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Hearing Aid Types

In psychology, the Paradox of Choice describes a phenomenon in which too much choice negatively affects the decision-making process and, in most cases, leads to a delay in the final decision. Choosing the right hearing aid from the mass of choices can quickly become overwhelming or even lead to frustration. To offer an approach of relief, this blog article will give you an overview of different types of hearing aids as well as their advantages and disadvantages. It should be noted that this is always a highly individual decision, depending on personal factors such as visual requirements, technical expectations, and the degree of hearing loss.

Hearing aid overview: what forms of hearing aids are available?

First, a general distinction can be made between in-the-ear (ITE) and behind-the-ear (BTE) hearing aids. The different designs work with different technical implementations to increase your hearing ability. In this regard, further sub-types can be identified in each of the two wearing styles, which are listed below.

In-the-ear (ITE) hearing aids

In-the-ear hearing aids function with a closed fitting, in which the outer part of the ear canal is mostly closed by the hearing aid itself. Thanks to a custom fit to your ear, the hearing aid sits optimally in the ear canal, ensuring ventilation while allowing direct transmission of sounds. Consequently, the natural power is fully utilized, ensuring usability for a wide range of hearing problems.

The ITE devices get their name because of their placement in the ear. A distinction is made between concha devices, which are placed in the pinna, ear canal devices, which have a deeper seat in the ear canal, and models that completely disappear into the latter.

Subtypes of in-the-ear hearing aids at a glance:

ITE hearing aids (In the Ear)

ITE hearing aids sit inside the pinna of the ear and fill it completely.

ITC Hearing Aids (In the Canal)

The ITC hearing aids are inserted into the ear canal, leaving the pinna free and allowing for subtle wearability.

CIC Hearing Aids (Completely in the Canal)

For a particularly unobtrusive hearing solution, CIC devices are a good choice. Considered the smallest ITE, these disappear completely into the ear and can be removed from it with the help of a nylon pull cord.

IIC hearing aids (Invisible in the Canal)

An IIC hearing aid sits even deeper in the ear canal than the CIC, so it becomes nearly invisible in the ear.

Behind-the-ear (BTE) hearing aids

With the open fitting found in BTE hearing aids, sound waves naturally reach the eardrum because the pinna is not occupied by the hearing aid. Instead, as the name promises, the devices sit behind the ear, a little above the pinna. Sound waves are transmitted via a transparent tube to the earmold, which sits in the ear canal and ensures a good fit for the hearing aid. The components and the loudspeaker are thereby securely integrated in the housing, so that BTE devices are also available as water-, sweat- or dust-resistant.

Subtypes of behind-the-ear hearing aids at a glance:

BTE hearing aids (Behind the Ear = with sound tube)

Hearing instruments that sit behind the ear and use a sound tube to direct sound into the ear canal are called BTE. They are characterized by the fact that the speaker is located in the housing of the hearing aid. Depending on the severity of the hearing loss, sound tubes of different diameters can be used.

RIC Hearing Aids (Receiver in Canal = With Ex-Hearer)

RIC models are more inconspicuous than other BTE devices, but they also sit behind the ear. A thin cable provides the connection to the speaker, which finds its place in the ear canal. Consequently, RIC hearing aids are considered to be particularly aesthetically pleasing, while being suitable for any ear and extremely effective.

Other types of hearing aids in brief:

Bone conduction hearing aids

Bone conduction hearing aids are designed in the shape of eyeglasses, with temples that fit snugly against the head. Thus, sound is transmitted to and audible through the skull bone. People who frequently suffer from middle ear infections especially benefit from this form of hearing aid.

Cochlear implant

Chochlear implants aim to use the remaining natural hearing function and bridge the sensory cells that are missing in the cochlea. This is realized by stimulating the auditory nerve.

Tinnitus Noiser

Whoever has tinnitus knows how much the constant disturbing noises can interfere with everyday life. To solve the problem, Tinnitus Noiser transmits sounds to the hearing aid to mask the actual tinnitus.

