Types of Hearing Aids: How to Choose the Right One for Your Needs
With so many types of hearing aid available, which is best suited to your specific requirements? We investigate the options to help you
According to the Hearing Loss Association of America (HLAA), around 48 million Americans have some degree of hearing loss, but only one in five people who would benefit from a hearing aid actually use one. This reluctance is probably down to the fact that many believe that hearing aids are neither comfortable nor discreet in their appearance. However, hearing aid design has come on leaps and bounds over the years, with many models now so diminutive in size that no one will realize you’re wearing one.
This guide lays out the various options, to help you choose the right hearing aid for your level of hearing loss, and your lifestyle.
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What is a hearing aid?
A hearing aid is a small electronic device that you wear either in or behind your ear. It makes some sounds louder, so that those with hearing loss can still hear and communicate with others. Hearing aids are made up of three basic parts: a microphone, an amplifier and a speaker. In very simplistic terms, the hearing aid receives sound through the microphone, which converts the sound waves to electrical signals and then sends them to an amplifier. This amplifier increases the power of the electrical signals and sends them back to the ear via a speaker.
How do hearing aids help you to hear?
Hearing aids are designed to help those with sensorineural hearing loss. This type of hearing loss is a result of damage to the hair cells – small sensory cells in the inner ear. This damage occurs naturally through aging, but can also be caused by disease, injury from noise or even certain machines.
A hearing aid works by magnifying sound vibrations entering the ear. These amplified vibrations can then be detected by the surviving hair cells, which then convert them into neural signals that are passed along to the brain. As you might expect, the more damage to the hair cells, the more severe hearing loss and the greater this amplification needs to be. Sadly, even hearing aids can’t help in all cases; if the inner ear is just too damaged, even deeper vibrations won’t be picked up.
What are the different types of hearing aids?
There are currently a variety of hearing aids available, each with their own pros and cons. Let’s look at these in more detail:
Behind the ear (BTE)
When most people think of hearing aids, this is the design they’re visualizing. However, BTE hearing aids have become much smaller over the years; they’re nowhere near as conspicuous as they used to be. Designed for mild to profound hearing loss, BTE hearing aids contain all their components (such as microphone, controls and battery) in a plastic case that’s worn behind the ear. This case is then connected to either a custom ear mold or disposable plastic ear tip that delivers the sound via clear tubing.
| Pros | Cons |
| Available in a variety of colors to match fashion choices or skin tones | Tricky to wear with glasses |
| Ear tips and custom molds can be swapped out if hearing deteriorates further | More visible than smaller hearing aids |
| Some models have more power available to help those with severe hearing loss | Can feel a little heavy behind the ear |
| Larger design means there’s more room for controls, such as adjusting the volume or changing programs |
Receiver in canal (RIC)
The RIC hearing aids are extremely popular, due to their smaller size and discreet appearance. Designed for those with mild to severe hearing loss, the RIC delivers sound through a tiny speaker that sits inside the ear canal. It is then electronically transferred via a tiny plastic-encased speaker wire, which connects the speaker to the hearing aid. You’ll also hear this speaker referred to as a receiver (hence the name).
| Pros | Cons |
| Smaller and less visible than a BTE hearing aid | Smaller models might not have a device level volume control |
| Rechargeable models available | Smaller size means those with dexterity issues may find them awkward to insert |
| Custom molds available for more volume |
In the ear (ITE)
ITE hearing aids fit on the inside of the outer part of the ear, with all the components contained in a hard plastic case. They’re designed for mild to severe hearing loss.
| Pros | Cons |
| Many ITE hearing aids include telecoils – small magnetic coils that allow users to receive sound through the circuitry of the hearing aid, rather than its microphone – for accessing hearing loops and using landlines more easily | More visible than other custom hearing aids, and even some BTE and RIC hearing aids |
| Rechargeable models and those with larger batteries for easy replacement are available | Comfort can be an issue |
| Slightly bigger to allow for easy to access controls such as volume wheels |
In the canal (ITC)
ITC hearing aids are custom-made, sitting inside the ear canal and some of the outer part of the ear. Designed for those with mild to severe hearing loss, all the components are contained inside a lightweight plastic shell.
| Pros | Cons |
| Easier to put in the ear than a BTE or RIC hearing aid | Less room for components |
| Less visible than the larger custom ITE hearing aids | More visible than the smallest in-canal hearing aids |
| Often use larger batteries, which makes them easier to use for those with dexterity issues |
Completely in canal (CIC)
Again, these are custom-made to sit inside the ear canal, but are even smaller and less visible than ITC hearing aids. Primarily designed for mild to moderate hearing loss, they may assist those with severe hearing loss, depending on the power of the amplifier.
| Pros | Cons |
| Smaller size means that they’re almost invisible | Small battery, which can be fiddly to change |
| Lightweight | Can be uncomfortable for some users |
| Require more maintenance than other hearing aids due to their position in the ear canal |
Invisible in the canal (IIC)
IIC hearing aids are the smallest available, sitting deep in the ear canal and making them largely undetectable to others. Again, these are mainly suited for mild to moderate hearing loss.
| Pros | Cons |
| Their diminutive size means they’re invisible or nearly invisible | Small battery, which can be fiddly to change |
| No interference when using the telephone | Can be uncomfortable for some users |
| Some users can wear earbuds or even stethoscopes alongside them, depending on the size of their ears | Require more maintenance than other hearing aids due to their position in the ear canal |
Extended wear hearing aids
These hearing aids are designed to be worn 24/7 and must be set deep into the ear canal by a professional hearing care specialist. The hearing aid has a solid core containing the battery and other components. This is surrounded by a flexible material that will conform to the curvature of each user’s ear canal. Available in seven different sizes, extended wear hearing aids are designed to stay in place for up to four months at a time.
| Pros | Cons |
| Completely invisible | Must be inserted by a healthcare professional and replaced every time the battery dies |
| Comfortable | Unsuitable for many due to the shape or size of their ear canal shape, earwax production or ear-related medical conditions |
| Removes the need to insert and remove a hearing aid daily | You’ll need special earplugs if you want to go swimming |
Questions to ask before buying a hearing aid
Hearing aids can be expensive, so it’s important to make sure you choose the right one for your needs. Here are the key questions you should ask your audiologist:
- What instruction for how to use the hearing aids will the audiologist provide?
- What features would be most useful to me as an individual?
- Is it worth paying more for newer technologies?
- Is there a trial period to test hearing aids (look for brands offering a 30 to 60 day trial period)?
- Are there any fees that aren’t refundable if the hearing aids are returned after this trial period?
- How long is the warranty; can it be extended and what does it cover?
- Can the audiologist make adjustments, provide servicing and handle minor repairs? If not, who can?