Ear Moulds or Domes?  Which is Best for You?

Earmolds are made of either plastic or silicone and custom-fit so that they sit snugly and precisely within the ear canal. They generally have small vents in them to let air through. 

Depending on the type and degree of hearing loss, and the anatomy of the ear, the earmold can be canal size (small), half-shell size (medium) or full-shell size (large). The kind of earmold you wear also depends on your personal preference, the shape and texture of your ear, and your specific hearing aid. 

For people who have trouble hearing at low frequencies or across all frequencies, earmolds deliver better sound because they fit snugly inside the ear. The snug fit keeps amplified sound from traveling back outside the canal and creating a feedback loop, which is a high-pitched whistling that’s caused as the amplified sound leaks out and gets reamplified.

Earmolds are usually best for hearing loss across the entire speech spectrum.  People who are already accustomed to wearing hearing aids may prefer the earmold style, while first time hearing aid users often opt for hearing aid domes because they are more comfortable, have less occlusion, and are easily changed.

Since ears come in all shapes and sizes, it’s important to have a hearing healthcare professional customise an earmold to fit the unique shape of your ear. These devices must be tight enough to prevent sound from leaking out and creating feedback—but not so tight they cause pain.

The customization process is painless and includes making an impression of your ear canal and outer ear with a soft molding compound, much like a dentist would use to take an impression of your teeth. 

Over time, ears and moulds can change shape, so make sure you get the audiologist to check regularly for changes.
Some of the common problems earmold users can experience include:

• Your own voice sounds muffled. Because the earmold blocks the ear canal, users may notice their voices sound muffled, much like during a bad cold. This is known as the occlusion effect and can be managed with earmold modifications or hearing aid circuit changes.
• Your own voice sounds too loud. When a hearing aid user complains their own voice sounds too loud, the earmold may need a larger vent.
• Feedback or whistling. If the vent in the earmold is too large or in the wrong place, sound can leak through and cause feedback. Your hearing healthcare professional can address this problem by attaching a small handle called a “canal lock” that will hold the earmold more securely in place, preventing feedback. 

Domes are small, bell- or mushroom-shaped silicone pieces that attach to the end of hearing aid tubing and fit deep in the ear canal. They come in different shapes and sizes to accommodate the unique twists and turns of each individual’s ear canal.

They’re usually used with behind-the-ear styles of hearing aids referred to as either receiver in the canal (RIC) or receiver in the ear (RITE). Your hearing healthcare professional helps you pick which size of dome and length of tubing is best suited for the width and length of your ear canal.

Hearing aids with domes are best for those with mild-to-moderate hearing loss, especially those with high frequency hearing loss—the most common type of age-related hearing loss, known as presbycusis.

Hearing aids with domes are generally best for those with mild-to-moderate hearing loss.

RIC or RITE hearing aid devices are typically small, with a microphone and processor that fits in a small case and rests behind the ear. The speaker is attached to the processor by a thin tube or wire, and it’s meant to fit deep inside the ear canal.

This style of hearing aid is not recommended for those with severe-to-profound hearing loss; instead, a behind-the-ear device using earmolds is often more suitable. Earmolds provide the most powerful amplification and are less susceptible to moisture damage from the ear canal.

Although, in a lot of cases it comes down to personal preference. 

Pros
One of the biggest advantages to wearing a dome is the way it fits inside the ear canal.

The important thing about hearing aids is we must vent the hearing device so the ears don’t get occluded. This allows some natural sound and airflow to come into the ear. Domes are open enough to let low frequencies come through so the hearing aid amplifies higher frequencies and you can hear more clearly. That’s how we get better high frequencies without acoustic feedback.

Domes are easily cleaned by wiping them with a soft cloth each night after use. Because some hearing aid manufacturers share dome styles and sizes, they are also relatively inexpensive to replace.

Cons
they don’t last forever, and domes must be changed every two to three months. And if a person isn’t careful, it can get stuck in their ear if they are in a hurry or too lazy.

To prevent problems, talk to your audiologist about how often to change your hearing aid domes and how to take care of them. Never use old domes on new hearing aids. They’re not always compatible and can become stuck in someone’s ear canal if they don’t stay attached to the receiver.

Also, domes are susceptible to damage from wax or moisture in the ear. Lastly, their small size can be problematic for those with dexterity issues.

work with your hearing care professional to find the device that best addresses their particular hearing needs. An improper fit can affect your ability to hear clearly as well as cause pain or discomfort.

No two people process sound the same way so it’s important to make that determination on a case-by-case basis.

(Source: healthyhearing.com)