Audiology (hearing) Directory
A hearing aid is an electroacoustic body worn apparatus which typically fits in or behind the wearer's ear, and is designed to amplify and modulate sound for the wearer. Earlier devices, known as an "ear trumpet" or "ear horn", were passive funnel-like amplification cones designed to gather sound energy and direct it into the ear canal. Similar devices include the bone anchored hearing aid, and cochlear implant.
Body worn aids
This was the first type of hearing aid invented by Harvey Fletcher while working at Bell Laboratories, thanks to developments in technology they are now rarely used. These aids consist of a case containing the components of amplification and an ear mold connected to the case by a cord. The case is about the size of a pack of playing cards and is worn in the pocket or on a belt. Because of their large size, body worn aids are capable of large amounts of amplification and were once used for profound hearing losses. Today, body aids have largely been replaced by Behind-The-Ear (BTE) instruments.
Behind the ear aids (BTE)
BTE aids have a small plastic case that fits behind the pinna (ear) and provides sound to the ear via air conduction of sound through a small length of tubing, or electrically with a wire and miniature speaker placed in the ear canal. The delivery of sound to the ear is usually through an earmold that is custom made, or other pliable fixture that contours to the individuals ear. BTEs can be used for mild to profound hearing losses and are especially useful for children because of their durability and ability to connect to assistive listening devices such as classroom FM systems. Another benefit when used with children is cost, when the child is growing quickly a new mold can be made for a fraction of the price of a new ITE. Their colors range from very inconspicuous skin tones to bright colors and optional decorations. Recent innovations in BTEs include miniature "invisible" BTEs with thin hair-like sound tubes (see open-fit devices below). These are often less visible than In-The-Ear aids (ITEs) and some keep the ear canal more open so listeners may still utilise their residual natural hearing (most helpful for those with normal hearing in the lower frequencies). Ideal for high frequency losses, these miniature versions are generally used for mild to moderate hearing loss.
In the ear aids (ITE)
These devices fit in the outer ear bowl (called the concha); they are sometimes visible when standing face to face with someone. ITE hearing aids are custom made to fit each individual's ear. They can be used in mild to some severe hearing losses. Feedback, a squealing/whistling caused by sound (particularly high frequency sound) leaking and being amplified again, may be a problem for severe hearing losses. Some modern circuits are able to provide feedback regulation or cancellation to assist with this. Traditionally, ITEs have not been recommended for young children because their fit could not be as easily modified as the earmold for a BTE, and thus the aid had to be replaced frequently as the child grew. However, there are new ITEs made from a silicone type material that mitigates the need for costly replacements.
Receiver In the Canal/Ear (RIC/RITE)
At a first glance, these devices are similar to the BTE aid. There is however one crucial difference: The speaker ('receiver') of the hearing aid is placed inside the ear canal of the user and thin electrical wires replace the acoustic tube of the BTE aid. There are some advantages with this approach: Firstly, the sound of the hearing aid is arguably smoother than that of a traditional BTE hearing aid. With a traditional BTE hearing aid, the amplified signal is emitted by the speaker (receiver) which is located within the body of the hearing aid (behind the ear). The amplified signal is then directed to the ear canal through an acoustic tube, which creates a peaky frequency response. With a RITE hearing aid, the speaker (receiver) is right in the ear canal and the amplified output of the hearing aid does not need to be pushed through an acoustic tube to get there, and is therefore free of this distortion. Secondly, RITE hearing aids can typically be made with a very small part behind-the-ear and the wire connecting the hearing aid and the speaker (receiver) is extremely inconspicuous. For the majority of people this is one of the most cosmetically acceptable hearing device types. Thirdly, RITE devices are suited to "open fit" technology (see below) so they can be fitted without plugging up the ear, offering relief from occlusion.
In the canal (ITC), mini canal (MIC) and completely in the canal aids (CIC)
ITC aids are smaller, filling only the bottom half of the external ear. You usually cannot see very much of this hearing aid when you are face to face with someone. MIC and CIC aids are often not visible unless you look directly into the wearer's ear. These aids are intended for mild to moderately-severe losses. CICs are usually not recommended for people with good low frequency hearing, as the occlusion effect is much more perceivable.
Extended wear hearing aids
Main article: Extended wear hearing aid
Extended wear hearing aids are hearing devices that are non-surgically placed in the ear canal by a hearing professional. They are worn up to several months at a time without removal. The devices are made of soft material designed to contour to each user and can be used by people with mild to moderately severe hearing loss. They work by directing sound into the ear canal from the outer ear (the pinna). Their close proximity to the ear drum results in improved sound directionality and localization, reduced feedback, and improved high frequency gain. While traditional BTE or ITC hearing aids require daily insertion and removal, extended wear hearing aids are worn continuously and then replaced with a new device. Users can change volume and settings without the aid of a hearing professional. The devices are very useful for active individuals because their design protects against moisture and earwax and can be worn while exercising, showering, etc. Because the device’s placement within the ear canal makes them invisible to observers, extended wear hearing aids are popular with those who are self-conscious about the aesthetics of BTE or ITC hearing aid models. As with other hearing devices, compatibility is based on an individual’s hearing loss, ear size and shape, medical conditions, and lifestyle.
Open-fit devices
"Open-fit" or "Over-the-Ear" OTE hearing aids are small behind-the-ear type devices. This type is characterized by a small plastic case behind the ear, and a very fine clear tube running into the ear canal. Inside the ear canal, a small soft silicone dome or a molded, highly vented acrylic tip holds the tube in place. This design is intended to reduce the occlusion effect. Conversely, because of the increased possibility of feedback, they are limited to moderately severe high frequency losses.
Personal programmable or consumer programmable
The personal programmable, consumer programmable, consumer adjustable, or self programmable hearing aid allows the consumer to adjust their own hearing aid settings to their own preference using any PC. Personal programmable hearing aid manufacturers also have the capability to remotely adjust these types of hearing aids for the customer utilizing remote access technology. Available in most hearing aid styles, these hearing aids differ from traditional hearing aids only in that they are adjustable by the consumer themselves.
Disposable Hearing Aids
Disposable hearing aids are hearing aids that have a battery or power cell that is integrated into the design of the hearing aid and is not meant to be removed. These aids are specifically engineered to use power sparingly, so that this integrated power cell can last far longer than batteries used in traditional hearing aids. By virtue of this long-lasting integrated battery, disposable hearing aids are meant to remove the task of battery replacement and other maintenance chores (adjustment or cleanings). To date, two companies have brought disposable hearing aids to market: Songbird Hearing and Lyric. Both are digital, but are used in very different ways by the consumer. Songbird is a BTE hearing aid that is bought online and worn like any other BTE device. When it runs out, the user replaces it with a new one. Lyric is implanted deep in the ear canal by a professional. When it runs out, it must be removed and replaced with a new one by a professional.
