Abstract:
A method for fitting a hearing device in an ear canal, comprises, providing a receiver module sized and shaped to fit in any of a wide range of ear canals, selecting a conformal tip from a plurality of differently sized conformal tips, each conformal tip of the plurality having an inside circumference adapted to engage the same size receiver module, wherein the selected conformal tip has an outside circumference slightly larger than the circumference of the ear canal, engaging the receiver module within the selected conformal tip, and inserting the selected conformal tip and engaged receiver module into the ear canal.

Description:
FIELD OF THE INVENTION 
     The present invention pertains to hearing aids. More particularly, the present invention pertains to methods for fitting universal hearing devices. 
     BACKGROUND OF THE INVENTION 
     The modern trend in the design and implementation of hearing devices is focusing to a large extent on reducing the physical size of the hearing device. Miniaturization of hearing device components is becoming increasingly feasible with rapid technological advances in the fields of power supplies, sound processing electronics and micro-mechanics. The demand for smaller and less conspicuous hearing devices continues to increase as a larger portion of our population ages and faces hearing loss. Those who face hearing loss also encounter the accompanying desire to avoid the stigma and self consciousness associated with this condition. As a result, smaller hearing devices, which are cosmetically less visible, but more sophisticated, are increasingly sought after. 
     Hearing device technology has progressed rapidly in recent years. First generation hearing devices were primarily of the Behind-The-Ear (BTE) type, where an externally mounted device was connected by an acoustic tube to a molded shell placed within the ear. With the advancement of component miniaturization, modern hearing devices rarely use this Behind-The-Ear technique, focusing primarily on one of several forms of an In-The-Canal hearing device. Three main types of In-The-Canal hearing devices are routinely offered by audiologists and physicians. In-The-Ear (ITE) devices rest primarily in the concha of the ear and have the disadvantages of being fairly conspicuous to a bystander and relatively bulky and uncomfortable to wear. Smaller In-The-Canal (ITC) devices fit partially in the concha and partially in the ear canal and are less visible but still leave a substantial portion of the hearing device exposed. Recently, Completely-In-The-Canal (CIC) hearing devices have come into greater use. As the name implicates, these devices fit deep within the ear canal and are essentially hidden from view from the outside. 
     In addition to the obvious cosmetic advantages these types of in-the-canal devices provide, they also have several performance advantages that larger, externally mounted devices do not offer. Placing the hearing device deep within the ear canal and close to the tympanic membrane (ear drum) improves the frequency response of the device, reduces distortion due to jaw extrusion, reduces the occurrence of occlusion effects and improves overall sound fidelity. Earlier generation hearing devices function primarily by sound amplification and are typically not altered to user&#39;s particular hearing impairment. Modem electronics improvements allow specific sound processing schemes to be incorporated into the hearing device. Similarly, custom programming can be incorporated into the hearing device circuitry allowing a truly custom device for any particular user. 
     The shape and structure (morphology) of the ear canal varies from person to person. However, certain characteristics are common to all individuals. When viewed in the transverse plane, the path of the ear canal is extremely irregular, having several sharp bends and curves. The overall cross section of the ear canal generally constricts as you move deeper into the ear canal. It is these inherent structural characteristics that create problems for the acoustic scientist and the hearing device designer. 
     For general discussion purposes, the ear canal can be broken into three main segments. The external and medial segments are both surrounded by a relatively soft cartilaginous tissue. The external segment is largely visible from the outside and represents the largest cavity of the ear canal. The innermost segment of the ear canal, closest to the tympanic membrane, is surrounded by a denser bony material and is covered with only a thin layer of soft tissue. The presence of this bony material allows for little expansion to occur in this region compared with the cartilaginous regions of the ear canal. In addition to being surrounded by cartilage rather than bone, these areas are covered with a substantially thicker tissue layer. Since there is less cushion, pressure exerted by a hearing device on the inner bony region of the canal can lead to discomfort and/or pain, especially when a deep insertion technique is used. 
     Since the morphology of the ear canal varies so greatly from person to person, hearing aid manufacturers and audiologists use custom manufactured devices in order to precisely fit the dimensions of a user&#39;s ear canal. This technique frequently requires impressions of the user&#39;s ear canal to be taken. The resulting mold is then used to fabricate a rigid hearing device shell. This process is both expensive and time consuming and the resulting rigid device shell does not perform well during the deformations of the ear canal that occur during normal jaw movement. In order to receive a properly fit hearing device, the user typically has to make several trips to the audiologist for reshaping and resizing. Even after the best possible fit is obtained, the rigid shell rarely provides comfortable hearing enhancement at all times. 
     Because the resulting hearing aid device shell is typically formed from a hard acrylic material, discomfort to the user is increased when worn for extended periods of time. The inability of the hard shell to conform to normal ear canal deformations can cause it to become easily dislodged from its proper position. Consequently, the quality of the hearing enhancement suffers. Furthermore, due to the added manufacturing costs, it is desirable to utilize a hearing device that is at least partially formed from an off-the-shelf or pre-formed component readily available to the audiologist or physician. 
