Hi guys. Cliff Olson,
Doctor of Audiology and founder of Applied Hearing Solutions in Phoenix,
Arizona.
And in this video I'm gonna teach you how to know if you should be using a
rubber dome or a custom ear mold to get the most out of your hearing
aids...coming up!
If you've been watching my channel for a while now,
then you already know how complicated it can be to hear your absolute best.
Even if you have a great pair of hearing aids,
there are literally hundreds of different variables that must be taken into
account when selecting the most appropriate technology,
the most appropriate components,
and the most appropriate way to program your devices. And like I say,
if you make a mistake on even one of these different variables,
it can have a detrimental effect on your overall performance with your devices.
One of the variables that I'm going to be talking about in this video is how you
couple your hearing aids to your ear canals,
and I'm specifically talking about whether or not you use a rubber dome or a
custom ear mold. But before I teach you how to select the right one,
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Now let's take a look at why there's even a debate between rubber domes and
custom ear molds,
and make sure that you stay tuned to the end of this video because I will be
giving you audiogram examples to help you understand why you should be going
with one or the other.
Receiver in canal hearing aids have been extremely popular for a while now,
and they're the most widely used style of hearing aid on the planet.
They are so commonly
recommended by hearing care professionals because they are
extremely comfortable,
they can fit a wide range of hearing losses, they have a ton of great features
like Bluetooth connectivity and rechargeability,
and they're even quicker to fit because you don't have to wait for a custom
product.
That's because you can use a rubber dome on the tips of these hearing aids like
you see right here.
But not only can you use a rubber dome on this style of hearing aid,
you can use one of those custom ear molds like you see right here as
well,
which allows you to fit a wide range of hearing losses between both of these.
So the question then becomes why would you actually want to use a rubber dome
instead of a custom ear mold? Let's go ahead and get into it.
Rubber domes are by far more popular than custom ear molds,
not because they're always better,
but because they're much easier for a hearing care professional to fit much
quicker. Domes come in a variety of different sizes all the way from small to
large, and they come in a variety of different styles as well.
Going from an open fit to a vented fit to a closed fit,
all your hearing care professional has to do is select the most appropriate dome
for your ears and for your hearing loss,
and they could technically fit you with a pair of hearing aids the exact same
day that you get your hearing tested.
Domes are also typically very comfortable because they're made from a very soft
silicone and they can bend and contour to your ear canal shape acoustically.
Rubber domes are typically more appropriate for
individuals who have a mild to
moderate level of hearing loss with that hearing loss being primarily in the mid
and high frequency ranges with normal low frequency hearing.
This is because rubber domes,
especially open and vented styles of rubber domes, are such a good option because
they typically allow in the
low frequencies that you can hear naturally already
and just supplement the mid and high frequencies depending on the level of
hearing loss that you have. And it does a very good job of preventing a
phenomenon called insertion loss,
which is something that you experience if you plug up your ears with something.
This then allows the mid and high frequencies that
are being amplified by the
hearing aid to combine with the natural low frequency sounds that are entering
into your ear canal unaffected. Now, if you do happen to have a low,
mid and high frequency hearing loss and you're in a pinch,
you can use a closed dome or a power dome to try to trap in the low frequency
sounds as well. I never typically recommend this though if you can help it.
Rubber domes are also very easy to replace and exchange.
So if you wear out your dome, you can just put on another one,
or if your hearing loss changes,
your hearing care professional can grab a different style of dome,
attach it to your hearing aid and reprogram your
devices for you. Even though
rubber domes are extremely critical to the performance of your hearing aids,
they are still very cheap.
So if you have to replace them often it's not gonna hit you in the pocketbook
very hard.
But as great as rubber domes are for a lot of individuals with hearing loss,
custom ear molds can oftentimes be even more appropriate.
So let's go ahead and take a look and actually see what a custom ear mold is.
Custom ear molds are made by either taking a physical impression of your ear and
ear canal using a form of injectable silicone or gel
that solidifies after three
to four minutes or a 3D ear impression with a laser scanner to create
an instant digital image of your ear that could be sent to a manufacturer for
custom ear mold fabrication.
Custom ear molds typically outperform rubber domes for more complex cases of
hearing loss and more severe cases of hearing loss. This is because you can do a
much more precise job of trapping amplification inside
of your ear canals when
you have a custom molded earpiece that is made specifically for your ear canal
anatomy.
Custom venting inside of a custom ear mold is also another reason why a custom
ear mold can outperform a generic rubber dome.
By being able to control the exact vent size,
your hearing care professional
can determine which sounds they want to allow to
enter into your ear canal naturally and which sounds they want to be amplified
by the hearing aids, all while preventing whistling and feedback.
The ability to restrict which sounds enter into your ear canal naturally
also allows your hearing aid to do a better job of noise reduction and
directionality, so you can cut out a lot more background noise.
Wireless music streaming almost always sounds better with a custom ear mold
because custom ear molds allow you to trap in the low frequency bass tones. So
music sounds much more rich and full. If you use a rubber dome,
a lot of these bass tones will just leak outside of your ear canals and you
won't even perceive them.
