Hearing Aid Types

Table of Contents

What Type of Hearing Aid Is Best for You?

Your hearing is as unique as your fingerprint. Your experiences, perception and relationship with hearing loss are unlike anyone else’s. Ear Health in Auckland and Christchurch offer multiple hearing aid types to suit your needs.

When it comes to finding the right hearing aid, there is no one-size-fits-all solution. The hearing aid best for you will depend on several factors, including the type and severity of your hearing loss, lifestyle, and personal preferences.

Your audiologist will help determine which hearing aid type is right for you. An audiologist will assess your needs and make recommendations based on the latest technology.

However, there are a few things that you can keep in mind when making your decision.

First, consider the different types of hearing aids available. Compared to just 30 years ago, the array of products and services has dramatically expanded. The choices are extensive, whether shopping for groceries, planning a vacation, or buying a car.

The hearing aid industry is no exception, with a more incredible selection of styles and features available today than ever.

No matter your style, your hearing aid will be programmed to suit your hearing loss. The solution unique to you may also be very discrete or almost invisible with today’s advanced styles.

Second, explore all of the hearing aid funding options available in New Zealand. You might be surprised to learn all NZ residents are eligible for some funding.

Lastly, your lifestyle plays a significant role in finding the perfect hearing aid.

How Does Lifestyle Influence Your Hearing Aid Choice?

Your lifestyle will significantly influence what type of hearing aid is best for you.

For example, if you have a busy social life or work full-time, your focus will likely be on how well the hearing aid technology performs in challenging listening environments. Rechargeable hearing aids may also be high on your list.

Active people who enjoy the outdoors may find that water and dust-resistant behind-the-ear models are more durable and stay in place better than those that fit inside the ear canal.

If you have a job requiring safety equipment, such as earmuffs, you may prefer an in-the-canal hearing aid model that doesn’t interfere with the fit of these devices.

Perhaps manual dexterity is an issue, so you may find it easier to handle a behind-the-ear hearing aid than a smaller in-the-ear model.

No matter your lifestyle, a hearing aid style can be found for you – so be sure to discuss your options with your audiologist.

Hearing Aids vs Hearing Implants

Two types of devices can help people with hearing loss: hearing aids and hearing implants. Both are suitable for different types of hearing loss and have advantages and disadvantages, so it is essential to consider all factors before deciding.

You’ll need guidance on which device applies to your hearing loss from your general practitioner, audiologist or otolaryngologist (also called an ENT or ear, nose and throat specialist).

Hearing Aids

Hearing aids are small electronic devices that sit outside the ear and amplify sound. They are relatively easy to use and adjust, and they can be made to look nearly invisible. 

Hearing aids are most useful for people with sensorineural hearing loss (SNHL). SNHL represents about 90 per cent of reported hearing loss. SNHL results from damage to the small sensory cells in the inner ear, called hair-cell stereocilia. Age-related hearing loss (presbycusis) is the most common form of SNHL, and noise-induced hearing loss is the second.

Hearing aids work by amplifying sound vibrations entering the ear and increasing the stimulation of the hair-cell stereocilia.

Of course, improving a person’s hearing is more difficult to achieve than just making sounds louder. Delivering a natural sound matched to an individual’s unique hearing loss is a complex assignment.

Hearing Implants

Most people with hearing loss can benefit from the use of hearing aids. However, in some cases, hearing aids are not enough to restore hearing. Often when there is damage to the inner ear or the auditory nerve.

A hearing implant has two parts. A small device is surgically inserted under the skin, and an externally placed sound processor sits on the head.

Hearing implants are usually reserved for people with severe or profound hearing loss that would not typically benefit from a hearing aid. However, as technology continues to improve, implants may become an option for more people with hearing loss in the future.

Both hearing aids and hearing implants can help people with hearing loss improve their quality of life. The best option for each individual depends on many factors, so you must consult a medical professional or qualified audiologist to determine which choice is right for you.

Types of Hearing Aids

There are two main categories of hearing aids: behind-the-ear (BTE) and in-the-ear (ITE). BTE hearing aids are larger in size and fit over the top of the ear, whereas ITE hearing aids are smaller and fit directly into the ear canal.

Both types of hearing aids have their advantages and disadvantages. BTE hearing aids tend to be more powerful and easier to use, while ITE hearing aids are less visible and may be more comfortable for some people.

Ultimately, the best type of hearing aid for each individual will depend on their specific needs and preferences.

6 Hearing Aid Styles

1. In-the-Ear (ITE)

In-the-ear hearing aids – also known as ITE hearing aids – are among the larger hearing aid styles. But don’t let that put you off straight away. The slightly larger shell has the benefit of allowing room for extra technology inside.

In-the-ear hearing aids sit entirely within the outer portion of the ear. True, this is more visible than other styles. But this allows for several components to be contained within, providing the benefit of more features and better sound quality.

closeup senior woman inserting ITE hearing aid
ITE hearing aid
Who Are They For?

