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

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!