Not only do custom ear molds give you more precision when programming and trap
in more low frequency sounds for better music streaming,
but they also have better retention as well,
because if a custom custom ear mold doesn't wanna stay inside of your ears,
you can add on canal locks, you can add on helix locks,
and you can even add on skeleton locks to make sure that those hearing aids
never fall out of your ears. Now, you might be thinking to yourself,
there's gotta be a visual
difference between a rubber dome and a custom ear mold
while you're wearing them. Well,
I'm gonna go ahead and put in a rubber dome inside of my left ear canal here,
and I'm going to put a custom ear mold inside of my right ear
and let you decide for yourself which one looks better and if they have
a big difference between them. So this is the open dome on this side,
and then this is the custom ear mold on this side.
So if you ask me,
I think that they look very similar when you look inside of someone's ear canal,
both of them are relatively inconspicuous and you probably cannot even tell a
difference when you're looking at me head on.
Now that you have a basic understanding of rubber domes and custom ear molds,
let's go ahead and take a look at some different audiograms to show you what I'm
looking for when I'm selecting which type of ear coupling to go with.
And let's go ahead and start with the rubber domes first. In general,
when looking at an audiogram,
I'm always the most concerned with what speech information is able to make it to
the brain without amplification,
and what information is not able to make it to the brain without amplification,
as well as how much amplification would be required based on the severity of a
particular hearing loss. Any of these speech sounds that are below the X's and
the O's are able to make it to the brain without any assistance of a hearing
aid. Any of these speech sounds above the X's and the O's, however,
require amplification to return them back to the brain so they can be heard.
In the case of this mild high frequency hearing loss,
an open rubber dome would be the most appropriate because they would allow the
low frequencies to enter the ear canal naturally and allow the hearing aid to
amplify the high frequencies enough to make them audible again,
all without the risk of feedback or whistling from the hearing aid as long as
the hearing aids are programmed properly using real ear measurement. Now,
if you do not know what real ear measurement is,
I highly recommend that you check out my video that I will link in the
description because being able to determine the
acoustic differences between a
rubber dome and a custom ear mold are impossible unless they're being measured
inside of your ear canals. In the case of this mild mid frequency to moderate
high frequency hearing loss,
a vented dome would likely be most appropriate because
it would not restrict the
good low frequency hearing,
but would allow for better amplification of the mid and high frequencies.
And the unique case of a reverse low hearing loss,
either an open dome or vented dome,
is also often the most appropriate despite the inability to be able to amplify
low frequency sounds. Without a closed dome or custom ear mold,
going with an open or vented dome will prevent the upward spread of masking that
can easily occur with reverse slope hearing losses,
and totally destroy your performance. Now,
reverse slope hearing losses are very complicated,
and I do have another video where I discuss how to treat a reverse slope hearing
loss, and of course, I'll link that in the description as well. All right,
let's go ahead and take a look at a few hearing loss examples that would be more
appropriately treated with a custom ear mold instead of a rubber dome. In the
case of a moderate flat hearing loss, we need to be able to trap enough low,
mid,
and high frequency amplification inside of the ear canals so it does not just
leak out substantially limiting hearing aid benefit.
A custom ear mold would do this extremely well as long as the proper vent size
is selected by your hearing care professional and again,
verified using real ear measurement.
In the case of a steeply sloping high frequency hearing loss,
a custom ear mold with a custom vent size is also most appropriate because it
can allow for the low frequencies to enter the ear canal naturally,
but without the vent being so large that it allows the hearing aid to whistle
because we need to amplify the high frequencies so much.
This can be a tricky hearing loss to treat,
but it is much easier to do
with a properly fit custom ear mold. In the case of
a severe to profound hearing loss,
it is critical to use a custom ear mold either without a vent or just a very
small pressure vent to ensure that enough amplification is retained inside of
the ear canal.
Attempting to fit a hearing loss severity such as this with a rubber dome would
be in extremely poor decision and ultimately a waste of a good hearing aid.
Alright.
Hopefully me going over these different types of audiograms helps you understand
a little bit better if you should be using a rubber dome or a custom ear mold at
the end of the day.
In order to correctly identify whether or not you need a rubber dome or a custom
ear mold,
it comes down to your understanding of acoustics and if those acoustics have
been verified inside of your ear canals using real ear measurement. Ideally,
you should be able to rely on your hearing care professional's recommendation of
whether or not you should be going with one versus the other,
but you have to make sure that you go to a hearing care professional who knows
what they're doing, because in my opinion,
rubber domes are way over-prescribed for most types of hearing losses that are
out there,
and there's a lot of benefit that's just leaking out of people's ears. So the
next time you get a new set of hearing aids and your hearing care professional
is fitting you with those devices,
make sure that you ask them
why they selected a rubber dome or a custom ear mold
so you can make sure that you hear your absolute best. That's it for this video.
If you have any questions, leave them in the comments section below.
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go ahead and hit that subscribe button. Also, feel free to check out my website,
HearingUp.com.