Once your hearing problem has been diagnosed and the pattern of hearing loss has been analyzed, the hearing-aid dispenser should offer a choice of several types of devices.
Hearing aids are simple in principle: all consist of a tiny microphone, amplifier, speaker, and a battery to power them. But hearing aids vary in their levels of electronic complexity and their overall size and design — both of which affect price.
The price of hearing aids varies widely. Your audiologist will meet with you to discuss types of hearing aids, communication needs and expectations for hearing aid use. She or he will help you to decide what hearing aid is best for you. All the audiologists at UW Hospital and Clinics are licensed by the state to fit/dispense hearing aids.
Hearing aids have generally become smaller in recent years. This is a cosmetic advantage for those who don't want others to know they are wearing hearing aids.
However, smaller devices generally cost more and have several other drawbacks. Their batteries usually expire more rapidly, they need more frequent repair, their controls are more difficult to operate, and they are offered with fewer optional extras. The type of battery you will need varies with the size of the hearing aid.
Size categories, from largest to smallest, are:
Behind-the-ear (BTE) hearing aids
Behind-the-ear hearing aids are coupled to the ear with a custom earmold to ensure proper fit. This type houses the microphone, speaker and amplifier in a curved case that fits behind the ear. A short plastic tube conducts sound from the case to an earpiece that fits inside the ear. The case on some of the newer models is only about one-inch long and no more noticeable than an in-the-ear aid, especially if your hair covers the tops of your ears.
BTE aids offer several advantages. Because they are larger, they can hold larger, longer-lasting batteries that may only need to be changed once per month. BTEs also have room for more circuitry. Their controls are larger and easier to adjust. Finally, BTE aids tend to be more reliable than other types, since their components are protected from wax.
The advantage to the microphone's position outside the ear is in minimizing feedback, the squeal that is produced when some of the sounds form the speaker leaks to the microphone. The disadvantage is that the external microphone sometimes picks up and amplifies the whistling of the wind.
In-the-ear (ITE) or all-in-the-ear hearing aids
With this type of aid, a custom-molded housing that contains all of the components fits directly in the ear. The aid itself, the volume control, and the battery compartment are all smaller on an in-the-ear model and so may be harder for some people to operate.
Canal hearing aids
Canal aids are barely visible. They are more expensive and have tiny controls, and may require more frequent repair. These small devices fit entirely within the ear canal and are barely visible from the outside. Cosmetic appeal is the main advantage of canal aids, which former president Ronald Reagan made popular in the early 1980s.
Canal aids can be made smaller than other models because they sit deeper in the ear canal and do not need to amplify sound as much as other types do. Still, they are too weak to correct for severe hearing loss. Changing the battery may take a great deal of dexterity. Canal aids cost more than most other types. They also tend to require extra cleaning and more frequent repair because of wax buildup on the tiny components.
Completely in-the-canal (CIC) hearing aids
Completely in-the-canal aids are deeply inserted and are cosmetically appealing. These custom, miniaturized hearing aids have shown increased sales in the United States.