Fitting Considerations

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 PurposeAcrylics – Hard Clear, Softex, Ultraflex
Child – General PurposePVCs – Protint, Hydroclear, Dermatex
High GainSilicone, Silicone II, Ultraflex
Facial MovementHard/Flex, PVCs, Silicone II
Very Soft Ear TextureHard, Medicryl
Very Hard Ear TextureAny soft material
Allergy ConcernsSilicone II, Hard Clear, Hydroclear

Style Considerations

IdentityWho is your client and what is their lifestyle? Are they an active child, or a sedentary, perhaps senile senior?
Past HistoryIs this their first hearing device? Have they previously used Completely-In-Canal instruments, or open-fitting devices? Have there been numerous adjustments or changes to previous fittings?
Physical Ear ShapeDoes the client have a well-defined, normal ear, or will sharp bends, collapsed canals, or surgically altered ears affect the comfort and ease of use?
DexterityWhat can the client handle, and what physical limitations must be considered?
Ear TextureWhat materials and/or styles can improve, or adversely affect, the ease of insertion and removal?
Hearing Instrument GainWhat degree of seal will be needed to contain the hearing aid’s output?
AcousticsWhat are the amplification objectives of this fitting? What venting, if any, will be possible given the client’s loss?
ReactivityAre there any known allergies to plastics or silicones?
CosmeticsWhat is the appropriate colour for the earmold and tubing? Is discretion the most important, or does your client prefer a more outgoing, brightly coloured earmold?
AdaptabilityDo you anticipate an easy fitting and adjustment period, or do you need to allow for potential earmold modifications after delivery?