Hearing Aid Styles Explained [Pros and Cons]
With all the different hearing aid styles on the market, it can be difficult to know which is best for you.
There are numerous factors to consider, and it is the job of your local hearing provider to help you navigate your options and determine which style will be best.
Lifestyle, budget, hearing loss, and cosmetic preferences are just a few factors to be considered.
In this post I will review the different styles so you can get a better idea of which might be right for you.
Prefer a video? 14 minute watch time: Hearing Aid Styles Explained
What are the different styles of hearing aids?
Hearing aids can range from being completely invisible in-the-ear, to large and powerful behind-the-ear devices.
Each of these styles or form factors has an acronym by which it can be identified.
For example, the smallest style available is called an IIC, which is an acronym for invisible-in-canal.
Here is a list of hearing aid styles, from smallest to largest:
- IIC (invisible-in-canal)
- CIC (completely-in-canal)
- ITC (in-the-canal)
- ITE (in-the-ear)
- RIC (receiver-in-canal)
- BTE (behind-the-ear)
In each of the sections below I’ll review the different kinds of hearing aids available, along with pictures of the different hearing aid types.
IIC invisible-in-canal style hearing aids
- The most discreet fit possible
- Lack of occlusion
- Reduced wind noise
- Less likely to feedback
Advantages of IIC hearing aids
The most discreet fit possible: If ultimate discretion is important, there really is no other choice. Sitting deep in the second bend of the ear canal, IICs are the most hidden hearing aids. The IIC is one of the new types of hearing aids in the last decade for people who want their hearing aids hidden.
Lack of occlusion: Many who wear custom hearing aids complain of feeling like their head is in a barrel when they talk. This sensation is known as the occlusion effect.
Because IICs sit deep in the bony portion of the ear canal, occlusion is less of an issue with this style.
Reduced wind noise: The microphone of an IIC sits deep in the ear protected from the wind, preventing wind from being amplified.
Less likely to feedback: Because IICs fit just millimeters from the ear drum, less volume is needed from the hearing aid. As a result, it’s less likely to feedback or whistle.
Disadvantages of IIC hearing aids
Short battery life, 2-5 days: IIC devices use the smallest batteries, and as a result the battery life is very short. Every 2-5 days you have to change the battery.
Small parts require great dexterity: Because IICs are so small, changing batteries and general maintenance requires excellent dexterity. If you have poor feeling in your fingers IICs may not be a great choice.
Limited features due to size: In order to make IICs as small as possible, the manufacturer can only leave room for essential features. As a result, you won’t find advanced features like Bluetooth or background noise reduction in this style.
More likely to break down needing repairs: The ear is a tough environment for the parts inside hearing aids. As a result, these parts are slowly worn down and will need repair.
Not suitable for severe to profound hearing loss: IICs are so small that they can’t provide the power that larger hearing aids can. This means if you have severe to profound hearing loss IICs will not work for you.
CIC completely-in-canal style hearing aids
- Relatively discreet
- Easier to manipulate than an IIC because it’s larger
- Will fit a larger amount of ears vs an IIC
- Can sometimes be “instant-fit”
Advantages of CIC hearing aids
Relatively discreet: Though not the most discreet style available, this is still one of the least noticeable styles. Usually, just the faceplate of the hearing aid will be visible to others, and maybe part of the pull string used to remove the hearing aid.
Easier to manipulate than an IIC because it’s larger: Although still requiring good dexterity, CICs are easier to handle and maintain as they are a few millimeters larger than CICs.
Will fit a larger amount of ears vs an IIC: Most people that want to wear CIC hearing aids can, and a good fit can be achieved. This is in contrast to the IIC style, which requires a particular diameter, bend, and length of the ear canal to fit properly.
Can sometimes be “instant-fit”: The instant-fit CIC is a relatively new style of hearing aid. An instant-fit CIC is not a custom-built product, it is available “off-the-shelf.” Instant-fit CICs fit entirely within the ear canal just like a CIC does, and sometimes deeper.
There are two main benefits to instant-fit CIC hearing aids. First, there is no wait time to get the hearing aid built. Second, occlusion is reduced as a result of the aid not being custom-molded.
Few manufacturers offer an instant-fit hearing aid at the current time, but here’s a video of the most popular one, Signia Silk.
Disadvantages of CIC hearing aids
There are numerous downsides to the CIC style. All of of the above disadvantages from the IIC style also apply to the CIC style, in addition to:
Users wearing CICs are more likely to complain of occlusion: The CIC doesn’t fit deep within the bony portion of the ear canal like the IIC does. As a result, wearers often complain of a “plugged up” sensation.
