5 Types of Hearing Aids and How To Choose the One for You

Published August 22nd, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Chris Riley

Since their inception, hearing aids have helped raise the quality of life for millions of people with debilitating hearing loss. 

Hearing loss is one of the most prevalent conditions in the world, affecting adults and children alike.

According to the World Health Organization, hearing loss affects roughly five percent of the world’s population. 

While it is true that hearing aids are an important tool in hearing care, they are not a cure for hearing loss.

They do, however, help enhance a person’s hearing and speech comprehension.

Choosing the right hearing aid depends largely on your degree of hearing loss.

What Are Hearing Aids?

Hearing devices have been around for many decades. The first hearing aid was invented at the turn of the 20th century — though it wasn’t very practical.

According to the National Institute on Deafness and Other Communication Disorders, a hearing aid is a small electronic device that helps magnify and amplify sound vibrations that enter the ear. They sit in (or behind) the ear. 

In short, hearing aids help amplify sound vibrations that enter the ear.

They can make sounds louder for patients with hearing loss, helping them listen and communicate better. 

Hearing aids have three basic parts:

  • Microphone. This is where sound waves are received. These sound waves then convert to electrical signals.
  • Amplifier. The amplifier is where the electrical signals are received from the microphone and are increased (amplified).
  • Speaker. The amplified sound goes to the speaker (receiver).

How Can Hearing Aids Help?

Hearing aids can help those with sensorineural hearing loss. This hearing loss typically occurs due to normal aging and happens gradually over time.

Age is the strongest predictor of hearing loss among adults (ages 20 to 69).

This age-related hearing loss occurs when the functions of the auditory system degenerate or experience damage to the auditory nerve or small sensory cells (hair cells) in the inner ear.

Of course, hearing loss can also be a result of heredity, disease, medications, or environmental factors. 

Essentially, hearing aids magnify the sound vibrations that enter the ear.

The surviving hair cells can detect these vibrations, converting them to neural signals and sending them to the brain. 

In short, the greater the damage a person has to their hair cells, the more severe the hearing loss.

Profound hearing loss resulting from hair cell damage would require a hearing aid with powerful amplification. 

Do All Hearing Aids Work in the Same Way?

Not all hearing aids work the same. They operate differently depending on the type of electronics inside. The two main types of electronics used in hearing aids are analog and digital.

Analog Hearing Aids 

Analog hearing aids turn sound waves into electrical signals, where they are then amplified.

Analog hearing aids are adjustable, custom-built, and programmed for each user by the aid manufacturer and an audiologist. 

Analog hearing aids tend to be less expensive than digital aids.

Digital Hearing Aids 

Digital hearing aids also convert sound waves, but instead of electrical signals, these sound waves are converted into numerical codes before they get amplified.

This numerical code is similar to binary code used in computers. 

Digital hearing aids allow for more programming and flexibility for adjusting to a user’s needs. They also tend to be more expensive. 

5 Types of Hearing Aids

Hearing aids come in a variety of styles and sizes.

While style is certainly important, the biggest factor when choosing the right hearing aid will depend on the severity and degree of your hearing loss. 

The degree of hearing loss must be determined by a hearing care professional, such as an audiologist or otolaryngologist.

These hearing healthcare professionals will be able to perform a hearing test to evaluate the extent of your hearing loss and give you direction on hearing aid options. 

There are five main types of hearing aids. Let’s take a look at each style in more detail. 

1. Behind-the-Ear (BTE) Hearing Aids

Behind-the-ear (BTE) hearing aids use a hard plastic case behind the ear that connects to a plastic earmold, which is usually a custom fit.

A small tube joins the hearing aid to the custom earmold and fits inside the ear canal.

Sound travels from the hearing aid microphone through the electronics and into the speaker in the earmold. BTE hearing aids are suitable for people of all ages and work for most degrees of hearing loss, from mild to severe. 

According to the Food and Drug Administration, BTE is the style most often chosen for children with hearing loss since it allows them to change earmolds as they grow. 

Benefits

  • They are much easier to use, clean, and handle than other hearing aid styles. 
  • They typically boast a longer battery life than smaller devices.

Drawbacks

  • They may pick up more background noise than other styles. 
  • They are much bulkier and more noticeable than other styles. 

2. Mini BTE and Open-Fit Hearing Aids

There are also variations of BTE hearing aids, mainly mini BTE aids and open-fit style hearing aids.

The mini BTE, sometimes called “on-the-ear,” can fit behind or on the ear. It is much smaller and thinner than the traditional BTE.