Differences: ITE or BTE hearing aids

The different designs of hearing aid types each carry advantages and disadvantages that can influence selection based on personal judgment. In terms of emphasis, the devices are distinguished from one another by their design and thus their conspicuousness when worn. In addition, the varying size causes a variation in the technical equipment options, which determines the suitability for certain degrees of hearing impairment.

Advantages of ITE hearing aids

In terms of inconspicuousness, subtly wearable ITE hearing aids, some of which are virtually invisible, are impressive. Their fit inside the ear ensures optimum wearing comfort, which proves particularly practical when wearing glasses and during sports, as snagging is avoided due to their protected position. The custom-made design as well as the technical features ensure that the conditions of the ear are used effectively. This in turn results in a natural sound experience.

Disadvantages of ITE hearing aids

The disadvantage of ITE hearing aids is their limited applicability to mild to moderate hearing impairment, while the price factor is a particular burden. From a technical point of view, the limited space means that trade-offs in features, such as the lack of an audio port or a T-coil (installed only in Concha devices), must be accepted. Another aspect of size is the suitability of the ear canal, which must have a certain size to allow insertion. Ultimately, a shortened runtime compared to BTE hearing aids must be considered.

Advantages of BTE hearing aids

BTE hearing aids can also be used for moderate to severe hearing loss or small ear canals. Nowadays, elegant, stylish solutions with classic designs can be found in this regard, even with a comparably larger belly. The size factor allows the BTE to perform better, as there is more room for larger batteries. Consequently, another advantage is extended runtime and connectivity to external devices. In handling the hearing aids, simplified operability, cleaning and adjustment can also be noted, also aided by size.

Disadvantages of BTE hearing aids

Despite minimal design, BTE hearing aids remain more conspicuous to wear than the hidden ITE devices. This disadvantage is eliminated in RIC models, but there is an increased maintenance requirement here. Due to the risk of snagging, BTE devices are less suitable for spectacle wearers and can also become a disruptive factor when wearing a mask. Finally, it can be criticized that no use of the natural function of the auricle takes place, as is the case with ITE devices.

Battery or rechargeable battery?

In addition to deciding whether the new hearing aid should sit in or behind the ear, you also need to weigh whether it should run on battery or rechargeable battery power. Again, these are very personal preferences that need to be thought through on an individual basis.

While hearing aids with battery offer quite a long runtime and allow for continuous wear, hearing aids with rechargeable battery require nightly charging to ensure hearing throughout the day. Rechargeable devices offer the advantage of carrying powerbanks to charge on the go. Here, the battery level can usually be viewed in the apps for the respective hearing aids. In case the battery device fails while on the road, however, replacement batteries must always be carried along. The frequent change can represent not only a motor challenge, but is to be questioned particularly before an environmental aspect critically.

Pricewise, the battery devices represent a higher financial burden in the purchase. At the same time there is with battery hearing a running expenditure in the form of the spare batteries, while a battery change must be accomplished only approximately every five years, but for it a higher cost point exhibits. Finally, it should be remembered that in cases of particularly severe hearing loss, the performance of hearing aids with rechargeable batteries is not always adequate.

Conclusion: which type of hearing aid is right for me?

This article has provided an overview of what types of hearing aids are available to you when making a purchase. Ultimately, which hearing aid is right for you can only be decided based on your individual preferences. Do you have a mild to moderate hearing loss, wear glasses, or do you place special emphasis on subtle wear? Then ITE hearing aids may be suitable for you. If you desire increased performance, simplified handling, or if you have severe hearing loss, you should take a closer look at BTE hearing aids.

Another decision issue is the choice between battery or rechargeable operation. Also relevant here is which form of operation is most convenient for you - do you prefer nightly charging versus carrying batteries around permanently in case a swap is needed? What is your price budget? Answering these questions can provide good guidance, but ultimately testing the pre-selected hearing aid is necessary to find out if it is indeed a good fit for you. To learn how you can test hearing aids for free at MySecondEar, here.