Earmold Fitting
The earmold is truly the most important link in the fitting of a hearing aid system, since it must routinely and simultaneously fulfill numerous functions. If it fails in any one of them, the hearing aid fitting can fail. It must:
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Most appropriate application of materials:
| Adult General Purpose | Acrylic - Hard, Softex, Ultraflex |
| Child General Purpose | PVC Protint, Hydroclear, Dermatex, Silicone II |
| Facial Flex | Hard/Flex, PVC, Silicone II |
| High Gain | PVC, Silicone, Silicone II |
| Allergies | Hard, Medicryl, Mediflex, Hydroclear, Silicone |
| Soft Ear Texture | Hard, Medicryl |
| Hard Ear Texture | Any soft material |
Application Material
With many patients, consideration should also be given to the prospect of required in-office modifications. Hard, semi-hard and PVC materials are the easiest to modify, while Silicones are almost impossible to change, except for straight cuts to remove excess bulk. Proper impression technique and intelligent style selection procedures can minimize major in-office modifications. The Hearing Instrument Specialist should retain as much flexibility and control as possible when choosing a material. Just as everyone can't wear Lucite molds, not everyone should have Silicone molds, either.
Patient evaluation for earmold selection.
The Hearing Instrument Specialist must evaluate each patient prior to material and style selection and must address the following considerations:
| Identity | Who is your patient? An active child or a sedentary, perhaps senile senior? |
| Dexterity | What can the patient handle and what are possible limitations? |
| Ear texture | What material and/or styles can improve, or adversely affect, ease of insertion? |
| Hearing aid gain | What degree of seal is necessary to contain the hearing aid's output? |
| Acoustics | What are the amplification objectives of the fitting? |
| Toxicity | Are there any known allergies to plastics or silicones? |
| Cosmetics | What is the appropriate colour for the earmold and/or tubing? |
| Vanity | What limits are imposed by the patient with regard to acceptability? |
| Adaptability | Do you anticipate an easy fitting and adjustment period, or do you need to allow for potentially numerous earmold modifications after delivery? |
Earmold Style Selection
Style selection involves a range of choices, which can optimize a fitting. Generally, more than one option will exist for any given fitting. Don't underestimate your patient's concern for the cosmetics. While you can't always give the patient the least visible earmold due to the extent of the hearing loss, you can indeed satisfy most people without a sacrifice of fitting goals.