How do I choose a stethoscope?

[Ferrismonk]

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Okay, so I've been accepted to MSUCOM for next year (Class of 2012) and I don't think that I need a stethoscope yet, but basically my entire family thinks that they should get one for me for Christmas. My question is this, how do you choose between them? Is one stethoscope as good as another is is there something you should be looking for in particular when you are buying one?

I'd appreciate any help you could give.

Thanks,
-Travis-

------------------------------------------------------------
Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

 

[KateGia]

Okay, so I've been accepted to MSUCOM for next year (Class of 2012) and I don't think that I need a stethoscope yet, but basically my entire family thinks that they should get one for me for Christmas. My question is this, how do you choose between them? Is one stethoscope as good as another is is there something you should be looking for in particular when you are buying one?

I'd appreciate any help you could give.

Thanks,
-Travis-

------------------------------------------------------------
Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

A mod will move this for you, but meanwhile, i'll give you a brief answer. First, before people spend money on it, find out if your school gives stethescopes to all of the students. Our school doesn't, but apparently some do. Second, do a search on here, there will be tons of info on this topic. Third, get a good quality one. I know there are people that say the cheap ones are the same, but if you get a good one (like a littmann cardio III) when you are learning, it makes it easier to hear things, plus if someone else is buying it, who cares if it's more expensive 😀. Our school just told us to get one that has 2 seperate tubes (or whatever) coming from the bell. In the nice ones, these are combined inside one big tube, so you may have to ask. Basically they meant don't get the cheap $20 ones with a little plastic single tube (geez i can't think of a better word) connected to the bell. Some people may disagree, but that's my $.02 Good luck and congrats on your acceptance!

 

[jpatzi]

At DMU, we have the choice between 4 or 5 stethascopes that we need for next semester. I would hold off on buying one because your school may require a certain kind.

 

[cyclohexanol]

Okay, so I've been accepted to MSUCOM for next year (Class of 2012) and I don't think that I need a stethoscope yet, but basically my entire family thinks that they should get one for me for Christmas. My question is this, how do you choose between them? Is one stethoscope as good as another is is there something you should be looking for in particular when you are buying one?

I'd appreciate any help you could give.

Thanks,
-Travis-

------------------------------------------------------------
Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

1) No, stethoscopes are not all made equal
2) You might want to wait, but if you find a good deal on one now, go for it. Nobody is going to require you to have a certain 'type'.
3) You probably want one that allows you to switch from bell to diaphragm (as opposed to having to modulate your finger pressure to hear different sounds)
4) Can't go wrong with the littmann cardio III or the harvey elite

 

[thesooch39]

I have found that there is a big difference in cheap and expensive scopes. I have been doing EMS for about 5 years and at first I had a cheap Littman, it was nice but I found that I could not hear lung sounds properly nor could I hear in the back of the ambulance that well. I was in the fortunate position to have many people around me with many different scopes so I tried them out to decide, so far I have found that the Littman Cardio III or Master Cardio are two of the best out there, and when you think about how long they last they are well worth the money. It boils down to what works for you but also the versitility of the scope, the Cardio III has options for the bell side diaphragm which can be used for peds or remove the diaphragm and use as a standard bell. I think ADC makes a comparable scope but I have never used it.

 

[Slothbear]

I'm a vet student, and I've got the littmann cardio III. I love it!

 

[DannMann99]

How do I choose a stethoscope?

You put it on your ears. Then tap the end... HARD.

 

[mastamark]

I have found that there is a big difference in cheap and expensive scopes. I have been doing EMS for about 5 years and at first I had a cheap Littman, it was nice but I found that I could not hear lung sounds properly nor could I hear in the back of the ambulance that well. I was in the fortunate position to have many people around me with many different scopes so I tried them out to decide, so far I have found that the Littman Cardio III or Master Cardio are two of the best out there, and when you think about how long they last they are well worth the money. It boils down to what works for you but also the versitility of the scope, the Cardio III has options for the bell side diaphragm which can be used for peds or remove the diaphragm and use as a standard bell. I think ADC makes a comparable scope but I have never used it.

Don't forget Littman has that lifetime waranty(I think).

 

[TexasTriathlete]

How do I choose a stethoscope?

It works something like this...

