Logo Transparent

What You Need to Know About Hearing Aids


Untreated hearing loss can damage your physical, emotional, and social health and well-being, but studies by the National Council on Aging and the Seniors Research Group indicates that wearing hearing aids can lead to impressive improvements in the social, emotional, psychological, and physical well-being of people with mild to severe hearing loss.

This document provides essential information on hearing aids…it assumes that a comprehensive audiologic assessment was conducted to:

  • identify the type and extent of hearing loss through a hearing evaluation
  • determine the need for medical/surgical treatment and/or referral to a physician
  • determine the need and motivation for audiologic rehabilitation

Once hearing aids are selected to match the type and degree of hearing loss, lifestyle choices, and budget…they will need to be fitted and adjusted. Successful hearing aid fitting is a complex process and will be covered in a separate document.

Digital Hearing Aids

Digital hearing aids use a microprocessor to convert incoming sounds into digital information. Then they analyze and adjust the sounds to suit a user’s hearing loss characteristics and listening needs. More than 70 % of fitted hearing aids contain Digital Signal Processing (DSP).

Digital hearing aids contain a growing list of hearing-enhancing features. For example, they can suppress background noise so you can hear speech better. They can also detect whether you are in a quiet or noisy environment and automatically adapt to changing conditions. Wireless technology such as Bluetooth can stream desired sounds directly to your hearing aids from many electronic devices, including cell phones, TVs, MP3 players, iPods, computers, GPS devices, FM systems, and more. Current technology trends include truly invisible, extended wear hearing aids, and models with tinnitus management programs. A more thorough discussion of Digital technology and hearing aid batteries technology.

Levels of Technology

Digital hearing aids are available with various levels of the technology listed above, each designed to fit specific lifestyles and listening needs. For example, it makes little sense to purchase top-level technology if your lifestyle doesn’t require it. On the other hand, an active social life may dictate a higher technology level. Since higher technology levels are progressively more expensive, many people need to compromise between listening preferences and personal budgets.

Higher technology levels allow greater listening clarity, especially in challenging environments. People with active social lives may require this added flexibility to fully embrace their listening needs. Mid-level technology may be sufficient to fully accommodate the needs of moderately active people. Most people fall into this category. Basic technology will tend to limit speech clarity to relatively quiet environments. Lower technology levels may be more appropriate for less active individuals and/or budget-restricted consumers. A more thorough discussion of hearing aid features vs. lifestyle and cost can be found here.

Hearing Aid Styles

Completely-in-the-canal (CIC)

The smallest hearing aid on the market. It usually requires a “removal string” due to its small size and the fact that it fits so deeply into the canal. Accommodates mild to moderate hearing loss.

In-the-canal (ITC)

This is slightly bigger than the CIC. It provides more options than a CIC. Accommodates mild to moderate hearing loss.

In-the-ear (ITE)

This fills the whole “bowl” of the ear. It may be easier to handle due to the larger size. Accommodates mild to moderately severe hearing loss.

Behind-the-ear (BTE)

The BTE sits behind the ear and transmits sound into the ear canal via an ear mold. One of the more flexible hearing aids. Accommodates mild to profound hearing loss.

BTE Micro

The BTE micro can be open fit or fit with a conventional ear mold. It is micro-sized for greater discretion. Accommodates mild to moderate hearing loss.

Open Fit

A small plastic case rests behind the ear, and a very fine clear tube runs into the ear canal. Inside the ear canal, a small, soft silicone dome or a molded, highly vented acrylic tip holds the tube in place. These aids offer cosmetic and listening advantages and are used typically for adults.

Receiver-in-the-ear (RITE)

With this BTE, the speaker of the hearing aid sits inside the ear canal providing more natural sound. Accommodates mild to severe hearing loss.

Invisible (extended wear) Hearing Aids

These hearing aids are non-surgically placed deep in the ear canal by a qualified audiologist. They are worn continuously for several months at a time without removal and then replaced with new hearing aids.. The devices are made of soft material designed to fit the geometry of the ear. They are very useful for active individuals because their design protects against moisture and earwax, and they can be worn while exercising, showering, and other daily activities.

Let the Buyer Beware

Don’t make a purchasing decision based only on price, stated technology, or emotion. Some of the low priced digital hearing aids cut important corners to reduce their price, by reducing or eliminating most of the benefits of digital technology. Also, you can’t assume high quality merely because a hearing aid is advertised as “digital”. It is possible for an analog hearing aid to produce better hearing quality than a budget digital hearing aid…and that isn’t saying much! On the other hand, high-end, high quality digital hearing aids can create a bad listening experience if they aren’t programmed and fitted correctly, or fine-tuned during follow-up visits.

There is no substitute for a well-qualified Audiologist using state-of- the-art hearing aid fitting technology with effective post-fitting counseling!

The Bottom Line

Hearing aids have become smaller and less conspicuous while offering an array of advanced features such as digital signal processing, automatic switching between listening programs, adaptive directional microphones, noise management, and remote controls. Some of these features are for convenience and ease of use, while others are designed to improve your speech understanding or listening comfort. An audiologist will work with you to find the best hearing aids for your degree of hearing loss, lifestyle, and personal financial goals. Information eGuides from the Better Hearing Institute can be found here

About the Author: Dr. Ha-Sheng Li-Korotky is the President and co-founder of Pacific Northwest Audiology (www.pnwaudiology.com), based in Bend, Oregon (see back inside cover). The Doctor is a nationally acclaimed clinician and research scientist, with AuD, PhD, and MD credentials and more than 100 scientific publications.