Well, a tri-flange may conform to most ears, but a custom fits the ear canal like a glove, and I believe, depending on the impressions, goes farther into the canal. I also think that the soft silicone material of the custom sleeves (the type I have) are a better sound material than just the even softer silicone of the tri-flanges. But it's all a personal preference. I know you've not had much faith in custom sleeves on IEMs in the past, but to me, especially with phones like the Etys that do not go over the ear, the comfort and iso can't be matched by tri-flanges, and listening to both, there is a SQ boost as well (richer bass, etc.).
Oddly enough, when I use custom sleeves with over the ear IEMs (Westone 2, UM3X, SM3s, DBAs), the comfort is not as good, because often the driver housing bumps into my ear and can cause pain. Of course, that's strange because the custom sleeves were made for over the ear cabled IEMs.
Again, not saying everyone should get them. But your last point is also part of the decision. Some people who can't tolerate tri-flanges can tolerate customs is my guess. I can use either, but with the Etys I prefer the customs, With the SM3s and the DBAs, as far as comfort is concerned, I use triple-flanged sleeves. In the latter cases, the futzing around with the customs/IEMs can become problematic. But not with the Etys. Once you get them in, they are very easy to deal with.
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Given the simple straight nozzle ergonomics of the Etys, what is the difference between a custom and a soft tri-flange? I guess I don't understand how much better the fit could be? That soft tri-flange conforms to virtually any ear canal size does it not? Is it a matter of the different material not irritating the ear canal for some people?