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When do custom earmolds add value?

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Edited

I’m a bit puzzled by my current situation. When consulting healthcare professionals about my hearing loss, I’ve received various recommendations, including:

  1. Oticon Bass domes.
  2. Oticon Power domes with both 85 and 105 dB speakers.
  3. Custom molds.

Now, I have a couple of questions:

  1. Is it necessary for me to get custom molds for my hearing loss? When is it typically recommended to use custom molds?
  2. What’s the difference between the 85 dB and 105 dB speakers? How does one determine which one is appropriate?
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@elderflower said:

What’s the difference between the 85 dB and 105 dB speakers? How does one determine which one is appropriate?

Which one is higher?

How bad is your ? You’re hitting close to 90 .

Custom molds are needed for a couple of situations: 1) You can’t find any domes that stay in place 2) You can’t get enough gain to hear properly without generating feedback or occlusion effect.
Although most people with your loss would prefer custom molds, if you’ve found a dome that satisfies the above two criteria, they should work fine. I’m thinking your loss should do fine with the 85 receivers. Ideally look at a fitting range chart, but eyeballing an the worst your loss gets out to 4000 Hz is 75 dB so 85 dB should be fine.

From how I understand it, the closer you are to 85dB and you are using 85dB receivers / speakers, then sound will be heavily compressed but I’m not an expert in Aids.

:slight_smile:

In reply to @Zebras

Yes, 85 at 6kHz, but as I mentioned out to 4kHz only 75 dB. I think there will be minimal if any benefit to give additional gain at 6 kHz, but I could be wrong.

In reply to @elderflower

If you look at the fitting range chart, they extend the range down to almost 90 for 6kHz. The goal is to have most of your frequencies within range, especially 250 Hz to 3 or 4 kHz. 105 dB receivers would also work, but are bigger and I believe require custom molds that are fixed to the receiver.

I have had domes once and hated them. It was the first MINI aids that got from the . I bagged to either go back to my Custom hearing aids or get ear molds. I don’t like the way that domes felt in my ear canals, and I definitely didn’t like the tinny sound.

In reply to @MDB

@cvkemp said:

nd hated them. It was the first MINI RITE aids that got from the VA. I bagged to either go back to my Custom hearing aids or get ear molds. I don’t like the way that domes felt in my ear canals, and I definitely didn’t like the tinny sound.

So using 105 speakers with my loss would not have any disadvantages?

Edited

Ear molds are needed with severe or profound hearing loss. I would say your hearing loss would definitely need ear molds. Your loss isn’t that much different than my hearing loss. I have 105 db receivers, and they are very helpful. I fact i don’t have and feedback issues and none ot the artifacts of feedback trying to engage.

In reply to @elderflower

I don’t think so, but I’d ask your audiologist/fitter instead of listening to a stranger. Things that might make it beneficial that I don’t know: If it were a conductive loss instead of sensorineural, 105 would likely be helpful. If you like more gain than most people, it could be helpful. There are likely other reasons. Downsides of 105 is that they’re bigger and require fixed custom molds.

In general, it is usually recommended to use the 85 vs the 105 if the 85 sufficiently covers your use case. The 105 is built for more volume and there are tradeoffs in fidelity that could be tolerated if your hearing demanded the volume boost of the 105s. Custom molds would likely extend the life of the 85 receivers if your hearing slope of decline is different from your anticipated hearing aid replacement (upgrade) cycle.

@elderflower

With your hearing loss, I’d definitely have some form of custom moulds, especially with Phonak.

Anything less, and the feedback suppression software will take huge chunks out of the gain in your speech areas.

Slimtip custom moulds with would be my recommendation, as they may help in avoiding occlusion (hearing your own voice).

Another advatage of moulds over domes, is streaming. With streaming, the sound source starts in your ear canal, and moulds help keep it in there. Domes, leak out bass tones, so they sound tinny.

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