The earmold is truly the most important link in the fitting of a hearing aid system, since it must routinely and simultaneously fulfil numerous functions. If it fails in any one of them, the hearing aid fitting can fail.

Every earmold must:

• Provide a satisfactory acoustic seal
• Acoustically couple the hearing aid to the ear
• Retain the hearing aid behind the pinna
• Be comfortable to wear for an extended period of time
• Be aesthetically acceptable to the patient

In addition, as every case will be subtly different, you may need to consider other factors, and alter the recommendation such that the earmold will:

• Modify the acoustic signal to suit unusual hearing losses
• Be of a style that the patient can physically handle in case of disability
• Be easy to use by caretakers or medical professionals

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 with small hand tools, 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.

Dealers must evaluate each patient individually before selecting a mold, and should retain as much flexibility as possible in their selections. 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.

Material Considerations

Adult – General Purpose	Acrylics – Hard Clear, Softex, Ultraflex
Child – General Purpose	PVCs – Protint, Hydroclear, Dermatex
High Gain	Silicone, Silicone II, Ultraflex
Facial Movement	Hard/Flex, PVCs, Silicone II
Very Soft Ear Texture	Hard, Medicryl
Very Hard Ear Texture	Any soft material
Allergy Concerns	Silicone II, Hard Clear, Hydroclear