Selecting Earpiece Materials
Many decisions are needed in order to successfully
fit your patients with hearing instruments and earpieces. The following
are simple guidelines based on our nearly 50 years of making custom-fit
products for the ear.
Discomfort
If you suspect that discomfort might be an issue,
there are a few things to consider before selecting an earpiece
material. First, check your patient's skin texture. If the skin texture
is firm, consider using a soft earpiece material. If your patient's
skin is soft or delicate, as can often happen with elderly patients,
try using a firmer earpiece material.
The helix area of an
earpiece can sometimes cause problems. Many earpiece styles do not
require a helix to ensure a secure fit. You can reduce potential
problems by ordering a 3/4 or 1/2 shell-style earpiece. This is a
particularly good choice for patients who may experience difficulty
inserting the earpiece into the ear.
Loose Fit
If loose fit is a concern (i.e., the patient's ear is
very soft), consider using a stiffer material for the earpiece, such as
acrylic (see the fitting range charts). If you are using a soft
material, a bulkier earpiece style might be helpful.
Allergies
Use Mediflex or Frosted Flex silicone earpiece
material if allergies are a concern. However, earpieces made from
silicone can be abrasive to delicate skin, particularly in elderly
patients. Select acrylic or vinyl earpiece materials that have been
boiled in saline solution as an alternative to Mediflex or Frosted
Flex. Polyethylene earpiece material is available for extreme allergy
situations.
Mandibular Action
Use the softest earpiece material possible for
fitting a patient with severe mandibular action. Consider tapering the
canal or specify a KC (hollow) style that will allow the earpiece to
flex with jaw movement.
Tubing
Tubing can cause problems if not chosen properly.
Keep in mind that tubing cannot be glued into silicone earpieces. When
the tubing is used as a handle to remove the earpiece, it can become
dislodged. This is especially a concern with children, elderly
patients, or those with limited dexterity.
Feedback
If you suspect that feedback could be a problem, use
a bite-block, deep-impression technique. Consider using a silicone
material if the patient's skin texture will allow. If acoustic
modifications will permit, always tube the earpiece through and vent
conservatively.