Hearing aid types and styles

On the hunt for a hearing aid? Finding the right type and style for you depends on your degree of hearing loss, your lifestyle preferences, and cosmetic concerns.

Where you buy hearing aids also matters, too. If you seek out professionally fitted hearing aids at a clinic, you'll have access to a wide range of types and styles, along with extensive customization provided by your audiologist or hearing instrument specialist. If you seek out OTC hearing aids at a drugstore or online, you'll generally have fewer choices than what's listed below, and you won't have access to as much customization.

Hearing aid types

As a starting point, there are two basic types of hearing aids that come in many different styles:

• In-the-ear (ITE) hearing aids
• Behind-the-ear (BTE) hearing aids

In-the-ear (ITE) hearing aids 

ITE aids—sometimes referred to as "invisible hearing aids"—are worn in the ear canal and are usually custom-fit, based on an impression that is taken by your hearing care professional at the time of your hearing aid consultation. These styles are typically available in different skin tones to blend with the outer ear. Some types of ITE hearing aids fit very deeply within the ear canal, while others are closer to the outer ear.

Behind-the-ear (BTE) hearing aids

The more popular option, BTE aids sit behind or on top of the outer ear with tubing that routes the sound down into the ear canal via a custom-fit earmold or a dome style that doesn’t block the entire ear canal opening. BTE styles are available in different colors to match hair or skin tone, as well as flashier designs for personalized flair.

For either ITE or BTE, most devices come with batteries that are either rechargeable (like smartphones) or disposable, meaning they must be replaced anywhere from 3-20 days.

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Common hearing aid styles

In-the-ear styles

Invisible in the canal (IIC)
Completely in the canal (CIC) 

IIC and CIC styles are the smallest and most discreet hearing aids available. "Invisible in the canal" IIC styles are as described—virtually invisible. A wearer places them very deeply in the ears, and they must be removed by tugging on a small pull-out string. "Completely in the canal" CIC are very similar, but don't sit quite so deeply within the ears. 

These styles are typically fit for people with mild to moderate hearing loss. Because of their small size, they don’t usually come with any manual controls, like volume wheels or program buttons.

Advantages:

• very discreet
• good sound quality because of how they fit within the ear 

Disadvantages:

• susceptible to ear wax and moisture damage
• small size can be a problem for dexterity
• small batteries require more frequent replacement
• small size also can limit connectivity to wireless devices, like smartphones

 

In-the-canal (ITC) hearing aids

ITC hearing aids sit in the lower portion of the outer ear bowl, making them comfortable and easy to use. Because they’re slightly larger than IIC and CIC styles, they tend to have a slightly longer battery life and can fit a wider range of hearing losses. Their size also allows them to host additional features such as directional microphones for better understanding in noisy environments and manual controls, like a volume wheel, if desired. 

Advantages:

• discreet
• longer battery life and more features than IIC and CIC styles

Disadvantages:

• susceptible to ear wax and moisture damage
• more occlusion, can make wearers feel plugged up (more common among people with mild low-frequency hearing loss)
• small size can be a problem for connectivity to wireless devices
   

Low-profile hearing aids

Low-profile hearing aids are similar to ITC styles, and range from half-shell designs that fill half the bowl of the outer ear to full-shell designs that fill almost the entire outer ear bowl. Like ITC styles, low-profile designs are large enough to feature directional microphones and manual controls, such as a volume wheel and a push-button for changing programs. The size of a low-profile style makes it desirable for people with dexterity issues because it is easier to handle than the smaller sizes.

Advantages:

• larger size easier to insert and remove
• accommodates more features and user controls
• likely to have connectivity to wireless devices like phones

Disadvantages:

• less discreet than smaller in-the-ear styles
• more occlusion, can make wearers feel plugged up
   

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Behind-the-ear styles

Receiver in the ear (RITE)

One of the most popular hearing aids styles are what's known as either "receiver in the ear" (RITE) or "receiver in canal" (RIC), depending on the manufacturer. But they essentially mean the same thing—an open-fit hearing aid style that has the speaker built into an insertable ear dome, instead of the main body of the hearing aid. In other words, the speaker of the hearing aid rests in the ear canal, but the microphone and processor sit in a tiny case behind the ear. They are connected by a thin wire. This style of hearing aid tends to have above-average sound quality and is made by all major hearing aid manufacturers. 

If it gets damaged, the speaker portion of the hearing aid that fits in the ear can often be replaced at the hearing aid clinic, instead of having to be shipped off to the manufacturer for repair. 

Advantages:

• easy to find options that have rechargeable batteries
• most likely to come with wireless connectivity to devices like phones
• most likely to have advanced technology such as artificial intelligence
• the speaker can be replaced separately
• telecoil options are common

Disadvantages:

• smaller RITE sizes (known as mini-RITEs) can be a problem for dexterity
• speaker, which is inside the ear, is susceptible to moisture and ear wax damage
• the microphone and sound processor that sit behind the ear is visible
   

Behind-the-ear with earmold

BTE styles that come with earmolds can fit any type of hearing loss, from mild to profound. Their longer shape follows the contour behind the outer ear and can generally house more features, controls and battery power than any other style of hearing aid. A BTE with earmold style is commonly used for children because the BTE can be reprogrammed as needed and the earmold can be replaced as the child grows.

