Hearing Aids

What is a hearing aid?

A hearing aid is a medical device for people with hearing loss. Hearing aids are worn in or behind the ear and they amplify sound. It is important to understand that although hearing aids make sounds louder, they do not restore normal hearing. Depending on the type and cause of the hearing loss, sounds may be distorted or unclear, even when they are amplified to audible levels. For this reason, management of hearing loss may include other aspects (e.g., auditory training, communication strategies, speechreading etc.) in addition to hearing aids.

How does a hearing aid work?

Hearing aids are electronic devices and they require batteries to power them; some devices are rechargeable. Virtually all hearing aids that are dispensed today are digital. All hearing aids contain the same basic components to amplify sounds. A microphone picks up sounds in the environment. Then, an amplifier makes the sounds louder. The amplifier is on a computer chip that converts the sound to a digital signal. The hearing aid analyzes the signal and makes specific adjustments to the signal based on the degree of the person’s hearing loss. Finally, the digital signal is converted back to sound waves that are sent to the ear by a speaker (also called a receiver). Hearing aids are able to give different amounts of amplification to soft, medium and loud sounds due to signal processing technology called “compression.” This helps ensure that the hearing aid doesn’t amplify loud sounds and make the listener uncomfortable.

What types of hearing aids are there?

Behind-the-ear (BTE)

Behind-the-ear (BTE) style hearing aids sit behind the ear and are attached to a custom mold that sits in the ear canal via plastic tubing. This style of device can accommodate the widest range of hearing losses (i.e., mild to profound).

Receiver-in-the-ear (RITE)

Receiver-in-the-ear (RITE) hearing aids, also called receiver-in-the-canal (RIC) hearing aids, sit behind the ear with a thin wire that connects the instrument to the receiver or speaker that sends the sound into the ear. The receiver tends to be attached to a dome that allows sounds to enter the ear canal naturally and causes less occlusion. This style is often recommended for individuals with high-frequency hearing losses, such as those associated with aging.

In-the-ear (ITE)

In-the-ear (ITE) style hearing aids fit in the ear canal and fill the bowl of the outer ear (pinna). This style of hearing aid is generally appropriate for mild to severe hearing losses. It can be a good option for individuals with dexterity issues due to the size and relative ease of manipulation.

In-the-canal (ITC)

In-the-canal (ITC) hearing aids may be appropriate for mild to moderate hearing losses. These devices fit into the ear canal and fill a small portion of the bowl of the outer ear (pinna).

Completely-in-the-canal (CIC)

Completely-in-the-canal (CIC) hearing aids are even smaller and less visible than ITC devices. Because of the size, there are often features that cannot be included in this style of device. CIC devices are also appropriate for mild to moderately-severe hearing loss.

Invisible-in-canal (IIC)

Invisible-in-canal (IIC) hearing aids sit deep inside the ear canal. Depending on the brand and type, some IIC devices must be professionally placed and remain in the ear for months at a time. These devices are appropriate for mild to moderately-severe hearing losses.
Your hearing care professional will recommend which style may be the best option for your needs. It is worth noting smaller devices require smaller batteries which have less battery life. Additionally, some circuitry options and features may not be available in smaller devices. Furthermore, styles that are positioned in the ear may be more prone to issues of earwax and drainage of the ear.

Who needs hearing aids?

There are different types and causes of hearing loss. Hearing aids are most often recommended for sensorineural hearing loss, which is due to damage in the cochlea (the bony, snail-shaped structure that contains the sensory organ for hearing) and/or the auditory nerve. Your hearing care professional can help you determine whether you are a candidate for hearing aids. Hearing aids are appropriate for various degrees of hearing loss.

You may have hearing loss if you start to notice difficulty understanding people talking in different situations, such as on the telephone or in meetings and restaurants. People often report feeling like people are mumbling in conversations. Additionally, you may notice that you prefer a louder setting for the volume on the radio and television. If you notice any of these difficulties, it is recommended that you see an audiologist to ascertain your hearing status.

How do you get a hearing aid?

Hearing aids are typically dispensed by licensed hearing healthcare professionals, such as audiologists or hearing instrument dispensers. The process typically begins with a comprehensive audiological evaluation to determine the severity of the hearing loss. In some cases, a medical evaluation may be recommended prior to being fitted with hearing aids to address underlying medical issues. Examples of some situations may include when the amount of hearing loss is different in each ear or if the hearing loss is accompanied by dizziness and/or tinnitus.

Congress passed the Over-the-Counter Hearing Aid Act of 2017 to increase accessibility and affordability of hearing instruments. At this time, the U.S. Food and Drug Administration has not yet approved over-the-counter hearing aids for sale. Therefore, there are no hearing aids that are currently sold over the counter directly to patients without the need for a hearing test. Personal sound amplification devices (PSAPs) are ear-level listening devices that are available for consumers to purchase for themselves. PSAPs are designed to amplify environmental sounds. They are not medical devices, nor are they intended to address hearing loss.

All your hearing aid questions answered below