26/01/2014 Cut and drill virtually Shape and define Check fit back into scanned ear Check final product design 2

Transcription

1 Impression Anatomy Earmould Technology Sue Falkingham Audiologist, Education and Training HELIX smooth 2 nd BEND CONCHA ANTI-TRAGUS Inter-tragic incisure MEATUS TRAGUS Digital Shell Modeling Manipulate Scans 1

2 Cut and drill virtually Shape and define Check fit back into scanned ear Check final product design 2

3 Lay out a batch on screen Print ID TAG/BOX IDENTIFICATION REMOVE ID TAG AND SHARP AREAS (PIPS) Confidential 2006 Starkey Laboratories, Inc. Confidential 2006 Starkey Laboratories, Inc. 3

4 ENGRAVE SERIAL NUMBER/TM SELECT DESIRED TUBE OR ANCHOR. FIX USING TRADITIONAL METHODS Confidential 2006 Starkey Laboratories, Inc. Confidential 2006 Starkey Laboratories, Inc. Introducing a soft SLA technique Mould is printed in wax covering Previously only available in hard materials from 3D printing we are now able to supply soft Biopore Material in a range of Shore values The process is slightly different 4

5 Wax is melted off at 180 degrees to leave a cast Biopore is injected into the cast Product is finished off but not coated Final Product benefits Scanned impressions which are kept on file for 3 years a. Allows duplication b. Faster response and no new impressions for lost aids c. Modifications from an exact image not an impression or old mould Faster than normal process Accuracy and consistency of build improve Finer detail than could be drilled or cured by hand is possible 5

6 General point Remember, you are the only one who sees the ear from which the impression is made. The manufacturer can only process what you send. If the impression does not look anatomically correct or complete, take another impression. If it really is odd take two impressions send them both and a note EARMOULD SELECTION Earmoulds Moulds vary in the extent of the concha and ear canal that they fill this will affect four things: 1) Appearance 2) Acoustic performance 3) Comfort 4) Security and retention of the aid How do we choose the right earmould? The audiogram Type of loss Static vs. fluctuating Ear/skin condition Anatomy of the ear Ear canal size Shell or skeleton mould Patient preference Software targets Patient dexterity Vent size Patient vision Tubing specifications Costs Non allergenic Maintenance 6

7 Considerations in Conductive loss Need more gain for same air conduction thresholds May need to consider easy cleaning Biggest vent possible for some pathologies Vari-vent for fluctuations Power vents Happy ears are dry ears! Earmould material selection Texture of the ear: a soft ear will make insertion of an earmould more difficult. In this case, a rigid mould is recommended. Power of hearing instrument : A high power aid will tend to cause more feedback that a mild gain aid. A softer material will tend to seal better than rigid material. There are several materials available offering a range of softness. Possible allergies to material: There are a variety of rigid or soft materials that are less likely to cause an allergic reaction Hard Acrylic e.g PROS- clear rigid acrylic material, does not deteriorate over time Smooth surface for easy insertion. Easy to clean. Cons Will not compress to get past narrow areas in the canal. Leaks easily. Potentially shatters if struck Biopor Extreme e.g. 2112BP Pros Available in different shore ratings of 25, 40 and = Jelly baby 40 = Starburst 70 = Toffee Extremely tear resistant and soft-flexible material with high wearing comfort. All shore ratings are suitable for severe to profound losses. The least flexible, 70, is suited to help patients with dexterity problems. Shore ratings can be combined, allowing a very soft meatal portion to be chemically bonded to a less flexible concha area to create a soft tip effect. Cons Not possible to adjust Tube needs regular replacement to aid retention Requires thick wall tube 7

8 Allergy? Is the sensitivity to touch and pressure Is it a discharge? Consider harder easier to maintain more ventilation Contact reaction goes all the way down the canal Sweat reaction is a reddened shiny itchy skin but just in concha bowl 8