Behind the ear hearing aids—they’re what most people think of when they imagine hearing aids.
With good reason. These devices—also known as “BTE” hearing aids—are the most common type of hearing aids on the market. According to the Hearing Industry Association, they account for more than 85% of hearing aids sold.
The devices are instantly recognizable thanks to their molded plastic casings, which fit directly over the ear and contain electronic components and batteries. In traditional BTE hearing aids, a clear tube carries sound from the casing into the ear. In newer BTE hearing aids, called “receiver in the ear” models, a cable connects the casing to a small speaker that is placed inside the ear.
This Audientes Insights article will tell you about different styles of behind the ear hearing aids—and about how they compare to other types of hearing aids. It will give you a breakdown of common behind the ear hearing aid parts. Finally, it will discuss the advantages and disadvantages of these hearing aids, as well as typical costs.
(Note: Because analog BTE hearing aids are generally considered obsolete, this article will only discuss digital behind the ear hearing aids.)
Types of behind the ear hearing aids
To get started, let’s compare and contrast traditional behind the ear BTE hearing aids and the newer receiver in the ear (“RITE”) style.
Of course, both styles are defined by hard plastic enclosures that fit behind the ears. In the past, these enclosures were typically beige, but today they are available in a range of colors. Both styles also feature a piece that goes inside the ear. Typically, this is a custom-fitted earmold, but it could also be a (nonfitted) ear dome.
As far as batteries go, rechargeable and disposable options are available for both BTE and RITE hearing aids. Both styles also typically include volume and program controls, which are located on the plastic enclosures, making them relatively easy to access.
The main difference between the styles is the location of the receiver/speaker. As their name implies, receiver in the ear hearing aids feature speakers that are placed inside the ear. If you’re looking for the smallest behind the ear hearing aids, RITE might be the best option—because the speaker goes inside the ear canal, the casing can be smaller. However, you should be aware that RITE speakers are frequently damaged by earwax or moisture build up in the ear, resulting in costly repairs.
(Note: For additional behind the ear hearing aid information—including information about how to insert a behind the ear hearing aid—consult this guide from the U.K.’s National Health Service.)
Behind the ear hearing aid parts
Models vary, but generally speaking, there are 9 main components in a behind the ear hearing aid:
- Casing – also known as the “shell”, “enclosure” or “housing”, the plastic casing holds all the electronic components of the hearing aid.
- Controls – depending on the model, these may include power, volume and program controls.
- Microphone(s) – one or more microphones are used to pick up sound and send it to the amplifier.
- Amplifier/processor – makes sounds louder and easier to hear.
- Speaker/receiver – emits the amplified sound.
- Battery compartment –where the batteries are stored.
- Earhook – connects traditional BTE hearing aids to the dome or earmold.
- Cable – a wire that connects RITE style hearing aids to the in-ear speaker.
- Earmold or dome – plastic or silicone parts that fit inside the ear. Earmolds are custom-fitted, while domes are small cones that come in standard sizes.
Behind the ear hearing aids accessories are also available. These include charging cases and cables (for rechargeable models), disposable batteries, phone and television adaptors, cleaning kits and more. Visit the Audientes Accessories page to learn more.
Open fit vs closed fit
One of the most important decisions you’ll make when purchasing BTE hearing aids is whether you’ll go for an open or closed fit style.
In open fit behind the ear hearing aids, the ear canal isn’t totally sealed, meaning that sounds from the outside world can enter the ear—as can air. In the closed-fit style, on the other hand, the ear canal is totally sealed off by the earmold or dome, so you can only hear audio that’s been enhanced by the hearing aid.
The advantages of open fit are that it provides a more natural feeling and your hearing aid is less visible. One big downside, however, is that it lets in more outside noise—which can make it harder to hear. A closed-fit style keeps the earmold sealed up against the ear and offers a bit more protection from outside sounds. But this type of device may feel unnatural and can be more visible.
If your hearing loss is particularly bad or you work in a noisy environment, a closed-fit device might be a better choice. Otherwise, an open fit style could be the better option.
Can’t choose between open or closed fit? Ven™ by Audientes is compatible with both styles. Check out our Accessories page to find out more.
Pros and cons of BTE hearing aids
Many of the biggest advantages of behind the ear hearing aids are, at the same time, disadvantages. First invented in 1955, these devices are certainly time-tested. However, they also generally look and feel outdated. Their large size means that they are able to amplify noises more effectively and accommodate bigger batteries—but it also means that they aren’t discreet. Even the smallest behind the ear hearing aids are quite obvious to onlookers.
Consumers are frequently curious about the advantages of behind the ear hearing aids vs in the canal styles, which are less noticeable. For the especially hard of hearing, BTE is the better option, as it allows for more amplification of sounds. Behind the ear models also typically produce less feedback, since the microphones and speakers are placed farther apart than in in the canal models. However, BTE hearing aids are often problematic for users with glasses—so an in the canal model, or another type of hearing aid, might be best for them.
Worried that hearing aids will interfere with your glasses? Try Ven—an affordable, high-tech, glasses-compatible option.
One frequent complaint is that behind the ear hearing aids make users ears feel “full” or “stuffed up”—what in medical terminology is called “occlusion”. Excessive earwax buildup is also a concern.
The biggest disadvantage? Probably behind the ear hearing aids’ price. Many with hearing loss are simply unable to afford even the least expensive options. A pair of cheap behind the ear hearing aids will run you at least $1,000. BTE options below this price point will likely have serious quality issues. For the best behind the ear hearing aids, you’ll need to pay up to $6,000 per pair—a cost that’s usually not covered by insurance.