Earmold

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Cotton otoblockers that are used to prevent the impression material from hitting the tympanic membrane Cotton otoblockers.jpg
Cotton otoblockers that are used to prevent the impression material from hitting the tympanic membrane
Impression material being mixed together. This is the start of the mixing process, as the material needs to be one color. Impression material being mixed together.jpg
Impression material being mixed together. This is the start of the mixing process, as the material needs to be one color.

An earmold (also spelled; ear mold, ear mould or earmould) is a device worn inserted into the ear for sound conduction or hearing protection. Earmolds are anatomically shaped and can be produced in different sizes for general use or specially cast from particular ear forms. [1] Some users specify how hard or soft they want their mold to be, an audiologist can also suggest this. As a conductor, it improves sound transmission to eardrums. This is an essential feature to diminish feedback paths in hearing aids and assure better intelligibility in noisy-environment communication. The main goal in wearing earmolds is to attain better user comfort and efficiency. Earmolds (and their tubes) often turn yellow and stiff with age, and thus need replacement on a regular basis. [2] Traditionally, the job of making earmolds is very time-consuming and skillful; each one is made individually in a molding process. However, new digital ear laser scanners can accelerate this process. [3]

Contents

Viscosity

The texture of the earmold can have low, medium, or high viscosity. The lower type of viscosity will be soft while the higher viscosity is firm. It is thought that a higher viscosity will lead to a better impression of the ear canal while the lower viscosity may not fill in the ear canal as well. The type of viscosity to use is dependent on the person using the material and the type of viscosity they are most comfortable with. [4]

Syringe or Pistol

Once the viscosity is chosen the person can then choose to use a pistol or syringe for pushing the ear impression material in the ear. The syringes need the material mixed together until it is a singular color and then it can be pushed through the tube of the syringe. The plunger of the syringe will then be used to push the material into the smaller area. [5]  The pistol uses pre-measured impression material and requires the person to press the trigger lever for the impression material to come out. Before the impression material is set in the external auditory canal, otoscopy needs to be performed to make sure the canal is free of cerumen or any other foreign objects. With the impression material ready to use the clinician will want to put an otoblocker into the ear canal. This will help prevent material from reaching the tympanic membrane of the middle ear. For the otoblocker to be put in appropriately the clinician will want to pull up on the top of the pinna so the otoblocker can be put past the second bend of the ear canal. [6] With the otoblocker in place the impression material can now be used to fill in the external ear canal and the spaces and crevices of the outer ear. [4]

Gun/pistol for earmolds Pistol-gun for earmold.jpg
Gun/pistol for earmolds
Syringe that can be used for earmolds Syringe for earmold.jpg
Syringe that can be used for earmolds

Earmold Material

With the impression material in place and set in the ear canal the clinician can decide what type of earmold material would benefit the patient the most. The three types of earmold materials include: acrylic, polyvinyl chloride, and silicone. Each type of material has positives and negatives about them, for instance, acrylic can help older patients with dexterity issues as the earmold is hard so insertion and removal of the earmold is easier or a silicone earmold which is soft and is extremely useful for children because of how pliable the material is. [4]

Impression material hardening in the external ear canal Letting the earmold impression material harden in the external auditory canal.jpg
Impression material hardening in the external ear canal

Ear Scanning

The external ear canal probe on an ear scanner Ear Scanner.jpg
The external ear canal probe on an ear scanner

Earmolds present a variety of challenges. They can be inconsistent, time-consuming, or inaccurate. [7] [8] This is why, in the early 2000s, [7] a new idea for determining the anatomical shape of the individual's ear canal began circulating. The Navy often had issues with earmolds, for the fact that once the initial impression was taken, the impressions would have to be shipped to a manufacturer before the hearing protection could be made. [7] This made imperative personal protective equipment often time-consuming and difficult to obtain. [7] This is why the Navy then began looking for universities to create an anatomical 3D model of the ear using a scanner. The idea was that these scans could be sent electronically to manufacturers almost instantaneously. [7]  Karol Hatzilias from Georgia Tech undertook inventing an ear scanner, which has since then been successfully integrated onto Naval ships. [7] This technology has slowly been working its way into clinical settings. Many different companies have come up with their own version of ear scanning.

Related Research Articles

<span class="mw-page-title-main">Silicone</span> Family of polymers of the repeating form [R2Si–O–SiR2]

In organosilicon and polymer chemistry, a silicone or polysiloxane is a polymer composed of repeating units of siloxane. They are typically colorless oils or rubber-like substances. Silicones are used in sealants, adhesives, lubricants, medicine, cooking utensils, thermal insulation, and electrical insulation. Some common forms include silicone oil, grease, rubber, resin, and caulk.

<span class="mw-page-title-main">Earwax</span> Waxy substance secreted by the ear

Earwax, also known by the medical term cerumen, is a waxy substance secreted in the ear canal of humans and other mammals. Earwax can be many colors, including brown, orange, red, yellowish, and gray. Earwax protects the skin of the human ear canal, assists in cleaning and lubrication, and provides protection against bacteria, fungi, particulate matter, and water.