In-the-ear hearing aids are helpful for any level of hearing loss from mild to severe. 

They can be suitable for people with dexterity challenges. As they have a larger shell than other types, they are easier to handle. Replacing batteries and adjusting the settings is more straightforward than in smaller in-the-canal models.

  • The larger size means bigger batteries, longer battery life.
  • Excellent sound quality. 
  • Great for glasses and hat wearers.
  • Relatively easy to put in, take out and change batteries.
  • Sit snugly in the outer ear – custom-moulded for you.
  • Rechargeable options.
  • More visible than deeper fit in-the-ear hearing aid types.
  • Can pick up distracting sounds, such as wind noise.
  • Require more frequent cleaning and servicing than behind-the-ear models.

2. In-the-Canal (ITC)

In-the-canal hearing aids are custom-made to fit into the ear canal. They are partially hidden, but you can usually see a small portion from the outside. In some models, this contains a volume wheel to allow you to adjust the volume quickly.

It’s important to note that in-the-canal style hearing aids require a mould of the ear canal. The mould forms a hearing aid that is a custom fit for your ear canal. 

While this is great as it is a snug fit and will comfortably stay in place, some users struggle with the sensation of having something inside their ears. Other users find this doesn’t bother them at all. Models with vents can help to keep the air flowing and reduce this sensation.

ITC hearing aid in womans ear
ITC hearing aid
Who Are They For?

They are suitable for people with a wide range of hearing loss from mild to moderately severe. Your ear canals must be large enough to accommodate them. They work on the same principles as the larger in-the-ear hearing aids but are a more discreet option. 

  • Less visible than the larger ITE.
  • Easier to handle and operate than smaller in-the-ear models.
  • Custom-designed for a snug fit in your ear.
  • Batteries are smaller and need replacing more often.
  • Require more frequent cleaning and servicing than behind-the-ear models.
  • Earwax build-up is a common issue.

3. Completely-in-the-Canal (CIC)

CICs are custom-moulded to fit quite deep in your ear canal and are often regarded as “almost invisible”. All that is visible is a very small faceplate if you look closely at the wearer’s ear canal. 

CIC hearing aid in woman's ear
CIC hearing aid
Who Are They For?

They are suitable for people with mild to moderately severe hearing loss. They are an excellent choice for those who prefer a concealed hearing aid.

Due to their small size, CICs don’t have features such as Bluetooth streaming of calls, music, and other audio directly through your hearing aids.

As they are positioned quite deep in the ear canal, some users report issues with earwax, moisture and skin build-up. This can interfere with sound quality and increase the frequency of cleaning and repairs.

Your ear canals must be large enough to accommodate CIC hearing aids. 

  • One of the most discreet options available.
  • Moulded to your ear for maximum comfort.
  • Don’t interfere with eyeglasses and hats.
  • Not recommended if you have dexterity challenges.
  • Batteries are smaller and may need to be changed more frequently.
  • They may cause a blocked feeling in the ear if they get clogged.
  • Not suitable for people who produce lots of earwax.
  • Require frequent cleaning and servicing.
  • Not compatible with Bluetooth streaming technology.

4. Invisible-in-the-Canal (IIC)

As the name suggests, the invisible-in-the-canal hearing aids are genuinely invisible when viewing the ear canal. The features and functionality of IICs are almost identical to completely-in-the-canal hearing aids.

The key difference of an IIC is its miniature size. Few manufacturers have IIC hearing aids in their catalogues because the tiny components are complex to manufacture.

IIC hearing aid in human ear anatomy model
IIC hearing aid
Who Are They For?

IICs are the smallest hearing aids available and sit deep in the ear – as far as the second bend of the ear canal. This makes them invisible from the outside. They are only suitable for users with mild to moderate hearing loss.

  • Complete discretion – nobody knows you’re wearing a hearing aid.
  • Custom-fit for your ear canals.
  • Very small – a good level of dexterity is required to operate them.
  • Prone to becoming clogged with earwax and skin cells.
  • Not be compatible with Bluetooth streaming technology.
  • Fitting and acceptance can be more challenging due to the deep fit.
  • The smallest battery size requires frequent changing.

5. Receiver-in-the-Canal (RIC)

Receiver-in-the-canal (RIC) is the most commonly available and popular type of hearing aid.

What makes them so popular? Over the years, their design and technology have improved as manufacturers have invested in enhancing their most commonly fitted devices.

They are relatively discreet, comfortable to wear and have the best available sound quality and features. Comfort is paramount because hearing aids need to be worn for several hours a day to get the optimum benefit.

They are called RIC because the receiver (speaker) is located in the ear canal. This allows them to be made smaller than traditional behind-the-ear (BTE) models while still having enough space in the housing for every available technology.