ITC In-the-canal style hearing aids
- Large enough for on-board controls
- Easier to handle than IIC and CIC styles
- Improved battery life vs IIC and CIC
- Large enough for features like directional microphones
Advantages of ITC hearing aids
Large enough for on-board controls: ITCs have room for at least a push-button, which allows you to change settings of the hearing aids, like the volume. While most hearing aids today can auto-adjust or be controlled through an app, on-board controls provide more flexibility and can be nice to have.
Easier to handle than IIC and CIC styles: Significantly larger than IIC and CIC styles, ITC hearing aids are much easier to handle and maintain.
Improved battery life vs IIC and CIC: Usually using a size 312 battery, users commonly report at least a week of battery life with ITC hearing aids.
Large enough for features like directional microphones: ITC hearing aids are the smallest custom style that will allow for technology like directional microphones. This important feature serves to improve speech clarity in noisy situations and is beneficial to have.
Disadvantages of ITC hearing aids
More likely to break down needing repairs: Like all custom hearing aids, ITC hearing aids are more prone to breaking down. These repairs are covered by a warranty, but it is hard being without your hearing aids while they’re repaired.
More likely to amplify wind noise: Unlike CIC and IIC hearing aids, in which the microphone sits inside the ear canal and is hidden from the wind, the microphone on an ITC hearing aid sits in the concha (bowl) of the ear canal and is exposed to wind. As a result, when wind passes over the ear, the microphones can sometimes amplify the wind which can be quite annoying.
ITE in-the-ear style hearing aids
- Large enough for on-board controls
- Very easy to handle
- Great battery life of 7-14 days
- Large enough for on-board controls
- Large enough for features like directional microphones
Advantages of ITE hearing aids
Very easy to handle: The ITE is in my opinion the easiest hearing aid style to handle. It has relatively large parts which are easy to see and maintain. Another benefit is, in most ears, ITE hearing aids really “pop” into place nicely and are easy to remove.
Great battery life of 7-14 days: Compared to the other custom styles, ITE hearing aids usually use a large battery and can sometimes provide power for weeks.
Large enough for on-board controls: Whatever on-board controls you prefer, from a push-button, to volume control, the ITE style can accommodate everything.
Large enough for features like directional microphones: Due to the large size of ITE hearing aids, there is no compromise necessary when it comes to features. Whether it’s Bluetooth or directional microphones, ITEs can house the most advanced technology available.
Disdvantages of ITE hearing aids
Very noticeable: This may not be a con at all! But it’s worth noting that if discretion is important, you’ll probably not be happy with how noticeable ITE hearing aids are.
More likely to amplify wind noise: The microphone on an ITE hearing aid is exposed to wind as it passes over the ear. This can sometimes lead to the wind being amplified and making a sort of “shh” sound.
…Finally, a disadvantage that applies to all custom hearing aids- they’re usually more expensive than the non-custom styles (below).
Because custom hearing aids are built to each individual’s ear, hearing providers cannot buy this style in bulk, which serves to lower the cost of non-custom devices.
Another factor which increases the price of custom devices, is the fitting process is longer, requiring more of the local hearing provider’s time.
RIC receiver-in-canal style hearing aids
- Most natural sound quality
- Most comfortable fit
- Wide fitting range
- Very discreet fitting
- Large enough for latest technology like Bluetooth & rechargeability
Advantages of RIC hearing aids
Most natural sound quality: With a custom hearing aid (like any of the above styles), the ear canal is closed off. As a result, almost all sound the wearer hears has been reproduced as it passes through hearing aid.
In contrast, RIC hearing aids allow for the ear canal to remain open, allowing certain sounds to pass through the ear canal as they naturally would without being amplified. This results in a more natural sound quality.
Most comfortable fit: As a result of the ear canal being left mostly open, RIC hearing aids feel more comfortable than other styles. In fact, many wearers report that they completely forget they are wearing their RIC hearing aids.
Wide fitting range: RIC hearing aids are one of the few styles that can accommodate individuals with mild, all the way to profound hearing losses. How is this possible? While most people wear RIC hearing aids with a silicone dome, this is not the only way to wear it. A RIC hearing aid can also use a custom earmold, which drastically increases the power it’s capable of giving.
Very discreet fitting: Many people new to hearing aids are opposed to hearing aid styles in which part of the aid sits outside the ear. People are pleasantly surprised when they try on a RIC. It is a discreet style and most people will never notice if you are wearing a RIC. The receiver wire that leads into the ear canal is very thin and the hearing aid behind the ear can be matched to most hair colors.
