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Giving Up On IIC Due to Poor Fit

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Hello everyone. I’ve got a 40% hearing loss in one ear. I have been using a Soundlens for a year and a half, and finally gave up on it. First of all, it never fit very deeply into my ear canal, about the same as a , and it stretched my ear canal to the point where it was constantly needing to be pushed back in. The “invisible” hearing aid ended up more conspicuous than an would have been. A re-fit resulted in the same problem within a couple of weeks. The other thing that I noticed with it was that I did not seem to gain any clarity with voices in noisy environments. After trying an RIC in my hearing aid dispenser’s office side by side with my old IIC, the difference in speech clarity was dramatic–two microphones as apposed to one probably being the main reason I guess. Not much guidance from the professionals on this. So I’ve got a new RIC coming, and wish I would have figured this out to begin with, saving a lot of money and messing around with tuning. Hope this helps somebody else shorten up the learning curve.

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I feel your pain.
I’m in the process of ending my 8 months of trying to get my ’s to work.I would have loved for them to work, but I’m guess we’re in the 80% it doesn’t work out for. I’m also trying to get into a right now.
Good luck with the new aids.

Please don’t take it personally or that you all did something wrong; the just doesn’t work well for everyone.

I wish you well with your experiences! I’m sure you will find them much more comfortable to wear and keep seated in your ears.

I guess the lesson learned here is to get as much info as you can from places like this forum before purchasing. Market hype is huge in the business. Between not necessarily knowing the right questions to ask and the dispenser not offering as much info perhaps as he should have, a lot of trial and error and expense had to take place. I do understand that these are relatively new on the market, and there isn’t a huge amount of info available. My dispenser only had two other clients using them, and they apparently were not experiencing any of my problems.

I haven’t fit many of the because I usually strongly recommend , mainly for the speech in noise factor. I also feel they’re about even cosmetically with IICs, and the RICs are generally more comfortable.

One of my patients who decided to go ahead and order IICs was using my demo RICs until his aids came in, and then when he tried them he decided to stay with the RICs and return the IICs due to occlusion.

I did notice markedly less occlusion with the over the that I was first fitted with. It was so bad that I ended up taking it out during conversations because my booming voice was worse than background noise was. On the other hand, the CIC was much better at picking voices out of noisy environments, which I find hard to understand since it sat almost exactly the same way in my ear as the IIC did. I am guessing that I will need to change receiver sizes a few times as my ear canal (hopefully) returns to a normal shape once I begin wearing the new .

I recently heard a quote from a manufacturer rep that 90% of patients could wear their (based strictly on canal size). I guess they’d taken a large sample of ear impressions sent in and found that about 90% of those impressions had enough space to get the job done.

With that said, (if your loss supports it) an open-fit will almost always be way more comfortable than any in-the-ear hearing aid and much easier to adjust to. Usually we see that the ad for the “invisible hearing aid” helps a hard of hearing person rationalize “well, if it’s invisible I suppose I could consider a hearing aid.” Once they’re in my office it’s (usually) part of my job to help them realize that a RIC would be better for them and nearly as discreet. Of course, I’m not sure that all of my colleagues got the “memo” on this one…

@MinnesotaHIS said:

I recently heard a quote from a manufacturer rep that 90% of patients could wear their IICs (based strictly on canal size). I guess they’d taken a large sample of ear impressions sent in and found that about 90% of those impressions had enough space to get the job done.

With that said, (if your loss supports it) an open-fit RIC will almost always be way more comfortable than any in-the-ear hearing aid and much easier to adjust to. Usually we see that the ad for the “invisible hearing aid” helps a hard of hearing person rationalize “well, if it’s invisible I suppose I could consider a hearing aid.” Once they’re in my office it’s (usually) part of my job to help them realize that a RIC would be better for them and nearly as discreet. Of course, I’m not sure that all of my colleagues got the “memo” on this one…

That 90% is not a representation of the ‘average’ population though: it’s 90% of ear mould wearers which by definition are going to have larger than average canals. This group is likely already beyond the normal fitting range of most .

@Um_bongo said:

That 90% is not a representation of the ‘average’ population though: it’s 90% of ear mould wearers which by definition are going to have larger than average canals. This group is likely already beyond the normal fitting range of most IIC.

I’m curious why you would expect earmold wearers to have larger than average sized canals? You can fit earmolds in some pretty small canals and I wouldn’t think having larger canals would make a person more likely to have a significant hearing loss or need hearing aids.

I could see there being a bias towards open-fit VS in patients in smaller canals (maybe they originally wanted CICs and were talked out of it by the specialist they were working with who said their canals were too small and recommended open-fit instead), which would skew the results slightly higher than they really are.

I am very curious about the canal stretching issue. The did fit well for the first couple of weeks after being fit and then after being re-fit. I assume that if it were sitting deeper in the canal, stretching might not be such an issue.

In reply to @MinnesotaHIS

@MinnesotaHIS said:

I’m curious why you would expect earmold wearers to have larger than average sized canals? You can fit earmolds in some pretty small canals and I wouldn’t think having larger canals would make a person more likely to have a significant hearing loss or need hearing aids.

I could see there being a bias towards open-fit VS CICs in patients in smaller canals (maybe they originally wanted CICs and were talked out of it by the specialist they were working with who said their canals were too small and recommended open-fit instead), which would skew the results slightly higher than they really are.

The average size issue is obvious if you consider the compression of cartilage through TMJ action. Day one they will have ‘average’ canals, from day 2 onwards they will not. It’s exemplified by long term NHS monaural wear, invariably the fitted ear has a larger canal. Project this onto the candidacy rates: ie the difference for candidates with 6 mm vs 8mm canals and you can see why the assertion that the average mould wearer is atypical of the general population.

Ironically this issue has been largely down to the manufacturers skewing their own data with instant fit becoming the start point for new fittings and milder losses, thereby removing this part of the population from the mould analysis data. The data sets didn’t exist so extensively before CAM shell manufacture so there’s no ‘before ’ comparison to sit alongside the current data.

The link I made to the levels of hearing loss is based on the population who are already long term hearing aid wearers not being likely candidates for due to the fitting range not being up to their needs.

@Um_bongo said:

The average size issue is obvious if you consider the compression of cartilage through TMJ action. Day one they will have ‘average’ canals, from day 2 onwards they will not. It’s exemplified by long term NHS monaural wear, invariably the fitted ear has a larger canal. Project this onto the candidacy rates: ie the difference for candidates with 6 mm vs 8mm canals and you can see why the assertion that the average mould wearer is atypical of the general population.

Ironically this issue has been largely down to the manufacturers skewing their own data with instant fit becoming the start point for new fittings and milder losses, thereby removing this part of the population from the mould analysis data. The data sets didn’t exist so extensively before CAM shell manufacture so there’s no ‘before RIC’ comparison to sit alongside the current data.

The link I made to the levels of hearing loss is based on the population who are already long term hearing aid wearers not being likely candidates for IIC due to the fitting range not being up to their needs.

I have to admit I was unaware of a link between wearing an earmold and increased canal size so thanks for explaining that and the underlying mechanism. With that said, do you know of any studies quantifying how much of a change we’re talking about? This is going into the weeds a bit, but now you have me curious about this phenomena.

I often see patients with 5 to 10 year old hearing aids where the earmold or custom shell still provide an excellent acoustic seal (without any modifications). One would expect an increasing canal size to lead to feedback problems, given that these hearing aids had primitive feedback managers (if they even had one) so I would suspect that the change you’re describing must be very gradually occurring. Of course, I also see patients where feedback problems have emerged, but generally chalked this up to the patient gaining or losing weight.

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