Interview with Randy Morgan President, Westone Laboratories, Inc.
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AO/Beck: Hi Randy, thanks for spending sometime with me.
Morgan: Hi Doug. Thanks for the opportunity.
AO/Beck: Before we get into earmold issues, please tell me about yourself.
Morgan: I've been the president of Westone for 14 years and I've been with the company for 30 years.
AO/Beck: Wow, that's pretty impressive. You don't meet many folks who've been with the same company for 30 years any more. How many offices does Westone have?
Morgan: We have three. All of the information is available through our website (www.earmold.com) . However, to make it a little easier for the readers, I can give the 800 phone numbers and the locations. The main office is in Colorado Springs, the phone number there is 1-800-525-5071. We have a production facility in Renton, Washington - just outside of Seattle, the number there is 1-800-222-8358 and the third site is in Kalamazoo, Michigan, the phone number is 1-800-552-7203.
AO/Beck: Thanks Randy. OK, let's move on to the issues at hand. If I were going to take an earmold impression of your left ear, for a CIC hearing aid, what are your personal preferences?
Morgan: I always prefer cartridge materials. In particular, cartridge materials delivered through an electric gun are the most consistent and usually the best way to go. Issues related to hand strength, wiggle factors and bubbles vanish when using electric guns. In fact, the electric guns are significantly better than the "hand-crank" manual guns. For example, if you use the manual guns, there simply isn't enough material available in one squeeze of the trigger to complete the impression. So when you "re-cock" the trigger of the manual gun, the wiggles, the wrinkles and the voids occur. Of course someone who is extremely experienced and cautious will do fine with almost anything. However, for most of us, it's best to use the best tools to minimize the chances of errors occurring.
AO/Beck: Very good. What about the actual materials themselves?
Morgan: As you know, there are lots of cartridge materials out there. We make a few types of materials, but my favorite is "SiliClone®", which is, of course a Westone product. The material is a vinylpolysiloxane.
AO/Beck: And what is the typical "set-up" time for SiliClone?
AO/Morgan: Usually about three minutes. Certainly that will vary a bit with temperature, humidity and related factors, but three minutes is typical.
AO/Beck: Randy what are the most typical problems you find day-in and day-out regarding the impressions you receive from across the world?
Morgan: Typically, they can be boiled down to the impression taker not paying enough attention to the ear impression process. The specific issues include; inadequate ear canal depth, too much material which causes the impression to droop, voids/bubbles in the impression, using the very inexpensive material in the middle of the summer and having the heat and humidity change the physical characteristics of the impression before we even open the box and on and on. Basically, the problems are simple ones and they are all based on not paying due respect to the ear impression. My advice is simple - pay attention and do your best with the ear impression. If the impression is fantastic, the earmold will be fantastic. If the impression is sub-par, the earmold will be sub-par.
AO/Beck: What is the least expensive ear impression material?
Morgan: Powder-liquid runs about 80-85 cents an ear. The silicones run about a buck an ear.
AO/Beck: What is the cost of the manual-crank guns and what is the cost of the electric guns?
Morgan: The hand-crank guns run about $34 dollars each. The electric guns are about $600.00.
AO/Beck: OK, well I have to tell you that powder-liquid is indeed what I prefer. Not because it's cheap, and by the way, price is important when you're running a practice, but because powder-liquid is "forgiving". That is, once I have the dam placed where I want it, I Iike to inject the material slowly and purposefully, and with a feel for where it is going and how tightly I'm packing it in there. Also, and I know it's a cardinal sin, I like to have the extra time to make sure the material is where I want it and I like the ability to manipulate it a bit in case I want to change the physical characteristics of the impression regarding a low-profile impression, or whatever other physical characteristics I want to change.
Morgan: Well that is certainly an issue. Clinicians have their personal preferences and those are important too. If you're making excellent impressions and if your success rate approaches 100 percent, then if it ain't broke, don't fix it. Again, experience and expertise matter a great deal. However, for new clinicians, and for people who don't achieve consistently excellent results, better tools and materials will increase their ability to make better ear mold impressions. Regarding the powder-liquid, the actual mix ratio is very important too. Some folks mix their own and that may add to the inconsistency. In our pre-measured materials, we measure to the tenth of a gram regarding the powder and we use a one drop tolerance on the liquid - so it's pretty much the exact same mix every time. Additionally, we check the batches every two to three hours. Since we ship over a half million of those powder-liquid pre-measures each year, we do our best to make sure they are highly consistent!
