First off, congratulations on the channel. It's very helpful! My question is, where did you get that table at 1'37" recommending vent size according to tonal threshold? I've looked online and haven't been able to find a reference.
Dr Cliff, thanks again for another quality video. I have one question that I have not been able to figure. I am going to have my ear molds taken soon for the Virto M90-312. How exactly is MY vent size determined? By my AUD or by Phonak using the 1600 data points when analyzing the mold prior to production of my HA?
I have a pair of Phonak Vitro full shell in the canal hearing aids. If find it difficult to wear them full time due to moisture accumulating in my hear. Always thought it was because the vent size was to small. But, this wasn't mentioned in the video.
I see very little information about the best ear mold for people like myself who have hearing loss in the low frequency region and normal hearing in the high frequency region. I experience an occlusion effect when I have NO hearing aid in my ear. That has been one of my main complaints. After seeing three different ENT's in a year, the third ENT I consulted said, "do you know why your own voice sounds like you are in a tunnel, or have your finger in your ears?" When, I replied, "No, no one every explained that to me. The other two ENT's said my hearing was fine, and the one audiologist I visited said I really wasn't a candidate for hearing aids because I had normal hearing in the part of the frequency specturm used for speech.The third ENT then explained, " I would expect that anyone with low frequency hearing attenuation would feel a sense of fullness in the ear. "At a subsequent visit with this ENT, I asked, "WHY would a low frequency hearing loss give rise to a feeling of fullnes in my ears? He responded, saying that, quite frankly, he couldn't explain it. When I asked if it was just his experience that caused him to say this, he replied that it wasn't just his experience, but was a generally accepted fact by all ENT's The second audiologist said she disagreed with the statement that I wasn't a candidate for hearing aids, as some of the bass frequencies were necessary to distinguish vowel sounds. So, I am now starting wearing Oticon hearing aids. The occlusion effect became very evident at the fitting sesion and when the audiologist sensed how upset I was, she said, "let me try this," and proceeded, I believe, to change the tip to a smaller size. That helped. But, having worn the hearing aids for about four days now, which I realize is probably too short a period to expect positive results, I have yet to experience any benefits. My main compalints are: 1) if I am in a resonant restuarant, or any resonant room for that matter, with lots of people present, resulting in a lot of reverberation in the room, the noise is extremely uncomfortable for me, and makes it hard for me to speak, and prevents me from being able to hear my own voice. 2) Years ago, I used to sing in an accapella group. Not too long ago, when I went to sing with the group at an informal get together, It became evident right away that I couldn't sing lead, or background for that matter, because the sound of the group prevented me from being able to hear my own voice. Something like trying to sing onstage without monitor speakers. So, frustrating and upsetting to see that I couldn't sing with the group anymore. Another loss due to the aging process. Interestingly, when the members went upstairs from the very resonant basement we had been singing in, as we got ready to leave, and we started an impromptu song in the living room, with me on lead, it was an entirely different experience. I was exhilarated by the fact that I could hear myself with the group as they chimed in with the background vocals while standing next to me, just as it used to be. From this experience, I concluded, that the lower ceilings and general geometry of the basement, which encouraged tons of reflections, was the cause of my hearing issue. I haven't had an opportunity to see if my new hearing aids will deal with these issues, but I am pessimistic that they will do so. Can a hearing aid deal with such issues?
Your hearing loss is not so common and the hearing aids can help but you need to be patient, cause is a long journey, and probably you will need to go to your audiologist a multiple times to do any necessary adjustment.
What would you recommend for reverse slope hearing loss with recruitment? Low and mid-range frequencies entering my bad ear sound distorted, irritating, and distracting --but above 1,800 Hz they're fine.
Thanks for the channel. I find the vids really enlightening. I have a question re vents. Does the length of the vent matter? I currently have 8 year old Phonak ITE Virto Q90 with 2mm vents that are 25mm long and am happy with the voice intelligibilty they give me. My trial aids have 2mm vents but are 18mm long and intelligibilty is not so good.
I would be shocked if you have vents that are 25mm long. That would be the longest I have ever seen! Vent length does matter, but I think the performance is more due to how the aids are setup.
