The Pros and Cons of In-the-Ear, Behind-the-Ear, and Completely-in-Canal Hearing Aid Styles

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The comparison of hearing aid styles reveals distinct advantages, guiding individuals to make informed choices based on personal hearing needs.
The Pros and Cons of In-the-Ear, Behind-the-Ear, and Completely-in-Canal Hearing Aid Styles

For those with hearing loss, hearing aids can be an absolute game changer. These devices allow people to once again hear conversations, music, and all those subtle ambient sounds that add richness to daily life. Thanks to major technological advances, today’s hearing aids are smaller, more powerful, and more adaptable than ever before.

When selecting a hearing aid, one of the most important choices is the style – whether in-the-ear, behind-the-ear, or completely-in-canal. Each style has unique advantages and disadvantages that can impact comfort, sound quality, size, ease of use, and other key factors. Understanding these differences will ensure you find the best match for your individual hearing needs and lifestyle.

We planned to explore the pros and cons of the three prominent hearing aid styles:

  1. In-the-Ear (ITE)
  2. Behind-the-Ear (BTE)
  3. Completely-In-Canal (CIC)

We’ll also discuss key considerations when choosing a style, as well as provide an FAQ and summary of best practices. Let’s get started!

How Do Hearing Aids Work?

Photo of a transparent hearing aid revealing the internal components, positioned next to a human ear to suggest the concept of sound transmission and hearing assistance. There should be an abstract representation of sound waves emanating from the hearing aid into the ear without any text or numbers.
Photo of a transparent hearing aid revealing the internal components, positioned next to a human ear to suggest the concept of sound transmission and hearing assistance. There should be an abstract representation of sound waves emanating from the hearing aid into the ear without any text or numbers.

Before diving into specific styles, it helps to understand exactly how hearing aids work their magic.

All hearing aids have the same basic components:

  • A microphone picks up sounds from your environment.
  • An amplifier makes sounds louder so they are audible.
  • A speaker delivers the amplified sounds into your ear canal.
  • A battery provides power.

Hearing aids also contain a processor chip that analyzes incoming sound signals and adjusts amplification based on your specific hearing loss prescription and program settings.

The device receives sound through the microphone, analyzes and amplifies it digitally, and then sends it to the speaker to transmit into your ear. The goal is to make soft sounds audible while keeping loud sounds at comfortable levels.

Hearing Aid Styles Overview

Photo of a row of silicone ears in various skin tones, each wearing a different style of hearing aid (in-the-ear, behind-the-ear, and completely-in-canal), arrayed on a soft gradient background that implies a broad overview without the need for text.
Photo of a row of silicone ears in various skin tones, each wearing a different style of hearing aid (in-the-ear, behind-the-ear, and completely-in-canal), arrayed on a soft gradient background that implies a broad overview without the need for text.

Now let’s look at how the three main styles differ in their positioning of these key components:

  • In-the-ear (ITE) – All components fit in a custom housing that sits in your outer ear bowl.
  • Behind-the-ear (BTE) – The amplifier, processor, and battery housing sit behind the ear with a tube transmitting sound into the ear canal.
  • Completely-in-canal (CIC) – All components are miniaturized to fit completely within your ear canal.

The location differences impact factors like size, visibility, sound quality, ease of use, and more, as we’ll explore next.

In-the-ear (ITE) Hearing Aids

Illustration of an array of in-the-ear (ITE) hearing aids in various colors and sizes, spread out on a surface that resembles a wooden table, with a soft focus on the background to draw attention to the ITE hearing aids at the forefront.
Illustration of an array of in-the-ear (ITE) hearing aids in various colors and sizes, spread out on a surface that resembles a wooden table, with a soft focus on the background to draw attention to the ITE hearing aids at the forefront.

ITE hearing aids fit completely in your outer ear bowl. A customized housing is made from an ear mold to match the exact shape of your ear. The microphone, amplifier, battery, and speaker output all fit inside this single housing.

ITE Pros

  • Comfortable, secure fit within the ear bowl
  • Enhanced sound quality and spatial awareness due to positioning
  • More volume control options from venting

ITE Cons

  • It is more visible than other styles as it fills the ear bowl.
  • Smaller battery capacity equals shorter battery life
  • It may not fit small ears well.
  • Harder battery access for those with dexterity challenges

ITE hearing aids are best for:

  • Moderate to severe hearing losses that need more amplification
  • Those who desire optimal sound localization
  • People without frequent ear infections

Behind-the-ear (BTE) Hearing Aids

Photo of a series of behind-the-ear (BTE) hearing aids in different colors and designs neatly lined up on a reflective glass surface, showcasing the variety without the use of text.
Photo of a series of behind-the-ear (BTE) hearing aids in different colors and designs neatly lined up on a reflective glass surface, showcasing the variety without the use of text.

BTE hearing aids have two separate components – one behind the ear and one in the ear canal.

The plastic casing behind the ear houses the microphone, amplifier, battery, and processor. This connects to a customized eartip placed inside your ear canal via slim transparent tubing.

BTE Pros

  • Can accommodate more powerful amplifiers
  • Larger batteries for longer wear time
  • Easier to manipulate for those with dexterity issues
  • There is less feedback since the microphone is further from the speaker.

BTE Cons

  • The external component makes them more visible.
  • Some dislike having tubing resting in the ear canal.
  • It may be less effective for spatial hearing or wind noise.

