A Guide to ITE (In the Ear) Hearing Aids

In-the-Ear Hearing Aids or ITEs are hearing aids that fit in the outer ear (concha). The components of ITE hearing aids are contained inside a full shell, which is typically made of a hard plastic material. ITEs are custom made to fit the wearer’s outer ear and covers most of it when worn.

While not as big as Behind-the-Ear hearing aids, they are also quite visible especially when standing face to face with someone or when looking directly at the wearer’s ear.

Main Components

Like other hearing aids, ITE hearing aids come equipped with the basic components like a microphone that picks up sound waves and converts it to electrical signals, an amplifier that makes the sound louder, a receiver that converts the electrical signal back to sound waves and sends it to the ear, and of course, batteries to power the hearing aids.

ITE hearing aids contain bigger batteries compared to In-the-Canal, Completely-in-the-Canal, or Invisible-in-the-Canal hearing aids. As a result, ITEs offer more amplification and are generally more durable than their smaller counterparts.

Additional Features

Modern ITE models come with additional features to make them more functional and suitable for various everyday situations.

Most modern ITE hearing aids come equipped with a telecoil, a magnetic coil that receives sounds using the circuitry of the hearing aid instead of the microphone. Telecoils are especially useful when using the telephone and can also be used with hearing loop systems installed in large public areas to allow the user to easily focus on the sound of interest.

Other ITE hearing aids also come equipped with directional microphones, which improves signal to noise ratio as it eliminates sounds from behind and amplifies sounds coming from the front.

ITEs can also come with user controls outside of the shell so that the user can adjust program settings and speaker volume manually.

Advantages of ITE Hearing Aids

  • Suitable for mild to severe hearing loss.
  • Some ITE models can be used by children (e.g. silicon type)

While ITEs are generally not recommended for children because the shell cannot accommodate the growth of children’s ears, a new type made out of a silicon material instead of a plastic shell has been designed to address this issue. It is worth noting, however, that ITE hearing aids are only recommended for children aged 10 and above.

  • Custom Made to Fit the User

ITE hearing aids are generally bigger and more visible than ITC, CIC, and IIC hearing aids but since the shell is custom made to fit the user, the size will depend on the degree of hearing loss and the shape of the user’s ear.

  • Longer battery life and provides more amplification because of its size.
  • Easier to insert and remove.

Disadvantages of ITE Hearing Aids

  • Cosmetic Disadvantages

While not as visible as BTE hearing aids, ITE hearing aids are difficult to conceal because of their size and placement in the outer ear. ITEs are easily noticeable compared to smaller varieties like In-the-Canal and Completely-in-the-Canal hearing aids.

  • Feedback Problems

Due to the proximity of the microphone and receiver, users may experience feedback problems, especially people with severe hearing loss. Many modern ITEs, however, come equipped with feedback regulation controls to address this issue.

  • Requires daily maintenance and cleaning to avoid moisture damage.

ITE hearing aids offer many listening advantages that smaller hearing aids cannot offer but like all styles of hearing aids, it carries some disadvantages as well. Consult your audiologist to find out if ITE hearing aids are suitable for your degree of hearing loss.

A Guide to ITC (In the Canal) Hearing Aids

In the Canal or ITC hearing aids are custom made to fit inside the ear canal of the wearer. Unlike Completely in the Canal (CIC) hearing aids, ITC hearing aids only fit partially in the ear canal. ITCs are bigger than CIC hearing aids because of their positioning in the ear canal. Due to their slightly larger size, they are able to carry more features than Completely in the Canal Hearing Aids.

Since ITC hearing aids are placed inside the ear canal, they are less visible than BTE (behind the ear) or ITE (in the ear) hearing aids.

How it Works         

ITC hearing aids work in the same manner as CIC hearing aids but they are bigger in size. The microphone, speaker, and batteries are all placed inside the case that fits partially in the ear canal. ITC hearing aids have all the basic features of a hearing aid: the microphone picks up sound, the amplifier makes the sound louder, and the receiver sends the sound to the ear. However, some ITC hearing aids have extra features, depending on the brand and model.

Most ITCs come with automatic volume controls that detect environmental noise to determine the volume level suitable for the user in a particular situation but some may also come with a volume wheel to allow the user to manually adjust the volume of the hearing aids.

Since ITCs are bigger compared to CICs or IICs (invisible in the canal), they have more room for a Telecoil to be added. A T-coil is extra useful when talking on the telephone and can also be used with hearing loops installed in large public places.

ITC hearing aids can accommodate mild to moderate hearing loss, although some models can also work for people with mildly severe hearing loss.

Advantages of ITC Hearing Aids

  • Cosmetic Advantages

Due to the placement in the ear canal, ITC hearing aids offer cosmetic advantages that BTEs and other in-the-ear hearing aid models cannot offer. They are less visible compared to BTEs and are generally not noticeable unless one looks in the ear bowl.

  • Listening Advantages

ITC hearing aids are easier to use with the telephone, as they don’t get in the way of the telephone receiver. Those that come equipped with a T-coil also offer additional listening advantages especially in large public places equipped with hearing loop systems. Due to their positioning inside the ear canal, they offer a more natural listening experience compared to BTEs. There is also lesser wind noise in ITCs because the microphone is in the canal.