Large enough for latest technology like Bluetooth & rechargeability: When you buy a RIC hearing aid, you never have to wonder if you’re getting state of the art technology. Anytime a manufacturer releases new technology, it’s always available in their RIC hearing aid styles first. With everyone glued to their phones these days, many people want Bluetooth style hearing aids, and if that sounds like you then the RIC is probably the style you should buy.
Disadvantages of RIC hearing aids
Receiver wire needs replacing: The receiver wire is the weakest link on a RIC hearing aid. It is normal to replace a receiver wire every year or two, sometimes even more. These wires get brittle over time, or simply get overwhelmed with wax or oil and need to be replaced. Receivers usually have a multi-year warranty which matches the warranty of the hearing aids. However, once the warranty has expired receivers can range from $75-$150 each.
BTE behind-the-ear style hearing aids
- Most reliable style
- Low maintenance
- Most powerful style
- Large enough for latest technology like Bluetooth & rechargeability
- Easy to put on and take off
- Wide fitting range
Advantages of BTE hearing aids
Most reliable style: BTE hearing aids are considered the “workhorses” of hearing aid styles. Because both the microphone and receiver are housed behind the ear, this style tends to last longer than others and requires less repairs.
Low maintenance: There isn’t much that can go wrong with a BTE. They require simple and routine cleaning to prevent excessive wax and moisture buildup.
Most powerful style: The BTE style is always the strongest style a hearing aid manufacturer makes. BTEs are known to “pack a punch” that other styles can’t match. For this reason, BTEs are preferred by wearers with profound hearing losses.
Large enough for latest technology like Bluetooth & rechargeable batteries: Just like the RIC style, BTE hearing aids have room for the latest technologies like Bluetooth, directional microphones, and rechargeable batteries.
Easy to put on and take off: It doesn’t get much easier than a BTE, especially when worn with a large custom mold. Just put the mold in the ear and flip the hearing aid up behind your ear and you’re good to go.
Wide fitting range: Just like RIC hearing aids, BTEs have a pretty wide fitting range. They can be worn “open-fit” with a small silicone dome in the ear, or with a custom earmold to provide more power.
Disadvantages of BTE hearing aids
Tubing needs replacing: Though a low maintenance style, the tubing on BTEs needs to be replaced routinely or it gets hard and cracks. As a result, the tubing leaks sound and begins to feedback or whistle. Many hearing providers instruct BTE wearers on how to change this tubing at home and it can be ordered online pretty inexpensively.
Very noticeable: Again, not necessarily a con! In fact, many BTE wearers want their hearing aids to be seen so others know to speak clearly and face them while speaking. But if discretion is important, consider the RIC style with an earmold, as it’s usually a more streamlined design.
Hearing aid earmold styles
If you buy a BTE or RIC and have a severe to profound hearing loss, your hearing provider will probably recommend you get a custom-built earmold. A custom-built earmold allows the hearing aid to provide more power for your hearing loss.
With the help of your hearing provider, you’ll have to decide which earmold type you want to wear. The earmold styles you’ll have to choose from are generally similar in appearance to all the above mentioned custom in-the-ear styles. It’s just a matter of finding the size that you are comfortable with.
Although an older article, there’s a great resource to learn more about earmolds and all the variations and implications for selecting the right mold style.
So which type of hearing aid should you choose?
After taking into account all factors, there could be several different kinds of hearing aids that seem like they may be a good fit for you.
My recommendation? Start with the one that sounds the most ideal to you.
If you love the idea of IICs and feel like they’d make you happiest and you’d be more likely to wear them, then try those first!
Anytime you buy hearing aids you should have a trial period. If you aren’t satisfied with a particular hearing aid style, then you can exchange and try another.
Hearing aids today are more dynamic and capable than they’ve ever been, and hearing aid satisfaction rates continue to rise.
With patience and a trusted hearing provider to guide you, I’m confident you’ll be able to find the right style!
More information please?
Hi Sylvia, you bet! What can I help you with?
I am afraid to buy aids on-line because I have profound loss. I like to have my aids discrete as possible. I had to go to an ear mold because there was to much loss with the thin tubes and in the ear inserts. I also was told that the processor in the aid behind the ear was best for me. I would not like to pay and find out that it is my loss.
Hi Tony,
Thanks for your comment! To your first point- I wouldn’t recommend buying hearing aids online either. All purchases through ZipHearing are facilitated by a local hearing provider in your community with whom we have a partnership. We provide the hearing aids at a discount, and they provide the local care as part of the price.