[YOUTUBE]http://www.youtube.com/watch?v=HZFCQd3XVMc&feature=related[/YOUTUBE]

 

[Orthodoc40]

3) You probably want one that allows you to switch from bell to diaphragm (as opposed to having to modulate your finger pressure to hear different sounds)
4) Can't go wrong with the littmann cardio III or the harvey elite

Okay but I'm pretty sure the Littmann Cardio III has exactly that feature of having to change your finger pressure to 'switch' from bell to diaphragm... 😕

 

[146233]

I've got a Littman Master Cardio. Love it. That said, I've seen plenty of docs/students with the Cardio III or a Master Classic.

 

[scpod]

Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

Yep!

 

[spicedmanna]

I'm with Zip. I really love my Littmann Master Cardiology steth; it's probably more power than what we as medical students need, but the sound quality is truly awesome. I think most people go with the Littmann Cardiology III, though. It's a good overall stethoscope and you can convert the pediatric side into a bell, if you want. This way you don't have to futz with the tunable diaphragm, if you aren't comfortable with it yet.

 

[madscientist50]

I would like to echo an earlier comment, be sure to check with MSUCOM before you choose. At NSU we are required to have a steth with both the bell and diaphram for our clinical course. And they don't accept the Master Cardio, with the bell within the diaphram. Good luck with school.

 

[MJB]

I have a Welch Allyn...can't remember the model...but I'm not a fan.

It's too short, of all things.

 

[spicedmanna]

I have a Welch Allyn...can't remember the model...but I'm not a fan.

It's too short, of all things.

Yeah, I actually have one of those, too. The tube on the steth is so short that I feel like I'm right up in my patient's face when I use it. Also, I don't feel like I can hear as well with it as compared to my Littmann. Anyway, it was a mandatory purchase. I don't use it at all and am trying to sell it on ebay. I suppose I am expected to practice with and use the mandatory purchase, but nobody has yet come up to me to tell me that I must use it, so I'm going to keep on practicing/using the steth that I enjoy until I hear otherwise. However, it should be noted that I will probably have to borrow a steth with a bell for my upcoming practical (the Littmann Master Cardiology doesn't have a bell). I am told that this is what is required for the practical. Anyway, OP, as another person mentioned, it is best to check with your school to see what they want, what their specifications are for a stethoscope.

 

[mig2k]

Get the most expensive one 😉

 

[cyclohexanol]

Okay but I'm pretty sure the Littmann Cardio III has exactly that feature of having to change your finger pressure to 'switch' from bell to diaphragm... 😕

Okay but I'm pretty sure you knew exactly what was meant...

Yes, it features tunable diaphragms to "switch" between hearing low and high frequency sounds by modulating finger pressure. However, you can also use the "peds" head as a bell by using the sleeve, in case you would like to hear low frequency sounds without having to modulate finger pressure.

 

[RockfordWF]

Okay, so I've been accepted to MSUCOM for next year (Class of 2012) and I don't think that I need a stethoscope yet, but basically my entire family thinks that they should get one for me for Christmas. My question is this, how do you choose between them? Is one stethoscope as good as another is is there something you should be looking for in particular when you are buying one?

I'd appreciate any help you could give.

Thanks,
-Travis-

------------------------------------------------------------
Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

Get the cheapest one that feels comfortable on your ears and you can hear out of.

Don't listen to the propaganda about buying a nicer stethoscope.

 

[Orthodoc40]

Okay but I'm pretty sure you knew exactly what was meant...

Yes, it features tunable diaphragms to "switch" between hearing low and high frequency sounds by modulating finger pressure. However, you can also use the "peds" head as a bell by using the sleeve, in case you would like to hear low frequency sounds without having to modulate finger pressure.

No, I was actually confused, sorry to say. 😳 But thanks for clearing that up, I didn't know it had the extra bell.

 

[kylek044]

Okay, so I've been accepted to MSUCOM for next year (Class of 2012) and I don't think that I need a stethoscope yet, but basically my entire family thinks that they should get one for me for Christmas. My question is this, how do you choose between them? Is one stethoscope as good as another is is there something you should be looking for in particular when you are buying one?

I'd appreciate any help you could give.

Thanks,
-Travis-

------------------------------------------------------------
Sorry I put this in the wrong forum! Is there any way to move it to the main med student area?

