Comparing Hearing Aids

Previously bulky and unsightly, hearing aids have come a long way in the last few years. Modern devices are significantly smaller and more effective than their older counterparts, and manufacturers have moved away from a ‘one size fits all’ approach.

These days, there are multiple types and styles of hearing aids available, each with different strengths and weaknesses depending on level of hearing loss, aesthetic preferences, lifestyle needs, and budget. Presented below is a brief overview of some of the options currently available on the market.

Types Of Hearing Aids

Air Conduction Hearing Aids

Hearing Aids vary greatly in size, price, style and even where they are placed in the ear. Here are some common air conduction hearing aid styles along with their advantages and disadvantages, which will hopefully assist you in finding the right product. Air conduction aids typically treat those with a sensorineural hearing loss, this is the most common type of hearing loss and is often caused by aging and repeated exposure to loud noise.

Behind-The-Ear (BTE): This is the most common hearing aid style. It hooks over the top of the ear and rests behind. The BTE is attached to a custom-made earmold by a thin, clear plastic tube. This style is very commonly chosen for young children as the earmold can be replaced as the child grows.

Advantages

• Easy to clean and maintain. This type of hearing aid rarely needs repair.
• Ideal for most people, no matter the age or degree of hearing loss.
• The microphone and receivers are separated so feedback is less of an issue than other models. This also means it is capable of greater amplification.

Disadvantages

• Typically the largest hearing aid styles but have been streamlined in recent years.
• May pick up more wind noise than other styles.
• If earmolds are present in the aid they will most likely need to be remade every 2-4 years to preserve the acoustic seal.

In-The-Ear (ITE): Custom made hearing aid where all parts are contained in a shell that fits within the lower portion of the outer ear.

Advantages

• The majority of these aids have twin microphones which means they will deliver a much clearer sound when in noisy environments. They are also extremely good at picking up high-frequency sounds.
• Due to the placement, the wearer is able to use telephones and headsets normally, as there is no obstruction.
• No external tubes or wires, very easy to use and the larger size of these aids make them easier to clean and handle.

Disadvantages

• People with poor motor control or eyesight may have difficulty replacing the battery or operating the controls.
• Higher risk of needing to be repaired due to moisture and earwax. Cleaning them often, even daily, is necessary.
• The microphone and receivers are closer together than other models so feedback may be an issue.

In-The-Canal (ITC) – Custom made hearing aid, contained in a tiny case that fits in the ear canal with the smaller portion showing in the outer ear.

Advantages

• They are small in size and cosmetically appealing. They are smaller than the ITE hearing aid but larger than the canal styles that sit completely in the ear.
• The microphone placement on the device offers the wearer a natural sound reception and, if the aid is large enough, they can feature dual microphones which mean they work well in noisy environments.
• Custom made to fit in your ear canal for optimum comfort.

Disadvantages

• Not suitable for all types of hearing loss. May not suit people with steeply sloping hearing loss.
• The position in the ear can make the wearer feel occluded.
• This type of device is, again, more susceptible to damage from moisture and earwax.

Completely-In-Canal (CIC) – The hearing aid is encased and fits in the canal of the ear so that only the tiny removal handle shows.

Advantages

• Small and very discreet, it is the least visible type of aid as only the removal handle is outside of the ear canal.
• Sound quality is typically good due to the location in the ear and wind noise is less likely to be picked up by the microphone.
• High level of comfort when worn and convenient to use with a telephone and headphones.
• No issue with wearing eyeglasses.

Disadvantages

• The aid’s smaller size means a shorter battery life and fewer features than some of the larger models.
• Manual dexterity is needed to clean and maintain them.
• The position in the ear can make the wearer feel occluded.
• Susceptible to damage from moisture and earwax. Typically, it is the receiver (the small loudspeaker) which fails. In this case, the hearing aid will be sent away for a loudspeaker replacement.

Receiver-In-Canal (RIC) – This is similar to the BTE aid, except the clear plastic tube is replaced by a tiny wire to connect the receiver.   

