How to choose: In-the-ear vs Behind-the-ear Hearing Aids

Image Credit: https://www.soundly.com/

If you are looking for a hearing aid in the market, there are many choices to look at and it can be tough to decide which is right.

There are several distinctive types and styles of hearing aids. One of the first decisions you need to make is whether you prefer a hearing aid that sits inside- the- ear canal or behind- the- ear. This guide will help you understand both styles: behind-the-ear hearing aids and in-the-ear hearing aids and their benefits to find the best choice for your hearing needs.

Better in or better out? That is the question. If you are experiencing hearing loss signs and a hearing test reveals that you should start using a hearing aid, sorting through the options can be overwhelming.

When you are checking which hearing aid you could benefit from, you may be evaluating between both options: in-the-ear or behind-the-ear hearing aids. Choosing between the two types depends on several factors, including the level of hearing loss, lifestyle, aesthetic concerns, required features, and a lot more. To ensure you receive the best treatment option for your needs though, you should be consulting your audiologist and deciding together on the right one.

Behind-the-ear (BTE) hearing aids

Let’s start with a clearer look at behind-the-ear hearing aids. 

Around 80% of hearing aid wearers choose behind-the-ear hearing aid that sits behind the ear with a wire or tube that reaches into the ear canal. This type of hearing aid is appropriate for all degrees of hearing loss from mild to profound.

• They are commonly the most affordable option.

• They are often available in both battery-power and rechargeable options.

• They contain two microphones on them.

• Most people don’t feel them, but it can be hard for those with dexterity issues.

It comes in two forms:

1. Behind-the-ear (BTE) hearing aids

2. Receiver-in-canal (RIC) hearing aids

BTE hearing aid

1. It keeps the microphone on the body of the hearing aid.

2. They can be programmable so as your hearing loss progresses, you can be able to adjust them.

3. It provides more power for users with severe or profound hearing loss.

RIC hearing aid

1. It places the speaker at the end of the wire.

In-the-ear (ITE) hearing aids

They are suitable for most types of hearing loss: mild to severe hearing loss, but not profound hearing loss. This hearing aid is worn in the shell of the ear. It often includes a custom mold. It requires a visit to the local audiologist who fills the custom mold (silicone material) in the ear canal. This custom mold is shipped to the manufacturer and used to shape the hearing aid device to match the intricacies of the ear.

1. They are easier to insert than BTE hearing aids but require more cleaning due to the wax build-up and moisture.

2. They are less noticeable and more expensive.

3. Since they sit inside the ear, they are less likely to pick up any wind noise. This makes them easier to wear when you are out.

4. They can be connected to your phone through Bluetooth. They allow only one microphone on the device.

• It ranges in size from almost filling the outer ear (ITE), to an invisible-in-the-canal hearing aid (IIC) practically visible in the ear.  It comes in four forms:

1. In-The-Ear (ITE)

2. In-The-Canal (ITC)

3. Invisible-In-The-Canal (IIC)

4. Completely-In-The-Canal (CIC)

Image Credit: https://www.soundly.com/

Choosing between In-The-Ear vs Behind-The-Ear Hearing aid styles

There is a selection of key factors that you should consider when you choose a hearing aid style. If your degree of hearing loss is less than severe and you have the option to choose, these are some of the key factors to consider:

• Comfort

When users choose a specific hearing aid, the style impacts the physical ease of all-day wear. The style of both hearing aids can be equally comfortable for most people. Custom-molded ITE hearing aids fit securely inside the ear canal and are shaped to fit the ear shape and size.

Some people with bendy ear canals might feel uncomfortable with the hard acrylic material. However, with time, they will adjust and forget they are wearing the device. The audiologist can modify in this case the device to help with the comfort. They either reshape or buff the hearing aid shape if a specific part of the device is troubling the ear canal. Since the way to wear both hearing aids is different, this means that nearly everyone will find a comfortable fit.

The only drawback here is that behind-the-ear style shares space with glasses, oxygen tubes, and masks.

• Sound quality

Both hearing aid styles come with their unique sound profiles, based on how they sit inside the ear. This can impact the overall sound experience.

People with normal or mild hearing loss usually don’t like the sound quality of custom-molded hearing aids because of their occlusion effect. To understand what we mean by this, plug your ears and try chewing or talking. The sound doesn’t escape your ears and will return to the eardrum, creating a boonic sound. With time, your brain adjusts to this effect, but it can be very frustrating. If you are a first-time hearing aid wearer, it is safe to start with the behind-the-ear style to receive the easiest adjustment period and maximum flexibility.

• Technology

Some styles support popular features such as Bluetooth, Telehealth, and rechargeability.

Behind-the-ear hearing aid style has the most up-to-date rechargeable hearing aid options and Bluetooth features.

For example, the largest custom hearing aid ITE features Bluetooth connectivity, but a smaller one than ITC doesn’t.

As for rechargeability, some hearing aid manufacturers are currently making their larger in-the-ear technology rechargeable.

• Dexterity

The ability to handle the hearing aid, put it in, take it out, and replace its batteries is very important and can be challenging. If you have dexterity issues- tremors, arthritis, or any other issue using your hands, it can be very challenging to choose.

• Maintenance

Maintaining and cleaning the device is very important to the life of the device. Wax, debris, and moisture can cause damage to the hearing aid. It’s very important to consider that in your choice. How to clean, how often, and when to change the wax guards at home is something you should ask your hearing healthcare professional about.

• Appearance/ Aesthetics

The aesthetics of hearing aids vary by style. Many people think that hearing aids behind the ear are too visible, but because of modern technology, this style of hearing aids has become smaller than ever.

Many BTE hearing aids come in different modern colors, customized to match your skin tone. The small wire of the aid is very low-profile and the piece itself is well hidden by the hair. It blends in without being noticed.

Either hearing aid option provides a sleek appearance, but the most discreet one is in-the-ear invisible hearing aid.

So, which type of hearing aid is best for you? This depends on your individual preferences and needs. If you’re looking for a discreet hearing aid that blends in, an ITE hearing aid can be a great option. However, if you are seeking a device with flexible sound quality and the latest technology features, BTE is a better option.

No matter which type of hearing aid you choose, this blog post helps demystify this confusion so you can make an informed decision about which type is right for you!