When you take your hearing aids out of the box, the tiny little mushroom-shaped bits attached to the end of the hearing aids might be the first things that catch your attention. They come with your receiver-in-canal hearing aids and serve many purposes. These magical pieces, despite being similar to normal earbud tips, have a unique name --- hearing aid domes.
Typically, hearing aid domes have these functions:
The major function: Delivering the amplified sound from the hearing devices directly into your ear canal
Providing wearing comfort
Protecting your hearing aids from earwax build-up
Making sure your aids are placed securely and properly in your ear canal
Hearing aid domes usually come in three types. When you buy hearing aids from a hearing clinic, the audiologist will select the suitable domes for you based on your ear canal size and hearing loss level.
As hearing aids become increasingly available online these days, users now may have to choose their own type of domes. While seeking advice from a professional/specialist is still a recommended practice, it's important that we have at least some degree of knowledge about them so as to find a good match.
As the name suggests, open domes are designed with multiple holes around the center. This particular design makes it conducive for low frequency sounds to pass through the domes, while high-frequency sounds can still get amplified by your hearing aids. Also, open domes invite more natural sounds to come into your ears, and help create a natural sounding for your ears without causing a sense of occlusion.
These ones are also self-explanatory in that they do not have noticeable holes (some do with tiny holes around). While a closed dome does better in preventing whistling from occurring in your ears, they can feel a bit more clogged in the ears. They also provide better sound amplification.
Some people also call this certain type a power dome because they deliver the best sound amplification. The double-layered design offers the best seal so that the least amount of sounds can enter your ear canal without being processed by hearing aids. That said, whistling can be reduced to the largest extent when you pair this type with your hearing aids. And they are recommended for people with a greater need for sound enhancement.
Whistling/feedback is probably one of the most frustrating yet common issues concerning hearing aid users. At least at some point in time we have been annoyed by the harsh jarring sounds coming out of our devices. And some may still be suffering this. Whistling happens when the hearing aid microphone picks up the already-amplified sound and re-enhances it. That way, the sound can go distorted and excessively loud, making a very unpleasant feedback to the ears.
Though open domes do better in providing natural sounding quality, the vented shape may allow some amplified sounds to leak out and get picked up and amplified again by hearing aids, therefore causing unwanted feedback.
Occlusive types like closed and double domes can efficiently block the sounds within the ear canal, playing the role of a meticulous gatekeeper. The negative side, though, is they can feel uncomfortable in the ears, especially for new wearers.
It's important to note that while vented domes can be a major cause for whistling, other factors such as earwax build-up and excessively high volume can trigger feedback too. When there is constant whistling with our hearing aids, it's best to check your domes for earwax blockade and damages, then change to a new one where needed . If the situation does not improve, switching to an occlusive type is always recommended.
Besides a match of type and regular replacement, proper wearing of the domes matters as well. A loose dome in the ear leaves a lot of room for unwanted sounds to sneak in and out, thus causing significant feedback. Always make sure we try out every single size under each type until we find the best fit.
Fun fact: whistling can occur particularly when we are chewing food, where the inner shape of our ear canals change alongside our jaw movement. This can further loosen the domes and widen the gap. Next time when trying out domes, drop your jaw and see whether the dome feels secure in the ear canal.
For many first-time users, starting with closed or double domes is not going to be a satisfying experience. In addition to a discomfort of being stuffed in the ears, there is an occlusion effect that often comes into play where body-conducted sounds like our own voice gets trapped in the blocked ear canal, resulting in a hollow and bass-like sounding effect, aka occlusion effect.
This explains why audiologists suggest trying open-type domes to start for users with relatively mild hearing loss. But one thing to bear in mind is that, there is no perfect dome and each type has their pros and cons. Most importantly, whatever the type we stick with, adaption matters --- It always takes time for us to get used to it. During the first few weeks, try gradually increasing the amount of wearing time day by day. When things do not feel right, turning to a professional is a choice that can never go wrong.
If this lengthy article seems too much to digest, here's a few takeaways regarding how to choose the right domes.
A best way to learn about one's degree of hearing loss is always read their audiogram to identify the loss level and type. This gives adequate information for dome selection.
Usually, your hearing aids will arrive with an all-inclusive dome pack. And you are always welcome to book an audiologist session for recommendations. It's still suggested that we try out every type and size to see which one sits securely in our ears and works best with our hearing aids.
Like what's been said above, this never goes wrong. Whether it's continuous whistling, occlusion effect or uncomfortable wearing, you can always rely on an audiologist for solutions. When changing dome does not work, they can still fine-tune your hearing aids to address the issue. That's why going for a DTC brand with professional after-sale service is so important.
While we might be mentally prepared to welcome a new pair of hearing aids, our ears are possibly not ready with their new neighbors. Spare some time and keep wearing your hearing aids on a daily basis. This surely facilitates the adaption process and helps you quickly form the habit.
Great news though, given the difficulties finding a dome that satisfies the needs for both comfort and whistling prevention, DTC hearing aids like Orka One have developed tech-powered features to tackle the whistling issue. Users can turn on Whistle Block via the hearing aid app when they hear constant whistling now.
While many are still torn between open domes and closed domes, Orka users are spared from the headache now that they can enjoy both comfort and feedback reduction by switching on the function whenever they feel the need to.