The trick i was taught is to place the diaphragm flat against your palm, then to take a finger from your other hand and LIGHTLY tap the back of you hand. The better you can hear that tap, the better the stethoscope is for you.

 

[Jpc984]

A mod will move this for you, but meanwhile, i'll give you a brief answer. First, before people spend money on it, find out if your school gives stethescopes to all of the students. Our school doesn't, but apparently some do. Second, do a search on here, there will be tons of info on this topic. Third, get a good quality one. I know there are people that say the cheap ones are the same, but if you get a good one (like a littmann cardio III) when you are learning, it makes it easier to hear things, plus if someone else is buying it, who cares if it's more expensive 😀. Our school just told us to get one that has 2 seperate tubes (or whatever) coming from the bell. In the nice ones, these are combined inside one big tube, so you may have to ask. Basically they meant don't get the cheap $20 ones with a little plastic single tube (geez i can't think of a better word) connected to the bell. Some people may disagree, but that's my $.02 Good luck and congrats on your acceptance!

http://images.jupiterimages.com/common/detail/50/90/22189050.jpg

Meets the requirements!

 

[spicedmanna]

Get the cheapest one that feels comfortable on your ears and you can hear out of.

Don't listen to the propaganda about buying a nicer stethoscope.

Why? It's a gift. 😀

Good advice in general though. That said, I'd probably go with the Littmann Cardiology III, since it seems to be pretty standard gear these days. IDK.

 

[cyclohexanol]

No, I was actually confused, sorry to say. 😳 But thanks for clearing that up, I didn't know it had the extra bell.

Hah, my bad! I thought you were being a jerk about semantics. Sorry about the tone 🙂

 

[RockfordWF]

Why? It's a gift. 😀

Good advice in general though. That said, I'd probably go with the Littmann Cardiology III, since it seems to be pretty standard gear these days. IDK.

In that case, get the Cardiology STC or Master Cardiology. There is no need to have a bulky 2 headed stethoscope.

 

[MJB]

Yeah, I actually have one of those, too. The tube on the steth is so short that I feel like I'm right up in my patient's face when I use it. Also, I don't feel like I can hear as well with it as compared to my Littmann. Anyway, it was a mandatory purchase. I don't use it at all and am trying to sell it on ebay. I suppose I am expected to practice with and use the mandatory purchase, but nobody has yet come up to me to tell me that I must use it, so I'm going to keep on practicing/using the steth that I enjoy until I hear otherwise. However, it should be noted that I will probably have to borrow a steth with a bell for my upcoming practical (the Littmann Master Cardiology doesn't have a bell). I am told that this is what is required for the practical. Anyway, OP, as another person mentioned, it is best to check with your school to see what they want, what their specifications are for a stethoscope.

Exactly my complaints, and it also hurts my ears. I might look into a Cardio III...

 

[Lamborghini1315]

I have a cardiology Littmann 3, i can tell you first hand that so far it works and looks great!! I bought it at www.allheart.com, you can get your scrubs and medical equipment here as well..so hope this helps.

 

[howelljolly]

Do NOT jump on the Littmann bandwagon at this point in your training. The "tunable diaphragm" is old technology that was pulled out of the trash, and marketed successfully to first year med students. Just look at the timeline of the invention, even restricited to Littmann.

Master Cardio > Cardio2 (no tunable diaphragm)> trashed Cardio2 > Cardio3

So whats wrong with a tunable diaphragm that the separate bell/diaphragm improvement had fixed?

1. The tunable diaphragm will miss sounds at the extremes of the frequency, ie. very low, and very high.
2. How firm is firm, and how light is light? How can you know if you are tuned into the right frequency?
3. In order to be a tunable diaphragm, it is not tight. I think this may be why sounds are not sharply distinct from each other with a tunable diaphragm. Its harder to detect S2 splitting, for example. If you have not been able to detect the normal physiological S2 splitting in all your patients with the Littmann, this may be why!

Once you know what a diastolic murmur or a midsystolic click sounds like, you can "tune in" to it. Otherwise you need a stethoscope thats pre-set to those frequencies. Also keep in mind that Amplitude and Frequency are different things. Louder does not mean better.

