenBass domes and they work great for me. I use them with both my Widex and Phonak hearing aids, though OpenBass domes are made exclusively by Oticon (its a propietary design – a super clever one in my opinion). They are not exactly open domes but something in between open and bass domes.

Switching to a more might cause occlusion (that plugged feeling you get when you put your fingers in your ear canal, the pressure feeling you describe). Also, hearing aids with open domes are more prone to whistling, which depends on factors like programmed gains, ear canal shape, and so on.

OpenBass domes may not be ideal for some people in noisy environments as they allow most sounds to enter the ear canal. This means the hearing aid struggles to manage voice and noise effectively due to minimal noise filtering. If you struggle with speech in noise, open domes may not be the optimal solution.

If OpenBass domes worked well for you before and you were happy with them, it might be worth asking why they were changed. Perhaps the new programming isn’t compatible with openbass domes.

Adjusting to a different type of dome can take some time. My audiologist flat-out refused to give me open domes, saying, “I don’t prescribe open domes to anyone anymore.”. I self-program my aids now and I’m super happy with my domes.

Oticon doesn’t manufacture tulips, so it’s interesting that they fitted you with them. From my experience, the performance of tulips and OpenBass domes is quite similar.

Your hearing loss and gain per will dictate what domes/molds are needed.

Just because it sounds good doesn’t mean it’s right for your hearing loss. It’s key to properly adjust the aids to your loss first. Then give your brain time to acclimate to these properly fit aids. If that’s unbearable the overall gain can be lowered to allow you time to acclimate. Then gains should be moved up eventually reaching 100% of your prescription.

IMO

If you haven’t already seen this, it might offer some further information.

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