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Hearing Loss
May 22, 2024
7min

In-the-Ear vs. Behind-the-Ear Hearing Aids

In this guide, we'll examine the main differences between two popular hearing aid styles: In-the-Ear and Behind-the-Ear Hearing Aids. Click here to read all about it!

Author:
Nicole Brener
In-the-Ear vs. Behind-the-Ear Hearing Aids
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If you're shopping for hearing aids, you've probably encountered an overwhelming number of choices. With different styles, brands, and prices, the many options might make it harder to choose the best one for you. 

In this guide, we'll examine the main differences between two popular hearing aid styles: In-the-Ear and Behind-the-Ear Hearing Aids. 

After learning about their specific features and considering your unique preferences and hearing needs, you'll be able to make an informed decision. However, we advise you to consult an audiologist to ensure the best treatment selection.

In-the-Ear Hearing Aids

In-the-ear hearing aid

In-the-ear (ITE) hearing aids are custom-fitted hearing devices that sit entirely within the outer ear. Most in-the-ear hearing aids are molded to the shape of the ear canal, ensuring a snug and comfortable fit. 

The custom mold process requires a visit to an audiologist to get a precise impression of the shape of your ear to match your hearing aid, much like a dental mold impression.

The different types of in-the-ear hearing aids include:

  • In-the-ear (ITE)

This is the largest in-the-ear hearing aid style, effectively treating mild to severe hearing loss. 

  • In-the-canal (ITC)

In this case, a small part of the hearing device is visible in the outer ear. It’s also suitable for people with mild to moderate hearing loss.

  • Completely-In-the-canal (CIC)

This hearing aid device fits completely inside the ear canal, with only a small removal handle visible in the outer canal. While the small design makes it easy to use with headphones and phones with little interference and feedback, it is limited in battery life and volume control.

  • Invisible-In-the-canal (IIC)

As the name implies, this style of hearing aid is “invisible” as it fits completely inside the ear canal. Optimal to treat mild to moderate hearing loss and also ideal for those seeking discrete options. 

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Behind-the-Ear Hearing Aids

Close up of male wearing behind-the-ear hearing aid

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When you think of hearing aids, most likely you envision behind-the-ear hearing aids. These are the most commonly used type of hearing aid, with a visible part sitting behind the ear connected to a tube that fits the earpiece in the ear canal. This type is appropriate for all ages.

  

Behind-the-ear hearing aids can address every degree of hearing loss and some models are available over the counter. Given their larger size, they can pack larger batteries and powerful amplifiers, delivering clear and amplified audio directly to the ear canal.

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This type of hearing aid also includes additional features such as noise reduction, directional microphones, wireless connectivity, and remote controls. 

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Choosing Between In-the-Ear Vs. Behind-the-Ear Hearing Aids

Choosing the right hearing aid for you should be based on several deciding factors. 

Comfort level

  • In-the-Ear: For some, the molded fit can create discomfort, especially for those with sensitive ears.
  • Behind-the-Ear: For some, the plastic behind-the-ear hearing aids can feel uncomfortable and interfere with wearing glasses or oxygen nasal cannulas.

Hearing loss degree

  • In-the-Ear: ITE aids are typically recommended for mild to moderate hearing loss. 
  • Behind-the-Ear: BTE hearing aids are generally better for more severe hearing loss due to their larger size, accommodating more powerful amplification. However, they can accommodate almost every degree of hearing loss.

Technology

  • In-the-Ear: Not all models feature the latest technology. 
  • Behind-the-ear: BTE hearing aids are generally built with more features, such as tap control, Bluetooth connectivity, Smartphone app connectivity, telecoil options and even remote adjustment capabilities by audiologists.

Maintenance

  • In-the-Ear: They are more prone to moisture and wax buildup since they sit completely inside the ear canal. 
  • Behind-the-ear: These require basic maintenance from wax buildup and dust, but they are slightly easier to clean and maintain. 

Durability 

  • In-the-Ear: Due to their small size, they are considered more delicate devices.
  • Behind-the-ear: Generally more robust and less prone to damage from earwax and moisture.

Visibility 

  • In-the-Ear: They are the most discrete option due to their small size.
  • Behind-the-ear: Generally more noticeable due to their external part resting behind the ear.

Sound Quality

  • In-the-Ear: Produce less feedback and experience little interference.
  • Behind-the-ear: Can sometimes produce feedback noise, especially if not fitted correctly. 

Before you buy

Getting used to hearing aids usually takes a few weeks to a few months. Consistent use and follow-up adjustments with your audiologist can significantly improve this adaptation period. You may want to consider:

Asking about a trial period: Some hearing aids are available for purchase with a trial period, a great perk allowing you to test drive them before committing. 

Check for warranty: Make sure the hearing aids include a warranty or professional services included.

Ask an audiologist: When in doubt, consult with a hearing specialist. They can guide you in the right direction and get the best results.

Your success with hearing aids will depend on patience, goodwill, quality professional care, and proper device maintenance. Remember, getting used to hearing aids is a process, but if you allow it time and practice wearing them in different environments, you’ll gradually become accustomed to them.

Seek support from specialists if you need adjustments, and stay positive!

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Nicole Brener

Copywriter based in Miami, FL. Leads copywriting workshops and mentors women entrepreneurs at the Idea Center of Miami Dade College.

