Hearing Aids for Severe Hearing Loss: What To Know

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

Mild hearing loss is a very common condition that affects millions of people worldwide.

In most cases, it is simply a result of aging. But severe hearing loss poses more difficult issues. 

Severe hearing loss is a debilitating condition that makes the simplest tasks of daily life hard to manage.

It can make life feel limited, conversations harder and harder to enjoy and leave you feeling isolated. 

Thankfully, there are solutions for those struggling to manage severe hearing loss.

Many high-quality hearing aid options on the market can help get you back in the conversation and restore auditory function. 

What Is Hearing Loss?

Hearing loss is a condition that occurs when your auditory system stops functioning properly.

According to the National Institute on Deafness and Other Communication Disorders, age is the strongest predictor of hearing loss among adults (ages 20 to 69). 

Roughly one in three people between the ages of 65 to 74 have some hearing loss.

This hearing loss is normally due to age-related hearing loss, known medically as presbycusis. 

But hearing loss is not just an issue for older adults; it can affect anyone at any age.

It also varies in degree, ranging from mild to profound hearing loss. 

Here are a few signs and symptoms that could indicate issues with hearing loss:

  • Constantly struggling to understand speech, especially in noisy environments.
  • Having to ask people to repeat themselves multiple times during conversations. 
  • Needing to turn the volume up louder and louder on the TV or radio.
  • Having issues hearing someone speak over the telephone. 
  • Not being able to discern high-pitched voices (like children or women). 
  • Issues hearing because of background noise.
  • Having to read lips to understand what people are saying.

A hearing care professional should evaluate the level of hearing loss in the audiology field who is trained to perform a hearing test. 

What Are the Types of Hearing Loss?

As a condition, hearing loss fits into two main categories: conductive and sensorineural.

A third category, mixed hearing loss, is simply a combination of the two.

Conductive Hearing Loss

Conductive hearing loss is typically the result of an obstruction in the ear canal or some sort of trauma to the ear structures. 

Sound cannot pass through the outer, middle, or inner ear through obstruction or trauma, resulting in hearing loss. It can be temporary or permanent.

Some causes of conductive hearing loss:

  • Impaction of earwax (cerumen) in the ear canal.
  • Small items obstructing the ear canal.
  • Trauma, like fractures to the ossicles (bones in the middle ear).
  • Ear infections that cause fluid buildup.
  • Rupturing an eardrum.

Sensorineural Hearing Loss

Sensorineural hearing loss is a much more common condition and is typically the result of normal aging.

This type of hearing loss usually occurs gradually over time as the auditory system degenerates or there is damage to the inner ear or auditory nerve.

Although it is less common, sudden sensorineural hearing loss can also occur.

Sensorineural hearing loss is generally permanent.

It is this type of hearing loss that benefits most from hearing devices like hearing aids or cochlear implants.

Some other causes of sensorineural hearing loss besides normal aging include:

  • Illnesses and diseases like Ménière's disease, autoimmune inner ear disease, cochlear otosclerosis, or benign tumors.
  • Medication side effects contributing to sensorineural hearing loss. 

Degree of Hearing Loss

Before the journey to finding the right ear hearing aids can begin, you must understand the degree of hearing loss you have.

Generally, a healthcare professional like an audiologist will perform a hearing test. 

You may be told you have mild, moderate, or more severe hearing loss.

These descriptions refer to the degree of hearing loss.

Hearing is measured in decibels (dB). Hearing tests measure how loud sounds need to be for you to hear them. 

Those with a mild to moderate degree of hearing loss will have a decibel range from 26 to 55 dB, making soft sounds difficult to hear.

Those with moderately severe to profound hearing degrees of hearing loss will have a decibel range of 56 dB and beyond. 

How Do I Choose Hearing Aids for Severe Hearing Loss?

The market has hundreds of different types of hearing aids.

As discussed, step one in the journey to better hearing is to get evaluated by a hearing specialist. 

If they determine that hearing aids are right for you, the next step is understanding how they work and which styles will work best for your needs. 

What Is a Hearing Aid?

A hearing aid is a small electronic device worn in (or behind) the ear. In simple terms, a hearing aid helps magnify sound vibrations entering the ear.

A greater degree of hearing loss requires a more powerful hearing aid. 

Hearing aids make some sounds louder, allowing those with hearing loss to listen and communicate better.

They can also help individuals hear better in both noisy and quiet environments. 

While hearing aids can’t cure hearing loss or improve hearing health, they help improve a person’s hearing and speech comprehension.

This alone can help raise a person's quality of life. 

Hearing aids, regardless of the type, have three basic parts:

  • Microphone: Where sound is received and converted to electrical signals.
  • Amplifier: Where electrical signals are received and increased.
  • Speaker: Where amplification is delivered (sometimes called a receiver).