<span class="mw-page-title-main">Hearing aid</span> Electroacoustic device

A hearing aid is a device designed to improve hearing by making sound audible to a person with hearing loss. Hearing aids are classified as medical devices in most countries, and regulated by the respective regulations. Small audio amplifiers such as personal sound amplification products (PSAPs) or other plain sound reinforcing systems cannot be sold as "hearing aids".

<span class="mw-page-title-main">Dentures</span> Prosthetic devices constructed to replace missing teeth

Dentures are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable. However, there are many denture designs, some of which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, the distinction being whether they fit onto the mandibular arch or on the maxillary arch.

<span class="mw-page-title-main">Earplug</span> Device to protect ears from loud noises

An earplug is a device that is inserted in the ear canal to protect the user's ears from loud noises, intrusion of water, foreign bodies, dust or excessive wind. Since they reduce the sound volume, earplugs may prevent hearing loss and tinnitus, in some causes.

<span class="mw-page-title-main">Conductive hearing loss</span> Medical condition

Conductive hearing loss (CHL) occurs when there is a problem transferring sound waves anywhere along the pathway through the outer ear, tympanic membrane (eardrum), or middle ear (ossicles). If a conductive hearing loss occurs in conjunction with a sensorineural hearing loss, it is referred to as a mixed hearing loss. Depending upon the severity and nature of the conductive loss, this type of hearing impairment can often be treated with surgical intervention or pharmaceuticals to partially or, in some cases, fully restore hearing acuity to within normal range. However, cases of permanent or chronic conductive hearing loss may require other treatment modalities such as hearing aid devices to improve detection of sound and speech perception.

<span class="mw-page-title-main">Microtia</span> Medical condition

Microtia is a congenital deformity where the auricle is underdeveloped. A completely undeveloped pinna is referred to as anotia. Because microtia and anotia have the same origin, it can be referred to as microtia-anotia. Microtia can be unilateral or bilateral. Microtia occurs in 1 out of about 8,000–10,000 births. In unilateral microtia, the right ear is most commonly affected. It may occur as a complication of taking Accutane (isotretinoin) during pregnancy.

Spin casting, also known as centrifugal rubber mold casting (CRMC), is a method of utilizing inertia to produce castings from a rubber mold. Typically, a disc-shaped mold is spun along its central axis at a set speed. The casting material, usually molten metal or liquid thermoset plastic, is then poured in through an opening at the top-center of the mold. The filled mold then continues to spin as the metal solidifies.

<span class="mw-page-title-main">Bone-anchored hearing aid</span>

A bone-anchored hearing aid (BAHA) is a type of hearing aid based on bone conduction. It is primarily suited for people who have conductive hearing losses, unilateral hearing loss, single-sided deafness and people with mixed hearing losses who cannot otherwise wear 'in the ear' or 'behind the ear' hearing aids. They are more expensive than conventional hearing aids, and their placement involves invasive surgery which carries a risk of complications, although when complications do occur, they are usually minor.

<span class="mw-page-title-main">Dental impression</span>

A dental impression is a negative imprint of hard and soft tissues in the mouth from which a positive reproduction, such as a cast or model, can be formed. It is made by placing an appropriate material in a dental impression tray which is designed to roughly fit over the dental arches. The impression material is liquid or semi-solid when first mixed and placed in the mouth. It then sets to become an elastic solid, which usually takes a few minutes depending upon the material. This leaves an imprint of a person's dentition and surrounding structures of the oral cavity.

Injection molding of liquid silicone rubber (LSR) is a process to produce pliable, durable parts in high volume.

<span class="mw-page-title-main">CAD/CAM dentistry</span> Computer-aided design and manufacturing of dental prostheses

CAD/CAM dentistry is a field of dentistry and prosthodontics using CAD/CAM to improve the design and creation of dental restorations, especially dental prostheses, including crowns, crown lays, veneers, inlays and onlays, fixed dental prostheses (bridges), dental implant supported restorations, dentures, and orthodontic appliances. CAD/CAM technology allows the delivery of a well-fitting, aesthetic, and a durable prostheses for the patient. CAD/CAM complements earlier technologies used for these purposes by any combination of increasing the speed of design and creation; increasing the convenience or simplicity of the design, creation, and insertion processes; and making possible restorations and appliances that otherwise would have been infeasible. Other goals include reducing unit cost and making affordable restorations and appliances that otherwise would have been prohibitively expensive. However, to date, chairside CAD/CAM often involves extra time on the part of the dentist, and the fee is often at least two times higher than for conventional restorative treatments using lab services.

