How to Choose a Hearing Aid Style? Are Behind-the-Ear or Custom Models Better?

Currently, hearing aids on the market can be divided into two main categories: those worn behind the ear and those placed inside the ear. Traditional behind-the-ear (BTE) hearing aids include the classic BTE and receiver-in-the-ear (RITE/RIC) models. Custom in-the-ear hearing aids, which vary in size from larger to smaller, include: in-the-ear (ITE), in-the-canal (ITC), completely-in-the-canal (CIC), and invisible-in-the-canal (IIC). Each type has its own advantages and disadvantages and is suitable for different users. Below, I’ll provide a detailed introduction to the pros and cons of each category and how to choose the right one.
Hearing Aid Appearance Diagram
1. Traditional Behind-the-Ear (BTE) Hearing Aids
These offer a wide range of power options, flexible pricing, and broad applicability, meeting the needs of various degrees of hearing loss. They also include ultra-high-power models suitable for individuals with profound hearing loss (fitting range <120 dB).
As the "elder statesman" of hearing aids, BTEs are mature, reliable, and versatile, with many advantages and broad applicability.
Advantages:
1. For children whose ear canals are still developing, only the soft ear mold needs periodic replacement, ensuring safety and stability. They can also connect wirelessly to speech training devices, facilitating rehabilitation.
2. Due to their larger size, they can incorporate features like dual microphones, telecoils, automatic phone switching, and wireless connectivity to improve comfort and clarity. They are also easy for elderly users with limited dexterity to handle.
3. For users with problematic ear canals, such as those with chronic otitis media or persistent moisture/discharge, BTEs can be a suitable option after consulting an audiologist.
4. Most BTEs use size 13 or 675 batteries, which last longer, reducing the frequency of battery changes and offering convenience and cost savings.
5. Dustproof, waterproof, and shock-resistant, with a durable casing that is less prone to damage.
6. Ready to use immediately after fitting, ideal for users who live far away. Easy to clean and maintain at home by removing the sound tube or ear mold for cleaning.
Disadvantages:
1. Larger size makes them less discreet, which may not suit users who prioritize aesthetics and discretion.
2. Cannot utilize the natural sound-collecting function of the pinna. Since the microphone is located above the ear, phone calls may be less convenient, and feedback (whistling) may occur.
3. May cause discomfort for users who wear glasses or masks regularly, adding pressure to the ears.
2. Custom In-the-Ear Hearing Aids
These have specific requirements for ear canal shape and hearing loss severity, making them suitable for users with mild to moderate or some severe hearing loss who prefer a discreet appearance. Generally, the greater the hearing loss, the larger the device, reducing its invisibility.
As the "rising star" of hearing aids, custom models offer several advantages over BTEs:
Advantages:
1. Custom-made based on ear impressions, ensuring a better physiological fit, improved stability, and reduced risk of slipping or loss.
2. The sound outlet is closer to the eardrum, providing higher fidelity and more natural sound.
3. Utilizes the pinna’s natural sound-collecting function, making phone calls easier without needing to adjust microphone placement. Sound localization is also better.
4. More discreet than BTEs and does not interfere with glasses or masks.
Disadvantages:
1. Requires time for manufacturing, with a waiting period of 1–2 weeks or longer for fitting and delivery.
2. Not suitable for children under 12 whose ear canals are still developing. Frequent shell replacements can disrupt usage and learning, and ill-fitting shells may cause feedback.
3. Not ideal for users with certain ear canal conditions, such as post-surgical changes (e.g., cholesteatoma surgery) or chronic discharge, as moisture can damage the device and hinder ear canal recovery.
4. Limited internal space due to small size, making them unsuitable for profound hearing loss. Some features (e.g., wireless, telecoil) may be omitted, reducing cost-effectiveness compared to similarly priced BTEs.
5. Typically use size 13, 312, or 10 batteries, which have shorter lifespans, requiring frequent replacements that may be inconvenient for elderly users.
6. Made of acrylic, making them more fragile and less resistant to water, dust, and drops compared to BTEs.
7. More prone to wax buildup in the sound outlet, requiring more frequent maintenance to ensure proper amplification.
8. May cause occlusion effects, requiring a longer adaptation period.
3. Receiver-in-the-Ear (RITE/RIC) Hearing Aids
These combine the advantages of BTEs and custom models by placing the receiver directly in the ear canal. They retain most features while being more compact and discreet, reducing ear pressure and delivering more natural sound. The receiver is replaceable, making them cost-effective for users with fluctuating hearing needs without requiring a full device replacement. They also minimize occlusion effects and have a shorter adaptation period.
Disadvantages:
1. Cannot fully utilize the pinna’s natural sound-collecting function.
2. The receiver in the ear canal is prone to wax blockage and moisture damage.
3. May interfere with glasses or masks.
Conclusion
Now that you understand the differences, you can make a more informed decision about which hearing aid style suits you best. Be sure to consider your habits, preferences, and needs—avoid following trends blindly. Just like shoes, what fits others may not fit you! Choose the one that truly meets your requirements.