Hearing Aid Dome Types Intro

Receiver-in-the-ear (RITE) or receiver-in-canal (RIC) hearing aids are one of the most popular styles today due to their ability to fit a wide range of hearing losses, their discrete appearance, overall comfort and ease of use, and excellent technology options in terms of rechargeability, noise reduction, and streaming capabilities.

RIC/RITE hearing aids, as the name implies, have the receiver (speaker) in the ear canal; this is part of what contributes to great sound quality. Placing a speaker in a place with ear wax, sweat, and hair makes it vulnerable to damage or, at the very least, being blocked. Hearing aid domes are small, soft plastic pieces that sit over the receiver in order to protect it, offer a comfortable fit in the ear canal, and aid in retention of the hearing aid. This article will review the different types of hearing aid domes and when each are suitable.

What Are The Different Hearing Aid Dome Types Available?

  1. Open-fit hearing aid domes. Open domes are named for the small holes which allow air and natural noise to come through the ear canal. These are ideal for patients who have normal or near-normal hearing sensitivity in the low frequencies. Low pitched sounds can come through the ear naturally, while the hearing aids amplify the mid and high frequencies where the hearing loss is present.

    This is a very common configuration of hearing loss, and many patients may be good candidates for open domes if they pursue hearing aids early on. Open fit domes are often quite comfortable, as well, because of the soft material and the available air flow.
  2. Closed-fit hearing aid domes. As the name implies, closed domes do not have any of the aforementioned holes or openings in them. These domes are needed to keep the amplified low frequency sounds in the ear for people who do experience more moderate degrees of hearing loss in that range. The tradeoff of keeping the low frequency sounds in is that some patients may experience the occlusion effect, which is the sensation that low frequency sounds are disproportionately loud, hollow, or echoey.

    You can simulate this by gently placing your fingers in your ear canals and listening to the sound of your own voice. Fortunately, there is technology in the hearing aids that helps to account for this, and the proprietary manufacturer software even factors in the specific dome type in the programming. There are a few different shape options for closed domes, including the classic bell-shaped style as well as “tulip” domes. This choice would be dictated by patient comfort and preference.
  3. Power domes. These are for even greater degrees of hearing loss and contain two or more layers of soft plastic within the bell shape to further close off the ear canal and prevent any amplified sound from leaking out. A power dome would be used for someone who is starting to push the limits of a RIC/RITE hearing aid’s fitting range. The next step beyond a power dome would be a custom piece.
  4. Custom coupling options. It is possible to have a custom micro-mold made which the receiver fits into. This could be the most appropriate option because the hearing loss is more severe and requires a better seal in the ear canal, or because of comfort. Additionally, domes need to be replaced regularly whereas a micro-mold would be made from acrylic or another durable material and would be more long-lasting.

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How Do I Know If My Hearing Aid Domes Fit Properly?

hearing aid dome types

Your audiologist or hearing aid dispenser will make a recommendation for the type of dome based on your degree of hearing loss. Each dome type is also available in different sizes, usually at least three. Your domes should be able to slide comfortably into your ear canal and then stay in place. It should not be overly difficult to insert the receiver into your ear, nor should it slip right out when the receiver is fully inserted.

You know the receiver is fully inserted when the receiver wire sits flush against the side of your face. Receivers also come in a variety of lengths, and your audiologist will have measured your ear to ensure the proper size, and thus when the receiver is fully inserted the hearing aid should sit comfortably and remain in place.

What Factors Should I Consider When Choosing Hearing Aid Domes?

Fortunately, this decision will largely fall on your audiologist or hearing aid dispenser. They will make a recommendation based on your degree of hearing loss and your ear canal shape and size. RIC/RITE hearing aids come with a selection of domes and you will be able to experiment with different sizes for the best fit.

You will also be sent home with extra domes, and your provider will give you instructions for changing them periodically. Sometimes it can take some trial and error to find the best dome that balances sound quality, comfort, and retention, so do not be discouraged if your provider makes changes along the way.

There are a few other pieces to the hearing aid that help with sound quality and retention. Most hearing aids have a wax guard in addition to the dome. This looks like a small basket over the opening of the speaker that protects it from wax and other debris. This is something that needs to be inspected and changed regularly; your provider will show you how to do this and give you replacement wax guards. Just a tiny amount of wax can block the guard and affect the overall amplification and sound quality of your hearing aids.

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If you are still struggling with hearing aid retention and your provider is confident that you have the correct dome shape and size, you can add a retention wire to your hearing aids. This is a small piece of plastic that sits in the concha bowl and provides a bit of counter pressure to keep the receiver in place. After a few days of use, the receiver wire will bend to fit your ear and you won’t even notice it is there. This is something that may have to be replaced, though it is likely a piece that your provider will check and change rather than having you do it at home. If the retention wire is not working, it could be time to consider a custom micro-mold for comfort and retention.

How Do I Care For My Hearing Aid Domes?

Depending on the biological makeup of your ear, you may go through domes at different rates than others. They can become occluded with wax, or they may become hard, brittle, or cracked as a result of moisture in the ear. Either of these can affect the overall sound quality of your hearing aids, so you should get in the habit of inspecting the domes when you take your hearing aids out each day to determine whether they need to be replaced.

Keep in mind that your hearing sensitivity can change over time, so if you begin to notice a decline in sound quality or hearing performance and you know that you have new domes on your hearing aids, you may need to see your provider. It is possible that you will need an updated hearing test and/or a change in your dome size or type.

Hearing Aid Dome Types Conclusion

Who knew that a small piece of plastic could play such a large role in your hearing journey?

The comfort and fit of your hearing aids is critical in sound quality, but also in your willingness to wear your devices for all waking hours. This is crucial for success as a hearing aid user. Your provider can help you make these decisions and advise you if and when changes are needed based on comfort and degree of hearing loss.

erin edwards aud
Clinical Audiologist at Towson University | + posts

Erin Edwards received her Doctor of Audiology degree from Towson University in 2015 and her Ph.D. in Education and Leadership from Pacific University in 2022. She has worked with patients of all ages in a variety of settings and has a specific interest in cochlear implants, the relationship of hearing loss and dementia, and interdisciplinary healthcare.

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