Hearing Aid Buyer’s Guide: Types of Hearing Aids

Hearing Aid Buyer’s Guide: Types of Hearing Aids

The first chapter of our hearing aid buyer’s guide explained the different places you can buy hearing aids. Now that you know your hearing aid seller options, what types of hearing aids can you choose from? Which type makes the most sense for your budget and needs? Part two of our hearing aid buyer’s guide dives into the types of hearing aids: which hearing aids fit behind your ear, which sit deep in your ear, and which sit in the outer opening. But first…

What’s in a hearing aid?

Simply put, hearing aids are devices worn behind, on, or in the ear that helps people with hearing loss hear better. They consist of three basic parts: a microphone to pick up the sound around you, an amplifier to increase the sound, and a receiver to deliver the sound to your ear. Modern digital hearing aids compensate for any uneven hearing loss by boosting certain frequencies over others. This programming can be customized, but some hearing aids also have one-size-fits-most programs to help people with the most common age-related hearing issues.

Why is something so small… so expensive?

Hearing aids seem like simple technology, but their small size creates a major challenge. The closer together you put those three basic components described above, the larger the risk for feedback and poor sound quality, meaning the technology in those parts needs to be better in smaller devices. The rule of thumb is the smaller you have to make the device’s technology, the steeper the price tag.

The Types of Hearing Aids

types of hearing aids

Behind-the-ear (BTE)

Like the name implies, behind-the-ear hearing aids are designed to sit behind the ear, largely out of sight. The microphone, amplifier, and receiver are all within the body of the hearing aid, and the sound travels through thin, clear tubing into the ear canal.

Easy to adjust controls
Some visibility
Tubing and ear tip variety
Replaceable parts
Longer battery life

Behind-the-ear (BTE)—Pros

The control settings on BTE hearing aids are located at the back of the aid, making it easier for the user to delicately adjust the volume at a moment’s notice. When it comes to users with dexterity problems, BTE could be a better choice than hearing aid designs that go directly into the ear.

BTE hearing aids are a popular design because the tips and tubing can be changed and customized for the comfort of different ear sizes and shapes. These parts can also easily be removed for cleaning or replacing, making BTE hearing aids very easy to maintain without needing to go to a clinic. Additionally, replacement tubing, tips, and batteries tend to be inexpensive, so BTEs are a budget-friendly option when it comes to repairs.

Behind-the-ear models usually have more space for a larger battery so they offer a longer battery life than other types of hearing aids.

Behind-the-ear (BTE)—Cons

Some hearing aid users dislike that this style is still visible behind their ears if you look close. That said, new hearing aid technology has allowed BTE hearing aids to be designed so small that they’re practically invisible when worn.

Receiver-in-the-canal (RIC)

The bodies of receiver-in-the-canal hearing aids rest behind the ear like they do with BTE models. The difference is that the receiver is separate from the body and sits directly in the ear canal, with wired tubing linking the receiver to the hearing aid body.

Smaller, more discreet body
Wax build-up
Easy-to-use controls
More maintenance
Can avoid feedback
Expensive receiver

Receiver-in-the-canal (RIC)—Pros

Because the receiver is external, it allows the body of RIC hearing aids to be a little smaller and more discreet than BTE. Like BTEs, RICs have easy to reach controls on the body of the hearing aid. The receiver and the microphone are much further apart than in other models, making feedback less of an issue at higher volumes.

Receiver-in-the-canal (RIC)—Cons

Since the receiver is directly in your ear, RIC hearing aids tend to have more wax build up. Wax and moisture build up will start blocking the sound and at worst could destroy the receiver itself. These receivers cost $100 on average and typically need to be replaced at least once a year (or sooner if wax builds up too quickly). Those costs add up.

Completely-in-the-canal (CIC)

CIC hearing aids sit deep in the ear canal and have no parts sitting behind the ear at all.

Most discreet
Limited user controls
Custom fit
Low battery life
More wax build-up
Harder to clean

Completely-in-the-canal (CIC)—Pros

By design, CIC hearing aids are the smallest available. Among the models that fit entirely in the ear, this is the most discreet. They’re custom fitted to the user’s ear canal.

