Expected Outcomes:

• Appropriate earmold/hearing aid shell configuration and material will be selected for maximum comfort and hearing aid performance.
• Alleviation of a problem with physical or acoustic comfort (i.e., occlusion, loudness, discomfort).
• Restore the aid to manufacturer’s specifications.

Indications for Procedure:

• Patient is being fitted for new amplification.
• Patient or family reports a problem with the function, comfort or benefit being received from the hearing aid.

Procedure Methods:

• Assess ear canal for ear impression vis-à-vis size, length and direction.
• Perform proper ear impression procedures, e.g. otoblock placement.
• Determine earmold/hearing aid shell configuration and material.
• Examine surface of earmold and instrument for damage and sharp edges.
• Perform physical fitting of coupler and instrument.
• Appropriateness of physical fit should be assessed through ease of insertion and removal, cosmetic appeal, comfort, absence of feedback, placement of microphone port(s) and ease of volume control use when present.
• Program selected hearing aids to patient’s baseline audiometric data.
• Adjust/modify hearing instrument electronics based on patient feedback.
• Make venting modifications as needed for reduction of occlusion effect and/or to control feedback. Modify shell or earmold for improved, more comfortable fit.
• In the event the patient returns with a malfunctioning hearing aid, conduct in-office internal inspection of earmold and instrument and take appropriate corrective action (suctioning wax and debris from receiver and microphone ports, cleaning corrosion from battery contacts, replacing earmold tubing, etc.). Conduct electric current drain measurement of hearing aid. If in-office repair is not possible, return aid to manufacturer for repair and offer the patient a loaner hearing aid to use while his/hers is being repaired.
• If the hearing aid needs to go to the factory for repair and it is out of warranty, inform the patient of the charges and repair warranty.
• Validation of fitting should be done with sound field testing using frequency specific thresholds and/or aided speech discrimination and speech reception thresholds or with real-ear aided measurements or with live speech mapping.
• Reprogram hearing aids based on patient feedback.
(Reprinted from the International Hearing Society web site open to the public)