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/introduction-to-lantos-3d-scanning-33466Introduction to Lantos 3D ScanningIn this course, we will examine the foundational aspects of scanning using the Lantos 3D Scanner. We’ll also discuss commonly asked questions regarding scanning, how data is collected, and which patient populations it can be used for.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comIntroduction to Lantos 3D ScanningIn this course, we will examine the foundational aspects of scanning using the Lantos 3D Scanner. We’ll also discuss commonly asked questions regarding scanning, how data is collected, and which patient populations it can be used for.33466OnlinePT60M
In this course, we will examine the foundational aspects of scanning using the Lantos 3D Scanner. We’ll also discuss commonly asked questions regarding scanning, how data is collected, and which patient populations it can be used for.
3https://www.audiologyonline.com/audiology-ceus/course/why-open-hearing-aid-fittings-33262Why Open Hearing Aid Fittings are Often Not the Best Choice for the PatientThis course reviews the pros and cons of open-canal versus occluding ear-coupling systems for hearing aids, and presents comparative data of three different options. Data was collected for both laboratory testing and real-world judgments.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comWhy Open Hearing Aid Fittings are Often Not the Best Choice for the PatientThis course reviews the pros and cons of open-canal versus occluding ear-coupling systems for hearing aids, and presents comparative data of three different options. Data was collected for both laboratory testing and real-world judgments.33262OnlinePT60M
This course reviews the pros and cons of open-canal versus occluding ear-coupling systems for hearing aids, and presents comparative data of three different options. Data was collected for both laboratory testing and real-world judgments.
4https://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.
5https://www.audiologyonline.com/audiology-ceus/course/deeper-look-at-sound-environments-33536A Deeper Look at Sound EnvironmentsThe characteristics of the sound environment have a fundamental impact on the performance of the hearing aid user. In this course, we will describe the obvious and sometimes more subtle aspects of sound environments that will affect hearing aid performance.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyAudiologyOnlinewww.audiologyonline.comA Deeper Look at Sound EnvironmentsThe characteristics of the sound environment have a fundamental impact on the performance of the hearing aid user. In this course, we will describe the obvious and sometimes more subtle aspects of sound environments that will affect hearing aid performance.33536OnlinePT60M
The characteristics of the sound environment have a fundamental impact on the performance of the hearing aid user. In this course, we will describe the obvious and sometimes more subtle aspects of sound environments that will affect hearing aid performance.