Advantages:

• fits all degrees of hearing loss, including profound hearing loss
• usually available in models with wireless connectivity to devices and advanced technology
• custom-fit earmold can be replaced separately
• less susceptible to moisture damage

Disadvantages:

• more occlusion, can make wearers feel plugged up, although this is generally very minor
• potential space limitations for eyeglass wearers and/or people with small ears
• not as cosmetically hidden

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What is the best hearing aid for me?

When shopping for a hearing aid, the choices can be confusing. At a minimum, hearing loss advocates recommend four basic features: They’re rechargeable, cosmetically appealing, come with built-in Bluetooth, and have the ability to enable telecoil. The challenge? Only receiver-in-the-ear models have all four features, at least for now, so you may miss out if you go with a CIC over a RITE.

We created this flow chart to help first-time hearing aid users or people in the market for a new device figure out which hearing technology might be the best fit.

When it comes to hearing aids, there are multiple features and styles available to suit different hearing loss needs. It’s important to consider a number of different things when selecting the right style to fit your needs. (See legend below for acronyms).

Flow chart legend: ALDs= assistive listening devices that can augment what hearing aids are capable of; advanced technology=generally the newest aids that cost more, but offer the most technologically advanced features; ITE=in the ear; BTE=behind the ear; CIC=completely in canal; ITC=in the canal; RIC=receiver in the canal (same as a RITE). 

Do you currently wear hearing aids?

If you're already wearing hearing aids and want to update them, the best place to start is with the current device style. If you're happy with that style, you'll often be able to find the same or a similar style to your outdated device, just equipped with newer and more modern features. It’s possible the type of hearing loss has changed over time, however, so it’s important to have your hearing tested before updating hearing aids. 

Do you have problems with dexterity?

If you have dexterity issues (for example, difficulty grasping small items or losing feeling in fingertips), it’s usually better to avoid smaller devices. Low-profile ITE or BTE devices with earmolds might be suitable because they are the largest instruments and easiest to handle. Additionally, the batteries will be the largest—sizes 13 or 675— or rechargeable, which are easy to use. Lastly, hearing aids that come with automated features should also be considered — so you don't have to use the tiny buttons to adjust the volume. You may also want to talk to your hearing care practitioner about the possibility of a remote control if the volume or program controls on your hearing aids are difficult to use.

Are your activities limited?

If you are homebound, restricted in daily activities or have cognitive impairments, BTE devices with earmolds might be most suitable. Selecting earmolds made of soft, flexible material can help it fit comfortably in the ear and make it easy for a caretaker to assist. Other items to consider include assistive listening devices and alarming devices, such as amplified telephones, special smoke detectors, bed-shaker alarms, doorbells that flash a light or a device to amplify the television.

What is your hearing ability?

What kind of hearing loss do you have?

If your hearing loss is primarily in the high frequencies—which most people have, especially if they have age-related hearing loss—the open-fit RITE styles are the most comfortable because they let in the natural low-frequency sounds you are still capable of hearing, while amplifying the high frequencies. These options can also be equipped with advanced features to allow hearing aids to filter noise from speech, adapt to different environments, suppress feedback and wirelessly connect to mobile phones, a personal microphone system or other public assistive listening devices.

A low-frequency hearing loss can be tricky to fit with a hearing aid due to the perception of the sound quality. A custom hearing aid can work, if the patient prioritizes a discreet appearance. However, a premium behind-the-ear with an appropriately vented earmold is another option. Premium technology allows for more narrow-band fine-tuning adjustments (which helps with sound quality).

Severe-to-profound loss: Power aids

If you have severe or profound hearing loss, ITC hearing aids, low-profile ITE hearing aids or BTE hearing aids with earmolds might be suitable, depending on the degree of loss. They are known as "power" or "super power" hearing aids. These styles of hearing aids provide the most powerful amplification and are least susceptible to moisture damage from the ear canal.  Advanced features are important to consider, as they can filter noise from speech, adapt to different environments, suppress feedback and wirelessly connect mobile phones, a personal microphone system or other public assistive listening devices. 

More: Hearing aids for profound hearing loss

Unilateral hearing loss

For people with single-sided deafness, options include a CROS or BiCROS hearing aid, bone-anchored hearing systems and cochlear implants. 

What about cochlear implants?

For some people, hearing aids won't sufficiently address their hearing loss, and instead they may have better success with cochlear implants or a bone-anchored hearing system.

Do you need hearing aids?

Hearing aids can be fit for a broad range of hearing losses in more styles and sizes than ever before, in part due to the miniaturization of electronics. More people than ever can wear tiny, nearly invisible models, and even the larger-sized instruments are available in modern, sleek styles. Need to get fit for hearing aids, or think you have hearing loss? A good next step is visiting our directory of consumer-reviewed hearing healthcare professionals to find hearing aids near you.

^{This article has been medically reviewed by Dr. Amy Sarow. She obtained her Doctor of Audiology degree at the University of Iowa. She spent her 4th year residency at the Mayo Clinic School of Health Sciences in Jacksonville, Florida. In addition to her full time work as clinical audiologist, she enjoys writing on hearing health and wellness.}