     While the performance of CIC hearing devices are generally superior to other larger and less sophisticated devices, several problems remain. Complications typically arise due to the small size of CIC hearing devices and the depth that they are inserted into a user&#39;s ear canal. 
     Because a CIC hearing device forms an essentially air tight seal between the tip of the hearing device and the wall of the ear canal, discomfort to a user is common. This acoustic seal prevents the equalization of pressure between the internal chamber formed between the tympanic membrane and the hearing device, and the outside environment. Due to the sensitivity of the tympanic membrane, even small pressure differentials can cause severe discomfort. Additionally, since the acoustic seal is formed by pressure exerted by the hearing device, this can also lead to discomfort. 
     Due to their small size and positioning within the ear canal, CIC hearing devices can cause handling problems, making insertion and removal by a user difficult and cumbersome, and can often lead to damage to the hearing device. In the larger, BTE, or ITC hearing devices, the size of the device usually makes it unnecessary to incorporate a retrieval mechanism into its structure, i.e., the wearer normally will not have any difficulty grasping the device in order to remove it. But in smaller hearing devices, such as a CIC device, retrieval cords and other extraction tools become a necessary addition in order to allow for easy and safe removal by the user. 
     Manufacturing problems may also arise when dealing with CIC hearing devices. The increased complexity of the sound processing electronics and the frequent need to fit all working components into a single housing, causes physical layout problems for the designer and manufacturer. The need to combine various hearing device elements, i.e., integrated circuits, receiver, microphone, capacitors, wiring, etc. into a single small space ultimately adds to the complexity of the manufacturing operation and the overall cost of the device. It is desirable to simplify the layout of the hearing device components and the manufacturing process to accommodate these complex systems. Designing the hearing device to minimize manual procedures during assembly is also desired in a mass production operation. 
     Further adding to the complexity of known hearing devices, they are usually formatted to be either a right handed or left handed orientation, specifically formatted for a single ear canal. Known hearing devices are therefore not interchangeable. While being substantially symmetric, the ear canals of an individual are not identical and known hearing devices require specific configurations for each ear. It would be beneficial and cost effective to be able to manufacture a hearing device with a single configuration that could be safely and comfortably used in either ear canal and with a variety of users. 
     The quality of the microphone system that receives sound waves is also critical to the performance of the hearing device. Interference with the microphone reception due to wind or other extraneous noise can lead to a degradation of sound quality. Additionally, vibrations from within a users ear canal and skull, as well as vibrations generated by the hearing device itself can interfere with the operation of the hearing device electronics, particularly the microphone and receiver system. Known hearing devices do not adequately isolate the microphone and receiver elements within the hearing device in order to shield them from this type of interference. 
     Finally, it is becoming increasingly important to keep the hearing device, and particularly the internal electronics of the hearing device, shielded from extraneous electromagnetic interference. A common problem arises when using a cellular telephone while wearing a hearing device. Magnetic interference generated by the cellular telephone may interfere with the operation of the hearing device electronics and cause a deterioration in sound quality. Shielding from electromagnetic interference is best accomplished by the use of a metal enclosure. Known hearing devices have not been able to adequately utilize metal enclosures because they typically add to the size of the device. Thin walled metal hearing device shells are therefore desired, particularly in the context of a completely in-the-canal device. 
     U.S. Pat. No. 5,701,348, entitled “Articulated Hearing Device” (“the &#39;348 patent”), discloses a segmented hearing device with several articulating and non-contiguous parts. The hearing device disclosed in the &#39;348 patent includes a rigid receiver module with a surrounding acoustic seal. The device disclosed in the &#39;348 patent is not applicable for complex electronic hearing device systems incorporated into a CIC hearing device. The device taught by the &#39;348 patent does not provide for all of the hearing device components to be included in a single device housing. Additionally, manufacturing the hearing device of the &#39;348 patent is not conducive to automated processes and does not fully take advantage of the available space in the device housing. A large amount of manual labor is still required to assemble the hearing device of the &#39;348 patent. 
     SUMMARY OF THE INVENTION 
     The present invention solves the foregoing problems by providing a method for fitting a hearing device in an ear canal utilizing a single receiver module with a variety of differently sized conformal tips, enabling the receiver module to be used in a wide range of ear canals, and interchangeably in either a right or a left ear canal. 
     In a first aspect of the present invention, a method for fitting a hearing device in an ear canal, comprises, providing a receiver module sized and shaped to fit in any of a wide range of ear canals, selecting a conformal tip from a plurality of differently sized conformal tips, each conformal tip of the plurality having an inside circumference adapted to engage the same size receiver module, wherein the selected conformal tip has an outside circumference slightly larger than the circumference of the ear canal, engaging the receiver module within the selected conformal tip, and inserting the selected conformal tip and engaged receiver module into the ear canal. 
