Hearing Aid Basics

Reviewed by Shelley A. Borgia, CCCA on June 09, 2021
in ear hearing aid

Hearing loss can have a big impact on your life, from your work to your relationships and emotional well-being. Hearing aids can make a big difference, especially if you pick the right ones and get help adjusting to them.

A hearing aid is a battery-powered electronic device designed to improve your hearing. Small enough to wear in or behind your ear, they make some sounds louder. They may help you hear better when it's quiet and when it's noisy. Here’s how they work:

  • A microphone picks up sound around you.
  • An amplifier makes the sound louder.
  • A receiver sends these amplified sounds into your ear.

Not everyone with hearing loss can benefit from hearing aids. But only 1 in 5 people who could have improvement wear them. Most of the time, they’re for people who have damage to their inner ear or the nerve that links the ear with the brain. The damage can come from:

  • Disease
  • Aging
  • Loud noises
  • Medications

Hearing loss that’s due to problems with the ear canal, eardrum, or middle ear is called conductive hearing loss. Most of the time, surgery or other medical help can make it better. But those options aren’t right for everyone. If you have an open ear canal and a relatively normal external ear, a hearing aid may help.

Some people are born without an external ear or ear canal, which means they can’t use a typical hearing aid. Instead, they may be able to use a device that sends sound to the inner ear through the bone of their skull.

If you don’t already know an ear, nose, and throat doctor (ENT), ask your regular doctor to send you to one. This specialist can evaluate and treat your hearing loss.

The ENT will do an exam to find out what’s causing your trouble. You also will see an audiologist who will do tests to find out the type of hearing loss you have and how bad it is.

These specialists can give you a hearing aid if you need one. Avoid mail-order hearing aids. They often don't fit well and don't improve your hearing enough.

If you have hearing loss in both ears, it’s probably best to wear two hearing aids.

Work with an audiologist to figure out which kind of hearing aid will work best for you, as well as any special features you need. The right device for you depends on:

  • The type of hearing loss you have and how severe it is
  • Your age
  • How well you can manage small devices
  • Your lifestyle
  • Cost. The devices vary greatly in price, from hundreds to thousands of dollars.

There are two main types of hearing aids:

Analog hearing aids convert sound waves into electrical signals and then make them louder. They’re usually less expensive and have simple volume controls.

Digital hearing aids convert sound waves into numerical codes similar to computer codes, then amplify them. The code includes information about the direction of a sound and its pitch or volume. That makes it easier to adjust the sound to what you need, whether you’re in a restaurant, a quiet room, or a stadium. Most will adjust automatically. Although this type costs more than an analog hearing aid, the results are much better. They’re also smaller and more powerful.

There are three main styles of hearing aids. They differ in size, placement in or on the ear, and how well they make sound louder:

Canal hearing aids fit inside your ear and are harder to see. An in-the-canal (ITC) hearing aid fits your specific ear canal. A completely-in-canal (CIC) aid is smaller and nearly hidden in your ear. Either type can help mild to moderately severe hearing loss. But because of their size, they can be harder to adjust and remove. This style of hearing aid isn’t ideal for children or adults who might have problems with very small devices. An invisible-in-canal (IIC) aid is nearly impossible for others to see. You may put it in every day, or it may be a device you wear for several months at a time.

In-the-ear (ITE) hearing aids fit completely inside your outer ear. They have a hard plastic case that holds the electronics. They’re best for people with mild to severe hearing loss, but they don’t work as well for children whose ears are still growing.

Behind-the-ear (BTE) hearing aids sit in a hard plastic case behind your ear. A plastic ear mold fits inside the outer ear and directs sound to the ear. A different type, called a Mini BTE, fits entirely behind your ear, with a narrow tube that goes into your ear canal. This helps keep earwax from building up and makes sure your own voice sounds clear. BTEs can work for mild to severe hearing loss, but they aren't for everyone. Learn more about wax guards for hearing aids and how they work.

Receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles both have a behind-the-ear component that connects to a receiver in the ear or ear canal with a tiny wire. These allow low-frequency sounds to enter the ear naturally and high-frequency sounds to be amplified through the hearing aid. RIC and RITE may be a good choice for people with mild to profound hearing loss. Learn more about the different types of hearing aids, including frequency-shifting hearing aids.

Be sure to ask if the device you choose has any special features you want. Not all hearing aids have the same ones. 

Directional microphones help you respond better to sound coming from a specific direction and tune out background noise. 

A telephone switch quiets background noise and is better at picking up sounds from the phone. This system can help you hear in theaters, auditoriums, and churches.

Direct audio input allows you to plug in a remote microphone or FM listening system. You can also connect directly to a TV or other device.

There are other types of hearing aids for specific types of hearing loss. For example, one type uses a bone vibrator for people without an ear canal or outer ear. Others may attach to eyeglasses. And others, like noise-cancelling hearing aids, actually help filter out background noise. Ask about other devices that may make your hearing aids work better in certain settings.

You may want to check out services offered for smartphones that allow you to answer calls and hear from both ears like a headphone.

It's important to understand that your hearing aid can’t make your hearing what it used to be. But as you use it, you’ll become more aware of sounds and where they are coming from.

When you first get your hearing aids, be patient. It may take some time to get used to them. In most states, you are allowed a trial period after you buy a device. Then, if yours don't work out for you, you may get a partial refund and be able try a different type that works better for you. Also ask about warranty coverage.

Take time to learn how your hearing aids work and insist on a good fit. Work closely with your audiologist to avoid problems such as:

  • Discomfort
  • Echo-like sounds from your voice
  • Feedback or a whistling sound
  • Background noise
  • Buzzing with cell phone use

It may help to start wearing your hearing aids in quiet areas and to keep a diary about how you feel.

Your hearing aids will last much longer if you take good care of them. Some tips to keep in mind:

  • Keep them away from heat, moisture, hair care products, children, and pets.
  • Clean them as directed.
  • Turn off your devices when you are not using them.
  • Replace dead batteries right away.

Hearing aid batteries may last from several days to a couple of weeks. Battery life depends on the battery type, hearing aid power requirements, and how often you use it.

In general, hearing aids can last for 3 to 6 years. You may need a new one sooner if your hearing loss gets worse. Behind-the-ear hearing aids give you more flexibility since they can be programmed for a wider range of hearing loss.

Digital hearing aids get stronger and better every few years as computer technology improves. This often prompts people to upgrade their devices. 

Show Sources

SOURCES:

American Speech-Language Hearing Association: "Hearing Aids."

National Institute on Deafness and Other Communication Disorders: "Hearing Aids."

American Academy of Otolaryngology -- Head and Neck Surgery: "Fact Sheet: Burying a Hearing Aid."

Audiology Online.

HenryFord.com: "Hearing Aid Styles."

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