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Nagish Acquires Sign.mt to Drive Research in AI and Sign Language. 
‍Read the announcement

In-the-Ear vs. Behind-the-Ear Hearing Aids

Key Findings

  • Workplace Impact: 62% of Deaf and 66% of Hard-of-Hearing individuals report that communication barriers hinder career mobility.
  • Healthcare Challenges: 62% of Deaf and 66% of Hard-of-Hearing individuals experience communication barriers in healthcare settings, contributing to delays in treatment.
  • Concerns About Emergency Communications: 20% of Deaf and 24.3% Hard-of-Hearing users also expressed serious concerns that communication barriers would prohibit them from contacting healthcare personnel in an emergency situation.
  • Independence Boost: Assistive technology nearly doubled rates of independence, with 60% of Deaf users and 63% of Hard-of-Hearing users reporting increased autonomy.
  • Emotional Strain: 55% of Deaf users and 83% of Hard-of-Hearing users reported emotional distress due to communication frustrations.
  • Social and Professional Opportunities: 46% of Deaf and 32.9% of Hard-of-Hearing users saw improved social and career prospects thanks to assistive technologies.

Empowering the Deaf and Hard-of-Hearing Through Technology: A New Era of Communication and Independence

At Nagish, we’ve seen firsthand just how much communication shapes daily life for Deaf and Hard-of-Hearing communities. Our recent survey highlights the significant barriers they face in the workplace, healthcare settings, and in their social lives. But it also sheds light on a powerful solution: assistive technology. The results of this survey reinforce our commitment to empowering these communities and remind us why our mission matters: with access to the right tools, independence grows, opportunities expand, and well-being improves.

We collected data through a comprehensive survey involving over 300 individuals who are Deaf or Hard-of-Hearing and currently use hearing assistive technology. The survey included 179 Deaf and 140 Hard-of-Hearing participants, with data collected in an inclusive and accessible manner to ensure that everyone could participate and share their experiences without barriers.Communication Barriers in the Workplace: Limiting Career Mobility

Communication challenges in the workplace remain one of the most significant hurdles for Deaf and Hard-of-Hearing individuals, preventing them from fully realizing their career potential. Assistive technology offers a solution by removing these barriers and expanding access to a broader range of job opportunities and career growth.

Download the PDF Report

A majority of Deaf and Hard-of-Hearing participants reported that communication barriers affected their career decisions, making it harder to pursue job opportunities or advance in their careers.

Deaf Participants

Hard-of-Hearing participants

65% of Deaf users rely on assistance from hearing individuals at least once a week to communicate effectively, which can limit their ability to fully engage in dynamic work environments.

Communication Barriers in Healthcare: A Matter of Public Safety
Communication challenges are not just a workplace issue — they extend into healthcare settings, where they can directly impact individuals’ health outcomes. Accessible communication tools are essential for ensuring that Deaf and Hard-of-Hearing individuals can receive timely and accurate medical care, especially in emergency situations

Many Deaf and Hard-of-Hearing users face communication barriers in healthcare settings, which can lead to missed appointments, misunderstandings about medical treatments, and delayed care.

Deaf users:

62%

Hard of Hearing users:

66%

Some Deaf and Hard-of-Hearing users have concerns about reaching healthcare professionals in emergencies, highlighting serious public safety risks.

Deaf users

Hard-of-Hearing users

Empowering Independence Through Assistive Technology
One of the most encouraging findings from our survey is just how much independence is boosted with assistive technology. This improvement in independence is not just about doing things on their own; it’s about having the confidence and ability to engage fully in both professional and personal settings.

Assistive technology has significantly increased the independence of Deaf and Hard-of-Hearing users in managing daily tasks, showing clear improvements after adoption.

Deaf users

Hard-of-Hearing users

Expanding Social and Professional Opportunities
Beyond independence, assistive technology creates connection.By removing communication barriers that keep people from joining in socially or professionallyassistive technology allows users to engage more deeply in social activities and pursue career opportunities that were previously out of reach.

Assistive technology has helped Deaf and Hard-of-Hearing users expand their social networks and professional opportunities, enabling new connections and career growth.

Emotional and Psychological Impact: The Hidden Toll of Communication Barriers
People often overlook the emotional and psychological toll of communication , but they can have a profound impact on the mental well-being of Deaf and Hard-of-Hearing individuals. Assistive technology can help alleviate this emotional strain, empowering users to communicate more effectively and reducing the anxiety associated with relying on others for basic communication.

A significant number of Deaf and Hard-of-Hearing users experience frustration and anxiety when communicating with family and friends, leading to isolation and stress.

Deaf users

Hard-of-Hearing users

Why This Matters: A Call for Widespread Adoption of Assistive Technologies
The findings from our survey are clear: communication barriers continue to limit the lives of Deaf and Hard-of-Hearing individuals in many areas, from the workplace to healthcare to their social lives. What’s also clear to us is that the question isn’t whether assistive technology helps—it’s how quickly we can make this powerful solution universally available.. By making these tools more accessible, we can open up new opportunities for individuals to thrive in their careers, maintain better health, and lead more independent lives.
At Nagish, we are committed to advocating for the integration of assistive technologies in all aspects of life. Whether it’s in healthcare, the workplace, or social settings, these technologies have the potential to create a more inclusive society where Deaf and Hard-of-Hearing individuals can live fully empowered lives. 
Our hope is that these findings inspire not just awareness, but action. We hope this survey creates awareness and action in promoting accessibility and inclusion for these communities. Together, we can create a world where everyone, regardless of their hearing abilities, has equal access to opportunities and services.