When it comes to hearing aids, there are a wide variety available. Things have moved on considerably from the traditional over-the-ear design. Choosing the right one for your needs and lifestyle is important if you are to gain the maximum benefit from your new hearing aid.

In this article we examine how hearing aids work, the types of hearing aids available, and the additional features that can be included when choosing your hearing aid.
How do hearing aids work?

The basic function of a hearing aid, whether analogue or digital, is to detect and process sounds before converting them into electrical signals, amplifying them, then transmitting the sound into the ear. All of these processes happen within microseconds of the sound occurring, so that users experience no discernible delay.

While there are different styles of hearing aids on the market, they all work in the same way and have the same parts. There are four principal components: the microphone; the amplifier; the receiver; and the battery. For digital hearing aids, there is also a microchip, which allows settings to be personalised to the individual’s needs.

The microphone is located on the outside of the hearing aid. The amplifier sits in the ear. While analogue hearing aids can adjust to the level of sound around them, digital hearing aids are much better at doing so, as the microchip processes and analyses sounds. Digital hearing aids can distinguish between those sounds that need to be heard, for example speech, and those that are unwanted, such as background noise.

Different hearing aid styles

There are six main styles of hearing aids, all of which have their benefits and disadvantages.

Behind The Ear

The most traditional style of hearing aid, the Behind The Ear – or BTE – hearing aid, hooks over the ear with the microphone located behind the ear. A tube connects the microphone to the earpiece, which is customised to fit the individual’s ear, and which sits in the ear canal. BTE’s are suitable for all levels of hearing loss.

Modern designs of the BTE are much more streamlined and less visible than traditional designs, and this style amplifies sound better than other styles. However, this has a downside as this model can pick up more wind noise than other designs.

Open Fit

Similar to a BTE, an Open Fit has a thin tube that conducts the sound. This style allows for more natural sound as it keeps the ear canal open. This allows lower frequency sounds to enter the ear canal naturally, while amplifying higher frequency sounds that may not be heard naturally. This design is best suited for those with mild to moderate hearing loss.

The advantages of the Open Fit style are that they are less visible than a traditional BTE design and, because it doesn’t plug the ear, the user’s voice sounds more natural to themselves. However, the small parts may make this style harder to handle and adjust than a BTE.

Receiver in Canal or Receiver in the Ear

The Receiver in Canal (RIC) and Receiver in the Ear (RITE) designs are also similar to a BTE, but these have a wire rather than a tube connecting the microphone to the amplifier. Like the Open Fit, these are more discreet and less noticeable than a traditional BTE but they are prone to earwax clogging the amplifier, making cleaning them properly particularly important.

Completely in the Canal

A Completely in the Canal, or CIC, is an individually moulded hearing that sits, as the name says, completely in the ear canal, making it extremely discreet and almost invisible. It’s best suited to those with mild to moderate hearing loss.

Its location means that it’s less likely to pick up wind noise, but the very small size of this style means that it has very small batteries with a shorter life span, and which can be tricky to handle. As it sits in the ar, it can be prone to earwax clogging the amplifier.

In the Canal

In the Canal (ITC) hearing aids are also individually moulded, and these sit partly in the ear canal. They’re suitable for mild to moderate hearing loss. Again, they’re discreet but can be prone to clogging from earwax. Because they are slightly larger than a CIC, they have more features but their small size can make them difficult to adjust.

In the Ear

In the Ear designs, or ITE’s, are available in three styles: a full shell which fills the bowl-shaped area of the ear; and a half shell, which fits only the lower half. Whichever design you choose, they are suitable for mild to severe hearing loss.

Just like the ITC, ITE’s include more features than smaller hearing aids, and they’re easier to handle. The larger battery means that they have a longer battery life than smaller devices. However, they are less discreet than CIC or ITC hearing aids and may pick up more wind noise. They’re also susceptible to ear wax clogging the amplifier.

Other features

In addition to their appearance, hearing aids can vary dramatically in terms of features:

  • Rechargeable batteries: these remove the need to fiddle with small batteries making the hearing aid easier to use.
  • Directional microphones: these are designed to detect sounds coming from in front of the listener, while reducing sounds from other directions. These are better for use in noisy environments.
  • Telecoils: telecoils can be used anywhere there is an induction loop system, or with telecoil-compatible telephones for improved sound.
  • Wireless connectivity: many modern hearing aids can now wirelessly connect to Bluetooth compatible devices, such as mobile phones, televisions and music centres. An additional compatible device may need to be installed for this feature. Alternatively, direct audio input allows you to plug directly into a television, computer or music centre.
  • Remote control: some hearing aids can be controlled with a remote control to adjust it without the need to touch the aid for more discreet adjustments.
  • Variable programmes: some hearing aids offer pre-programmed settings designed to work better in different environments for an improved hearing experience.
  • Environmental noise control: hearing can be difficult in noisy environments, even with hearing aids, Some hearing aids are able to cancel out background noise. Wind noise can be an issue with several types of hearing aid and some offer wind noise reduction.
  • Synchronisation: many people with hearing loss wear hearing aids in both ears. Synchronisation allows the aids to be programmed to function together so that any changes to one hearing aid will automatically occur in the second hearing aid.

Choosing a hearing aid

With so many designs and features, the best way to find the right hearing aid is to visit a qualified audiologist, such as the Hearing Centre. We will discuss your needs and preferences, and work with you to find the ideal solution for your hearing loss.

What our clients say

Two members of my family have just received excellent advice and treatment at the Chichester Centre.

My husband for ear plugs advice and my 12 year old son, who has been suffering with excessive ear wax building up for the past year or so and being told by GP that can do nothing except keep putting drops in.

Within 15 minutes he had his ears safely unblocked, using micro suction and washing, something the GP said was not available. My son is like a different child and can actually hear again.

Thank You!

Mr J Llewellyn – Chichester patient
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