Tech Topic | April 2014 Hearing Review
A new treatment for BTE and RIC/RITE receiver tubing and wire covers dyes the hearing aid plumbing to provide an even more invisible, personalized match to the individual’s skin color
Experienced clinicians know that the stigma of hearing instruments is much less than it was even a few years ago, largely due to high technology devices that allowed the disappearance of the devices into CIC, IIC, thin-tube, and receiver-in-canal/ear (RIC/RITE) styles. While all of these solutions are popular, the vast majority of hearing instruments (52%) fit in 2014 are small receiver in the ear/receiver in the canal BTE instruments.1 These new BTE styles now present a more acceptable cosmetic solution, especially when compared to the days before thin-tube RIC/RITEs.
Although hearing aid fitting technologies have become substantially better in the past 10 years, there are still millions of hearing-impaired individuals who should be using amplification. While the number of patients who use BTE hearing aids is higher, the stigma created by the use of hearing instruments is still of substantial concern to many of these unaided patients.
The National Institutes of Health2 indicates that stigma is still associated with hearing aid use and can be a factor as only 1 in 5 individuals with hearing loss actually use amplification. Wallhagan,3 investigating stigma and hearing instruments, suggests that there is a pervasive nature of stigma in the relationship to hearing loss and hearing aids, and the close association of this stigma to ageism. Other studies and discussions4-9 also support that stigma remains a factor, even for instruments that incorporate cosmetic small thin tubes and wires into their fittings.
A New “Plumbing” Process
Since there is such a stigma factor involved in hearing aid use, it makes sense to consider any alternative that offers a more cosmetic solution. While these new technologies and fitting methods have somewhat reduced stigma and made fittings more cosmetic for some individuals, current tubes and receiver wire covers remind us of Henry Ford’s classic motto for his all-black Model-T line: “You can have any color tubing you want as long as it is reflective white.”
Hearing aid manufacturers do not offer skin-colored tubes as it would require quite a significant increase in research and development costs to develop and produce 9 different cosmetically blending tube colors. Additionally, besides offering tubes and wire covers that are molded to right and left, in 3-5 different lengths, the availability in 9 different skin colors would create inventory issues for both the manufacturer and the dispenser in stocking these cosmetic tubes.
There are obvious reflections and skin color differences that make the thin tubes and wire transmission tubes still in need of some modification for the ultimate in cosmetic appeal. To some, these tubes can be appealing right out of the box; others are frustrated by a solution that does not blend these tubes with their skin color and reduce the reflectivity. Many patients would like their hearing aids to be less noticeable or distracting:
- Cosmetically sensitive light-skinned individuals.
- Tan and dark-skinned individuals, for whom tubes are reflective and provide an obvious contrast to skin color.
- Teenagers who are always self-conscious of their hearing aids, particularly BTE devices.
- Patients with short hair styles or who like to pull their hair back for recreation.
Figure 1. Tubing before and after application of the new Vanish tubing application.
About 5 years ago, the inventor of the Vanish process was dissatisfied with the stigma and the appearance of his RIC/RITE and BTE hearing instruments, and he began a quest to make these tubes and receiver wire covers more cosmetically discreet. This carried him virtually all over the country to various plastics laboratories and dye companies. As part of the research process, 24 plastics engineers evaluated 15 different plastic coatings and 9 specific chemicals to dull the surface of these polyamide thin tubes and receiver covers. After substantial research, the appropriate dyes were found and a process was then developed to treat these tubes and wire covers to blend with various skin colors (Figure 1). Once the dyes were determined, various accelerants were considered by the engineers to deliver the dye to the tubes. For the process to be conducted safely in a clinical environment, a special container was designed to be used in the blending process. The special container allows for the dyeing of the tube while leaving the receiver or the connection portion of the tube out of the process.
A 5-Step Process
Figure 2. Color chart showing different skin colors.
Prior to the dyeing of the tube, it is necessary to determine the patient’s skin color. This is done by the use of a color selection chart (Figure 2). The color should be selected by holding the chart behind the ear in natural daylight. Each of the possible colors (L1 to L6 and D7 to D9) has a special curing time that is required for the dyeing process. Care must be exercised to watch the timer to ensure the exact color desired. The process of blending a tube or receiver wire cover (RWC) into a cosmetic solution for your patient involves a simple 5-step process as follows:
1) Depress the button on the top of the bottle and let the dye cascade into the mixture below to begin the mixing process. Once the dye is in the mixture, shake the bottle for 20 seconds and set aside (Figure 3).
Figure 3. The button on the top of the dye bottle is depressed, allowing the dye to flow into the mixture below.
Figure 4. Using the scuff pad to abrade surface of the tube and RWC.
