Question
I work in an ENT office and have seen patients with large mastoid cavities, but have yet to take an impression for one of these. Any tips or suggestions?
Answer
I've done about half a dozen of these. A lot depends on the size and shape of the cavity. Take extra time with otoscopy, particularly at the margin of the surgical area, so you'll know precisely how to pack it. If this is the kind of cavity where you can see everything with a flashlight as well as you can with an otoscope, you might do better with cotton packing material rather than otoblocks. No strings needed in this case and you can pick the cotton out with alligator forceps.
If this is not the kind of cavity where you can see everything, your otoblock material must have strings. The surgical area may delve in any direction. I recommend filling the surgical area with otoblock material. The block should extend all the way to the margin of the normal EAC section and maybe a little into the normal section. That will give you a better opportunity to make a mold of the proper depth with much less chance of blow-by.
If you try to keep the otoblock in a normal section of the EAC that's distal to the surgical area and the surgical area balloons closer to the TM, it's likely you'll push the block into the surgical area when you start laying impression material. It's also possible your impression will be shorter than you want if you manage to keep from pushing the block. Make sure you have enough impression material prepared. A surgical ear may take more than normal.
Don't worry about the impact of multiple strings because the ear mold company can fill in. The ear mold company is likely to recognize a mold from a surgical ear but it's best to tell them. Think carefully about style and material. If this is an experienced user they'll have a preference. A surgical ear is often more sensitive than normal. If it's a new user I'd probably pick acrylic for ease of insertion.
David Taylor, M.A., is an audiologist and the owner of Ears to You in Newport News, VA. He is a graduate of San Diego State University and has been practicing audiology for over 12 years.
David Taylor, MA
Related Courses
1https://www.audiologyonline.com/audiology-ceus/course/learning-amplification-with-carl-33692Learning Amplification with CARL: A New Patient SimulatorThis course demonstrates the importance of simulation in clinical training and outlines specific lessons in which CARL can be incorporated in. From basic lessons introducing the components of a hearing aid to advanced fitting of a high-gain hearing aid, this patient simulator provides several validated benefits to existing audiology curriculums.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comLearning Amplification with CARL: A New Patient SimulatorThis course demonstrates the importance of simulation in clinical training and outlines specific lessons in which CARL can be incorporated in. From basic lessons introducing the components of a hearing aid to advanced fitting of a high-gain hearing aid, this patient simulator provides several validated benefits to existing audiology curriculums.33692OnlinePT60M
This course demonstrates the importance of simulation in clinical training and outlines specific lessons in which CARL can be incorporated in. From basic lessons introducing the components of a hearing aid to advanced fitting of a high-gain hearing aid, this patient simulator provides several validated benefits to existing audiology curriculums.
2https://www.audiologyonline.com/audiology-ceus/course/deep-dive-into-custom-fittings-36600Deep Dive Into Custom FittingsThis courses focuses on achieving a proper ear mold impression and the impact the impression has on custom in-the-ear hearing aid and custom receiver design. This course also reviews the manufacturing process for custom hearing aids and receivers to set appropriate expectations.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comDeep Dive Into Custom FittingsThis courses focuses on achieving a proper ear mold impression and the impact the impression has on custom in-the-ear hearing aid and custom receiver design. This course also reviews the manufacturing process for custom hearing aids and receivers to set appropriate expectations.36600OnlinePT60M
This courses focuses on achieving a proper ear mold impression and the impact the impression has on custom in-the-ear hearing aid and custom receiver design. This course also reviews the manufacturing process for custom hearing aids and receivers to set appropriate expectations.
3https://www.audiologyonline.com/audiology-ceus/course/subjective-evaluation-new-hearing-aid-35584The Subjective Evaluation of a New Hearing Aid FittingThe final judge of the success of a new fitting will of course be the patient, and the criteria that they use may not always be in line with an objective audiological measure. This course will review some of the issues and options at play when having the patient weigh in on the value of the new devices.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comThe Subjective Evaluation of a New Hearing Aid FittingThe final judge of the success of a new fitting will of course be the patient, and the criteria that they use may not always be in line with an objective audiological measure. This course will review some of the issues and options at play when having the patient weigh in on the value of the new devices.35584OnlinePT60M
'What made this course excellent is how the content was broken down into sections in how to evaluate a fitting and all centered towards patient care'Read Reviews
The final judge of the success of a new fitting will of course be the patient, and the criteria that they use may not always be in line with an objective audiological measure. This course will review some of the issues and options at play when having the patient weigh in on the value of the new devices.
4https://www.audiologyonline.com/audiology-ceus/course/auditory-wellness-what-clinicians-need-36608Auditory Wellness: What Clinicians Need to KnowAs most hearing care professionals know, the functional capabilities of individuals with hearing loss are defined by more than the audiogram. Many of these functional capabilities fall under the rubric, auditory wellness. This podcast will be a discussion between Brian Taylor of Signia and his guest, Barbara Weinstein, professor of audiology at City University of New York. They will outline the concept of auditory wellness, how it can be measured clinically and how properly fitted hearing aids have the potential to improve auditory wellness.auditory129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comAuditory Wellness: What Clinicians Need to KnowAs most hearing care professionals know, the functional capabilities of individuals with hearing loss are defined by more than the audiogram. Many of these functional capabilities fall under the rubric, auditory wellness. This podcast will be a discussion between Brian Taylor of Signia and his guest, Barbara Weinstein, professor of audiology at City University of New York. They will outline the concept of auditory wellness, how it can be measured clinically and how properly fitted hearing aids have the potential to improve auditory wellness.36608OnlinePT30M
As most hearing care professionals know, the functional capabilities of individuals with hearing loss are defined by more than the audiogram. Many of these functional capabilities fall under the rubric, auditory wellness. This podcast will be a discussion between Brian Taylor of Signia and his guest, Barbara Weinstein, professor of audiology at City University of New York. They will outline the concept of auditory wellness, how it can be measured clinically and how properly fitted hearing aids have the potential to improve auditory wellness.
5https://www.audiologyonline.com/audiology-ceus/course/vanderbilt-audiology-journal-club-clinical-37376Vanderbilt Audiology Journal Club: Clinical Insights from Recent Hearing Aid ResearchThis course will review new key journal articles on hearing aid technology and provide clinical implications for practicing audiologists.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comVanderbilt Audiology Journal Club: Clinical Insights from Recent Hearing Aid ResearchThis course will review new key journal articles on hearing aid technology and provide clinical implications for practicing audiologists.37376OnlinePT60M