     Other and further aspects and advantages of the present invention will become apparent hereinafter. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The drawings illustrate both the design and utility of the preferred embodiments of the present invention, in which similar elements in different embodiments are referred to by the same reference numbers for purposes of ease in illustration of the invention, wherein: 
     FIG. 1 is a front perspective view of a receiver module utilizing a flexible circuit board assembly constructed in accordance with the present invention; 
     FIG. 2 is a rear perspective view of the receiver module of FIG. 1; 
     FIG. 3 is a front elevation view of the receiver module of FIG. 1; 
     FIG. 4 is a rear elevation view of the receiver module of FIG. 1; 
     FIG. 5 is a left side elevation view of the receiver module of FIG. 1; 
     FIG. 6 is a right side elevation view of the receiver module of FIG. 1; 
     FIG. 7 is a top plan view of the receiver module of FIG. 1; 
     FIG. 8 is a bottom plan view of the receiver module of FIG. 1; 
     FIG. 9 is an exploded perspective view of the receiver module of FIG. 1; 
     FIG. 10 is a front perspective view of the receiver module of FIG. 9 with the faceplate removed; 
     FIG. 11 is a front perspective view of a preferred flexible circuit board assembly constructed in accordance with the present invention; 
     FIG. 12 is a perspective view of a flexible substrate for use in a circuit board assembly constructed in accordance with the present invention; 
     FIGS. 12A-12D are isolated perspective views of respective component mounting regions of the substrate of FIG. 12; 
     FIG. 12E is a board level schematic of the substrate of FIG. 12; 
     FIG. 13 is a perspective view of the substrate of FIG. 12, after a first fold has been made; 
     FIG. 14 is a perspective view of the substrate of FIG. 12, after a second and third fold have been made; 
     FIG. 15 is a perspective view of the substrate of FIG. 12, after a fourth fold has been made; 
     FIG. 16 is a perspective view of the substrate of FIG. 12, after a fifth fold has been made; 
     FIG. 17 is a perspective view of the substrate of FIG. 12, after a sixth and seventh fold have been made; 
     FIG. 18 is a perspective view of the flexible circuit board assembly constructed in accordance with the present invention, as it aligns with a receiver housing faceplate; 
     FIG. 19 is a perspective view of the flexible circuit board assembly constructed in accordance with the present invention, as it engages with a receiver housing faceplate; 
     FIG. 20 is a right side longitudinal cross section of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention; 
     FIG. 21 is a top longitudinal cross section of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention taken at section marks A—A; 
     FIG. 22 is a lateral cross section of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention taken at section marks B—B; 
     FIG. 23 is a lateral cross section of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention taken at section marks C—C; 
     FIG. 24 is a front perspective view of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention engaged with a conformal hearing aid tip; and 
     FIG. 25 is a rear perspective view of a hearing device utilizing a flexible circuit board assembly constructed in accordance with the present invention engaged with a conformal hearing aid tip. 
     FIG. 26 is a rear perspective view of the conformal hearing aid tip shown in FIG.  25 . 
     FIG. 27 is a rear perspective view of another conformal hearing aid tip having a size that is smaller than the conformal hearing aid tip of FIG.  26 . 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     FIGS. 1-10 show various views of a receiver module  10  that is used in conjunction with a completely in-the-canal hearing device. The receiver module  10  comprises a rigid housing that is adapted to contain and protect a variety of hearing device electronics and other operative components, i.e., a hearing device receiver (amplification and speaker system), sound processing circuitry, a microphone, and a power source. Among other features of the receiver module  10 , which will be described in more detail below, it protects the sensitive hearing device components from damage due to moisture, dirt, cerumen (ear wax), and user interference. Additionally, the receiver module  10  preferably prevents electromagnetic energy from interfering with the hearing device electronics. 
     Preferably, the receiver module  10  is used in combination with a conformal hearing aid tip. U.S. patent application Ser. Nos. [not yet assigned], filed on the same date as the present application, 09/231,282, filed on Jan. 15, 1999, and 09/231,266, filed on Jan. 15, 1999, each disclose and describe several examples of preferred conformal hearing aid tips, the details of which are hereby fully incorporated by reference into the present application. 
     The receiver module  10  is preferably formed from two pieces, a distal shell  20  and a proximal faceplate  40 . As used herein, the term proximal refers to the portions of a hearing device and its components that are located closer to the exterior, or concha, of an ear canal when the hearing device is inserted. The term distal refers to the portions of a hearing device and its components that are located at a deeper point within an ear canal when a hearing device is inserted. The shell  20  defines an internal chamber  21  and the faceplate  20  defines an internal chamber  41  (Best seen in FIGS.  9  and  10 ). 
