Behind-the-Ear Hearing Aids: Hearing Aids Come in All Shapes

Hearing aids come in all shapes, colors, and sizes. As an audiologist, it is my job to help my patients choose the style that is most appropriate for their lifestyle and hearing loss. One style that I get a lot of questions about is the behind-the-ear (BTE) type. Many people think of them as large clunky instruments that weigh down the ear and are highly visible. This may have been true in the past, but not so anymore.

When examining the BTE family, there are actually three main sub-types of instruments. First is the standard or traditional BTE which consists of an acrylic or silicon earmold attached the hearing aid by a length of tubing. The second type is a slim tube or thin tube BTE; it is connected via tubing that is very thin and much more discreet to either a standard plastic dome piece or an earmold. The last member of the BTE family is the Receiver-in-the-Ear (RITE) or Receiver-in-the-Canal (RIC) type. With this kind of aid the behind-the-ear device is connected via a wire to a speaker or receiver that is in the ear; this receiver is covered with a soft plastic dome or imbedded in an earmold. There are many advantages to this versatile family of hearing aids. 

Fitting Range: In comparison to most other styles, BTEs have the widest fitting range—they can be appropriate for those with mild hearing loss all the way up to profound. They achieve this flexibility by coming in a variety of sizes and levels of power. More powerful instruments tend to be on the larger side of the spectrum. 

Visibility: Some of the smaller slim tube and RITE/RIC BTEs are barely visible on the ear. The hearing aid casing is made to closely match a person’s skin or hair color and the ultra thin tubing or wire fits snuggly against the side of the ear. They are easily able to blend in.

Durability:  In the slim tube and standard BTE styles there are not any electronic pieces directly in the ear. These somewhat delicate electronic parts remain further away from wax and debris of the ear canal. This can mean possibly fewer repairs down the road for those patients that have issues with wax. 

Cleaning: In this style the dome or earmold can be removed for easy cleaning. This can be an advantage for those patients who have excessive cerumen production or occasional ear drainage.

 Moisture: As most or all of the electrical components are located outside the ear canal, the hearing aid is less susceptible to moisture damage. This style is often more moisture resistant than any other. Though you should never immerse your hearing aids in water, some manufacturers claim that their BTEs can be made waterproof!! 

Battery Life: The average BTE has a larger battery than some other models. This can mean a longer life and less need to change batteries. This is also one of the only styles that come in a rechargeable battery option.

Size Changes: As we gain or lose weight, or as we grow, our ear changes size as well. It can be cheaper to replace an earmold or dome for a different size than to re-case an entire hearing aid to fit the new ear size. 

Colors: BTEs and earmolds come in a variety of colors. They can be made to match your skin or hair color and effectively blend in. There are generally more color choices with this style than with any other.

Open Fitting: For those patients with some areas of normal hearing, slim tube and RIC/RITE aids can be fitted with different size domes that allow some sound naturally into the ear canal. This more open fitting utilizes those preserved areas of normal hearing and can provide a more natural listening experience. 

Venting: In the BTE style, earmolds can possibly be made with larger venting with less chance of feedback. A larger vent may be desirable to decrease the occlusion effect. The occlusion effect occurs when the outer portion of a person's ear canal is blocked or plugged up. The person may perceive a hollow or booming echo-like sound quality of their own voice. Decreasing this effect, may help to make the wearer’s voice sound more natural.

Behind-the-ear devices are currently one of the most popular styles of hearing aids on the market. They are more functional, versatile, durable, and much smaller than the BTEs of old. The smaller and more streamline designs have given them a great advantage and their ability to fit more “openly” helps them have a more natural sound. In-the-ear hearing aids are still a viable option for many individuals but if you haven’t thought about BTE instruments, the game has changed. Talk to your audiologist about all the available hearing aid options…. 

For further information regarding different hearing aid styles please visit: http://www.affinityhearing.com/hearing-aids/hearing-aid-styles/

Sarah Nordberg, AuD is an audiologist at Affinity Hearing in Plymouth.  She may be reached at 763-744-1190 for any questions.  Affinity Hearing provides free hearing screenings and hearing protection consults to the general public.