Receiver-in-canal (RIC) Hearing Aids

Examples:

Slim RIC Hearing Aids by Signia

RIC Hearing Aids by GN ReSound

Definition and description of RIC hearing aids (RIC & Slim RIC)

Receiver-in-Canal hearing aids are similar to Behind-the-Ear hearing aids in which they are worn behind the ear. The difference is that in RIC hearing aids, the speaker or receiver sits inside the ear canal. They can hold more processors, which makes them better for severe hearing loss. They are beneficial for people with high-frequency sensorineural hearing loss. Many brands carry a slimmer version of RIC, called Slim RIC, for users concerned about the size of the hearing aid.

Advantages and disadvantages of RIC hearing aids

Advantages:

Rechargeable and disposable battery options

Most RIC hearing aids offer rechargeable batteries, although some models with disposable batteries are available.  

Widely popular

The RIC models have become increasingly popular. Therefore, hearing aid manufacturers often add the latest features and technology trends to RIC models, such as Bluetooth connectivity for direct audio streaming, TRT (Tinnitus Retraining Therapy), fall alert and more. 

Excellent sound quality

RIC hearing aids combine the power of a behind-the-ear piece with a receiver channelling sound directly into the ear canal. This combination allows users to have exceptionally good hearing quality.

Externally controlled

Most new models of RIC hearing aids now have a dedicated smartphone application that allows the user to quickly and easily adjust the hearing devices’ volume, settings and different features from their phone.

Disadvantages:

Handling might be tricky

Patients with dexterity issues may struggle to grasp the behind-the-ear piece and guide the tube with the receiver into the ear canal.

Not the best option 
for severe hearing loss

Patients with severe hearing loss may do better with an ITE or BTE, which amplifies more.

Requires cleaning

The receiver should be cleaned every so often to prevent earwax build-up. The RIC hearing aids may not be the best option for patients with recurrent wax build-up or prone to ear infections. 

Interested in RIC or SLIM RIC hearing aids? 

Behind-the-ear (BTE) Hearing Aids

Examples:

BTE Hearing Aids by Oticon

Definition and description of BTE hearing aids

Behind-the-Ear (BTE) hearing aids, as their name suggests, consist of two components: a main plastic unit containing all electronic parts of the hearing device placed behind the ear. A mould or dome receives the sound from the main unit via a tube that connects with the BTE part.The mould is usually made from resin and custom fits the ear canal without completely blocking it. Alternatively, the user can choose to use a soft silicone dome.

Advantages and disadvantages of BTE hearing aids

Advantages:

Easy to maintain

It doesn’t require specialised cleaning, and the maintenance is simpler than in the canal options.

Comfortable to wear

The piece inside the ear canal doesn’t block it completely, making it comfortable.

More affordable

BTE hearing aids usually cost less than other hearing aids.

No direct contact with the ear canal

Useful for patients with small ear canals that cannot fit intra-canal hearing aid units, with chronic ear infections or recurrent wax buildup.

Disadvantages:

Less discreet

Even though modern BTEs are designed to be concealed, with colours similar to skin tones, and sleek designs, BTEs are less discreet than other hearing devices. Because the electronic part sits behind the ear, they will likely be noticed when not hidden behind the hair or headwear.

Not suitable for all types of hearing loss

While BTEs can work for high levels of hearing loss, some types of severe hearing loss benefit more from the improved amplification of other types.

Wind and outdoor noises

These hearing devices can receive more wind noise in outdoor spaces as they sit outside the ear.

In-the-ear (ITE) Hearing Aids

Examples:

ITE hearing aids by Phonak

Definition and description of ITE hearing aids

These hearing aids contain the entire mechanism in a single piece that goes inside the ear. ITE hearing aids sit in the outer bowl of the ear instead of inside the canal. These models are typically smaller than BTEs, with smaller batteries, sound processors, and electronic components. ITE hearing aids are usually custom-made for the unique ear shape of the patient. This customisation aims to maximise comfort so the hearing device sits easily inside the patient’s ear. There is also the option of a generic shell, a one-size-fits-all, but although cheaper, it won’t fit and work as well as a bespoke earpiece. These hearing aids can work for mild to severe hearing loss, although it brings more support for severe hearing loss. 

Advantages and disadvantages of ITE hearing aids

Advantages:

Smaller and more discreet

They are usually skin-toned and not easily noticed outside the ear. 

