IHS - International Hearing Society Earmold and Impression Techniques Questions and Answers — Questions and Answers
Question 1: During an otoscopic examination prior to taking an ear impression, you observe a small, bony growth deep in the cartilaginous portion of the ear canal. This condition does not appear to be inflamed or causing discomfort. What is the most appropriate course of action?
- Note the presence of the exostosis and proceed with the impression, taking care not to place the otoblock behind the growth. (Correct answer)
- Immediately refer the client to a physician for medical clearance before proceeding with the impression.
- Use a smaller otoblock to bypass the growth and achieve a deeper impression.
- Cancel the appointment and rebook after the client has had the growth surgically removed.
Correct answer: Note the presence of the exostosis and proceed with the impression, taking care not to place the otoblock behind the growth.
Exostoses, or small bony growths, are a relatively common finding. As long as there is no inflammation, infection, or other contraindication, it is acceptable to proceed with the impression. The key is to ensure the otoblock is placed at or just beyond the narrowing to prevent the impression from locking behind it, which could cause discomfort and difficulty upon removal.
Question 2: A hearing instrument specialist is selecting an impression material for a client who requires a high-gain power BTE hearing aid, which necessitates a very snug fit to prevent feedback. Which property of the silicone material is most critical to consider for achieving this goal?
- A low shore value
- A high viscosity (Correct answer)
- A powder and liquid composition
- A long curing time
Correct answer: A high viscosity
Higher viscosity silicones are denser and more likely to slightly expand the ear canal tissue when injected. This results in a tighter fitting final product, which is desirable for high-gain instruments to create an effective acoustic seal and minimize feedback. Shore value relates to the hardness after curing, not the pressure exerted during the impression process.
Question 3: A new hearing professional is taking their first independent ear impression. To ensure all critical anatomical landmarks are captured for a full-shell ITE hearing aid, which of the following must be completely filled with impression material?
- The earlobe and mastoid process
- The cymba concha, external auditory meatus, and incisura intertragica
- The concha bowl (cavum and cymba), helix, tragus, and anti-tragus (Correct answer)
- The ear canal up to the first bend only
Correct answer: The concha bowl (cavum and cymba), helix, tragus, and anti-tragus
A successful ear impression for a custom hearing aid must be a complete and accurate reproduction of the outer ear's anatomy. This includes filling the entire concha bowl (both cavum and cymba), the helix curl, and capturing the tragus and anti-tragus landmarks to ensure proper fit, retention, and placement of components like microphones.
Question 4: When injecting impression material into a client's ear with a syringe, what is the recommended technique to prevent air pockets and voids in the final impression?
- Inject the material in short bursts to allow air to escape.
- Keep the syringe tip buried in the expressed material as the ear is filled and the syringe is withdrawn. (Correct answer)
- Move the syringe tip rapidly in a circular motion to spread the material quickly.
- Fill the concha bowl first before injecting material into the ear canal.
Correct answer: Keep the syringe tip buried in the expressed material as the ear is filled and the syringe is withdrawn.
To avoid introducing air pockets, folds, or voids, the tip of the syringe should be kept just under the surface of the material that has already been injected. The professional should slowly withdraw the syringe laterally as the material fills the canal and concha, ensuring a continuous, solid fill.
Question 5: A client presents for an earmold impression. The otoscopic exam reveals a significant amount of cerumen completely blocking the view of the ear canal beyond the first bend. Which of the following is the correct procedure?
- Use a high-viscosity material to push the wax against the otoblock.
- Proceed with the impression but inform the lab about the wax.
- Postpone the impression until the cerumen can be safely removed according to your scope of practice or by a medical professional. (Correct answer)
- Place the otoblock just in front of the wax blockage.
Correct answer: Postpone the impression until the cerumen can be safely removed according to your scope of practice or by a medical professional.
Taking an ear impression is contraindicated when impacted or excessive cerumen is present in the ear canal. Proceeding could push the wax further down, causing impaction or injury. The correct action is to delay the impression until the ear canal is clear, either through removal by the practitioner (if within their scope of practice) or by referring the client for medical removal.
Question 6: After successfully removing a cured silicone ear impression, what is the essential final step before concluding the procedure with the client?
- Trim any excess material from the helix area of the impression.
- Immediately package the impression in a box with foam padding for shipping.
- Ask the client if they experienced any dizziness.
- Perform a post-impression otoscopic examination of the ear. (Correct answer)
Correct answer: Perform a post-impression otoscopic examination of the ear.
It is critical to perform a final otoscopic examination after removing the impression. This step ensures that the otoblock has been removed along with the impression and that no material has been left behind in the ear canal, and it allows for a check of the canal and tympanic membrane for any signs of irritation or injury.
IHS - International Hearing Society Earmold and Impression Techniques Questions and Answers
During an otoscopic examination prior to taking an ear impression, you observe a small, bony growth deep in the cartilaginous portion of the ear canal.
This condition does not appear to be inflamed or causing discomfort.
What is the most appropriate course of action?