Which Are the Best Hearing Aids?

Small microphones gather sounds around you and are fed to a computer chip that converts them into electrical signals. These are amplified and sent to your ears through speakers, called receivers.

There are many types of hearing aids, from ones that are virtually invisible to those that fill the bowl-shaped area of your outer ear. Your audiologist can help you choose the right one for your needs and preferences.

In-the-ear (ITE)

ITE hearing aids have a small custom shell that fits comfortably inside your ear canal. Depending on your lifestyle, this may be an ideal option. They are less noticeable than traditional aids that hook over the top of your ear and can accommodate a range of hearing loss levels.

Like all types of hearing aids, ITEs collect sound from your environment and convert them into amplified signals. The sound is then delivered to your ear through a speaker. This process may make them more susceptible to picking up wind noise. This is something that you should discuss with your audiologist or hearing specialist before selecting this style of hearing aid for your needs.

In-the-canal (ITC) and completely-in-the-canal (CIC) styles are the smallest available ITE hearing aids, offering maximum discretion. They sit deep within the ear canal and are only visible when looking directly at your ear. However, the small size of these models means that they may not have manual controls, such as a volume wheel or program button.

Half-shell and full-shell ITE styles are slightly larger than ITC and CIC models. They fill the lower part of the outer ear bowl, and they are designed for people with mild to moderately severe hearing loss. Their size allows for features such as directional microphones, which can be used in noisy environments and manual controls, such as a volume wheel.

Behind-the-ear (BTE) and receiver-in-the-canal (RITE) styles are also a type of ITE hearing aid. The BTE hearing aid’s body is hooked over the ear, and a tube connects to a soft tip that sits in the ear canal without sealing it. These models are appropriate for a wide variety of hearing loss levels and are great for active individuals.

No matter what type of hearing aid you choose, you should take some time to practice wearing it in your everyday life with the help of your audiologist or hearing specialist. This will allow you to become accustomed to the sensation and to discover any potential problems that may arise. You’ll also learn how to handle the hearing aid, including putting it in and taking it out, identifying the right and left aids and changing the batteries.

Behind-the-ear (BTE)

BTE hearing aids sit behind or on top of the outer ear with tubing that channels sound down into the ear canal. They’re usually larger than RIC styles and, therefore, can accommodate more power for higher levels of amplification. The size of the case also gives them room to house more hardware and features, like directional microphones for better noise suppression or manual controls, like a programme button or telecoil.

BTEs use a clear tube that goes over your outer ear and channels sounds into the ear canal, similar to the way headphones work. Inside the case, small microphones collect sound from the environment and convert it to digital code. The computer chip inside analyzes and adjusts the incoming sounds based on your specific hearing needs and type of hearing loss. The amplifier then amplitudes the digital sound signals and sends them to the speaker (also called the receiver), which turns them into audible sounds for your ear.

These hearing aids are also available in closed fit models, which use a fitted ear dome to fill the opening of your outer ear to help reduce whistling and feedback (the squealing noise you sometimes hear from some devices). Closed fit BTEs can be more comfortable for people with limited dexterity as they don’t have the open tube that can allow airflow and cause moisture.

While the traditional BTE style has a reputation for being big and bulky, today’s models are sleeker than ever before. They can be designed with custom earmolds or non-custom ear domes to offer a comfortable and secure fit. The earmolds are attached to the hearing aid with tubing or a thin wire, depending on the style.

Generally, BTEs can be used by people with mild to moderately severe hearing loss. They can also be worn by people with more severe or profound hearing loss if they’re fitted with a super-power model, which has additional amplification features to help improve their hearing. Super-power devices typically come with a full load of hardware, including volume controls and a programme button, as well as a telecoil for access to induction loop systems at venues like churches, conference centres or the post office.

Receiver-in-canal (RIC)

RIC hearing aids, also known as RITE or receiver-in-the-canal are an advanced and inconspicuous solution for those with mild to moderate levels of hearing loss. Their inconspicuous design and advanced technology make them a popular choice with wearers, who can benefit from a clearer sound quality than BTE devices.

The main shell of a RIC device sits discreetly behind the ear, with a thin wire connecting it to an inner earpiece that fits into your ear canal. This allows the device to deliver a natural listening experience, while offering powerful amplification.

These devices are smaller and lighter than BTE models, making them more comfortable to wear. They are often reported to produce some of the most natural-sounding results of all types of hearing aids, thanks to their two-part design. The receiver rests inside the ear canal, funnelling sounds directly into your ear, while the speaker rests closer to the microphone, reducing feedback noises and whistling.

In recent years, RICs have become even more advanced with the introduction of bluetooth connectivity and other technological features, such as directional microphones. These features allow users to more effectively hear voices and other sounds from a specific direction, which can be particularly helpful for people with high-frequency hearing loss.

However, despite their popularity and powerful technology, RIC devices have several drawbacks to consider. For example, the thin tube that runs into the ear can easily get clogged with wax or moisture. This can affect performance and can lead to a loss of sound if not cleaned regularly. Additionally, these devices are not ideal for those with dexterity issues as they can be difficult to grasp and guide into the ear.

Another potential disadvantage is that they are not as durable as other hearing aids, meaning they are more susceptible to damage and require more frequent repairs. This can add up to a higher cost over time, and it may not be the most budget-friendly option for some consumers. Lastly, RICs are not as effective at addressing more severe forms of hearing loss, compared to BTE or ITE options.

Open-fit

Unlike the BTE styles, open-fit hearing aids leave your ears’ canal completely open for sound and air to pass through. This gives a more natural feel, with the added benefit of allowing low-frequency sounds to come through in their fullness rather than feeling plugged up. They are the most discreet BTE style of all and can even be fitted on the NHS.

The slim tube that holds the soft tip sits a short distance into the ear canal, rather than blocking it. This allows you to hear your own voice as normal and may help with a distorted or muffled self-image. Open-fit hearing aids are also less likely to get clogged with earwax and cosmetics, meaning you’ll be able to use them longer without the frustration of having them constantly blocked up.

Studies have shown that open-fit hearing aids reduce objective occlusion and improve own-voice perception, sound quality and localization performance. They are also favored by users for their more comfortable fit. However, the benefits of an open-fit design are not entirely without drawbacks. In addition to the occlusion effect, there is also a risk of feedback from acoustic leakage of the dome itself.

To minimize the risks, it is important that all patients be provided with a high level of training and support to ensure correct use and care. Additionally, if you are experiencing problems with feedback or aural discomfort, it is worth discussing the option of switching to another type of hearing aid with your hearing healthcare professional.

The RIC and ITE styles of open-fit hearing aids are the most popular because they offer a good balance of sound quality, comfort and cost. They are capable of a higher level of amplification than other types, and can be fitted with advanced features for noise suppression, adaptive microphones, personalization and wireless connections to mobile phones, TVs, personal audio players and public assistive listening systems. However, because of their small size and location, they are not suitable for those with severe or profound losses. They are also susceptible to aural feedback and can be more difficult for people with dexterity issues to manage.