These are great for first time hearing aid wearers as they are discreet, easily fitted, and powerful.  

Advantages

• Ideal for most people regardless of age and degree of hearing loss.
• Due to the placement of the loudspeaker (sitting inside the ear canal), the size of the aid is reduced, becoming impressively discreet even for those who experience severe to profound hearing loss.
• Greater separation between the microphone and receivers,  meaning fewer feedback problems compared with other models.

Disadvantages

• If earmolds are present in the aid they will most likely need to be remade every 2 – 4 years to preserve the acoustic seal. If ear tips are present they will have to be changed periodically.
• Due to the loudspeaker being in the canal they are more prone to failure than other types, however, replacing this in a RIC device is an easy job that can be done in a hearing aid centre rather than needing to be sent away.

Invisible Products – Custom made to rest in the second bend of the ear canal. Only removal handle is visible.

Advantages

• Easy to remove for better ear health.
• Completely invisible in most ears.
• May be a good option for first time hearing aid users.

Disadvantages

• The position in the ear can make the wearer feel occluded.
• Higher risk of needing to be repaired due to moisture and earwax.
• Higher price range.

These types of hearing aids use amplification to treat hearing loss, amplification only works if the inner ear, also known as the ‘organ of hearing’, or the cochlea, is damaged (but not too severely). All the other pathways have to be clear and working well in order for the sounds to be cleanly transmitted all the way to the inner ear.

Bone Conduction Hearing Aids (BCHA)

Conventional air conduction hearing aids have a fundamental role in rehabilitating hearing loss, but they do have their limits. When it comes to severe sensorineural, conductive, or unilateral hearing loss, these sound amplifying hearing aids may not be a reliable option.

Bone conduction or Bone-anchored hearing aids are typically used in cases of conductive hearing loss or unilateral hearing loss. If a person has single-sided deafness, a BCHA or BAHA can pick up the sounds from the direction of the head with the bad ear, send the vibrations across

Bone conduction hearing aids create vibrations that are sent across the skull to the inner ear, directly stimulating the cochlea where these vibrations are perceived as sound. So if there is an issue with the outer and middle ear components, the process of transmitting sound by air can be bypassed.

The bone conductor is either held in place by a headband, which presses the audio processor to the skull, or by an adhesive pad stuck behind the ear, which the processor attaches to.

Bone Anchored Hearing Aids (BAHA)

BAHA’s work in the same way, they collect sounds and convert them into mechanical vibrations which are sent through the skull directly into the inner ear. The audio processor is attached by an abutment, or a magnet, that is surgically implanted into the temporal bone behind the ear.

The external audio processor is attached to the skull via an embedded abutment or magnetic attachment, which is surgically implanted into the temporal bone. The processor picks up sound waves and converts them into electrical signals. These signals are then transmitted through the skin or abutment to the implant which is fixed in the temporal bone.

The implant converts the signals into mechanical vibrations which are transmitted to the skull bone, these vibrations naturally move across the skull to the inner ear.

The inner ear processes the mechanical vibrations in a similar way to natural hearing and transmits this acoustic information to the brain. It can take some time for the brain to get accustomed to receiving this new type of information and recognising it as sound. It is recommended to work with a professional to make the initial period of adjustment as comfortable as possible.

Features of Hearing Aids

Most hearing aid suppliers have a pricing tier of silver, gold, and platinum, with silver generally being the most affordable and widely available across all tiers. For example, Behind-The-Ear aids can range from $1,000 to $6,000 dollars depending on which features are present on the device.

Most styles now feature Bluetooth/wireless, noise reduction, and basic remote controls. If you are looking for higher technology features such as feedback suppression, direct audio input, and rechargeable batteries then you may need to look into the gold and platinum ranges.

This is where speaking to a hearing practitioner could be useful. They can go through the features you are looking for and you can directly compare and try different styles of hearing aids before committing to one. You can also request brochures and pamphlets to get a better idea of price ranges for suitable hearing aids.

Choosing the right hearing aid is something that should be discussed with a professional audiologist. Click here to book a free hearing test now.