Custom hearing aid ear molds have been around for a while. I love them because they allow me to do a variety of things with hearing aids that I can't do with generic silicone rubber domes. First, they allow me to create a hearing aid that perfectly fits someone's ear. Everyone's ears are different. Some of these ears require the use of custom ear molds to fit properly. Second, they allow for custom venting. Venting is CRITICAL to properly fit a set of hearing aids. Too big, and sound leaks out causing feedback and limited hearing benefit. Too small, and sound is trapped in the ear canal and causes the Occlusion Effect.Third, they allow for a better custom programming of your hearing aids. Being able to hit prescriptive targets is nearly impossible with generic domes for some types of hearing losses. Custom molds, with custom venting, dramatically improves the ability to custom program hearing aids. While custom ear molds are great, there haven't been any major innovations since the Acoustically Optimized Venting (AOV) by Phonak. However, this is where Phonak once again has led the way in innovation with their custom earmolds made out of Titanium. Traditionally, ear molds have been manufactured using Silicone or Acrylic. The problem with Silicone is that it shrinks, stains, and physically breaks down over time. The problem with Acrylic is that it is delicate, and can cause skin irritation for some individuals. Initially, Phonak introduced Titanium in their Virto B-Titanium Invisible In Canal (IIC) hearing aids. Titanium allows for a significantly smaller hearing devices because it is 15 times stronger than Acrylic and is 50% thinner than an Acrylic earmold. However, they have continued this trend with their Titanium Slim-Tip that attaches to the end of a Standard, Medium, or Power receiver in place of a rubber dome. They also released a custom Titanium C-Shell that embeds these receivers inside of the Titanium ear mold. Both of these custom Titanium ear molds are for use with Phonak's Audeo extremely popular Marvel Hearing Aids. Not only is Titanium significantly smaller than Acrylic, it is also hypoallergenic. In fact, Titanium is the most hypoallergenic material known to man. So if you have been avoiding hearing treatment due to skin sensitivity, Titanium is the perfect option. Benefits of Titanium aside, I personally believe that custom ear molds are significantly under utilized and could dramatically improve aid physical fit and performance for many hearing aid users. So the next time you see your hearing care professional, ask them if going custom could improve your hearing aid fitting and take your hearing aid performance to the next level.