AO/Beck: Good, I'm glad to learn you ship a half million sets of powder-liquid, that means I'm not the only one left using it! Now having told you that I prefer powder-liquid, I have to add that summer in Saint Louis is pretty hot and I know the earmold impressions will likely spend a few hours on the tarmac at Lambert airfield, or in the unairconditioned luggage hold of an outbound jet, so on hot days, even I use silicone materials. I really have not seen a difference in the results, but the audiologists I work with tell me they have noticed a difference and they have their preferences too.
Morgan: I think your observations are true and they make sense. But I also have to tell you that if everyone used silicone, we'd be better off as an industry. There is a well documented shrinkage factor of some 6 to12 percent that can occur with powder-liquid and as you mentioned, weather and environmental issues have a lot to do with that. The more we can do to reduce the uncontrollable variables, the better off we are. Silicone has essentially no shrinkage factor and silicone is not affected by heat or cold.
AO/Beck: OK, I'm starting to get the message. On a related topic, what is the best adhesive material to use to attach the impression to the box?
Morgan: You don't need an adhesive for silicone impressions. For impressions made of powder and liquid, we suggest folks use Duco household cement. It works well and it's fairly inexpensive. I like people to avoid rubber cement and white glue, those two materials do not do a very good job and they cause problems for all of us.
AO/Beck: What about allergic reactions to ear impression materials? Are there any issues there? Are more people allergic to silicone or powder-liquid or are those non-issues?
Morgan: They really are non-issues. All the materials are ISO certified and I have never seen any real solid evidence of allergic reactions. I don't doubt there are a few folks who appear to have an allergic reaction, but then again, those folks might also have had a contact dermatitis just by having something in the ear, and it may not be specific to the material at all. In other words, regardless of the material, that individual ear may react to anything used to take an ear impression.
AO/Beck: What about the issue of having the patient bite on a bite-block during the impression taking and set-up time?
Morgan: I was hoping that wasn't going to come up! I know some people are really opinionated on this. Some people swear by the bite-block, others say it doesn't matter. I have to say it doesn't seem to matter much. We see fantastic impressions with and without bite-blocks, and we see terrible impressions with and without bite-blocks. The key issue is to pay attention and do your best with whatever materials and techniques you use. Since the bulk of our products are made to fit in the external canal and concha bowl, if we had to settle on one method, we would lean toward "natural" movement, i.e. smiling, talking, turning the head, chewing. We think an impression should be made while duplicating the typical environment that the earmold will be worn in. Head still and mouth held open or closed makes for a great post-mortem fitting.
AO/Beck: What about using soft versus hard materials for profound SNHL? Is there truly any consistent difference or any reliable data that says use soft materials, rather than hard materals for a profound loss?
Morgan: I usually recommend soft or hard based on the texture of the ear, not the hearing loss. If the ear is stiff, use a soft material. If the ear is soft, use a hard material.
If the ear is medium, I would go with a soft material. Basically, after making about 8 million earmolds, we've learned that you get a better seal when you seal a rock with rubber, rather than trying to get a seal on a rock with a rock. So again, if the ear is firm, use a soft material and vice-versa.
AO/Beck: Randy, what are the options for using stethoscopes with hearing aids.
Morgan: We can make custom fitted earmolds that accommodate the tip of the stethoscope.
See figure below
AO/Beck: Randy, I know Westone is involved with many other aspects of hearing and hearing protection. Can you tell me a couple of the new projects underway?
Morgan: We're working with lots of musicians for their personal monitoring systems and that's a lot of fun. We've worked with Reba and the Backstreet Boys and others and those are always fun things to get involved with. We're working with the USAF on their communication devices on the F-22 and F-16 projects to try to overcome the horrible noise in the jets and to allow better communication between the tower and the cockpit. So we've got lots of exciting products and innovations in the works.
AO/Beck: Thanks Randy, it's always a pleasure to speak with you. I hope you and Westone have a happy and healthy 2001 and I'll look forward to speaking with you again soon.
