Expert: Harriet B Jacobster, Au.D. - 5/29/2009

Question
I am 39 year old male having sensorineural hearing loss of 75 db in both ears. I was using analog ITC hearing from Phonak last 10 years. One week back, I have purchased Widex digital ITC HA's. My old HA's had air vents. However, my new ones do not have and my audiologist says that as my loss has increased from 68 db to 75 db and now there is loss for both Low and High frequencies, I do not require venting.
I am afraid whether he is correct. Because, in last one week, I am unable to adjust to my own voice and do not know how much loud to speak. I also feel the blocked sensation. I want my audiologist to make vents for both HA's? Am I right in my opinion?

Answer
Hi Pradeep,
It's always hard to "second guess" another professional especially when that professional has first hand knowledge of the situation.  I can only tell you what I would do in such a situation.

In general, I order hearing aids with a variable vent.  A VV is a regular vent in the aid that comes with plugs of varying inside diameters. This way, I can always use one of the plugs to make the vent smaller.  My philosophy is that it is always easier to make an existing vent smaller than to make a non-existent vent bigger. Even with the most profound losses, I have found this the most viable option.  

Venting in a hearing aid serves several purposes; to let low frequencies escape thus minimizing the occlusion effect (that barrel sound) as well as to allow adequate ventilation to the ear.  Unfortunately, a large vent also makes the hearing aid more prone to feedback - that whistling sound.  With the modern digital programmable hearing aids, both these phenomena - occlusion and feedback - can be controlled to a great extent through programming. At the very least, if you still feel blocked, or that your ear is stuffy, you should have a pressure vent - a pinhole vent - in the hearing aid for better pressure equalization.  

But...the bottom line is that you are the customer and you are the one wearing the hearing aids.  If you want the vents, then your audiologist should work with you and try to accommodate your request to the best of his ability.  As I said, even a small pressure vent along with reprogramming will most likely work in your case.

Hope this helps.
Harriet B. Jacobster, AuD
Board Certified in Audiology