Do I need micro earmoulds?
- Koorosh Nejad
- Sep 16, 2024
- 5 min read
Updated: Jul 20
It is a general perception among the public that hearing aids can be fitted on silicone domes or large earmoulds. That is not true; there is a third option. This month, I enjoyed assisting a couple of patients with micro earmoulds. Please read this article to learn more about alternative fitting options and their applications.
Alice's hearing aid - A Phonak Lumity hearing aid with a cshell fitting
Patient #1: Alice
Alice is 12 years old. She visited with her parent this month for an earwax removal at our ear clinic in Dulwich. Right before the procedure, I noticed that she wears hearing aids, a pair of Phonak Sky Lumity fitted on vented power domes. After the microsuction cleaning, I answered a few questions they had about the cleaning and maintenance of the hearing aids, where I noticed that they had spent some £2500 on Alice's hearing aids and seemed to be worried that she might lose them during long school days.
Alice has some retention problems with the silicon domes, and her parents were positive about trying Phonak cshell micro earmoulds for better retention and to avoid the risk of losing the hearing aids accidentally.
A pair of impressions was taken from Alice's ears in the same appointment. Two weeks later, the family came back for a fitting. The silicon domes were replaced with Phonak cshell ear moulds (see above). Alice felt the moulds were comfortable, and the sound of her Phonak Sky Lumity was even better. She did confirm that the overall hearing experience is richer and the streaming music sounds deeper and nicer too. We explained the cleaning procedure and answered a few questions they had.
Patient #2: John
John is retired. He lives in London but frequently travels to Devon to join his friends and enjoy boating and sailing. His biggest fear is losing one (or both) of his hearing aids while sailing. For that reason, he puts them in a safe place during the sailing trips, which is not ideal at all, as he loses a lot of fun. The other problem that he had with his hearing aids is that now and then he had to push them in the ear canal, otherwise he and people around him would hear a loud feedback sound (his hearing is moderate to severe). This problem alone made him aware and on the edge at all times; often, it took his attention and his engagement with the group away. On a follow-up appointment, he decided to go ahead with micro moulds. When fitted with his hearing aids, he loved the way they were held tight in the ear, allowing him to forget about them and enjoy dinner and a long chat with friends. Also, gradually, he felt confident enough to keep his hearing aids on while on short sailing trips.
Patient #3: Sally
Sally is a musician with binaural tinnitus and severe high-frequency hearing loss. See below Sally's audiogram.
Sally's audiogram - Mild to severe high-frequency hearing loss
Her Oticon hearing aids were fitted on open fittings until she moved to SE London and came to our clinic for a hearing test and readjustment. Being a musician, her hearing and her sense of sound are super sharp. She didn't like the frequency conversion settings done on her hearing aids, so I helped her with a more natural sound setting, but then a high-pitch feedback was set off from time to time. She agreed to try micro moulds. The micromould placed the tip of the receiver deeper in the ear canal and allowed a better seal, so I could apply the right gains in the high-frequency range. She loves it! She felt the sounds were brighter with micromould.
The above examples are only 3 applications of the micro moulds and how they help improve the acoustics of the fitting for certain patients with hearing aids.
What is a micro earmould, or micromould?
A micro earmould is a very small earmould that holds the speaker unit of RIC hearing aids in your ear canal. Different hearing aid manufacturing companies call it a different name, but in simple terms, it is a shell made of silicon or acrylic or other material, e.g. Titanium if you have an allergy to Silicon and Acrylic.
What are the benefits of micromoulds?
It creates a better seal in your ear canal compared to rubber domes. Also, a better grip on the ear canal. As a result, your audiologist can:
Fewer feedback problems
a better sound quality in the range where your hearing loss is severe
Your hearing aid has better anchoring, hence a much better retention in the ear (popular among active people and young children with hearing aids)
Removes or reduces the sound of chewing food, which is common in power-dome fittings
Air circulation in the ear canal, hence less ear infection
Micro earmould compared to rubber domes
Who might benefit from micro mould for hearing aids?
A few groups of people can benefit from micro earmoulds:
Kids are always active, and there is a good chance that they may lose their hearing aids without noticing it.
Active and sporty people (for the above reason)
People with retention problems with their hearing aids. The retention problem could be due to the shape of their ear canal; simply, the little speaker unit doesn't stay in the ear canal for long, especially while talking or chewing food.
People who have to use earmoulds for audiological reasons, as their hearing loss might be at the level that they need much more amplification in certain frequencies, so that conventional silicone domes may not be able to seal the ear canal well enough.
Patients wish to remove or reduce the occlusion effect, which is usually worse in a moderate to severe hearing loss in low frequencies.
Patients wish to remove or reduce the sound of chewing food, which is usually worse in a moderate to severe hearing loss in low frequencies.
Patients with dry, sensitive skin or who have an allergy to silicon domes, or have skin conditions (e.g. Darmatitis), who need to have the air circulation maintained in their ear canals for clinical reasons, are especially prone to ear infection.
What is the quickest way to keep hearing aids in the ear?
Besides all the above discussions, perhaps a quick and cheap way to keep the receiver of RIC hearing aids in the ear canal is to use Grip Tip. The Grip Tip is a silicone universal fitting that comes in two different sizes and two fitting models, vented and closed. It can easily be bought off the shelf, and the user can replace the domes on the receiver with a pair of Grip Tips. My advice is to book an appointment to see your audiologist and allow him to make proper adjustments to your hearing aids if you decide to go ahead with Grip Tip. The Grip Tip makes a bigger surface contact with your ear canal, hence making the receivers stay firm and stay longer in your ears. It is a great option for active people or those hearing aid users with irregular ear canals.
If you see yourself among any of the above groups, please get in touch for a consultation in our ear clinics in East Dulwich or Crystal Palace.
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