When it comes to hearing aids, many people with hearing loss are self-conscious and desire to have a hearing aid that is inconspicuous and cannot be easily seen by others. Hearing aid manufactures have therefore tried to meet this demand by coming up with devices that are practically invisible. To this end, there has been a considerable reduction and streamlining in the size and shape of newer digital hearing instruments available to those suffering from hearing loss, over the past decade.

Completely in the canal hearing aids (CIC)
The completely-in-the-canal (CIC) device is the smallest, least noticeable hearing aid available today. It is custom designed from a mold in the shape of the wearer's ear and is worn directly into the ear canal. However, because this device is so tiny, the amount of power output it has is limited, and therefore those who have a severe or profound hearing loss are not candidates for this style device. Additionally, those who are prone to chronic ear infections are also not good candidates for this particular style hearing aid.

Pros of the completely-in-the-canal hearing aid
o Good for mild to moderate hearing loss in adults.
o Small, least visible type.
o Less likely to pick up wind noise.

Cons of the completely-in-the canal hearing aid
o Your own voice may sound unnatural.
o Very small battery with short battery life.
o May be difficult to manipulate due to small size.
o Doesn't contain extra features, such as directional microphone.
o No user controls on outside of device, e.g., volume control.

May not be large enough to accommodate wireless remote control options.

Extremely susceptible to earwax clogging the speaker.

Not recommended for infants and children.

In-the-canal hearing aids (ITC)
The in-the-canal hearing aid is slightly bigger than the CIC hearing aid and is able to have a slightly more powerful matrix. Again, it is custom designed from a mold in the shape of the wearer's ear but this time fits partly in the ear canal and partially in the concha of the outer ear, making it a bit more visible. This style also improves mild to moderate hearing loss in adults.

Pros of in-the-canal
hearing aid
o Less visible than some larger styles.
o Includes features that won't fit on the smaller completely-in-the-canal aid.
o Has user control on device.
o Is large enough to have wireless features.
o Wireless and remote control options available.
o Larger battery with longer battery life.
o Easier to operate.

Cons of in-the-canal hearing aids
o Your own voice may sound unnatural.
o Without a remote may be difficult to adjust onboard user controls.
o Is susceptible to earwax clogging the speaker.
o Not recommended for infants and children.

In-the-ear hearing aids (ITE)
The in-the-ear hearing aids are the largest of the custom made hearing aid options and come in two styles -- the half shell and the full shell. The half shell option fills the lower part of the concha or bowl of the outer ear, while the full shell option fills the entire concha making it the most visible of both the in-the-canal hearing aid and the half shell hearing aid. Nevertheless, because of its larger size, this style hearing aid can accommodate a much more powerful matrix and is therefore suitable for persons who may have even a severe hearing loss.

Pros of in-the-ear hearing aids
o May include all necessary or desired features.
o Wireless and remote control options available.
o Easier to handle.
o Larger battery for longer battery life.
o May be recommended for older teens.

Cons of in-the-ear hearing aids
o Your own voice may sound unnatural.
o Vulnerable to earwax clogging the speaker.
o May pick up more wind noise.
o More visible than smaller devices.
o Not recommended for infants and children.

Behind-the-ear hearing aid (BTE)
Behind-the-ear hearing aids hook over the top of and behind the helix of the outer ear. The hearing aid is held in the ear canal by a custom made earmold attached to a tube that connects to the earhook portion of the aid. Because the hearing aid itself is not limited by the size of a person's ear, it can accommodate all types of hearing loss from mild to profound and is suitable for any age group -- infants to adults.

Pros of behind-the-ear hearing aids
o Newer streamlined mini designs are barely visible.
o Can accommodate much more power than other styles.
o User control options are on the device.
o Wireless and remote control features available.
o Large battery.
o Easier to manipulate.
o Not susceptible to wax clogging the speaker.
o Good choice for those suffering from ear infections.
o Comes in a waterproof model.
o Recommended for all age groups.

Cons of behind-the-ear hearing aids
o Largest of all behind-the-ear hearing aids.
o May pick up more wind noise than other styles.

Receiver in the canal hearing aid
The receiver-in-canal (RIC) hearing aid looks very similar to a BTE hearing aid, except the receiver of the hearing aid is placed into the ear canal portion of the device. It is usually encased in either a custom earmold or a soft disposable dome. A tiny wire connects the receiver to the rest of the hearing aid. This style aid is suitable for mild to profound losses.

Pros of the receiver-in-canal hearing aid
o Your own voice is more natural sounding.
o Is less visible than the BTE aid.
o Can accommodate more power than most other styles.
o User control options are on the device.
o Wireless and remote control features available.
o Large battery.
o Easy to manipulate.
o Suitable for older teens.
o Rechargeable option.

Cons of the receiver-
in-the-canal aid
o Is susceptible to earwax clogging the speaker.
o Not recommended for infants and children.
o Not good choice for those suffering from ear infections.

Open-fit hearing aid
An open-fit hearing aid is a behind-the-ear hearing aid with a significantly thinner tube connecting the hearing aid to an earpiece that allows the concha area of the ear to remain open. This style hearing aid permits low-frequency sounds to enter the ear naturally while allowing the hearing aid to amplify the high-frequency sounds. This style is a good choice for people with mild to moderate hearing loss or one that is sloping.

Pros of an open-fit hearing aid
o Is barely noticeable.
o Does not plug the ear.
o Larger battery for longer battery life.
o Your own voice sounds more natural.
o Not susceptible to ear wax clogging the speaker.
o Suitable for older children and teens.

Cons of an open-fit hearing aid
o Not recommended for infants and younger children.

The sophistication of the computer chip on the inside of a hearing aid, along with its size and its special features all cause hearing instruments to vary greatly from one device to another, including variations in pricing. Considerations must also be made regarding power levels, and in the way the hearing aid is placed, whether into the ear, behind the top of the ear or even on a band worn over the head. Additionally, things like the severity of the hearing loss, deformities of the ear, excessive wax, a history of chronic ear infections, finger dexterity, age and the lifestyle of the individual will all play a role in determining which style hearing aid is best for a particular individual, and which hearing aid will be best suited for a certain type of hearing loss. An audiologist or hearing care professional will discuss these essential details with you and help you determine the hearing aid that is just right for you.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, at 356-2276 or 677-6627 in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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