     The faceplate  40  includes a door  50  that is hingedly attached to the proximal end of the faceplate  40 . As best seen in FIG. 1, the faceplate  40  includes a post  54  that engages within a channel  52  on the door  50 . The door  50  can thus be rotated about the post  54 , allowing access to the chamber  41  through an opening  58 , and, therefore, to components stored therein. Notably, when the door  50  is opened, a flexible circuit board assembly  100  that includes several components, such as battery contacts  190  and  126  and programming pads  120  and  122  (described in more detail below), can be accessed. 
     The door  50  includes a handle  56 , so that a user can more easily open and close the door  50 . When closed, the door  50  covers the opening  58 . Preferably, the door  50  includes a series of ridges  57  that prevent the door  50  from accidental opening, i.e., without some level of force applied. Preferably, the door  50  does not create an air tight seal and thus allows air to vent between a distal vent  26  and the proximal end of the receiver module  10 . 
     Also located in the faceplate  40  is a combined wind screen and microphone suspension  44 . The windscreen and microphone suspension  44  includes a dome shaped body  46  on the proximal end of the faceplate  40  and a suspension grommet  47  located within the faceplate  40 . The windscreen and microphone suspension  44  is aligned with a microphone  160  located within the receiver module  10 , and more particularly, within the faceplate  40 . The body  46  includes at least one aperture  48 , which in combination with the shape of the dome  46  allows sound waves to enter a sound port  162  on the microphone  160  while eliminating distortion or extraneous noise due to wind passing near the microphone. The body  46  also prevents dirt and other contaminants from entering the receiver module  10 . The grommet  47  suspends the microphone  160  within the chamber  41  defined by the faceplate  40 , so that vibrations generated by a user&#39;s voice or by the hearing device receiver do not interfere with the operation of the microphone  160 . 
     The grommet  47  aligns the sound port  162  with the wind screen body  46  and the apertures  48 . The apertures  48  allow sound waves to pass through the body  46  and into the sound port  162 . After the microphone receives the sound waves, they are processed, and amplified through a receiver outlet  24 . The receiver outlet  24  is connected to a receiver  150  located within the shell  20 . The vent aperture  26  is also located on the distal end  22  of the shell  20 . The vent aperture  26  allows pressure equalization between the inner regions of the ear canal and the outside environment. Additionally, the vent aperture  26  reduces occlusion effects by allowing sound waves generated within a users own head to propagate to the outside environment rather than resonating within the ear canal. 
     Since a deep insertion technique is generally preferred when utilizing completely in-the-canal hearing devices, the hearing device is preferably positioned in the narrowest parts of the ear canal. Thus, the shell  20  preferably has a narrower lateral cross-section than the faceplate  40 . Particularly in relation to the faceplate  40 , the shell  20  is tapered at a distal end  22 . Since many of the operative electronics of the hearing device are located within the shell  20 , it is preferable to form the shell  20  from a rigid material that will stand up to substantial pressures exerted by the ear canal wall, as well as potential damage due to handling by a user. 
     Additionally, since several of the components located within the shell  20  are susceptible to interference by electromagnetic waves given off by items such as cell phone, radios, etc., the shell  20  is preferably constructed from a metal such as stainless steel or aluminum that prevents electromagnetic interference from interfering with the components mounted therein, and will allow a thin construction of the shell  20  without sacrificing strength. Utilizing a metal such as stainless steel or aluminum for the shell  20  allows a smaller device to be constructed, while retaining strength and providing protection from electromagnetic interference. Notably, when a user is adjusting a conformal tip on the receiver housing  10 , pressure is exerted on the shell  20 . Using a metal shell provides a structure that will not shatter or crack when squeezed by a user. 
     The faceplate  40  is preferably formed from a bio-compatible and hygienic plastic. As discussed above, the faceplate  40  includes a post  54  and an opening  58  to allow access to several of the hearing device components located within the chamber  41  and, more particularly, on the flexible circuit board assembly  100 . In FIGS. 1,  2 ,  7 , and  8 , the arrow β shows the rotation of the door  50 . Since the receiver module  10  is a programmable hearing device, the faceplate  40  is preferably made from a non-conducting material in order to avoid interfering with any electronic programming connectors inserted through the opening  58 . 
     When assembled, the shell  20  and the faceplate  40  join to form the contiguous receiver module  10  which creates a singular housing for the hearing device components located within the shell  20  and faceplate  40 . FIG. 9 shows how the shell  20  and the faceplate  40  align in order to engage with each other. In particular, the faceplate  40  includes a slightly tapered ledge  60  that extends from a peripheral wall  62  of the faceplate  40 . A small portion of the peripheral wall  62  is exposed to form a seat  63 . 