Note, that many schools require a separate Bell and Diaphragm, and all the textbooks suggest it. Some schools require a Welch Allyn stethoscope so that you have a separate non-tunable diaphragm and bell.

So, go for the Welch Allyn, Elite, or DLX. There are pros and cons to each (PM me if you want details, Ive got both of them). The summary is: While the DLX has slightly better acoustics, the Elite is slightly more user and patient friendly. They come in two lengths, so get the longer one if thats important to you. It's only 2inches shorter than the Littmann Cardio, not much.

In the spirit of Evidence Based medicine, heres an article about which is the best stethosope:
http://cardinal.com/mps/focus/respiratory/abstracts/abstracts/ab2004/OF-04-250%20Waugh%20corrected.asp

Since the Allen and HP Sprague Rappaport are no longer available, as per the article your best bet is the Welch Allyn, which has the best bell, and a good diaphragm. (note that "least negative" is good)

 

[scpod]

Since the Allen and HP Sprague Rappaport are no longer available, as per the article your best bet is the Welch Allyn, which has the best bell, and a good diaphragm. (note that "least negative" is good)

It's funny how you came to that conclusion because that's not what I read. I did read where it said that they couldn't say if the "statistical differences have clinical significance."

While we're in the mood to quote studies, I thought I'd add one of my own:

"Comparison of the acoustic properties of six popular stethoscopes.Abella M, Formolo J, Penney DG.
Department of Internal Medicine, St. John Hospital, Detroit, Michigan 48236.

This study evaluated stethoscope acoustics by using a sound frequency generator and an active artificial ear. Six popular, currently available stethoscopes were compared in their various modes involving bells, diaphragms, etc.: Littmann Classic II, Littmann Cardiology II, Littmann Master Cardiology, Hewlett-Packard Rappaport-Sprague, Tycos Harvey Triple Head, and Allen Medical Series 5A RPS Binaural. The transfer function was measured from 37.5-1000 Hz, the range where nearly all heart and lung sounds are found. Sound in the low-frequency range (37.5-112.5 Hz) was in most cases amplified by the bells and attenuated by the diaphragms; however, there were no significant differences. Both bells and diaphragms attenuated sound transmission in the high range, and this increased with frequency. The Tycos Harvey Triple Head ribbed diaphragm attenuated sound transmission to a significantly greater extent than the other diaphragms (P less than 0.01). The results show that the bell and diaphragm for a given stethoscope usually have different transmission characteristics, particularly at low frequencies. The Littmann Classic II is an exception. The Hewlett-Packard and Tycos Harvey stethoscopes showed the greatest differences in low frequency response between the bell and the diaphragm. While the differences found in sound transmission between stethoscopes were in most cases small, the Littmann Cardiology II, bell and diaphragm, appears to possess the best overall performance by this study design.

PMID: 1597610 [PubMed - indexed for MEDLINE]"

http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

I guess you can find a study for anything if you really want to, huh?

 

[howelljolly]

Yep you can. I agree that the Littmann Cardio II is great. Ive only borrowed it once, and it was one of the best Ive ever used. Good luck finding it though, its was discontinued and replaced with the Littmann Cardio III. They simply replaced the non-tunable diaphragm with a tunable one, and added a peds diaphragm over the bell. You can sometimes find Littmann Cardio 2 available on Ebay. If you do, grab it.

But again, my take home point from that is... non-tunable diaphragms are better than tunable ones.

Based off of the study I found, I was thinking that the Welch Allyn DLX was the only scope thats available nowadays which has any advantage (only the bell in this case) over the others.

But lemmie tell you, since I have the W.A. DLX...along with the W.A. Elite, a Littman MasterCardio, and an ADC Cardio 602 which is a cheaper knockoff from the Littmann Cardio2. That funny looking bell on the DLX works the best out of all of 'em. (Yes, I am OCD about being able to hear heart sounds.)

Unfortunately the best stethoscopes have been discontinued. Littmann Cardio 2, and HP Rappaport-Sprague

Under those circumstances, I really think Welch Allyn is your best option.

 

[lord_jeebus]

I own an HP Rappaport-Sprague as well as a DRG Staff Cardiology.