Morgan: Thanks Doug. Best wishes to you and the readers for 2001 too.
Morgan: Hi Doug. Thanks for the opportunity.
AO/Beck: Before we get into earmold issues, please tell me about yourself.
Morgan: I've been the president of Westone for 14 years and I've been with the company for 30 years.
AO/Beck: Wow, that's pretty impressive. You don't meet many folks who've been with the same company for 30 years any more. How many offices does Westone have?
Morgan: We have three. All of the information is available through our website (www.earmold.com) . However, to make it a little easier for the readers, I can give the 800 phone numbers and the locations. The main office is in Colorado Springs, the phone number there is 1-800-525-5071. We have a production facility in Renton, Washington - just outside of Seattle, the number there is 1-800-222-8358 and the third site is in Kalamazoo, Michigan, the phone number is 1-800-552-7203.
AO/Beck: Thanks Randy. OK, let's move on to the issues at hand. If I were going to take an earmold impression of your left ear, for a CIC hearing aid, what are your personal preferences?
Morgan: I always prefer cartridge materials. In particular, cartridge materials delivered through an electric gun are the most consistent and usually the best way to go. Issues related to hand strength, wiggle factors and bubbles vanish when using electric guns. In fact, the electric guns are significantly better than the "hand-crank" manual guns. For example, if you use the manual guns, there simply isn't enough material available in one squeeze of the trigger to complete the impression. So when you "re-cock" the trigger of the manual gun, the wiggles, the wrinkles and the voids occur. Of course someone who is extremely experienced and cautious will do fine with almost anything. However, for most of us, it's best to use the best tools to minimize the chances of errors occurring.
AO/Beck: Very good. What about the actual materials themselves?
Morgan: As you know, there are lots of cartridge materials out there. We make a few types of materials, but my favorite is "SiliClone®", which is, of course a Westone product. The material is a vinylpolysiloxane.
AO/Beck: And what is the typical "set-up" time for SiliClone?
AO/Morgan: Usually about three minutes. Certainly that will vary a bit with temperature, humidity and related factors, but three minutes is typical.
AO/Beck: Randy what are the most typical problems you find day-in and day-out regarding the impressions you receive from across the world?
Morgan: Typically, they can be boiled down to the impression taker not paying enough attention to the ear impression process. The specific issues include; inadequate ear canal depth, too much material which causes the impression to droop, voids/bubbles in the impression, using the very inexpensive material in the middle of the summer and having the heat and humidity change the physical characteristics of the impression before we even open the box and on and on. Basically, the problems are simple ones and they are all based on not paying due respect to the ear impression. My advice is simple - pay attention and do your best with the ear impression. If the impression is fantastic, the earmold will be fantastic. If the impression is sub-par, the earmold will be sub-par.
AO/Beck: What is the least expensive ear impression material?
Morgan: Powder-liquid runs about 80-85 cents an ear. The silicones run about a buck an ear.
AO/Beck: What is the cost of the manual-crank guns and what is the cost of the electric guns?
Morgan: The hand-crank guns run about $34 dollars each. The electric guns are about $600.00.
AO/Beck: OK, well I have to tell you that powder-liquid is indeed what I prefer. Not because it's cheap, and by the way, price is important when you're running a practice, but because powder-liquid is "forgiving". That is, once I have the dam placed where I want it, I Iike to inject the material slowly and purposefully, and with a feel for where it is going and how tightly I'm packing it in there. Also, and I know it's a cardinal sin, I like to have the extra time to make sure the material is where I want it and I like the ability to manipulate it a bit in case I want to change the physical characteristics of the impression regarding a low-profile impression, or whatever other physical characteristics I want to change.
Morgan: Well that is certainly an issue. Clinicians have their personal preferences and those are important too. If you're making excellent impressions and if your success rate approaches 100 percent, then if it ain't broke, don't fix it. Again, experience and expertise matter a great deal. However, for new clinicians, and for people who don't achieve consistently excellent results, better tools and materials will increase their ability to make better ear mold impressions. Regarding the powder-liquid, the actual mix ratio is very important too. Some folks mix their own and that may add to the inconsistency. In our pre-measured materials, we measure to the tenth of a gram regarding the powder and we use a one drop tolerance on the liquid - so it's pretty much the exact same mix every time. Additionally, we check the batches every two to three hours. Since we ship over a half million of those powder-liquid pre-measures each year, we do our best to make sure they are highly consistent!