A soft dome or tip containing the receiver sits in the ear without sealing it, allowing air to pass through easily. Sound also reaches the eardrum faster than a traditional BTE, producing a natural, pleasant hearing experience for the user.

RIC hearing aid on mans ear
RIC hearing aid
Who Are They For?

RICs are very flexible and customisable and can accommodate individuals with mild to severe hearing loss. They also feature many options for audio streaming and connecting to devices like smartphones and remote controls. 

  • Small and lightweight – don’t notice you’re wearing it.
  • Relatively easy to handle and operate.
  • Receiver design can result in a more natural hearing experience.
  • Compatible with Bluetooth streaming.
  • Large battery sizes for power and longevity.
  • Most brands have rechargeable options.
  • The receiver can become clogged if not cleaned regularly.
  • More visible than some in-the-ear designs.

6. Behind-the-Ear (BTE)

When you hear the words hearing aids, behind-the-ear (BTE) hearing aids are probably the first ones that come to mind.

In recent years they have become smaller and sleeker and offer the latest hearing aid technology. 

Not quite as popular as RIC devices, BTEs still have some practical advantages, such as high-powered options and easy handling for people with dexterity difficulties.

BTEs are also the most robust type of hearing aid and, as a result, may require less maintenance and servicing.

BTE hearing aid on womans ear
BTE hearing aid
Who Are They For?

Behind-the-ear hearing aids are suitable for people with almost any level of hearing loss and people of all ages. Some models don’t require an earmould, so do not block the ear. Many users find this more comfortable.

  • Suitable for mild to profound levels of hearing loss.
  • Superior amplification compared to other styles.
  • Large battery sizes for power and longevity.
  • Very easy to handle.
  • Compatible with Bluetooth streaming.
  • Most brands have rechargeable options.
  • Some styles are quite visible.
  • They might not be comfortable if you wear glasses. 

4 Types of Hearing Implants

Hearing implants require surgery and are typically provided by an otolaryngologist in a public or private hospital setting. Ear Health clinics in Auckland and Christchurch do not offer hearing implants. However, the audiologists there are qualified to refer clients who may benefit from a hearing implant.

1. Bone Conduction Hearing Aids 

A bone condition device is a hearing device that vibrates your skull, transmitting noise to your auditory nerve and bypassing any damaged areas in the middle ear.

Percutaneous devices have a small titanium screw surgically placed into your jawbone’s upper part. The abutment, which is attached to the titanium screw, protrudes through the skin behind your ear. An external magnet sticks to the abutment, holding the device in place.

Transcutaneous devices don’t require surgery. Instead, they use an adhesive pad to hold the device in place on the skin behind your ear.

2. Cochlear Implants 

A cochlear implant is a surgically implanted electronic device that bypasses the inner ear’s damaged hair cells (stereocilia). It transmits signals directly to the brain via the auditory nerve.

Cochlear implants are generally only considered when you have damage to the inner ear or profound hearing loss that would not benefit from a regular hearing aid.

The implant consists of two parts: an external portion that sits behind the ear and a second internal portion that is surgically placed under the skin.

The external portion includes a microphone, a speech processor, and a transmitter.

The internal portion consists of a receiver-stimulator and one or more electrodes connected to the auditory nerve.

The microphone picks up sound waves and converts them into electrical signals. These signals are then sent to the speech processor, which analyses the sounds and creates a code representing them.

The coded signals are then transmitted to the receiver-stimulator, which converts them back into electrical impulses. These electrical impulses are sent to the electrodes, stimulating the auditory nerve.

3. Middle Ear Implants

A middle ear implant (MEI) is a hearing device that is surgically implanted into the middle ear. It consists of three main parts: an inner ear receiver-stimulator, a cable that goes from the receiver to a transmitter, and a microphone.

The microphone picks up sound from the environment and sends it to the transmitter. The transmitter sends electrical signals to the receiver-stimulator, which produces vibrations. These vibrations are transmitted to the ossicles of the middle ear.

MEIs are usually only considered when there is an obstruction of the outer or middle ear; other hearing aids haven’t worked, or when you have a severe or profound hearing loss. 

4. Auditory Brainstem Implants

An auditory brainstem implant (ABI) is a surgically implanted electronic device that bypasses the damaged or non-existent hair cells in the inner ear and directly stimulates the auditory nerve. The auditory nerve sends signals to the brainstem, which interprets them as sound.

ABI was developed for people diagnosed with neurofibromatosis type 2 (NF2), a genetic disorder that causes tumours to grow on the auditory nerve. However, ABI can also be used for people with other conditions, such as auditory nerve damage from cancer, meningitis, or trauma.

Ron Trounson
Ron Trounson
Ron Trounson holds a Master of Audiology (with Distinction) from the University of Canterbury. He has been in the hearing industry since 2010 and has a broad knowledge of ear disorders, hearing loss, hearing aids and specialised hearing devices.

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