it has been suggested that both methods could complement each other. a military noise-immune doppler based stethoscope has recently been developed for auscultation of patients in loud sound environments (up to 110 db). 3d-printed a 3d-printed stethoscope a 3d-printed stethoscope is an open-source medical device meant for auscultation and manufactured via means of 3d printing. the 3d stethoscope was developed by dr. tarek loubani and a team of medical and technology specialists. the 3d-stethoscope was developed as part of the glia project, and its design is open source from the outset. the stethoscope gained widespread media coverage in summer 2015. the need for a 3d-stethoscope was borne out of a lack of stethoscopes and other vital medical equipment because of the blockade of the gaza strip, where loubani, a palestinian-canadian, worked as an emergency physician during the 2012 conflict in gaza. the 1960s-era littmann cardiology 3 stethoscope became the basis for the 3d-printed stethoscope developed by loubani. esophageal prior to the 1960s, the esophageal stethoscope was a part of the routine intraoperative monitoring. earpieces stethoscopes usually have rubber earpieces, which aid comfort and create a seal with the ear, improving the acoustic function of the device. stethoscopes can be modified by replacing the standard earpieces with moulded versions, which improve comfort and transmission of sound. moulded earpieces can be cast by an audiologist or made by the stethoscope user from a kit.