Types of hearing aids
Hearing Aids come in a huge variety some hearing aid types will suit you and some will not. We have outlined the main types of hearing aids so that you can make a more informed choice before having the hearing test.
Main Types of Hearing Aids
Behind the ear hearing aids
Behind the ear (BTE) these hearing aids are by far the most common type you will find on the market. They are made so you have a plastic shell that houses a range of computing components which sits behind your ear. This is then attached with either a standard tube which leads to a plastic mould that fits into your ear (earmold) or a thin tube that has a soft tip (dome) on the end and goes into the opening of your ear canal (this is an open fitting).
The Advantages Of BTE Hearing Devices
Good all-round hearing solutions
BTE hearing aids normally have a lot of tech packed into them this can range from wireless, Bluetooth, volume control and telecoils. The telecoil is often an under-utilized addition in the hearing aids, but they can be great for connecting to loop systems in public buildings like conference centres, banks, shopping centres and church. Although technology is moving forward and the telecoil will eventually be replaced, it already has a very good infrastructure which if switched on are ready to be used
Reliable hearing aids
BTE hearing aids very rarely stop working and they are probably the most reliable hearing aids. The reason behind them being very reliable is due to all of the components being protected in the case behind the ear this means wax and moisture is highly unlikely to reach the internal of the hearing aid. Most hearing aids today have some sort of water resistance and dust protection which means the failing are even less likely to occur, if anything does go wrong it is usually due to a manufacturer defect.
Easy To Use
BTE hearing aids are fairly easy to use most people will get on with them depending on the model. With rechargeable technology coming in, it is getting even easier. However, there will always be some difficulty if someone’s dexterity or vision is really bad but this will be the same for all types of hearing aids. Overall BTE hearing aids can be a great choice.
The Disadvantages of BTE Hearing Devices
BTE cleaning can be and normally is a bit of a pain, this is normally due to having to push a very thin piece of wire down and up inside the thin tube, it is something that has to be taken off the main unit before doing so other wise it can cause issues.
BTE hearing aids are bigger, they have to be. This is because the speaker sits in the plastic housing. It also has most of the features. This will mean it’s bigger, please do not let anyone say that they are just as discreet, they are not. Not only is the size of the unit bigger the thin tube is more noticeable that that of a RIC / RITE product.
The argument however, BTE hearing aids generally are not given the same full functionality as its slightly smaller brother the RIC / RITE. This is because the market is moving more towards these slightly smaller more discreet hearing aids. While, the main buyer of the BTE hearing aids is by the NHS and NHS contractors. This means they have to be cheaper. And if you placed a top of the range BTE against a top of the range RIC / RITE you would find it difficult to find a BTE that would be as good. If you had to pay £4000 for a pair would you not want the smaller ones?
Receiver in the ear hearing aids (RITE) / Receiver in the canal (RIC)
RIC / RITE hearing aids are very similar to BTE hearing aids. The main difference is that with RIC / RITE hearing aids, instead of a tube sitting in the canal of the ear it is a piece of very thin wire which has a very small speaker at the end of it. RIC / RITE hearing aids are normally a lot more discreet than the standard BTE hearing aids and can be used for almost any hearing loss type.
The Advantages of RIC / RITE Devices
As mentioned above RIC / RITE products are very discreet devices, although much like the BTE the body of the hearing aid sits behind the ear however, unlike the BTE the body or housing of the hearing aid are usually very small and unobtrusive. Realistically unless someone is checking that you have hearing aids on, they will normally go unnoticed.
Changing Receivers is easy
Now this is important the little wire piece we have mentioned with the speaker on it can be easily changed. This is great for many reasons. For example, if you had a mild hearing loss that changed to a severe hearing loss the Hearing aid dispenser (HAD) could change the receiver part to account for your hearing loss. This understandably stops you having to replace the whole unit. It will also mean if the receiver part fails, it does not need to be sent back for repair instead be changed immediately by the HAD.
As mentioned in the BTE section, RIC / RITE have a huge amount of functionality, from Bluetooth, volume control, telecoils and wireless. Meaning you can do everything and sometimes more than that of an BTE has to offer.
The Disadvantages of RIC Devices
Where the receiver is placed in the canal it can be seen as both a good and a bad thing. This is because the placement exposes it to the hostile environment of the ear. Your ear canal is normally around 37C and is home to moisture such as sweat and oil. These things you can imagine are not very conducive for electronic products. Understandably the manufacturers go to great lengths to protect the receivers with nano coating materials. They do this by using enclosed casings and wax guard protectors. However, unless these are taken care of correctly and you change your wax guards when you should, wax will inevitably get into them.
When wax does get into the filters it can block the amount of sound transferred to the ear. Ultimately if the wax and moisture manage to penetrate into the receiver it will destroy it. However, the receivers are able to be quickly replaced by a hearing professional. While under a warranty period the receivers generally will not cost you anything. However, once this period is over it may start to cost you. The receivers tend to be a relatively small cost usually £30-40, but over time this could add up.