     As seen in FIG. 10, when the shell  20  is engaged with the faceplate  40 , a peripheral wall  65  of the shell  20  abuts against the seat  63 . A tab  64  extends from a bottom portion of the peripheral wall  62 . The tab  64  serves as a key and therefore aids in aligning the faceplate  40  with the shell  20 . In this manner, the shell  20  can only be attached to the faceplate  40  in a single orientation that properly aligns the tab  64 . The tab  64  also helps to secure the two components together. The tapered extension  60  allows the faceplate  40  to be inserted into the shell  20  and secured in place. Preferably, the faceplate  40  is held engaged to the shell  20  by friction between the extension  60  and the inside of the shell  20 , but other fastening systems may be employed and are contemplated by the present invention. For example, notches may be included in the tapered extension  60  that align with recesses in the shell  20 . When the faceplate  40  is engaged with the shell  20 , the notches engage with the recesses and further secure the faceplate  40  to the shell  20 . Squeezing down on the faceplate  40  will disengage the notches from the recesses and allow the faceplate  40  to be removed from the shell  20 . 
     A shelf  66  is provided within the chamber  41  defined by the faceplate  40 . The shelf  66  divides the chamber  41  into an upper portion  41   a  and a lower portion  41   b,  and isolates the microphone  160  in the upper portion  41   a  when it is inserted into the faceplate  40 . Since a user has access to the lower portion  41   b  through the door  50 , the shelf  66  prevents interference by a user with the operation of the microphone or other sensitive electronics in the upper portion  41   a.    
     FIG. 10 shows the shell  20  with the flexible circuit board assembly  100  installed within the chamber  21 . In FIG. 10, the microphone  160  is shown mounted within the chamber  21  and on the flexible circuit board assembly  100  so that when the faceplate  40  engages with the shell  20 , the microphone  160  will rest within the chamber  41 . The sound port  162  extends from the microphone  160  and is aligned with the apertures  48  on the windscreen and microphone suspension  44 . 
     FIG. 11 depicts the flexible circuit board assembly  100  isolated from the receiver module  10  and separated from the shell  20 . A foldable substrate  102  provides a base for mounting or otherwise fastening various hearing aid components, such as the microphone  160 , circuit capacitors  180 , an integrated circuit  170 , battery contacts  126 ,  190  and  194 , and programming pads  120  and  122 . The foldable substrate  102  also preferably includes various electrical interconnections that connect the hearing device components. While FIG. 11 depicts the receiver  150 , the receiver is not attached to the foldable substrate  102 , but is rather suspended within the shell  20 , and is shown in FIG. 11 for reference only. 
     FIG. 12 shows the foldable substrate  102  in a planar configuration prior to attachment of the microphone  160 , the integrated circuit  170  and the circuit capacitors  180 , and prior to the foldable substrate  102  being folded in accordance with a specific hearing device design. The foldable substrate  102  is preferably formed from a partially or totally flexible dielectric material that is suitable for use in semiconductor circuit board applications and is conducive to known semiconductor manufacturing processes. A preferred example of this type of dielectric substrate is manufactured by Dyconex Technologies under the name DYCOstrate®. 3M Corporation also makes a similar flexible dielectric substrate under the name Kapton®. The foldable substrate  102  is suitable for receipt of electrical traces, contact pads, solder pads, and other electronic components, electrical connectors, and circuit elements. In addition to its electrical and electronic characteristics, the foldable substrate  102  forms the structural backbone of the flexible circuit board assembly  100 . 
     More particularly, the foldable substrate  102  is configured for the receipt of a particular arrangement of hearing device components such as the microphone  160 , the integrated circuit  170 , and the circuit capacitors  180 . When fully assembled, the foldable substrate  102  and the various components together form the flexible circuit board assembly  100 , which can be coupled to the hearing aid receiver  150  in order to function as a complete hearing amplification and sound processing system. After assembly, the flexible circuit board assembly  100  is formatted to be inserted as a unit into the shell  20  and faceplate  40  forming the receiver module  10 . 
     The flexible circuit board assembly  100  provides a stock configuration with respect to the mechanical and electrical core components of the receiver module  10 , which do not need to be modified for a particular individuals ear canal size. A hearing device that utilizes such a flexible circuit board assembly  100  can be physically adjusted in order to fit various ear canal sizes by the use of a soft conformal tip. 
     By making the construction of the receiver module universal, the receiver module can be easily used in either a right or left ear canal rather than being restricted to a particular ear. With the use of a soft conformal tip, the receiver module can be used in a variety of differently sized ear canals as well, truly making a receiver module constructed in accordance with the present invention universal and in conjunction with a conformal tip, a “one-size-fits-all” hearing device. 
     With continuing attention to FIG.  12  and as shown in greater detail in FIGS. 12A-12D, a the foldable substrate  102  includes a first component mounting region  104 , a second component mounting region  106 , a third component mounting region  108 , and a fourth component mounting region  110 . Each of the component mounting regions  104 ,  106 ,  108 , and  110  are interconnected to each other to form the foldable substrate  102 . Further, each of the component mounting regions  104 ,  106 ,  108 , and  110  includes at least one flexible portion defined by etchings in the substrate that allow each of the respective component mounting regions to be folded into a desired configuration without affecting the performance or strength of the foldable substrate  102 , or any of the components attached to it. 