To your second point- I can totally understand wanting the hearing aids to be as discreet as possible. You may be surprised just how discreet some RIC style hearing aids can be, and the ear molds can be made small (and clear).
If you’d like to have a consultation with a provider near you, or to discuss this further, please feel free to call us at 800-731-6794.
Hi Jeff,
What an excellent and comprehensive description of the various types and their pros & cons.
As a totally satisfied & longtime wearer of Phonak RIC’s through a provider in the Netherlands where I live we will not be doing much business together I assume, but I wanted to express my admiration for your article and will keep on reading your mails!
Thanks and greetings from Amsterdam!
Hi Bob, thanks for the comment! As a longtime wearer of RICs, let me know if I missed anything 🙂
I presently have in ear canal, but have very difficult time hearing in a crowd. I need something better. My right ear is very close to my head and it may be difficult for the device to stay in place as well as sticking out more than I like. I plan to let my hair grow a bit over my ears so the “behind the ear” might be a problem. Money is an issue. I think the hearing aids are ridiculous in price. Do you have a good suggestion?
Hi Donald,
Thank you for your comment. For hearing better in noise, it would be better to use a RIC style, though I am not sure it’s possible due to the issue you mentioned, you’ll have to talk to a hearing care provider about that one. As far as cost, the challenge there is to get the best background noise reduction, you’d need a higher end model, probably something in the $3-4.5k range for a pair. Interest free financing is available if you go through one of our providers.
Loved your video, thank you so much – well done!
I do have two additional questions; battery vs. rechargeable in a RIC hearing aid and I like the wire on mine (it’s more discreet) but have been told the tube is better for sound and durability? What are your thoughts?
Thanks Becky! Here’s all you might want to know about rechargeable hearing aids. The tube is better for durability, but for sound quality, I believe wires are a better bet.
Hi Jeff – thanks for the greatly informative website.
I am a long time wearer of RIC style, but have had more and more problem with the receiver wire getting dislodged by my eyeglass frames, and now even worse by having to wear a Corona virus mask, (with either the over the ear loops, or ties around the head). When the wire gets hooked or entangled, I have had the entire RIC unit fall out multiple times ! I’m lucky not to have lost a hearing aid in the garden or along a hiking trail.
So I am seriously thinking of going back to one of the in the ear styles, but don;t want to lose the good parts of the RIC style.
My provider has tried different lengths of receiver wire, but not a lot of difference. Is this a common problem with other RIC wearers? Any great ideas, besides taping the wire to flatten it against my ears?
Hi Kurt, thanks for the comment 🙂 Before buying new hearing aids entirely, have you considered getting very small custom molds made? This will secure the hearing aid in place and make it very difficult for it to fall out. Some molds can be made to be very comfortable, and it’ll be at least as comfortable as custom in-the-ear aids would be. That would be my first recommendation.
Kurt,
I had a cholesteotoma years ago involving bone and eardrum loss. My ear does not drain properly so I see ENT twice a year for cleaning. I have severe hearing loss in the involved ear but other ear is fine. Last hearing aid (years ago) was frustrating and uncomfortable. I was told then that I had to have piece outside ear to conduct hearing via the bone. Assume technology has advanced significantly in the last ten years. Which type of hearing aid is best for ear health as it relates to infections? Cost is less of a concern than being happy with sound, quality and maintaining a healthy ear. Thanks, Terri
I am looking for some new aids. I would like the rechargeable ones but also would like to connect directly to the TV. Are there any aids available without having to use another device? Also I have heard that the bluetooth technology is still in it infancy and not very reliable and that when used others in the room can not hear the TV. I like the bte aids.
Hi Rose,
Technically, these hearing aids can be paired directly to Bluetooth TV’s with no accessory, but it doesn’t work with all TV’s, and it will drain the battery really quickly: https://www.youtube.com/watch?v=TA2PPmGJqaM (that is also the most reliable Bluetooth hearing aid, imo). Feel free to call me with questions! 800-731-6794
I have a notch in hearing in both ears. My big problem is with intelligibility (sp), I play in a concert band and I can not distinguish between C, B D E when getting rehearsal numbers
from the conductor. Also with certain voices depending on their voice frequency. Which of the types would be the best fit for me?
A RIC style would probably be best, though I can’t advise you on that without seeing a hearing test. I also recommend finding a provider that does real ear measurement. Feel free to call me at 800-731-6794 if you want to chat about it. real ear measurement.
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