Custom-molded, in-the-ear hearing aids (ITEs) are becoming more popular. They come in several sizes, including “invisible” hearing aids that are not visible to observers. The choice of a hearing aid depends on several factors, including the type of hearing loss, conditions under which the hearing aid will most often be used, individual anatomy, and personal preference.
Different Types of ITEs
ITEs can improve a wide range of hearing loss levels. ITEs sit entirely within the ear and must be fitted individually based on an impression of the wearer’s ear. They come in three different styles, including in-the-canal (ITC), which fits partially inside the ear canal, completely-in-the-canal (CIC), which fits entirely inside the ear canal, and invisible-in-the-canal (IIC), the smallest of all. IICs sit recessed within the ear canal and are totally invisible from the outside.
A portion of the ITC device sits outside of the ear canal, tucked in the outer ear. The portion in the outer ear is unobtrusive, but visible. The CIC device fits entirely within the ear canal and comes with small extensions that enable it to be removed for cleaning, battery replacement, and maintenance. Some IIC hearing aids are so small that the controls are operated wirelessly, via remote control.
ITC Hearing Aid
CIC Hearing Aid
IIC Hearing Aid
What Type of ITE Is Right for You?
Because the size and shape of each individual’s ear canal varies, not everyone can wear the smallest hearing aids. If an ear canal is very narrow, for example, wearing a CIC or IIC aid may become very uncomfortable after an extended period of time.
When choosing a hearing aid, it’s imperative to consider your specific type of hearing loss and the environments where you spend most of your time. For instance, if you frequently attend crowded public events, you may want a device that features digital noise reduction so you can minimize background sounds. Or, if you have trouble with hearing conversations, you may want an aid that has advanced signal processing to increase the clarity of speech. Someone who is often on the telephone or listens to a lot of music might choose an aid with telecoil or Bluetooth® technology, which allows the aid to connect to a smartphone or media-streaming device.
Because CIC and IIC units are placed into the ear canal, closer to the eardrum, some people feel they have an acoustical advantage. This placement also mitigates what is called the “occlusion effect,” where the wearer’s voice sounds to them like it’s coming from a cave or barrel.
As noted above, some hearing aids have features that are designed for specific types of environments. Think about the sound situation in each the places where you spend most of your time — your office, favorite social venues, parks, and your home — and consider which features would work best for your life.
CIC hearing aids are very small, which can make it hard for some people — especially those with impaired motor function — to insert and change batteries. Weigh your options, and consider what would be acceptable and realistic for you.
There are many factors that influence the selection of the best hearing instrument for your needs. An excellent doctor of audiology should be able to assess your hearing loss as well as your lifestyle and financial needs. Those needs considered along with your dexterity and complexity issues should give the professional a good indication of what you need. The audiologist will help you select the best model for you. It takes a skilled audiologist to then be able to personalize the settings in the hearing aid to make it work well for you. The brain is complex and each person reacts to sound differently. Be patient and find an audiologist that you feel comfortable working with through this process.