     As shown in FIGS. 12 and 12A, the first component mounting region  104  includes flexible portion  112   a,  bordered by etchings  112   a - 1  and  112   a - 2 , flexible portion  112   b  bordered by etchings  112   b - 1  and  112   b - 2 , and flexible portion  112   c  bordered by etchings  112   c - 1  and  112   c - 2 . The second component mounting region  106 , shown in FIGS. 12 and 12B includes flexible portion  116   a  bordered by etchings  116   a - 1  and  116   a - 2 , and flexible portion  116   b  bordered by etchings  116   b - 1  and  116   b - 2 . The third component mounting region  108 , shown in FIGS. 12 and 12C, includes flexible portion  128   a  bordered by etchings  128   a - 1  and  128   a - 2 , and the fourth component mounting region  110 , shown in FIGS. 12 and 12D, includes flexible portion  118   a  bordered by etchings  118   a - 1  and  118   a - 2 . 
     For ease of illustration, the divisions between the four component mounting regions  104 ,  106 ,  108 , and  110  are shown in FIGS. 12-12D with a thickened line at etchings  116   a - 1 ,  116   b - 1 , and  118   a - 2 . For instance, etching  116   a - 1  is the border between the first component mounting region  104  and the second component mounting region  106 . Etching  116   b - 1  is the border between the second component mounting region  106  and the third component mounting region  108 . Etching  118   a - 2  is the border between the third component mounting region  108  and the fourth component mounting region  110 . It is noted that the configuration of the substrate  102  shown in FIGS. 12-12D is by example only and other arrangements of the several component mounting regions are contemplated by the present invention. By way of example only, more or less than four component mounting regions can be utilized depending on the particular configuration desired in the hearing device. Additionally, the number of etchings and flexible portions on each particular component mounting region is not limited to the particular configuration shown in FIG. 12, and can be varied for different hearing device and flexible circuit board assemblies. Additionally, the flexible portions can be defined by a single etching, rather than a pair of substantially parallel etchings. 
     During the manufacturing process of the foldable substrate  102 , several of the hearing device components are incorporated. In particular, the first component mounting region  104  is provided with three microphone contacts, one for the microphone connection, one for the Regulated Voltage going to the microphone (VREG) connection, and one for a grounding connection. The third component mounting region  108  is provided with two receiver wire contacts  130  and  131 , as well as a positive battery contact  194 . The fourth component mounting region  110  is provided with programming pads  120  and  122  as well as a negative battery contact  190  and a ground contact  126 . Programming pad  120  is preferably for a clock signal (SCLOCK) to the integrated circuit during a programming sequence, and programming pad  122  is preferably for a data signal (SDA) to the integrated circuit during a programming sequence. During the manufacturing process of the substrate  102 , the integrated circuit  170  and the circuit capacitors  180  are also attached to the second component mounting region  106 . 
     FIG. 12E shows a board level schematic of a foldable substrate  102 . FIG. 12E shows incorporated onto the foldable substrate  102 , the various electrical components and connectors as well as the interconnective electrical and electronic pathways between the components and connectors. Together, these elements form a multi-layer flexible circuit board that can be folded into the flexible circuit board assembly  100  in accordance with the present invention. Notably, a series of electrically conductive pathways  200 ,  202 , and  204  interconnect the programming pads  120  and  122 , the battery contacts  126 ,  190 , and  194 , the microphone contacts  114 , the receiver wire pads  130  and  131 , the integrated circuit  170 , and the circuit capacitors  180 . Solder pads  172  and  182  are also included on the foldable substrate  102  in order to facilitate attachment of components such as the integrated circuit  170 , the circuit capacitors  180 , and the various contact pads. The electrically conductive pathways  200 ,  202 , and  204  are preferably a combination of traces along the surface of the substrate  102 , and vias or microvias between the different layers of the substrate  102 . Attaching the integrated circuit  170  and the capacitors  180  can be accomplished by a “wire bond” process or by a “flip chip” process, both of which are well known in the field of printed circuit board design and manufacturing. In the context of a flexible substrate, these processes are commonly referred to as “wire bond on flex” and “flip chip on flex”. Other types of surface mount (SMT) processes can be used and are contemplated by the present invention. 
     Referring to FIGS. 13-17, the foldable substrate  102  is shown in various stages as it would preferably be folded, and as hearing device components are preferably incorporated in order to complete the flexible circuit board assembly  100 . It is noted that the integrated circuit  170  and the circuit capacitors  180  are preferably incorporated onto the foldable substrate  102  during its initial manufacturing, and prior to the foldable substrate  102  being folded into the flexible circuit board assembly  100 . However, for ease of illustration, the integrated circuit  170  and the circuit capacitors  180  are not shown attached to the substrate  102  in FIGS. 13-16. 
