Finding a Good Fitting Earmold for the Tiniest Ear Canal

Finding a Good Fitting Earmold for the Tiniest Ear Canal

by Hung Mai, AuD

Today’s blog is inspired by a recent case that were both challenging and rewarding. Mrs. L and her husband walked into our office recently to schedule a hearing evaluation.  She was interested in new hearing aids, specifically with custom earmolds.  

Custom earmold is a custom-made earpiece that is attached to a receiver (speaker) of a behind-the-ear or receiver-in-canal style hearing aids. Earmolds usually provide the best physical fit and acoustical performance compared to alternative earpieces such as the popular instant ear tips.  
Examples of custom earmolds in different styles
Examples of instant eartips

Earlier that morning, she met a business associate for breakfast and saw his hearing aid with a custom acrylic earmold.  He happened to be one of my patients. She was intrigued because it seem to fit his ears so well.  She never knew such a thing existed.

She currently has hearing aids, but her earpiece is a tiny rubber ear tip that somewhat fits. She no longer wears them because she can’t insert them into her ears properly for two reasons:

1.) Her ear canals are especially small due to a collapsed ear canal (when the cartilage area of the ear canal closes in resulting in a very small ear canal)

2.) Her poor finger dexterity due to arthritis.  

She's currently using this instant eartip which actually fits, but she cannot insert it due to poor finger dexterity.

As you can imagine, she was very disappointed with her current hearing aids. For most days, she cannot insert the earpiece into her ears at all. On better days, it may take her over half-an-hour to get it in, usually by luck. Her energy is spent from trying to wear the hearing aids. So she stopped wearing them altogether.

Besides the earmold, she’s also intrigued by his ability to talk on his Android cell phone hands-free with his Phonak hearing aids via Bluetooth connection.  She also has a similar phone that she struggles to hear from.  

After the hearing consultation, we ended up ordering a pair of Phonak Audeo Lumity hearing aids with custom c-shell earmolds.  I made impressions of her ears, sent it to the Phonak lab, and crossed my fingers. There’s a chance that Phonak may not be able to make the custom earmolds due to how tiny the canals were, as you can see from the picture of her ear impression below.  

The long skinny, s-shaped part towards the top is her ear canal shape.

Fortunately, less than two weeks later, the hearing aids and earmolds arrived!  I was both excited and nervous.  Will it fit her tiny ear canals properly? Will she be able to insert it in herself? Will it stay in her ear?

Well not quite...The first earmolds were easy to insert but gradually slipped out when she talks or chew throughout the day.  It was sent back to Phonak for a remake.

The second earmolds stayed in better but was now too tight causing discomfort after wearing it for awhile.  Needless to say, it was sent back again for a another remake.

Frustration was setting in.  I started wondering if it was even possible to make a good fitting earmold for her.  I’m sure Ms. L was frustrated too, but I couldn't tell because she was so patient.    

Third Times the Charm

I’m so glad we tried again and did not settle for mediocrity. The third set was made with an extended receiver tube to help deliver the sound into her tiny canals, along with minor tweaks.  

Phonak c-shell earmold. The white tube is an extended receiver tube that sends sound into the tiniest ear canals.

Low and behold, it finally fits! Plus, she can finally put it in herself now.  And most importantly, she can hear!  Her eyes opened wide with joy, while I gave out a sigh of relief. As they say, third times really is the charm.

It Fits!

Moral of the Story

Do not settle for poor fitting hearing aids.  While the earpiece may seem like a minor part of the hearing aid, it can make or break your experience with hearing aids.  A poor fitting earpiece can be uncomfortable, may not deliver adequate sound, or even be impossible to insert for people with limited finger dexterity.   An experienced hearing care provider can help you find the most appropriate earpiece based on your ear anatomy, hearing loss type, and finger dexterity.  

Just don't give up right away if it does not fit great from the get-go. In this case, we could have settled with the second set of earmolds and call it a day, but we're so glad we sent it out one more time for another remake to get the best fitting version. The difference between the fit of the second and third set seems minor but was actually huge.

Do Not Settle For Poor Fitting Hearing Aids

If you have a challenging ear canal or cannot get a proper fit from your hearing aids, contact us to schedule a consultation appointment. We can access your current setup and recommend a solution, if needed. Call (504) 375-3075 or submit the online form below.

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