@@DrCliffAuD Thanks for the quick response. I remeasured and they are indeed 25mm long (they are 8 years old and half shell ITE molds). So its really the acoustic mass of the vent that is critical (not just the diameter) along with the prgramming/setup of course.
Hello, can you please give us informations/make a video on relationship between vent size and signal to noise ratio? (You know, automatic noise reduction in completely opened configuration with noise going directly inside de ear canal) thank you!
I really enjoy your chanel but I must say that Phonak have got their Acoustically Optimised Venting system wrong. I have a severe high frequency hearing loss and low frequency is almost perfect which would indicate the use of 3-4mm vents. Phonak in their wisdom have repeatedly given me 1-2mm vents despite multiple requests fro audiologists to make it 4mm. The occlusion effect was ridiculous. Eventually with 3mm vents the occlusion was okay but their p90’s were hopeless for speech in noise. We then went to Oticon OPN s1’s. They straight away gave me 4mm vents and speech in noise is now working. Occlusion is a thing of the past. Thank you Oticon
It could have also been the programing of the hearing aid, and also some people’s ears agree with certain manufacturers more as well… I’ve been through millions of different hearing aids and learnt that my ears like out of all the others i tried which was the resound and starkey ones… phonak is actually a great company overall, maybe just didn’t agree with you
Thanks for the explanation. I really love your video’s. Currently I have the Resound One MRIE with a closed dome with some ventilated ‘holes’ in it for the occlusion. The domes are not fitting well/comfortable. They itch, ‘plop’ constantly and got a lot of feedback. Is a custom made dome the answer and is this even possible at the MRIE 961 model?
Do you mean a microphone for a school situation? If so the newest phonak roger (the one with the screen) is really good, it shows you if you’re connected, charge percentage, different channels and more. For older students you can also use the roger pen which looks like a pen and has limited features but similar performance. There are other options but these are more common. It is recommended you talk to a specialist in hearing and microphone technology.
Someone who is used to wearing hearing aids; If you remove them and listen to LOUD music on a high end stereo, does it sound amazing? Or is a high end stereo lost on hearing aid(less) listeners?
I myself haven't tried that what I can tell you though is that when you take off your hearing aids at night or whenever really in my case everything sounds lower for a few seconds like the TV for example mostly because your brain is already used to the sounds from the hearing aids
@@meric12131415 Full hearing range is typically 20Hz - 20,000Hz. I have a friend that can only hear the tone up until 7500Hz. I suspect if someone with excellent hearing were to adjust their EQ, it would be nearly flat. I suspect if someone older were to adjust an EQ, they would boost the high's. An Aid may already apply a heavy correction that is lost with aids removed. Im curious to have someone used to wearing aids weigh in on a high end loudspeaker setup, and to also have them weigh in on EQ adjustments.
Dear Doctor I had the tympanoplasty surgery and I have a cavity near the ear drum. I will use cic hearing aid. My ear desibel result is 55 dB at 500 hz. So should I use vent or not. Ear cavity because of surgery how is effect the vent? There should be vent or not ? I really need your help please help me. Please:((
I also have had a tympanoplasty surgery.. And I’ve always had a mixed mild to moderate conductive and SN hearing loss.. when i had the hole, it had effected my hearing but after it was closed, it was more equivalent to my left.. i had my first pair of hearing aids at age 8 but didn’t wear them and got new ones when the tympanoplasty was healed.. still a work in progress though..
Dr Cliff, I was fitted for siemans aquarius hearing aids in 2016. It was suggested for me to get ear molds. First time wearing ear molds. I always hear my own voice weird? So does this mean I have the wrong vent size? I was just given a hearing test from another audiologist and they told me I'm on the edge between ear molds or no ear molds.
Do you have any problem to reach targets without feedback during REM on AOV-molds? My audi has said that Phonak probably makes a bit to large vent, because of comfort issues in patients with no experience with HAs. This problem resembles what you said about proprietary fitting formulas vs. REM. You also noticed that the first is cocentrating more on comfort than reaching the gain targets.
It also depends if your hearing aids are from silicon or acrylic, in either case if the space allows it, a second vent can be made in order to comfort you. Also, you didn’t specify if your problem is whistling or smth else, it might be smth that can be taken care of if digitally.
