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Different Styles of Hearing Aids

There are three basic styles of hearing aids, each with particular advantages and disadvantages.

Custom In-the-ear Hearing Aids (ITE)

ITE hearing aids are the most talked about and advertised hearing aids on the market. Components of this type of hearing aid are housed in a shell, which fits in the concha (bowl) of the ear and/or the ear canal.

ITE hearing aids are typically intended for mild to moderate degrees of hearing loss. These hearing aids come in a range of sizes, from the very small devices that fit completely-in-the-canal to those that entirely fill the bowl of your ear.

Because of their compact size, certain components of these hearing aids like the volume control and batteries, are very small and require good vision and dexterity to manipulate. Additionally, because these hearing aids sit in the ear canal, they are more prone to damage from wax and moisture – and will generally require more maintenance and repair than other hearing aid styles. Learn about troubleshooting for in-the-ear hearing aids.

Behind-the-ear Hearing Aids (BTE)

The BTE hearing aid sits behind the ear and is coupled to an earmold, which fits into the ear. With the hearing aid behind the ear, the problems of wax and moisture damaging the hearing aid are dramatically reduced. BTE hearing aids also vary in size depending upon the circuitry and power requirements. BTE aids usually stand up to a bit more wear and tear than the ITE styles.

The earmold that couples the hearing aid to the ear is made of a lightweight material and is custom made for comfort and fit. Additionally, the earmolds can be "vented" to allow air to circulate in and out of the ear canal, improving both comfort and sound quality.

BTE hearing aids have the flexibility to be fit to every type of hearing loss. Learn about troubleshooting for behind-the-ear hearing aids.

Pocket (Body) Hearing Aids

Probably the most misunderstood hearing aid, the pocket aid offers the user a high degree of fidelity and durability. The speaker and earmold are connected to the hearing aid by a cord. The hearing aid is small enough to be carried in a shirt pocket. It has larger controls that can be easily manipulated by patients with dexterity and vision problems. Traditionally, body-worn hearing aids have been fit to ears with severe to profound hearing losses where the power requirements exceed the capability of the other hearing aid styles. But because the pocket aid delivers such a clear signal with low distortion, it is especially appreciated by those with poor word understanding. Learn about troubleshooting for pocket (body) hearing aids.

What technological changes have occurred in hearing aids?

There have been many changes and advances in hearing aid technology. Over the past decade, improvements in miniaturization and circuitry development have been astounding. The advancements allow for more natural sound quality and improved clarity, including:

Digitally Programmable Hearing Aids

Digital hearing aids contain a computer chip and are programmed to conform to a wearer's hearing loss. While all digital hearing aids are programmable, some also have digital signal processing (DSP) capability. This type of digital hearing aid converts the incoming sound to a computerized (binary) code, adjusts it for the user's hearing loss, and converts it back to audible sound.

To some hearing aid users, the overall effect of this higher technology instrument is a more natural sound quality and increased comfort in a wider range of listening situations.

Digital technology is available for both in-the-ear (ITE) and behind-the-ear (BTE) styles of hearing aid and can be used with different degrees and types of hearing loss. Digital hearing aids can accommodate multiple programs which may be of benefit in environments with changing listening requirements. Some offer auxiliary devices such as remote controls that can make program switching easier for the hearing aid user.

Directional Microphones

Though no hearing aid can completely remove background noise, directional microphones are the most effective technology for improving speech understanding in the presence of background noise. The microphones amplify sounds directly in front of the user more than the sounds to the back and sides of the user.

For example, in a crowded restaurant, the aid will amplify the voice of the person you are looking at more than the voices at tables behind and around you. This technology is now available in both behind-the-ear and in-the-ear styles and can fit the majority of hearing losses that can benefit from amplification.

How will I know which hearing aid is best?

With all the styles and circuits available, a person buying a hearing aid may not know which device is best without careful, professional guidance.

The selection of proper amplification is a very detailed process. A poorly selected hearing aid will provide the user with little benefit and a great deal of frustration and dissatisfaction. To assure proper selection and fitting, one should consult an audiologist.

An audiologist is specially trained to evaluate your hearing and will help you through the selection process. At Mass. Eye and Ear, we not only dispense hearing aids; we study their components, test their claims and stay current on the latest technological developments. Every hearing aid we put on a patient has passed very high standards of fit and function.


 Page updated 2/16/09