Although there is a large overlap in the fitting ranges for each receiver, one or the other may provide a better fit for the individual. The low power receiver is thinner but slightly longer. size 2A (right) thin tube the horizontal part is shorter with size 2B thin tubeįigure 2: size 3 medium power receiver (left) vs. Finally, a customized earmold can also solve issues with itching, especially if the itching is caused by the dome not remaining in a stable position in the ear canal.įigure 1: size 2B (left) vs. If the physical fit is good, but the patient still complains about irritation, applying a bit of lubricatant (such as Eargene or Otoease) to the dome may help. However, the receivers are quite different physically and may feel quite different to the individual patient when worn. For example, the two receivers shown in Figure 2, both from the same manufacturer and for the same hearing aid, have similar gain and output characteristics. For RIE devices, if the audiogram falls in the fitting range of more than one power level of receivers, one receiver choice may provide a better fit than the other. This means the right one will go into the ear canal a little deeper. Is the dome insertion in the canal too deep or too shallow? Figure 1 shows a pair of thin tubes where the length of the vertical part is about the same, but the horizontal part of the left thin tube is shorter than the right one. Is the dome size right? Try to change the dome size or change to a different type of dome (open dome, tulip dome or closed dome). Is the tube too short, pulling the skin of ear too tight, or is it too long, causing the hearing aid to “float” above the ear? A too short tube will cause pressure to the skin a too loose tube may cause the hearing aid to move easily and cause irritation when the head is moved. When patients do complain about itching/irritation with an open fitting, we need to have a look at the fit. It follows that the fit cannot be perfect in all cases. Whether it is a thin tube or receiver-in-the-ear (RIE) style, we are dealing with non-customized fitting and limited tube/receiver lengths and dome sizes to select. One of the most common causes of itching for open fitting is poor fit of the dome in the ear canal. Chlorohexadin, a commonly used disinfectant in the clinic, is an example of such an agent. However, some patients can be allergic to the cleaning agent used to clean the dome. The domes for open fitting are made from medical grade silicone allergic reaction is less likely than for a custom earmold. These could include such issues as poor fit or allergic reaction to otoplastic materials. In many cases, users become accustomed to it and the itching sensation will pass, but there are instances that can be due to other factors and need our attention. Madsen, Larsen and Flink (1991) showed 39% of earmold users experienced itching as a side effect. So no wonder itching or irritation is a common complaint from the hearing aid user who comes in for a follow up visit. The ear canal has very delicate skin even a hair may cause itching in the ear. Question What can you do when the patient says the hearing instrument is making their ears itch? Answer
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