  • Directional Microphones

A lot of ITCs have directional microphone in them, which offers a better listening experience for the user. Directional microphones amplify sounds coming from in front of you and decrease sounds coming from behind. This makes it easier to follow conversations while simultaneously eliminating unnecessary background noise.

  • Durability and Ease of Use

Compared to CICs and IICs, ITC hearing aids are less prone to moisture damage because they don’t fit deep in the ear canal. Since they are bigger, they are also easier to remove and maintain compared to smaller models.

Disadvantages of ITC Hearing Aids

  • Battery Life

Just like completely in the canal and invisible in the canal hearing aids, ITCs have smaller batteries compared to BTEs. As such, battery life is shorter (about 10 to 12 days, depending on use).

  • Not Suitable for All Types of Hearing Loss

As previously mentioned, ITC hearing aids can only accommodate mild to moderate hearing loss. While there are some models that can accommodate mildy severe hearing loss, ITCs are not recommended for people with severe to profound hearing loss.

In addition, some people cannot use ITC hearing aids because of the size and shape of their ear canal. ITCs are also not suitable for children because of the size and placement.

Price Range

The price for In the Canal Hearing Aids can range from $800 for the basic models and $1300 to $2600 for digital hearing aids with more advanced features.

A Guide to IIC (Invisible in Canal) Hearing Aids

Advances in digital hearing aid technology has made it possible to create significantly smaller and less visible hearing aids that do not only offer cosmetic advantages but many listening advantages as well. Invisible in Canal Hearing Aids or IIC is one such product made possible by current digital hearing aid technology. IIC hearing aids are very small and are virtually invisible even if you look in the ear bowl. This is because IIC hearing aids fit completely inside the ear canal. Unlike conventional CIC hearing aids that only fit past the first bend of the ear canal, IIC hearing aids are so small that they can fit right past the second bend of the wearer’s ear canal.

How it Works

Since IIC hearing aids fit completely inside the ear canal, each one has to be custom made for the individual wearer. For optimum comfort and increased accuracy, an audiologist should take an ear impression of 10 to 12 mm past the second bend of the ear canal.

All the components of an IIC hearing aid are located inside a small plastic shell that fits right inside the ear canal. Since IICs are very small in size, they do not block the outer portion of the ear canal and allows for reduced occlusion to occur.

Some advanced IIC hearing aid models come equipped with mobile connectivity so the user can control the settings of the hearing aid from their mobile phones without having to take out the hearing aids. This is useful especially in social and public situations.

Due to their small size and positioning deep inside the ear canal, IIC hearing aids are not recommended for children. IIC hearing aids can accommodate mild to moderate hearing loss.

Advantages of IIC Hearing Aids

  • Offers Superior Cosmetic Advantages

Since they are very small and fit past the second bend of the ear canal, IIC hearing aids are virtually invisible even when one looks in the ear bowl.

  • Listening Advantages

IIC hearing aids offer the most natural listening experience for the wearer. Since sound can travel freely down the ear canal without any obstruction from large shells found in other hearing aid types, the experience can be very similar to normal hearing.

  • Reduced Occlusion

With larger hearing aid types, there is a tendency for occlusion to occur especially if the large shell covers the outer part of the ear canal. Occlusion refers to the echo or booming effect perceived when listening to one’s own voice.

  • Improved Sound Localization

Compared to bigger hearing aid types like BTEs, IIC hearing aids offers better localization of sound since the ear canal filters the sound before it travels to the eardrum. The placement of the microphone in the ear canal makes it possible for the user to maintain the function of the ears’ natural filters.

  • Comfort

IIC hearing aids don’t only offer physical comfort but also allows the user to feel more comfortable when going out. Many people refuse to wear hearing aids because they don’t want others to immediately notice their hearing loss. With invisible hearing aid types like the IIC, the user can feel much more comfortable when out in public.

  • Functionality

Advanced models allow the user to control the hearing aids using their mobile phone; this can be very functional in social situations and while traveling.

Disadvantages of IIC Hearing Aids

While IIC hearing aids offer many cosmetic and listening advantages, they also carry some disadvantages:

  • Shorter Battery Life

Due to the small size of IIC hearing aids, they can only accommodate small batteries. Smaller batteries usually don’t last as long as the bigger batteries found in BTEs and other models. Most IIC models have batteries that only last a maximum of five days.

  • Current models are not suitable for severe to profound hearing loss
  • May require frequent repairs

IIC hearing aids are exposed to moisture and fluid in the ears, which may affect the internal components in the hearing aid.

  • Cost

Due to the smaller components of IIC hearing aids, they are generally more expensive to make. Advanced models that offer mobile connectivity are also very expensive so they may not be accessible to everyone especially since hearing aids aren’t usually covered by most health insurance plans.

Despite its drawbacks, IIC hearing aids have come a long way especially in terms of strength and features. They also remain the best option for people with mild to moderate hearing loss who aren’t comfortable with wearing visible hearing aids.