While BTE hearing aids can pair with a traditional earmold, these BTE variations also feature a comfortable earpiece for an “open fit.” In short, it helps solve the issue of visibility. They are so small that they can barely be seen. 

Benefits

  • They have a much smaller profile than traditional BTE hearing aids. 
  • They usually don’t require an impression for fitting. 

Drawbacks

  • They work best for people with mild hearing loss. 
  • They are more expensive than traditional BTE hearing aids. 

In-the-Ear (ITE) Hearing Aids

In-the-ear (ITE) hearing aids fit completely inside the outer ear. All the electrical components and parts are in hard plastic.

ITE comes in two styles: full shell, which fills most of the outer ear, and half shell, which fills only the lower part of the outer ear. 

Most ITE aids feature small magnetic coils known as telecoils. These allow users to receive sound through the hearing aid's circuitry rather than a microphone.

ITE hearing aids make great options for those with mild to severe hearing loss.

Benefits

  • ITE hearing aids are one piece and have no extra tubes.  
  • They come in multiple color options to accommodate different skin tones. 

Drawbacks

  • They are more noticeable canal-style hearing aids. 
  • They are susceptible to clogging from earwax buildup. 

Canal-Style Hearing Aids

Canal-style hearing aids are the smallest and most discreet style of hearing aids available.

They fit in the ear canal, partly or completely, depending on the type. 

The in-the-canal (ITC) style hearing aid is custom fit to the size and shape of the wearer’s ear canal. A completely-in-canal (CIC) hearing aid is smaller and nearly invisible in the ear canal.

However, the small size of canal hearing aids can make them difficult for some people to handle, adjust, and remove. These styles are generally for people with mild to moderate hearing loss. 

Benefits

  • They are the most discreet hearing aids available. 
  • Using a phone is easier with canal-style hearing aids.  

Cons

  • Due to their small size, they can be clogged from earwax much more easily.
  • They don’t have many features, programmable buttons, or manual controls. 

Receiver-in-Canal (RIC) and Receiver-in-the-Ear (RITE)

The receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles of hearing aids are very similar to BTE hearing aids.

They feature a receiver (speaker) that sits in the ear canal. 

These are much smaller than BTE hearing aids. Rather than a tube, RIC and RITE use a tiny wire to connect the small receiver. RIC and RITE hearing aids are appropriate for mild to moderate hearing loss. 

Pros

  • They are more discreet than BTE-style hearing aids. 
  • They are known to have fewer feedback issues than other styles. 

Cons

  • They are more visible than canal-style hearing aids. 
  • They are more susceptible to earwax clogging and moisture than BTE styles.

How Can I Choose the Best Type of Hearing Aid?

The best hearing aids are going to be the ones that work best for you. As we have seen, different types of hearing aids are available; each comes with unique advantages and drawbacks.

Some features are important to consider when choosing a new hearing aid. 

Additional Features To Consider

  • Directional Microphone. Since these allow sound to be amplified from a certain direction, they are useful for conversing in noisy environments.

  • Direct Audio Input. This feature allows you to plug in a remote microphone directly to devices, such as TV, computers, radio, etc.

  • Noise Reduction.  Most hearing aids come with some sort of noise reduction feature, but the amount of noise reduction varies.

  • Rechargeable Batteries. Some hearing aid styles feature rechargeable batteries. This makes life easier and eliminates spending time and money changing batteries.

  • Wireless Connectivity. Many hearing aids feature a wireless interface. This allows you to link with Bluetooth devices like smartphones, computers, etc.

  • Remote Controls. Remote control options allow you to adjust certain hearing features straight from your smartphone.

Final Considerations Before Choosing Hearing Aids

Hearing aids can be a costly investment. Before diving in, consult a hearing specialist to get your hearing tested.

Also, it is important to consider your future needs as your hearing loss will likely change over time. 

Make sure you’re familiar with all the latest features and choose one that will work for you now and in the future.

Conclusion

Hearing aids have helped millions of people raise their quality of life. But choosing the right one can be a daunting task. But no need to fret. 

Before you take the plunge and spend the money, consult a hearing care professional and familiarize yourself with all the options to make the best decision for your hearing health and wallet.

For more on all things hearing and hearing loss, and other hubs to help you navigate your health, explore the USA Rx blog here.

References, Studies and Sources:

Deafness and hearing loss | WHO

Hearing Aids — Styles/Types & How They Work | NIDCD

Quick Statistics About Hearing | NIDCD

Age-Related Hearing Loss (Presbycusis) | Johns Hopkins Medicine

Types of Hearing Aids | FDA