Completely-in-the-canal (CIC)—Cons

CIC is a very small hearing aid that stays deep inside the ear, making it much harder for users to adjust settings on the fly.

Another trade-off for its small, nearly invisible profile is how quickly completely-in-the-ear hearing aids run through their batteries. The smaller the device, the smaller the battery needs to be in order to fit inside. And the smaller the battery, the less power it can provide.

Because the entire hearing aid is deep in the ear, wax build up is even more of a problem than with other hearing aids. CIC are the type of hearing aid that needs repair most often due to the daily exposure to wax and moisture. Its size makes general maintenance a challenge, too.

In-the-canal (ITC)

These hearing aids are still in the ear canal but are a little larger and don’t sit quite as deep as the completely-in-the-canal models.

Better controls than CIC
Challenge to keep clean
Better battery life than CIC
Not always comfortable
More noticeable than CIC

In-the-canal (ITC)—Pros

Because they are a little larger, ITC models allow for better controls than the types of hearing aids that fit deeper in ear. Although the controls still won’t be as easy to use as behind-the-ear, they will be easier than CIC models. ITC hearing aids are custom fitted. They allow allow for a slightly larger battery than other canal models, which means a longer battery life.

In-the-canal (ITC)—Cons

Like CIC models, these hearing aids are so small and fit directly into the ear canal, so wax build up is a problem and maintenance can be difficult. Because of ITC’s placement in the ear, some users feel “plugged up” and unnerved. While small enough to fit in the canal, ITCs are bigger and more noticeable than CICs.

In-the-ear (ITE)

In-the-ear hearing aids are similar to in-the-canal, but these devices are fitted to the bowl of your outer ear rather than in the ear canal.

Made just for you
Most noticeable
Better battery life than ITC
Wax build-up
Better controls than ITC
Maintenance issues

In-the-ear (ITE)—Pros

ITE hearing aids are usually custom-made to your ear, giving users with less common ear sizes and shapes more comfort. The battery is bigger in these hearing aids than other types of hearing aids that fit directly in the ear, which means it can last longer between replacements. Compared to ITCs, the controls are a little larger (although they’re still smaller than BTE).

In-the-ear (ITE)—Cons

While usually designed to be more flesh-colored to blend in with skin tones, ITE hearing aids take up the majority of your outer ear and is arguably the least discreet hearing aid design. Like the other designs that fit directly into the ear, ITE-style hearing aids need to be cleaned more often thanks to wax and moisture build-up.

But which type of hearing aid should I buy?

At the end of the day, picking from the various types of hearing aids comes down to what features you prioritize first. For instance, if you want the smallest hearing aid possible, you might have to deal with a less user-friendly style, a higher price, and less powerful batteries. If you’re looking for easy-to-use controls and easy-to-replace parts, you may need to choose a slightly bigger hearing aid body. It’s all about what makes the most sense for your needs and your budget.

That said, there are many reasons MDHearing specializes in behind-the-ear hearing aids. For one, our easy-to-use controls allow quick adjustments. Our hearing aids are also compatible with a variety of tips and tubing sizes so you can customize them to your unique ear size and shape. Our tips are the only part of the hearing aid to go in your ear, keeping the actual hearing aid technology safe from ear wax and moisture. The bodies of our hearing aids are small enough to fit discreetly behind the ear, but are big enough to accommodate modern hearing aid technology without needing to hike up the price. We feel it’s truly the best of both worlds.

Wait, what about PSAPs?

You may have seen Personal Sound Amplifiers (PSAPs), listed on Amazon and other online retailers. We didn’t include PSAPs on our types of hearing aids list because PSAPs are not designed to assist individuals with hearing loss. These devices are only meant to amplify environmental sounds for non-hearing impaired users in activities like bird watching. PSAPs are not an adequate replacement for FDA-registered hearing aids.

Next chapter in our Hearing Aid Buyer’s Guide: the hearing aid features you should know about as you weigh your options.