2) Using the enclosed scuffing pad (Figure 4), gently buff all the surfaces of the tube and/or RWC until they look like frosted glass (ie, a milky appearance). Each scuffing pad will process two tubes. Scuffing the tube or RWC reduces its reflectivity and opens up the surface of the plastic for the thorough penetration of the dye.
Figure 5. Inserting the right ear hearing aid tube into the right hole of the reusable soaking container.
3) One side of the reusable soaking container is marked left (L), and the other side is marked right (R). At the end of each side of the soaking tray is a hole designed for inserting the tube or RWC. When inserting the tube or RWC into the tray, it helps to push with one hand and pull with the other. Once in the soaking tray, ensure that the tube or RWC is resting on the floor of the tray. If the tube has a “wing” on the connector, put the included retainer tube over both. If a RWC, ensure that the receiver is covered.
4) Set the timer for the chosen color, shake the dye for another 20 seconds, pour the mixture into the soaking tray, and immediately start the timer. Be careful to accurately time the soaking process so that the final color matches the selected color from the color chart.
Figure 6. The right ear hearing aid plumbing in the soaking container.
5) When time expires, rotate the tube or RWC, and pour the remaining dye into a bowl or the sink. Then rinse the tube or RWC and the tray, pull the tube or RWC out of the container, and dry it off. The dyed tube or RWC may be used immediately.
Figure 7. Final result of the Vanish treatment.
This 5-step process is all that is necessary to turn a reflective white tube or receiver wire cover into a nonreflective skin-blending cosmetic solution for your patient (Figure 7). The whole Vanish process takes less than 15 minutes for both tubes and offers a significant cosmetic result for a minimal cost.
The Vanish blending process adds even more value to a true custom fitting; it not only offers a custom cosmetic solution for your patient’s hearing aid fitting, but also sets the clinic apart from its competitors.
As clinicians, we have watched tubing go from large to small, receivers go from in-the-instruments to in-the-canal. Clinically, they look rather small to the seasoned dispensing professional. However, new patients still feel that there are cosmetic issues with the use of amplification. To some, these tubes and RWCs look like conspicuous telephone poles in their ear. In these days of extreme competition, the Vanish process can help set your clinic apart from the competition and even be used to obtain new patients who simply want a better cosmetic solution.
For more information about this new receiver tube and wire cover treatment, visit http://myvanish.com.
References
1. Hearing Review (2014). Hearing aid sales rise by 4.8% in 2013: Industry closing in on 3-million unit mark. https://hearingreview.com/all-news/22220-hearing-aid-units-rise-by-4-8-in-2013-industry-closing-in-on-3-million-unit-mark. Accessed February 16, 2014.
2. National Institutes of Health (2014). Department of Health and Human Services, Research Portfolio. http://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=95. Accessed February 14, 2014.
3. Wallhagan M. The stigma of hearing loss. Gerontologist. 2010;50(1):66–75.
4. Kochkin S. 20Q: More Highlights from MarkeTrak. 20Q with Gus Mueller. Audiology Online, July 2012. http://www.audiologyonline.com/articles/more-highlights-from-marketrak-6830>. Accessed February 16, 2014.
5. Kochkin S. 20Q: More Highlights from MarkeTrak. 20Q with Gus Mueller. Audiology Online, June 2012. http://www.audiologyonline.com/articles/20q-25-years-marketrak-highlights-6616. Accessed February 16, 2014.
6. Gagné J-P, Southall K, Jennings MB. Stigma and self-stigma associated with acquired hearing loss in adults. Hearing Review. 2011;18(8):16–22.
7. Ross M. The stigma of hearing loss and hearing aids. Rehabilitation Engineering Research Center on Hearing Enhancement, Gallaudet University, 2011. http://www.hearingresearch.org/ross/hearing_aids/the_stigma_of_hearingloss_and_hearingaids.php. Accessed February 16, 2014.
8. Hear-it.org (2014). Stigma about hearing loss. Hear-it. http://www.hear-it.org/Hearing-impaired-people-still-stigmatized-2. Accessed February 16, 2014.
9. Erler S, Garstecki D. Hearing loss- and hearing aid-related stigma perceptions of women with age-normal hearing. Am J Audiol. 2002;11(2):83-91.
Robert Traynor, EdD, MBA, is CEO at Audiology Associates Inc in Greeley, Colo, and serves as an adjunct professor at the Universities of Florida, Colorado, and Northern Colorado. His book, coauthored with Robert Glaser, PhD, Strategic Practice Management, now in its second edition, is widely used in college programs. Correspondence can be addressed to Dr Traynor at: [email protected]
Original citation for this article: Traynor R. A disappearing receiver tube and wire cover treatment. Hearing Review. 2014;21(4):38-39.