     FIG. 13 shows the foldable substrate  102  after a first fold has been made. In FIG. 13, the flexible portion  116   b  is bent approximately 90 degrees so that the third component mounting region  108  and the fourth component mounting region  110  are substantially perpendicular to the first component mounting region  104  and the second component mounting region  106 . In FIG. 13, the third component mounting region  108  and the fourth component mounting region  110  can be seen from their bottom surface, including the negative battery contact  194 . 
     FIG. 14 shows the foldable substrate  102  after a second and a third fold have been made. First, the flexible portion  118   a  is bent approximately 90 degrees so that the fourth component mounting region  110  is substantially parallel to the first and second component mounting regions  104  and  106 . It is noted however that after the second fold has been made, the fourth component mounting region  110  is in a different plane than the first and second mounting regions  104  and  106  due to the first fold having been previously made. The second fold is made so that the upper surface of the fourth component mounting region  110  is facing in substantially the same direction as it was before the first fold was made. 
     Next, flexible portion  128   a  is bent so that the third component mounting region  108 , and particularly the surface of the third component mounting region that includes the receiver wire pads  130  and  131 , faces toward the fourth component mounting region  110 . Preferably, the third component mounting region  108  is bent approximately 45 degrees from its previous position. 
     FIG. 15 shows the foldable substrate  102  after a fourth fold is made, and how the microphone  160  is installed. In FIG. 15, the flexible portion  116   a  is bent approximately 90 degrees so that the first component mounting region  104  is substantially perpendicular to the second component mounting region  106 . After the fourth fold is made, the microphone  160  is positioned on the first component mounting region  104  so that contacts on the microphone (not shown) align with the contacts pads  114  on the first component mounting region  104 . The microphone  160  is preferably bonded onto the first component mounting region  160  in order to ensure a permanent physical and electrical connection. 
     FIG. 16 shows the foldable substrate  102  after a fifth fold is made. In FIG. 16, the flexible portion  112   c  is bent approximately 90 degrees so that the first component mounting region  104  is again parallel to the second and fourth component mounting regions  106  and  110 . It is noted however that after the fifth fold is made, the first component mounting region  104  is in a different plane than the first and second mounting regions  104  and  106  due to the previous folds of the substrate  102 . After the fifth fold is made, and because the microphone  160  was previously attached to the first component mounting surface  104 , the sound port  162  on the microphone  160  faces a proximal end  103  of the foldable substrate  102 . 
     FIG. 17 shows the substrate  102  after a sixth and seventh fold are made. First, flexible portion  112   a  is bent approximately 90 degrees so that the length of the microphone  160  is substantially perpendicular to its prior orientation. Next, the flexible portion  112   b  is bent approximately 90 degrees and in the same direction as the previous fold, so that the length of the microphone  160  is in the same orientation as it was before the sixth fold was made. After flexible portions  112   a  and  112   b  have been bent, the first component mounting region  104  is wrapped around the microphone  160 . Since the microphone has now been flipped 180°, the sound port  162  faces toward the proximal end  103  of the foldable substrate  102 . FIG. 17 also shows the integrated circuit  170  and the circuit capacitors  180  attached to the second component mounting region  106  of the substrate  102 . As mentioned above, the integrated circuit  170  and the circuit capacitors  180  are preferably attached to the foldable substrate  102  during the manufacturing process of the substrate  102  itself. However, for ease of illustration, the integrated circuit  170  and the circuit capacitors  180  were not shown attached to the substrate  102  in conjunction with FIGS. 13-16. 
     FIG. 17 shows receiver wires  132  and  134  attached to the receiver wire pads  130  and  131 . The receiver wires  132  and  134  lead from the contact pads  130  and  131  to the receiver  150  (not shown). When the hearing device is fully assembled, the receiver  150  is suspended within the shell  20  and preferably does not contact the foldable substrate  102  or the integrated circuit  170 . Suspending the receiver  150  within the shell  20  reduces feedback problems and prevents vibrations generated by the hearing device or a user from interfering with the operation of the hearing device. U.S. patent application Nos. [not yet assigned], filed on the same day as the present application, and 09/317,485, filed on May 24, 1999, teach and describe preferred embodiments of such a receiver suspension, the details of which are hereby fully incorporated by reference into the present disclosure. The use of the receiver wires  132  and  134  to connect the receiver contact pads  130  and  131  with the receiver  150 , reduces feedback problems by further isolating the receiver  150  from the rest of the hearing device, preventing vibrations generated by the receiver  150  from propagating toward the microphone  160 . 