My son jus got new hearing molds with a vent but it gives alot of feedback is there a way to seal it? Cuz when I put the old molds there no feedback at all..
Dr. Cliff is it possible to adjust the vent size of ITE in ear hearing aids to prevent or reduce the occlusion effect? Or can it only be done with behind the ear hearing aids?
Earl Drake some people prefer them because their sound quality is better. Some people don’t because it can sound muffled or “airy”. But it definitely doesn’t work for everybody. I personally prefer closed because it sounds better.
But isnt it true that other hearing aid manufacturers also provide similar vent options which are optimized based on the same principle phonak uses? Because you are explaining it like no one else does it. I find this missleading.
Most other manufacturers make a vent that is called SAV (Select A Vent). This allows a provider to find the right vent plug for the patient. In my opinion, it is a rather crude way to do it. I'm sorry you found the video misleading, but at no point did I say that Phonak was the only manufacturer to address the venting issue. I just find them to be the best.
First off, congratulations on the channel. It's very helpful! My question is, where did you get that table at 1'37" recommending vent size according to tonal threshold? I've looked online and haven't been able to find a reference.
Very useful and well done, as usual. Thanks.
Dr Cliff, thanks again for another quality video. I have one question that I have not been able to figure. I am going to have my ear molds taken soon for the Virto M90-312. How exactly is MY vent size determined? By my AUD or by Phonak using the 1600 data points when analyzing the mold prior to production of my HA?
It is calculated by Phonak.
I have a pair of Phonak Vitro full shell in the canal hearing aids. If find it difficult to wear them full time due to moisture accumulating in my hear. Always thought it was because the vent size was to small. But, this wasn't mentioned in the video.
I see very little information about the best ear mold for people like myself who have hearing loss in the low frequency region and normal hearing in the high frequency region. I experience an occlusion effect when I have NO hearing aid in my ear. That has been one of my main complaints. After seeing three different ENT's in a year, the third ENT I consulted said, "do you know why your own voice sounds like you are in a tunnel, or have your finger in your ears?" When, I replied, "No, no one every explained that to me. The other two ENT's said my hearing was fine, and the one audiologist I visited said I really wasn't a candidate for hearing aids because I had normal hearing in the part of the frequency specturm used for speech.The third ENT then explained, " I would expect that anyone with low frequency hearing attenuation would feel a sense of fullness in the ear. "At a subsequent visit with this ENT, I asked, "WHY would a low frequency hearing loss give rise to a feeling of fullnes in my ears? He responded, saying that, quite frankly, he couldn't explain it. When I asked if it was just his experience that caused him to say this, he replied that it wasn't just his experience, but was a generally accepted fact by all ENT's
The second audiologist said she disagreed with the statement that I wasn't a candidate for hearing aids, as some of the bass frequencies were necessary to distinguish vowel sounds. So, I am now starting wearing Oticon hearing aids. The occlusion effect became very evident at the fitting sesion and when the audiologist sensed how upset I was, she said, "let me try this," and proceeded, I believe, to change the tip to a smaller size. That helped. But, having worn the hearing aids for about four days now, which I realize is probably too short a period to expect positive results, I have yet to experience any benefits.
My main compalints are: 1) if I am in a resonant restuarant, or any resonant room for that matter, with lots of people present, resulting in a lot of reverberation in the room, the noise is extremely uncomfortable for me, and makes it hard for me to speak, and prevents me from being able to hear my own voice. 2) Years ago, I used to sing in an accapella group. Not too long ago, when I went to sing with the group at an informal get together, It became evident right away that I couldn't sing lead, or background for that matter, because the sound of the group prevented me from being able to hear my own voice. Something like trying to sing onstage without monitor speakers. So, frustrating and upsetting to see that I couldn't sing with the group anymore. Another loss due to the aging process.
Interestingly, when the members went upstairs from the very resonant basement we had been singing in, as we got ready to leave, and we started an impromptu song in the living room, with me on lead, it was an entirely different experience. I was exhilarated by the fact that I could hear myself with the group as they chimed in with the background vocals while standing next to me, just as it used to be. From this experience, I concluded, that the lower ceilings and general geometry of the basement, which encouraged tons of reflections, was the cause of my hearing issue. I haven't had an opportunity to see if my new hearing aids will deal with these issues, but I am pessimistic that they will do so.