Could be Too Small
As mentioned before, RIC products can be very discreet devices. This, understandably will mean the battery will usually be smaller. With both the size of the hearing aid and battery, it can cause difficulties for those with dexterity issues. Hearing aids are there to be used to enjoy the benefits of hearing. However, sometimes this can be overshadowed by the usability of them. Again, this can be true of the batteries, as the smaller the battery the harder it will be to handle. With the batteries being an issue can lead to frustration ending in not wearing the hearing aid. Unfortunately, this is not just an issue of the RIC products but with all products needing a battery. Thankfully, there have been some huge strides into the rechargeable market of recent which has made these hearing aids a lot easier to use.
ITE and ITC hearing aids
In the ear (ITE) hearing aids fill the area just outside the opening of your ear. ITE and ITC aids have all of the working components in side of the earmould. They tend to be slightly bigger than the in the canal ITC hearing aids. Unlike the BTE and RIC products these cannot be seen from behind but instead can be seen from the side.
ITE and ITC aids are generally suitable for most people with a hearing loss. However, this starts to change when there is a severe to profound loss. If you have a very small ear canal or are prone to a lot of ear infections these type of hearing aids may not be the best choice for you.
CIC and IIC aids
Completely in the canal (CIC) and invisible in the canal (IIC) hearing aids are some of the smallest types of hearing aids available to buy. These types of aids fit further in the ear that the ITE and ITC, making them less visible. Understandably, these hearing aid types are not available on the NHS but can be brought privately.
CIC and IIC hearing aids cannot be used with all types of hearing loss. They are typically suited for people with a mild to moderate hearing loss. As well as this due to the lack of space you do see a lot of the functionality go. We will come into more detail about this.
Extended wear hearing aids
Finally, on this list we will talk a little about extended wear hearing aids. These devices are implanted into the ear canal and stay there for up to 2 months. They can only be put in and replaced by a specially trained audiologist. As you may expect, this type of hearing aid is more expensive on a year by year basis.
The Advantages Of Custom Hearing Devices
Generally, you can expect these items to be very discreet and when you get to the invisible aids they are in fact, invisible. The larger devices like the ITE and ITC are of course not as discreet. They will be seen from the side plainly.
Easy To Handle
Due to all the components being in one unit, they tend to be easier to handle. Especially if you are not as dexterous, it can be a lot easier to place this type in the ear. Even more so with the larger ITE and ITC.
The Disadvantages of Custom Hearing Devices?
Receiver and Microphone Issues
Like RIC devices, the receiver is placed in the ear canal and again this placement exposes not just the receiver but all of the electronic components. This includes the microphones. Although the manufacturers take great care to protect all of the electronics including both the receivers and the microphones. A lot of the onus is placed on you to look after them correctly. It includes changing your wax filters when you should and making sure you clean the microphones. If this is not done religiously, it will most likely lead to possible failures.
When the inevitable happens, the aid may just need a filter change. However, if this does not fix the issue there is a strong possibility that the wax etc has destroyed the receivers or microphones. It is highly unlikely that anything other than the microphones and receivers have failed due to the wax etc. If and when they do fail, this is something you hearing aid dispenser (HAD) cannot repair. Therefore, it will need to be sent back to the manufacturer. This does take time and will mean that you will have to wait up to 4 weeks. You will not be charged for these repairs within a warranty period. However as soon as you are outside the warranty costs can vary and sometimes not be worth the repair.
Make sure you ask about the warranty when looking to purchase these hearing aids. If you feel these are the type of aids you do want, be prepared to keep an excellent cleaning routine. This should be given to you by your HAD.
Maybe Too Small
Again, as mentioned about the RIC products these can be very small. Especially if you go for an IIC. If you are not very dextrous these may not be the best product for you but ask the HAD as they will be able to guide you correctly. The hardest part like almost all hearing aids will be the batteries like we have mentioned before. However, like the other devices the bigger the hearing aid the bigger the battery.
CROS and BiCROS hearing aids
What are they?
These type of hearing aids are usually used for people that suffer from single sided deafness (SSD). The contralateral routing of signal or CROS were designed so someone that cannot hear from one side would be able to perceive the sound from their better ear. The CROS system is not normally a hearing aid but will look similar. It transfers the sound through the use of having a microphone and amplifier but no speaker.
CROS and BiCROS hearing aids are something most people will not have to think too much about. They can help if you’ve lost hearing in one ear but will depend if you can get on with them. The aids generally come as a pair, the side which does not hear will send the signals through either a wire or wireless to the other ear to be heard. As technology has moved on you will very rarely see one with a wire, even from the NHS.
If you need these types of hearing aids the HAD will normally take you through what to expect and how they work.
Bone Anchored aids
These hearing aids are very different to your normal hearing aids. Bone anchored aids will require the user to go through a minor surgical procedure. This is because the person wearing it will have an issue in the middle ear stopping the signals reaching the cochlear. This device bypasses the middle ear and sends the signal directly into the cochlear through vibration.
When getting the surgery, they will create a small square like incision into the skin behind the ear. They will then place and screw the plate into the skull. It will then be able to send the vibrations clearly into the cochlear which in turn will create the sound that’s transferred to the brain.
The surgery will normally be on the NHS but you can also have this done privately. This option should be used if hearing aids will not work.