     The receiver wires  132  and  134  are attached to the receiver wire pads  130  and  131  prior to the foldable substrate  102  being folded. Additionally, the receiver  150  is already attached to the receiver wires  132  and  134 . In general it is preferable to make all solder connections to the foldable substrate  102  prior to folding the foldable substrate  102 . FIG.  17  and the preceding figures do not show these elements for ease of illustration only. 
     In FIG. 18 the assembled flexible circuit board assembly  100  is shown as it aligns with the faceplate  40  and prior to being inserted into the faceplate  40 . In FIG. 19 the assembled flexible circuit board assembly  100  is shown after being inserted into the faceplate  40 . When inserted into the faceplate  40 , a shelf  66  within the chamber  41  separates several of the component mounting regions on the flexible circuit board assembly  100 . Namely, the first component mounting region  104  and the microphone  160  are positioned within an upper chamber  41   a  and the fourth component mounting region  110  is within a lower chamber  41   b.  As best seen in FIG. 19, when the flexible circuit board assembly  100  is inserted into the faceplate  40 , the third component mounting region  108  and the second component mounting region  106  extend out of the faceplate  40 . 
     Referring to FIGS. 20-23, the flexible circuit board assembly  100  is shown positioned within the shell  20  and the faceplate  40 . As discussed above, the proximal end of the faceplate includes a windscreen and microphone suspension  44 . The dome shaped cover  46  along with the apertures  48 , prevent noise due to wind or other extraneous noise from interfering with the reception of the microphone  160 . Further, the cover  46  prevent debris, dust, hairspray or other contaminants, from entering the microphone  160 , and from potentially interfering with the operation of the hearing device. A suspension grommet  47  extends through the faceplate  40  from the cover  46  and engages with the sound port  162  on the microphone  160 . The suspension grommet  47  positions the sound port  162  directly in front of the apertures  48  and directs sound waves into the sound port  162 . The suspension grommet  47  also helps secure and align the microphone  160  within the faceplate  40 . The microphone  160  is also preferably surrounded by a flexible skirt  164  (Best seen in FIG.  21 ), that helps position the microphone  160  within the faceplate  40  and ensures that the microphone  160  does not come into contact with the walls of the faceplate  40 . The flexible skirt  164  is preferably made from a flexible rubber or polyurethane material and reduces the effects of vibrations on the microphone  160 . 
     A receiver module  10  as described herein, is preferably used in conjunction with a conformal hearing aid tip. FIGS. 24 and 25 depict a receiver module  10  incorporating a flexible circuit board assembly constructed in accordance with the present invention, engaged within a conformal tip  200 . The conformal tip  200  is preferably a soft foam sheath with a bulbous end that is adapted to engage with the wall of an ear canal, provide an acoustic seal, and reduce discomfort to the user. U.S. patent application No. [not yet assigned], filed on the same day as the present application, teaches and describes a preferred embodiment of such a conformal tip  200 , the details of which are hereby fully incorporated by reference into the present application. Preferably, the conformal tip  200  includes a retrieval cord  210 . Alternately, the retrieval cord  210  can include a vent tube which provides pressure equalization between the inner regions of the ear canal and the outside environment. The conformal tip  200  can be made in different sizes as shown in FIGS. 26 and 27, which depict a conformal tip  200  that is larger than another conformal tip  300 . The receiver module can be used interchangeably with both conformal tip  200  and conformal tip  300 . 
     FIG. 21 also shows how the sound port  162  engages within the suspension grommet  47  and how the receiver  150  engages within the receiver grommet  154 . The receiver grommet  154  further aids in securing the receiver  150  within the shell  20 . 
     When building a hearing device, and particularly a completely in-the-canal hearing device, a flexible circuit board assembly, such as the flexible circuit board assembly  100  described above, is preferably adapted for a mass production or assembly line manufacturing process. The original planar configuration of the flexible circuit board assembly  100  of the present invention lends well to mass production and contributes to reduced cost and manufacturing time. 
     A receiver module  10  as described herein, is preferably used in conjunction with a conformal hearing aid tip. FIGS. 24 and 25 depict a receiver module  10  incorporating a flexible circuit board assembly constructed in accordance with the present invention, engaged within a conformal tip  200 . The conformal tip  200  is preferably a soft foam sheath with a bulbous end that is adapted to engage with the wall of an ear canal, provide an acoustic seal, and reduce discomfort to the user. U.S. patent application No. [not yet assigned], filed on the same day as the present application, teaches and describes a preferred embodiment of such a conformal tip  200 , the details of which are hereby fully incorporated by reference into the present application. Preferably, the conformal tip  200  includes a retrieval cord  210 . Alternately, the retrieval cord  210  can include a vent tube which provides pressure equalization between the inner regions of the ear canal and the outside environment. 
     Although the invention has been described and illustrated in the above description and drawings, it is understood that this description is by example only and that numerous changes and modifications can be made by those skilled in the art without departing from the true spirit and scope of the invention. The invention, therefore, is not to be restricted, except by the following claims and their equivalents.