Can a hearing aid deal with such issues?
Your hearing loss is not so common and the hearing aids can help but you need to be patient, cause is a long journey, and probably you will need to go to your audiologist a multiple times to do any necessary adjustment.
What would you recommend for reverse slope hearing loss with recruitment? Low and mid-range frequencies entering my bad ear sound distorted, irritating, and distracting --but above 1,800 Hz they're fine.
Thanks for asking--i would also like to know (esp. for someone who has acquired reversed slope after years of normal hearing).
Dr. Cliff,
Thank you so much!!!
Thank you Dr.Cliff so much for the elaborate explanation on hearing molds and vents.
Thanks for the channel. I find the vids really enlightening.
I have a question re vents. Does the length of the vent matter? I currently have 8 year old Phonak ITE Virto Q90 with 2mm vents that are 25mm long and am happy with the voice intelligibilty they give me. My trial aids have 2mm vents but are 18mm long and intelligibilty is not so good.
I would be shocked if you have vents that are 25mm long. That would be the longest I have ever seen! Vent length does matter, but I think the performance is more due to how the aids are setup.
@@DrCliffAuD Thanks for the quick response. I remeasured and they are indeed 25mm long (they are 8 years old and half shell ITE molds). So its really the acoustic mass of the vent that is critical (not just the diameter) along with the prgramming/setup of course.
@@elmdcw 🤣 wow you have long ear canals
Hi dr. Cliff
Does RIC hearing aid is the best for normal low frequencies hearing and high frequencies hearing loss or not??
Hello, can you please give us informations/make a video on relationship between vent size and signal to noise ratio? (You know, automatic noise reduction in completely opened configuration with noise going directly inside de ear canal) thank you!
I really enjoy your chanel but I must say that Phonak have got their Acoustically Optimised Venting system wrong. I have a severe high frequency hearing loss and low frequency is almost perfect which would indicate the use of 3-4mm vents. Phonak in their wisdom have repeatedly given me 1-2mm vents despite multiple requests fro audiologists to make it 4mm. The occlusion effect was ridiculous. Eventually with 3mm vents the occlusion was okay but their p90’s were hopeless for speech in noise.
We then went to Oticon OPN s1’s. They straight away gave me 4mm vents and speech in noise is now working. Occlusion is a thing of the past. Thank you Oticon
It could have also been the programing of the hearing aid, and also some people’s ears agree with certain manufacturers more as well… I’ve been through millions of different hearing aids and learnt that my ears like out of all the others i tried which was the resound and starkey ones… phonak is actually a great company overall, maybe just didn’t agree with you
If I have a mild to moderate flat hearing loss, what’s the most ideal option for that?
This felt like an ad for Phonak towards the end…. Quite disappointing considering how I’ve loved your videos in the past
do you have hearing loss ?Dr cliff
Thanks for the explanation. I really love your video’s. Currently I have the Resound One MRIE with a closed dome with some ventilated ‘holes’ in it for the occlusion. The domes are not fitting well/comfortable. They itch, ‘plop’ constantly and got a lot of feedback. Is a custom made dome the answer and is this even possible at the MRIE 961 model?
I didn't get clearly the 4th point about the ability of amplify the low frequencies
Thanks!
what do you think about rexton hearing aids?
a simple question: what kind of FM-solution do you prefere for children?
I don't do pediatric audiology. Sorry.
Do you mean a microphone for a school situation? If so the newest phonak roger (the one with the screen) is really good, it shows you if you’re connected, charge percentage, different channels and more. For older students you can also use the roger pen which looks like a pen and has limited features but similar performance. There are other options but these are more common. It is recommended you talk to a specialist in hearing and microphone technology.
Someone who is used to wearing hearing aids;
If you remove them
and listen to LOUD music on a high end stereo, does it sound amazing?
Or is a high end stereo lost on hearing aid(less) listeners?
I myself haven't tried that what I can tell you though is that when you take off your hearing aids at night or whenever really in my case everything sounds lower for a few seconds like the TV for example mostly because your brain is already used to the sounds from the hearing aids
@@meric12131415 Full hearing range is typically 20Hz - 20,000Hz. I have a friend that can only hear the tone up until 7500Hz.
