The use of insert earphones (IE) in audiometry has increased throughout the years. Although supra-aural headphones were once commonplace, insert earphones serve the same purpose. Inserts are basically eartips made from foam with tubing that transmits the test signal into the ear.
As a follow-up to the earlier piece on 6 Reasons Why Insert Earphones Should The Audiometry Standard and 6 common questions about insert earphones we decided to indulge in the proper use and insertion process of Foam ear-tips using the KUDUwave.
The Art of The Perfect Fit is difficult to master, yet it makes all the difference. Improperly fitted ear tips during audiometry may result in, I) the leaking of low frequencies resulting in what appears to be a low frequency hearing loss, and II) decreased attenuation abilities by the KUDUwave (foam ear tips + ear cups).
Steps to follow when using foam ear tips.
- Wash your hands regularly. Give your unclean paws a scrub before touching your ear tips.
- Between your fingers, pinch and roll the ear tip. Roll the ear tip into a thin, snake-like form with your thumb and index fingers. It will be smaller and easier to insert as a result of this.
- Pull the ear upwards and backwards (recommended by audiologists). With the hand that isn’t holding the ear tip, grab the top of your ear. Stretch it up and backwards a little, just a soft tug, nothing too strenuous. This will expand your ear a little more, making it easier to place the eartip. If you’re having problems, ask the patient to assist.
- Insert the ear tip with care.
Insert the ear tip with a steady hand. If you’re using a foam ear tip, hold it in the ear for 5-10 seconds to let the foam expand and fill the ear canal.
KUDUfoam eartips can only be purchased from an eMoyo branch. We are the only provider of KUDUfoam eartips, and we have a Class 1 CE accreditation from the European Union for KUDUfoam eartips. As a Class 1 medical device, we are aware of no other firm that may be able to offer KUDUfoam eartips.
Implications of using incorrect foam-tips
The KUDUwave audiometer is calibrated as per international (ANSI S3.6 and BS EN 60645-1) and national standards (SANS 10154-1). Electro-acoustic calibration takes into account many things including the physical features of the acoustic transducer (speaker). For example, the KUDUwave audiometer uses insert earphones to transmit pure tones and speech materials into the patient’s ears. The insert earphones are made up of long sound tubes protruding from each KUDUwave ear cup, and these long sound tubes are connected to a foam eartip with no extended black tubes.
The calibration values used to calibrate the KUDUwave audiometer takes into account the total length of the sound tube, among other things. What this means is that, if the sound tubes are elongated or shortened during use, the calibration of the KUDUwave will be invalid. Let us picture this, the calibration value of the KUDUwave insert earphone for 1000 Hz using a calibration ear simulator is 5.5 dB SPL – in an average adult ear, this sound pressure level will result in ~0 dB HL (the softest pure tone heard 50% of the time). In this case, using eartips with extended black tubes will result in longer sound tubes than used for calibration. Resultantly, less than 5.5 dB SPL at 1000 Hz will be delivered to the average ear. This means that an individual may present with worsened threshold or what appears to be decreased hearing sensitivity.
Even more importantly, using the incorrect ear tips, could injure the patient, with a worst case scenario being a perforated eardrum.
It is paramount that the right foam eartips are used to ensure accurate test results during audiometric measurements. eMoyo is not responsible for any hearing test results obtained on the KUDUwave with ear tips that were not provided by us.
In general, there are no left or right-sided ear tips. A tip is a tip. If the ear tip isn’t effectively filling the opening of the ear canal, you may want a larger ear tip. You may require a smaller ear tip if the ear tip is unpleasant and hurting the patient.
We are often guilty of this similar mindset in healthcare, and more especially in Audiology. Because things have always been done this way, they must continue to be done this way. Many procedures may be more efficient and productive, and there are better methods to accomplish things in some circumstances. As a guiding metric and a key to continual development, we should constantly be aware of the reasons for the things we do.
It’s only natural to convert to using insert ear tip foams. This isn’t to say that Internet Explorer doesn’t have its own set of problems. However, the positives greatly exceed the drawbacks.
Contact eMoyo today for further information or to order you Foam tips for your KUDUwave.