<span class="mw-page-title-main">In-ear monitor</span> Audio earpiece commonly used in live music and television

In-ear monitors, or simply IEMs or in-ears, are devices used by musicians, audio engineers and audiophiles to listen to music or to hear a personal mix of vocals and stage instrumentation for live performance or recording studio mixing. They are also used by television presenters to receive vocal instructions, information and breaking news announcements from a producer that only the presenter hears. They are often custom-fitted to an individual's ears to provide comfort and a high level of noise reduction from ambient surroundings. Their origins as a tool in live music performance can be traced back to the mid-1980s.

The occlusion effect occurs when an object fills the outer portion of a person's ear canal, causing that person to perceive echo-like "hollow" or "booming" sounds generated from their own voice.

<span class="mw-page-title-main">Nose prosthesis</span>

A nose prosthesis is a craniofacial prosthesis for someone who no longer has their original nose. Nose prostheses are designed by anaplastologists who have their patients referred to them by ear, nose, and throat doctors and plastic surgeons.

Resin casting is a method of plastic casting where a mold is filled with a liquid synthetic resin, which then hardens. It is primarily used for small-scale production like industrial prototypes and dentistry. It can be done by amateur hobbyists with little initial investment, and is used in the production of collectible toys, models and figures, as well as small-scale jewellery production.

RTV silicone is a type of silicone rubber that cures at room temperature. It is available as a one-component product, or mixed from two components. Manufacturers provide it in a range of hardnesses from very soft to medium—usually from 15 to 40 Shore A. RTV silicones can be cured with a catalyst consisting of either platinum or a tin compound such as dibutyltin dilaurate. Applications include low-temperature over-molding, making molds for reproducing, and lens applications for some optically clear grades. It is also used widely in the automotive industry as an adhesive and sealant, for example to create gaskets in-place.

<span class="mw-page-title-main">Real ear measurement</span>

Real ear measurement is the measurement of sound pressure level in a patient's ear canal developed when a hearing aid is worn. It is measured with the use of a silicone probe tube inserted in the canal connected to a microphone outside the ear and is done to verify that the hearing aid is providing suitable amplification for a patient's hearing loss. The American Speech–Language–Hearing Association (ASHA) and American Academy of Audiology (AAA) recommend real ear measures as the preferred method of verifying the performance of hearing aids. Used by audiologists and other hearing healthcare practitioners in the process of hearing aid fitting, real ear measures are the most reliable and efficient method for assessing the benefit provided by the amplification. Measurement of the sound level in the ear canal allows the clinician to make informed judgements on audibility of sound in the ear and the effectiveness of hearing aid treatment.

Comparison of orthotics refers to podiatrists molding custom orthotics to address patients' foot malformations. There are multiple means developed to create the basis for the molds, including plaster casts, foam box impressions, and three-dimensional computer imaging. The molds are used to create custom inserts that generally fit into three categories: firm, flexible, and soft.

A complete denture is a removable appliance used when all teeth within a jaw have been lost and need to be prosthetically replaced. In contrast to a partial denture, a complete denture is constructed when there are no more teeth left in an arch, hence it is an exclusively tissue-supported prosthesis. A complete denture can be opposed by natural dentition, a partial or complete denture, fixed appliances or, sometimes, soft tissues.

References

  1. Sandlin, Robert E. (2000). Textbook of Hearing Aid Amplification. Cengage Learning. p. 163. ISBN   1565939972 . Retrieved 15 November 2017.
  2. Tobin, Henry (1997). Practical Hearing Aid Selection and Fitting. DIANE Publishing. p. 6. ISBN   9780788147708 . Retrieved 15 November 2017.
  3. Watson, Jason; Hatamleh, Muhanad M. (2014). "Complete integration of technology for improved reproduction of auricular prostheses". The Journal of Prosthetic Dentistry. 111 (5): 430–436. doi:10.1016/j.prosdent.2013.07.018. ISSN   1097-6841. PMID   24445032.
  4. 1 2 3 Ricketts, Todd (2019). Essentials of modern hearing aids : selection, fitting, and verification. Bentler, Ruth A., Mueller, H. Gustav. San Diego, CA. ISBN   978-1-59756-853-1. OCLC   1002288505.{{cite book}}: CS1 maint: location missing publisher (link)
  5. Pirzanski, Chester (June 2002). "A practical guide to impression syringes and pistol injectors". The Hearing Journal. 55 (6): 30–35. doi: 10.1097/01.HJ.0000293274.68900.dc . ISSN   0745-7472. S2CID   112625298.
  6. Staff, Hearing Review (10 May 2006). "Earmolds and Hearing Aid Shells: A Tutorial Part 2: Impression-Taking Techniques that Result in Fewer Remakes - Hearing Review" . Retrieved 2020-10-29.
  7. 1 2 3 4 5 6 Phillips, Jackie. "Otoscan - 3D Ear Scanning: The Future is Now! Jackie Phillips". AudiologyOnline. Retrieved 2020-11-27.
  8. Staff, Hearing Review (10 May 2012). "Making a Digital Impression Using 3D Ear Canal Scanning - Hearing Review" . Retrieved 2020-11-27.