I suspect if someone with excellent hearing were to adjust their EQ, it would be nearly flat.
I suspect if someone older were to adjust an EQ, they would boost the high's.
An Aid may already apply a heavy correction that is lost with aids removed.
Im curious to have someone used to wearing aids weigh in on a high end loudspeaker setup, and to also have them weigh in on EQ adjustments.
@@andyh8239 🤣 ah sorry for the 2 year late reply but I can't exactly tell ya as I don't own a high end stereo setup
I am persuing bachlors of audiology in india ,want to go for AuD in Australia
Could you please direct me
i have moderate hearing...is treatment is necessary??if it is.. what treatment is effective
Moderate hearing loss eh? Hearing aids should do the trick
Dear Doctor I had the tympanoplasty surgery and I have a cavity near the ear drum. I will use cic hearing aid. My ear desibel result is 55 dB at 500 hz. So should I use vent or not. Ear cavity because of surgery how is effect the vent? There should be vent or not ? I really need your help please help me. Please:((
I also have had a tympanoplasty surgery.. And I’ve always had a mixed mild to moderate conductive and SN hearing loss.. when i had the hole, it had effected my hearing but after it was closed, it was more equivalent to my left.. i had my first pair of hearing aids at age 8 but didn’t wear them and got new ones when the tympanoplasty was healed.. still a work in progress though..
Dr Cliff,
I was fitted for siemans aquarius hearing aids in 2016. It was suggested for me to get ear molds. First time wearing ear molds. I always hear my own voice weird? So does this mean I have the wrong vent size? I was just given a hearing test from another audiologist and they told me I'm on the edge between ear molds or no ear molds.
Could mean there's wax build up in the vent hole. I tried cleaning mine with the tool given to me, but it really requires something bigger.
@@waynetubr I cleaned that hole a lot so it wasn't wax
Probably could be the occlusion effect
@The Gadget Guru yes that what it was.
@@GaryORiveraSr ah glad I could help😁
I've worn hearing aids with moulds since birth with no vents at all, am I missing out on anything at all?
James Wong not at all. I grew up without vents then when I moved and switched company’s they gave me vents. They ended up sounding airy and muffled.
Other manufacturers have the same thing with the AOV LOL 😂
Do you have any problem to reach targets without feedback during REM on AOV-molds? My audi has said that Phonak probably makes a bit to large vent, because of comfort issues in patients with no experience with HAs. This problem resembles what you said about proprietary fitting formulas vs. REM. You also noticed that the first is cocentrating more on comfort than reaching the gain targets.
What vent size would be best for someone who has problem hearing high frequency?
There is no absolute vent size for High Frequency alone. There are many variables to this equation.
It also depends if your hearing aids are from silicon or acrylic, in either case if the space allows it, a second vent can be made in order to comfort you. Also, you didn’t specify if your problem is whistling or smth else, it might be smth that can be taken care of if digitally.
My son jus got new hearing molds with a vent but it gives alot of feedback is there a way to seal it? Cuz when I put the old molds there no feedback at all..
May be the higher gain of the new aid. You could try sealing it with something removable.
Dr. Cliff is it possible to adjust the vent size of ITE in ear hearing aids to prevent or reduce the occlusion effect? Or can it only be done with behind the ear hearing aids?
I was not given a vent hole. I was told it wouldn't work for me. Is that true?
Earl Drake some people prefer them because their sound quality is better. Some people don’t because it can sound muffled or “airy”. But it definitely doesn’t work for everybody. I personally prefer closed because it sounds better.
You need venting if you have a moderate or less loss, otherwise you’ll have to much occlusion
But isnt it true that other hearing aid manufacturers also provide similar vent options which are optimized based on the same principle phonak uses?
Because you are explaining it like no one else does it. I find this missleading.
Most other manufacturers make a vent that is called SAV (Select A Vent). This allows a provider to find the right vent plug for the patient. In my opinion, it is a rather crude way to do it. I'm sorry you found the video misleading, but at no point did I say that Phonak was the only manufacturer to address the venting issue. I just find them to be the best.