AO/Beck: Good, I'm glad to learn you ship a half million sets of powder-liquid, that means I'm not the only one left using it! Now having told you that I prefer powder-liquid, I have to add that summer in Saint Louis is pretty hot and I know the earmold impressions will likely spend a few hours on the tarmac at Lambert airfield, or in the unairconditioned luggage hold of an outbound jet, so on hot days, even I use silicone materials. I really have not seen a difference in the results, but the audiologists I work with tell me they have noticed a difference and they have their preferences too.
Morgan: I think your observations are true and they make sense. But I also have to tell you that if everyone used silicone, we'd be better off as an industry. There is a well documented shrinkage factor of some 6 to12 percent that can occur with powder-liquid and as you mentioned, weather and environmental issues have a lot to do with that. The more we can do to reduce the uncontrollable variables, the better off we are. Silicone has essentially no shrinkage factor and silicone is not affected by heat or cold.
AO/Beck: OK, I'm starting to get the message. On a related topic, what is the best adhesive material to use to attach the impression to the box?
Morgan: You don't need an adhesive for silicone impressions. For impressions made of powder and liquid, we suggest folks use Duco household cement. It works well and it's fairly inexpensive. I like people to avoid rubber cement and white glue, those two materials do not do a very good job and they cause problems for all of us.
AO/Beck: What about allergic reactions to ear impression materials? Are there any issues there? Are more people allergic to silicone or powder-liquid or are those non-issues?
Morgan: They really are non-issues. All the materials are ISO certified and I have never seen any real solid evidence of allergic reactions. I don't doubt there are a few folks who appear to have an allergic reaction, but then again, those folks might also have had a contact dermatitis just by having something in the ear, and it may not be specific to the material at all. In other words, regardless of the material, that individual ear may react to anything used to take an ear impression.
AO/Beck: What about the issue of having the patient bite on a bite-block during the impression taking and set-up time?
Morgan: I was hoping that wasn't going to come up! I know some people are really opinionated on this. Some people swear by the bite-block, others say it doesn't matter. I have to say it doesn't seem to matter much. We see fantastic impressions with and without bite-blocks, and we see terrible impressions with and without bite-blocks. The key issue is to pay attention and do your best with whatever materials and techniques you use. Since the bulk of our products are made to fit in the external canal and concha bowl, if we had to settle on one method, we would lean toward "natural" movement, i.e. smiling, talking, turning the head, chewing. We think an impression should be made while duplicating the typical environment that the earmold will be worn in. Head still and mouth held open or closed makes for a great post-mortem fitting.
AO/Beck: What about using soft versus hard materials for profound SNHL? Is there truly any consistent difference or any reliable data that says use soft materials, rather than hard materals for a profound loss?
Morgan: I usually recommend soft or hard based on the texture of the ear, not the hearing loss. If the ear is stiff, use a soft material. If the ear is soft, use a hard material.
If the ear is medium, I would go with a soft material. Basically, after making about 8 million earmolds, we've learned that you get a better seal when you seal a rock with rubber, rather than trying to get a seal on a rock with a rock. So again, if the ear is firm, use a soft material and vice-versa.
AO/Beck: Randy, what are the options for using stethoscopes with hearing aids.
Morgan: We can make custom fitted earmolds that accommodate the tip of the stethoscope.
See figure below
AO/Beck: Randy, I know Westone is involved with many other aspects of hearing and hearing protection. Can you tell me a couple of the new projects underway?
Morgan: We're working with lots of musicians for their personal monitoring systems and that's a lot of fun. We've worked with Reba and the Backstreet Boys and others and those are always fun things to get involved with. We're working with the USAF on their communication devices on the F-22 and F-16 projects to try to overcome the horrible noise in the jets and to allow better communication between the tower and the cockpit. So we've got lots of exciting products and innovations in the works.
AO/Beck: Thanks Randy, it's always a pleasure to speak with you. I hope you and Westone have a happy and healthy 2001 and I'll look forward to speaking with you again soon.
Morgan: Thanks Doug. Best wishes to you and the readers for 2001 too.