The HP is great, but discontinued. The tubes are pretty worn and replacement parts are expensive (and are no longer being produced). In addition, it's latex. The two separate tubes do rub and this can be annoying. Nevertheless, if I was a cardiologist, this would be my stethoscope of choice.

The sound quality of the DRG is almost as good and what I use on a daily basis. The tubing is neoprene and resists wear much better than the HP. The gel eartips are amazing. The main disadvantages are its weight and the stiffness of the tubing - it's harder to stuff into a pocket.

I've tried Cardio III and I think either of mine are somewhat better, but not enough to replace a Cardio III if that's what you own. I've tried Welch Allyn as well, but that was when I was stethoscope shopping and didn't know what I was listening to.

 

[howelljolly]

I own an HP Rappaport-Sprague as well as a DRG Staff Cardiology.

The HP is great, but discontinued. The tubes are pretty worn and replacement parts are expensive (and are no longer being produced). In addition, it's latex. The two separate tubes do rub and this can be annoying. Nevertheless, if I was a cardiologist, this would be my stethoscope of choice.
quote]

And most of us are not. Im not either. This, unfortunately, is a conclusion I came to very recently. It depends on what field you go into but it is likely that you will not need a cardiology grade stethoscope. Ive got friends that matched into psychiatry and pathology, and are pretty miffed that they spent so much money a Littmann Cardiology 3, that they barely used.

But med schools want you to have a stethoscope with a dual lumen (2 tubes) and a separate bell and diaphragm. Thats turns out to be pretty expensive across all brands.

 

[kylek044]

But again, my take home point from that is... non-tunable diaphragms are better than tunable ones.

I had this problem - I ended up buying those DRG safeSEAL diaphragms... they fit right on to my Littmanns and they make it non-tunable. True story.

 

[The Janitor]

I had this problem - I ended up buying those DRG safeSEAL diaphragms... they fit right on to my Littmanns and they make it non-tunable. True story.

Indeed. If you can't find an old Cardiology/Cardiology II on eBay, just take the tunable diaphragm off your Cardiology III and replace it with a SafeSEAL diaphragm. You'll be amazed at the difference it makes.

 

[Old_Mil]

...take all the money out of your bank account. Go to the campus bookstore. Buy the one that results in your getting the least change back. Trust me on this - you want a good one when you hit the wards. Get a Littman Cardiology II/III - or even one of those digital ones.

 

[Instatewaiter]

Okay but I'm pretty sure the Littmann Cardio III has exactly that feature of having to change your finger pressure to 'switch' from bell to diaphragm... 😕

...take all the money out of your bank account. Go to the campus bookstore. Buy the one that results in your getting the least change back. Trust me on this - you want a good one when you hit the wards. Get a Littman Cardiology II/III - or even one of those digital ones.

Get your stethescope online. You will save a bundle especially if you bookstore is an extortion ring like mine is. It is owned by some outside company and the books are at least $5 more expensive than barnes and Noble in the store. I have a cardio III that was around $130 online. I went to the bookstore to check out diagnostic kits and saw my stethescope. It was almosts 200 in our bookstore. The run-of the mill Welch Allyn diagnostic kits were like $650. Needless to say I left pretty quickly and bought my stuff online.

http://www.medquestscientific.com/Littmann_Stethoscopes-Littmann_Cardiology_III.html

 

[howelljolly]

On Allheart.com

Littmann Cardiology III $126.99
Littmann Master Cardiology $ 145.99

Welch Allyn Elite $126.98
Welch Allyn DLX $146.98

And?

Evidently your CardioIII is not the most expensive/best model.

Buying your scope (or anything for that matter), based on how much it cost you is ridiculous... especially when the top two models, of the two most common brands have a difference in cost of 1c (for the more versatile and commonly used model) or 99c (for the high end model).

 

[Sartorius24]

Has anyone heard of the stethoscopes from Doctors Research Group? They teamed up with Bose to make their stethoscopes, and it seems interesting. Anyone own and use one of these?

 

[lord_jeebus]

Has anyone heard of the stethoscopes from Doctors Research Group? They teamed up with Bose to make their stethoscopes, and it seems interesting. Anyone own and use one of these?

see my previous post in this thread

The "bose" thing is this metal coiling in the tubing. You get a benefit of muted rubbing sounds when something touches the tubing. Disadvantage is a heavier stethoscope. The Bose affiliation has nothing to do with its acoustics.