BTE hearing aids work well for:

  • Mild-to-moderate hearing losses that need less amplification power
  • Children due to size needs and dexterity challenges
  • Very small or unusual ear shapes

Completely-in-Canal (CIC) Hearing Aids

Photo of an assortment of completely-in-canal (CIC) hearing aids placed on a smooth stone surface, highlighting the small size and discreet design of the aids.
Photo of an assortment of completely-in-canal (CIC) hearing aids placed on a smooth stone surface, highlighting the small size and discreet design of the aids.

As the name denotes, CIC hearing aids are positioned entirely inside your ear canal. All components are miniaturized to fit in a custom housing near your eardrum.

CIC Pros

  • Nearly invisible appearance
  • Uses your ear’s natural shape to amplify sounds
  • Less amplification is needed due to proximity to the eardrum.

CIC Cons

  • Can cause discomfort with extended wear
  • Higher risk of feedback with amplification
  • Tiny batteries with shorter lifespans
  • Difficulty with handling and battery changes
  • More prone to moisture damage from earwax

CIC hearing aids work best for:

  • Mild-to-moderate hearing losses
  • Those highly concerned about discretion
  • People without dexterity challenges

Key Hearing Aid Style Considerations

Photo of a person with medium skin tone sitting at a table with various styles of hearing aids (in-the-ear, behind-the-ear, completely-in-canal) in front of them, reflecting contemplation and comparison without any text.
Photo of a person with medium skin tone sitting at a table with various styles of hearing aids (in-the-ear, behind-the-ear, completely-in-canal) in front of them, reflecting contemplation and comparison without any text.

Choosing the right hearing aid style is a very individual decision based on your needs and preferences. Keep these factors in mind when deciding:

Degree of Hearing Loss

CIC and ITE styles can better serve moderate to severe hearing losses needing more amplification power. Mild losses usually do well with BTE amplification.

More on this topic:

Manual Dexterity

Smaller CIC and ITE aids require good dexterity to manipulate settings and change batteries. BTE is the easiest style to handle.

Ear Size and Shape

Very small ears or unusual anatomy may not accommodate ITE or CIC styles well. Custom molding is required.

Environment and Activities

Frequent high moisture or dust exposure? Go with BTE or ITE. Is wind noise a problem? ITE works better.

Discretion Preferences

If keeping your hearing aid invisible is important, CIC is the least visible option. BTE components are obvious.

Child Use

BTE styles are commonly recommended for children due to sizing needs and dexterity challenges.

There is no one “best” hearing aid style overall. The right choice depends entirely on your unique considerations. Discuss your lifestyle, challenges, and preferences with a hearing specialist. Together, you can select the optimal model that fits your needs.

Hearing Aid Style FAQs

Still, have questions about hearing aid styles and which may be right for you? Here are answers to some frequently asked questions:

Which hearing aid style is the smallest?

Completely-in-canal (CIC) hearing aids are the smallest style. All components fit in a casing located deep within your ear canal for a nearly invisible look.

What is the most powerful hearing aid?

Behind-the-ear (BTE) hearing aids can accommodate the most powerful processors and amplifiers as the components sit outside the ear. This style can provide the most amplification for severe hearing loss.

What hearing aid has the best sound quality?

In-the-ear (ITE) hearing aids are customized to your exact ear shape for the best sound localization and spatial awareness. Their position in the ear bowl enhances sound quality.

Which hearing aids are the most discreet?

Completely-in-canal (CIC) hearing aids are the most discreet and invisible option since everything sits within the ear canal. Only a small removal handle is visible.

What hearing aids do professionals recommend?

For children and those with dexterity concerns, professionals often recommend behind-the-ear (BTE) styles for easier handling and battery changes. BTE hearing aids also accommodate growing ear canal sizes.

Can you wear hearing aids in the shower?

No, most hearing aids are not waterproof enough for showering. However, some water-resistant behind-the-ear (BTE) styles can tolerate sweat and humidity. Remove hearing aids before showering or swimming.

How do you clean hearing aids?

Use a soft, dry cloth or brush to wipe away earwax and debris from your hearing aid. Never use water, solvents, or alcohol, which can damage components. Have your audiologist deep clean aids every 3-6 months.

What dries out hearing aids?

Excessive moisture and earwax can clog or corrode hearing aid components. Always wipe away wax each night and invest in a dehumidifier kit or drying capsule to absorb excess moisture from your hearing aids.

Can I wear hearing aids all day?

Most hearing aids are designed for all-day wear. However, adjusting to consistent wearing takes time. Slowly increase your hours of use per day to allow your ear canal to become accustomed to the aid. Take short breaks if you are very sore.

How do I choose the right hearing aid style?

Schedule a consultation with an audiologist to discuss your degree of hearing loss, dexterity, ear size, activities, discretion concerns, and other needs. They will make personalized recommendations on which style may be best for you.

Key Takeaways

  • The three main types of hearing aid styles are in-the-ear (ITE), behind-the-ear (BTE), and completely-in-canal (CIC).
  • ITE hearing aids offer great sound quality but are visible and require good dexterity.
  • BTE hearing aids are more powerful but have external components. They are easiest to use.
  • CIC hearing aids are nearly invisible but can cause discomfort and be difficult to manipulate.
  • Consider factors like hearing loss severity, ear size, discretion desired, dexterity, and activities when selecting a style.
  • Discuss your lifestyle and needs with an audiologist to choose the right hearing aid style for you.

Knowing the pros and cons of different hearing aid styles will ensure you find your perfect match. There are excellent options available in all styles to improve hearing ability. With custom programming tailored to your loss and activities, you can soon be hearing the world around you with greater ease and clarity.

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