By Abigail Dinkel, Au.D., CCC-A, F/AAA
After it has been determined that a patient is a hearing aid candidate, it is important for them to work with their audiologist to find the most appropriate style of hearing aid for their hearing loss and lifestyle. There are many factors that influence which hearing aid style is best for each patient: configuration and severity of hearing loss, ear anatomy, dexterity, etc. Patients may also have preferences as far as the features and visibility of the hearing aid, which differ from style to style.
Behind-The-Ear (BTE)
For BTEs, all sound processing in encased in the device behind the ear, which makes them very durable. The device is attached to a plastic tube and custom earmold that deliver sound to the ear. Their durability, as well as their ability to grow with the patient, additionally makes them ideal for pediatric patients. As a child’s ear grows, new earmolds are made to account for these changes. BTEs are the most powerful hearing aids and can accommodate all the way up to severe to profound hearing losses. The location of microphones is ideal for using directionality to determine speech from background noise. They are also often Bluetooth compatible with most recent cell phone models, allowing for remote control of the devices and streaming of phone calls and other media. This style of hearing aids tends to be more visible than other options and replacing the custom earmolds can be an added cost. Depending on the device, rechargeability may be available versus traditional batteries.
Receiver-In-Canal (RIC)
RIC hearing aids are one of the least visible styles of hearing aids. They are also one of the more comfortable styles, as the piece in the patient’s ear is typically a silicone dome. With appropriate hearing losses, RIC hearing aids can be configured so the ear canal is more open, allowing for the most natural sound quality. If hearing loss changes, the strength of the hearing aid can be adjusted by simply upgrading to a stronger receiver. RICs are also often Bluetooth compatible. The location of microphones is similar to BTEs, making it ideal for managing background noise. These hearing aids can be difficult to insert and remove for those with dexterity concerns. Over the last year, we have also learned that this style can be difficult to keep on the ear when removing a mask. Most manufacturers offer rechargeability versus using traditional batteries, but if traditional batteries are preferred, they can be custom ordered to accommodate for that preference.
In-The-Ear (ITE)
ITE hearing aids are custom made to each patient’s ear, which makes for ideal retention. Their larger size allows for use of directional microphones. They are easy to manipulate for those with dexterity concerns. If a repair is needed, we typically need to send the hearing aid into the manufacturer, as the components are all housed within the device. For the same reason, if hearing loss changes, we typically would need to order a new device, as the receiver is housed within the hearing aid. This style of hearing aid is highly visible and blocks off the entire ear canal, which, based on the configuration and severity of hearing loss, can lead to what we call the occlusion effect. This is the sensation of low frequency sounds being louder when the ear canal is blocked off, similar to how your own voice sounds when covering your ears. Some manufacturers offer rechargeability for ITEs, but it is not widely available.
Completely-In-Canal (CIC)
Similar in fit and function to the ITE, but a significantly smaller device, which decreases visibility, but can also decrease some features that there is no longer room for due to the decrease in size, such as Bluetooth connectivity. Due to its small size, there is typically only one microphone, which limits the ability to determine speech in background noise. Rechargeability is not currently available for this style of hearing aid.
Photo Source: https://www.healthyhearing.com/help/hearing-aids/types