Nevertheless I like it a lot.

 

[Sartorius24]

Yup, missed that....and thank you

 

[VentdependenT]

Get the cheapest piece of crap out there.

You only need it to quickly hear wheeze/ronchor/rale/complete absence of air from the lung. And to appreciate a GRADE IV or higher murmur/insane rub.

Most people are too fat to appreciate anything.


Gongrats to RADS for replacing the bacteria spreading stethoscope.

 

[MaximusD]

MAke sure your med school doesn't gift a stethoscope. POMA (Pennsylvania Osteopathic Medical Ass'n) gifts us our Littmann Cardio III's.

When you think about it, cheaping out on a stethoscope is probably one of the stupidest and short-sighted ideas there is. It is the only piece of equipment that you will always carry on your person, and the only piece of equipment that you are directly responsible for. What is 200 dollars vs your 200,000+ dollar education.

Don't cheap out but there is no need to get anything better than a cardio III let alone a master cardiology -- certainly something digital is entirely unnecessary.

 

[VentdependenT]

MAke sure your med school doesn't gift a stethoscope. POMA (Pennsylvania Osteopathic Medical Ass'n) gifts us our Littmann Cardio III's.

When you think about it, cheaping out on a stethoscope is probably one of the stupidest and short-sighted ideas there is. It is the only piece of equipment that you will always carry on your person, and the only piece of equipment that you are directly responsible for. What is 200 dollars vs your 200,000+ dollar education.

Don't cheap out but there is no need to get anything better than a cardio III let alone a master cardiology -- certainly something digital is entirely unnecessary.

I still think any piece of crap stethscope will do. If your patient is symptomatic you're going to get a CXR and EKG. Probably an ECHO to boot.

 

[drchick331]

I would advise spending more on a stethoscope (I have the Littman Cardio III) and completely skip the otoscope/opthalmoscope (borrow someones for a practical or buy something really cheap on ebay). That was the biggest waste of money - every clinic I have been on has had one to use, and I despise having to carry all that extra junk around...😳

 

[Bacchus]

Question all. My roommate is a PharmD candidate and is in his pharm skills seminar right now. They have to take BPs, etc. He's got a bit of a dilemma. His ear slit, to the canal, is not an open hole like a normal ear, rather it looks like the iris of a cat. Any idea of replacement ear pieces that should be used for this condition?

 

[Sartorius24]

The GELseal Eartips from DRG sound like they might contour to his ear

"[FONT=arial, helvetica]DRG's GELseal eartips contain a glycerin that allows the eartips to contour to an individual's ear canal anatomy".

http://www.allheart.com/drgget100bk.html

for $7 it might be worth a try...just my 0.02

 

[lord_jeebus]

The GELseal Eartips from DRG sound like they might contour to his ear

"[FONT=arial, helvetica]DRG's GELseal eartips contain a glycerin that allows the eartips to contour to an individual's ear canal anatomy".

http://www.allheart.com/drgget100bk.html

for $7 it might be worth a try...just my 0.02

I have them. I don't know how much they "contour" but they make a good seal.

I'm not sure they'd be better than normal eartips for this situation, but they would be worth a try (and are really comfortable).

 

[Eudjinn]

Hey I just got a gift from a coworker (neurologist) of a Littmann Master Classic II. Will this be good enough for school/rotations? I'm not sure if it's single or double tubing or what to listen for really, but it does have that tunable single sided diaphragm.

Thoughts?

 

[Bacchus]

The GELseal Eartips from DRG sound like they might contour to his ear

"[FONT=arial, helvetica]DRG's GELseal eartips contain a glycerin that allows the eartips to contour to an individual's ear canal anatomy".

http://www.allheart.com/drgget100bk.html

for $7 it might be worth a try...just my 0.02

I'll suggest this to him. However, I don't know if it will work. Basically it seems like he is losing soundwaves because the opening to his actual canal, into the middle ear, is much smaller than normal.

 

[Sartorius24]

I'll suggest this to him. However, I don't know if it will work. Basically it seems like he is losing soundwaves because the opening to his actual canal, into the middle ear, is much smaller than normal.

Keep us posted on if it works out