Hearing aids come in all different shapes and sizes. When exploring hearing aids, you’ll find options that sit behind the ear, in the ear, and in the ear canal. Choosing the right hearing aid for you will depend on your lifestyle as much as your ears.
In this article, we’ll discuss:
How do hearing aids work?
Hearing aids are small electronic devices that consist of five essential parts:
- Microphone to pick up the sound around you
- Amplifier to increase the sound
- Microchip (signal processor) to regulate the sounds that are amplified
- Receiver to deliver the sound to your ear
- Battery unit to power the electronics
Hearing aids may seem like simple technology, but their small size creates a significant challenge. The closer together you put the components described above, the greater the risk for feedback and poor sound quality. That means the technology needs to be better in smaller devices, which tends to steepen the price tag.
5 Styles of Hearing Aids
There are five main styles of hearing aids. Depending on the design, they are worn either behind or in the ear.
1. Behind-the-ear (BTE)
As the name implies, behind-the-ear hearing aids sit behind the ear, mainly out of sight. The body of the hearing aid contains the microphone, amplifier, microchip, receiver, and battery. The amplified sound travels from the body of the hearing aid and passes through thin, clear tubing into the ear canal.
- Easy-to-use controls: Settings controls are on the back of a BTE, making it easy to delicately adjust the volume at a moment’s notice. If you have a dexterity problem, a BTE may be better than hearing aids that go directly into the ear canal or bowl of the ear.
- Customizable parts: BTE’s have a variety of tubing and ear tip options to fit different ear sizes and shapes comfortably.
- Replaceable parts: The tubing and tips are inexpensive and easy to clean or replace.
- Longer battery life: BTEs usually have more space for a larger battery, so they offer a longer battery life than other types of hearing aids.
- Some visibility: Some hearing aid users dislike that this style is still visible behind their ears if they look closely.
2. Receiver-in-the-canal (RIC)
Like BTE models, the body of the receiver-in-the-canal hearing aid rests behind the ear. The difference is that the receiver is separate from the hearing aid body and sits in the ear canal. Wired tubing connects the receiver to the hearing aid body.
- More discreet body: RICs tend to have a smaller and a bit more discreet hearing aid body than a BTE.
- Easy-to-use controls: Like BTEs, RIC hearing aids have easy-to-reach controls and may be better for those with dexterity issues.
- Can avoid feedback: Because the receiver and the microphone are further apart than an in-the-ear aid, feedback is less of an issue at higher volumes.
- Wax buildup: RICs tend to have more issues from wax buildup because the receiver sits directly in your ear.
- More maintenance: Because wax and moisture buildup blocks the sound and could destroy the receiver itself, RICs require more cleaning and maintenance.
- Expensive receiver: On average, you'll spend $100 on receivers, which you typically need to replace at least once a year (or sooner if wax builds up too quickly).
3. In-the-ear (ITE)
In-the-ear hearing aids are placed entirely in the bowl of your outer ear and do not utilize any tubing or wires. ITEs are usually custom-made from an ear mold and are available as half shell models (covering half of the bowl of the outer ear) or full shell models (covering the entire bowl).
- Custom-made to fit ear: ITES can offer more comfort if your ear size and shape are less common.
- Better battery life than ITCs and CICs: Compared to other types of in-ear hearing aids (more on those below), an ITE has a larger battery that lasts longer.
- Better controls than ITCs and CICs: ITEs also have bigger controls than other in-ear aids, although they may not be as easy to use as BTEs and RICs.
- Most noticeable style: ITEs take up most of your outer ear and are arguably the least discreet design.
- Wax buildup and maintenance issues: Like the other designs that fit directly into the ear, you need to clean an ITE more often thanks to wax and moisture buildup.
- Not always comfortable: If not custom-made for your ear, ITEs can be difficult to fit due to the variety of ear shapes.
4. In-the-canal (ITC)
In-the-canal hearing aids fit entirely in the ear canal, rather than the bowl of the ear.
- Discreet: ITCs are smaller and more discreet than ITE models, but they are still visible at the opening of the ear canal.
- Better controls than CIC: Due to their smaller size, the controls won’t be as easy to use as ITEs. However, they will be easier than CIC models (more on these below).
- Better battery life than CIC: ITCs can hold a slightly larger battery than other canal models, which means a longer battery life.
- More noticeable than CIC: While small enough to fit in the canal, ITCs are bigger and more noticeable than CIC.
- Challenging to keep clean: Because these hearing aids are small and fit directly into the ear canal, wax buildup is a common problem, and maintenance can be difficult.
- Discomfort/may leave a "plugged up" feel: ITC’s placement in the ear canal can cause some users to feel “plugged up.”
5. Completely-in-the-canal (CIC)
CIC hearing aids sit deep in the ear canal and are the smallest hearing aid available (you may also learn of invisible-in-the-canal (IIC) hearing aids, which are a version that fit deeper in the canal). They must be removed by tugging on a small removal string.
- Most discreet: As the most discreet among the models worn entirely in the ear, CICs are virtually invisible.
- Comfortable: Their small size is comfortable.
- Less wind noise: CICs have good sound quality because of how they fit within the ear
- Limited or no user controls: A trade-off for its small, nearly invisible profile is that adjusting settings on the fly is much harder—if it even has controls on the hearing aid.
- Shorter battery life: You’ll run through the battery life quickest with this style. The smaller the device, the smaller the battery needs to fit inside; the smaller the battery, the less power it can provide.
- More wax buildup and maintenance: Because a CIC sits deep inside the ear, they’re even more prone to wax and often needs repair due to wax and moisture.
How to decide what is the best type
At the end of the day, choosing the best style of hearing aid 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 shorter battery life. If you’re looking for easy-to-use controls and easy-to-replace parts, you may want to choose a behind-the-ear style. It’s all about what makes the most sense for your needs and your budget.
MDHearing offers a range of affordable, FDA-registered OTC hearing aids. We offer a 45-day, risk-free trial so you can try them on in your daily life and make sure the fit is right for you. Our U.S.-based licensed hearing professionals are always here to help.
Looking for more resources?
- What are common signs of hearing loss?
- How will I know if hearing aids will work for me?
- What is the return policy?
- How will hearing aids look on my ear?
- Do I need a prescription or medical evaluation before buying a hearing aid?