What Style of Hearing Aid Should I Choose?

Your hearing experience with hearing aids depends largely on the device you choose.

What works well for one person may work differently for another, so it is important to understand all the options.

Typically, hearing aids for those with severe hearing loss are known as “power hearing aids” or “super power hearing aids.”

It is as the name implies. Hearing aid styles are differentiated depending on where they are in/around the ear. 

Hearing aids fit into four main categories:

  • Behind-the-ear (BTE)
  • Canal: Completely-in-canal (CIC) and In-the-canal (ITC)
  • In-the-ear (ITE)
  • Receiver-in-canal (RIC)

Behind-the-Ear (BTE)

This hearing aid is made to hook over the top of the ear and rests just behind the ear.

A small tube joins the hearing aid to a custom earmold that fits inside the ear canal. BTE can work for most degrees of hearing loss, including severe hearing loss. 

Pros

  • They’re easier to clean than other hearing aid styles. 
  • Typically have a longer battery life than smaller devices.

Cons

  • They are known for picking up background noise, like the wind.
  • They are larger and more noticeable than other styles. 

A great BTE choice for those with severe hearing loss is ReSound One.

This BTE hearing aid features a 25-hour rechargeable battery life, three microphones, and a four-year warranty. It is a pricier option.

Canal

Canal hearing aids, as the name implies, fit right into the ear canal.

They are available in two main styles: in-the-canal (ITC) and completely-in-canal (CIC). 

Typically these are custom fit for the size and shape of each wearer’s ear canal.

The one advantage of the CIC is that it is nearly hidden completely. 

Pros

  • They’re less visible and more discreet than larger hearing aids.
  • They are easier to use with a phone. 

Cons

  • They can be more susceptible to clogging from earwax.
  • They can be difficult to remove and adjust. 

A great canal choice for those with severe hearing loss is Signia Silk X.

This CIC is great for tinnitus relief, features Bluetooth connectivity, and requires no wait time for a custom fit.

It is on the pricier side and does not feature a rechargeable battery. 

In-the-Ear (ITE)

ITE hearing aids come in two styles that fit inside the outer ear.

One style only fills the lower part of the outer ear (half shell), while the other style fills most of the outer ear (full shell).

Directional microphones make good options for those with mild to severe hearing loss. 

Some ITE aids may have certain added features installed, such as a telecoil.

A telecoil is a small magnetic coil that allows users to receive sound through the hearing aid's circuitry rather than through its microphone.

Pros

  • They work well with directional microphones and telecoils. 
  • Have longer battery life as compared to smaller styles. 

Cons

  • More visible than canal-style hearing aids. 
  • Prone to clogging from earwax buildup. 

A great ITE choice for those with severe hearing loss is Oticon Opn. The Oticon Opn is available as a half or full-shell ITE.

It supports both Bluetooth wireless technology and telecoils and is available in multiple skin tone options. 

Receiver-in-Canal (RIC)

This style of hearing aid features a receiver that sits inside the ear canal.

While very similar to BTE hearing aids, the RIC uses a tiny wire instead of a tube to connect the speaker/receiver. 

Pros

  • They tend to be less visible than BTE styles. 
  • They have fewer feedback issues than other styles.

Cons

  • Not the best choice for those with profound hearing loss. 
  • More prone to earwax clogging than BTE styles.

A great RIC choice for those with severe hearing loss is Phonak Audeo Paradise.

This RIC-style hearing aid features a rechargeable battery and is Bluetooth-enabled — it can pair with up to eight different devices.

It also features a myPhonak app to help control microphone and noise-canceling settings. 

Final Things to Consider Before You Buy

  • Consult a Hearing Care Professional. Before investing, it is important to have your hearing tested by a hearing specialist (audiologist). They can also advise on which hearing aid style might work best for your needs. 
  • Consider Your Future Needs. Become familiar with the different hearing aid features and choose one that will still work for you if your hearing worsens. 
  • Plan for the Cost. Quality hearing aids are not cheap. Knowing your needs and budget is important before making a costly purchase. Also, make sure you understand the hearing aid warranties.

Conclusion

Choosing the best hearing aids to match your needs can be daunting.

New hearing aids can cost hundreds if not thousands of dollars. 

It is important to understand the styles and features that will work for you.

Severe hearing loss can be a discouraging condition to live with; thankfully, there are plenty of hearing aid options to help make life a little easier. 

For more articles on all things hearing loss and all things health, explore the rest of the USA Rx blog here

References, Studies and Sources:

Quick Statistics About Hearing | NIDCD

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

Degree of Hearing Loss | ASHA

What Is Tinnitus? — Causes and Treatment | NIDCD

What is a Telecoil? | ASU Speech and Hearing Clini