More comfortable

Custom fit, better suited for an active lifestyle and glasses wearers.

Better amplification

Less prone to feedback or wind noise. The amplification is more powerful.

Supports severe hearing loss

Patients requiring more amplification may benefit from these hearing aids.

Disadvantages:

Require daily cleaning

Failure to clean regularly can lead to earwax impaction or an infection of the ear canal.

More maintenance and repairs

These hearing aids have smaller parts which are more delicate and require repairs. Besides, the very small batteries may be difficult to change for patients with dexterity problems.

They are way more expensive

Because they are custom-made to your ear shape.

In-the-canal (ITC) Hearing Aids

Examples:

ITC Hearing Aids by Starkey

Definition and description of ITC hearing aids

In-the-canal hearing aids are placed inside the ear canal, providing a discreet way to improve the user’s hearing.  They are moulded to fit the patient’s ear, mostly invisible, with only a small portion showing in the outer ear.

Advantages and disadvantages of ITC hearing aids

Advantages:

Discreet

Designed to sit within the ear canal, they are custom-fit according to the shape of each patient’s ear.

Easy to pair with a phone

Because of their small size, many ITC hearing devices can be controlled via smartphone or external controls. Most ITC aids also pair with phones for direct streaming.  

Captures sound more naturally

Since the microphone is placed in the earpiece, it receives the surrounding sounds similarly to the natural ear.

Disadvantages:

Not suitable for all types of hearing loss

ITC hearing aids are not powerful enough to deliver optimal results for patients with severe hearing loss.

Not suitable for patients prone to ear infections

Because of their placement, these hearing aids are counterindicated for patients with excessive or recurrent earwax buildup or who suffer from ear infections.

May be difficult to clean

It is more difficult to clean because of its small size.

Difficult to handle for people with dexterity issues

Patients may find it difficult to change batteries.

Completely-in-canal (CIC) Hearing Aids

Examples:

Signia Silk Charge&Go IX

Definition and description of CIC hearing aids

Completely-in-canal hearing aids sit completely inside the ear canal, practically invisible to the outside world. These devices are naturally very small and made from a mould taken from the patient’s ear canal, which makes them custom fit and very comfortable. One of the characteristics of CIC hearing aids is that they allow the outer ear to conduct the sound towards the ear canal as it happens naturally. As such, many users find improved directionality detection.

Advantages and disadvantages of CIC hearing aid

Advantages:

Not visible

For many users, the reason for choosing a completely-in-canal hearing aid is that they are not noticeable to other people. Only when looking directly inside the user’s ear can they be detected.

Directionality

Because the CIC hearing aids are down in the ear canal, the user can identify where the sounds come from like the natural ear does.

Externally controlled

Because of their placement, CICs don’t have any control over the hearing aid. All settings and adjustments are made via a dedicated remote control or via a smartphone application, so adjusting the hearing aid is discreetly done.

Suitable for an active lifestyle

CIC hearing devices allow users to wear headgear, helmets and headphones comfortably. Their placement also results in reduced wind noise.

Disadvantages:

Limited functions and power

The number of processors and amplifiers are reduced, which makes them less suitable for patients with severe hearing loss. 

Low battery life

They hold very small batteries, so they don’t last very long. Rechargeable CIC hearing aids present a solution to this.

Daily cleaning

These hearing aids require more maintenance than other types to prevent occlusion and damage from ear wax and moisture.

Over-the-Counter (OTC) Hearing Aids

Examples:

OTC by Eargo

Definition and description of over-the-counter hearing aids

Over-the-counter hearing aids are sold directly to consumers in pharmacies, stores or online without needing a prescription. OTC hearing aids offer users a less expensive alternative without seeing an audiologist.

Advantages and disadvantages of OTC hearing aid

Advantages:

Inexpensive

They are typically much cheaper than regular hearing aids.

Available

Patients can buy them in pharmacies, physical and online stores.

Convenient

They don’t need professional settings, audiograms or adjustments.

Disadvantages:

One-size-fits-all

There is no customisation, and they don’t have many options for adjustment. 

Only for very mild hearing loss

They amplify most sounds. People with high-frequency or low-frequency hearing loss and those with severe hearing loss won’t benefit from OTC hearing aids.

You may still need to see an ENT or audiologist

The generic type of OTC  hearing aids may not bring a solution for some users. Conditions like tinnitus, eardrum problems or recurrent infections may need the intervention of an ENT or audiologist.