An in-the-ear technology delivery, positioning and sound management system comprises a body portion that provides support for a conformable fitting element adapted to be positioned in the user's ear canal and which is structured and arranged to anchor sound management technologies and medical instrumentalities at selected positions in the canal for the delivery and control of sound or for the performance of medical procedures therein. In an embodiment, a sound tube is provided which is adapted to deliver sound in close proximity to the ear drum and a method for selectively fitting the system in accordance with the wearer's personal comfort level is provided. In another embodiment, an apparatus and a method for a fitting pressure to be automatically applied along the device or aided by a fitting element that will facilitate placement and a secure fit in the ear canal is presented. A coating element comprising materials selected to manage, acoustically alter, or occlude sound properties and sound at selected depths within the ear canal is disclosed.