Hearing loss is a common problem that affects millions of people worldwide. Thankfully, modern technology has provided us with hearing aids, devices that can help individuals with hearing difficulties to hear more clearly.
Behind-the-Ear (BTE) hearing aids sit behind the ear. Some people find BTE hearing aids to be more comfortable, durable, and flexible than other types of hearing aids. Optional BTE features include TV and phone connectivity, directional microphones, voice clarification, and reduced background noise.
Compare BTE to In-the-Ear (ITE) hearing aids in my article: The Ultimate Guide to ITE Hearing Aids for Seniors
Choose from BTE and ITE Hearing Aid Types
Whether you get an in-the-ear (ITE) or a behind-the-hear (BTE) hearing aid will depend on the depth of your hearing loss and your need for hiding the device.
Do consider getting a hearing aid, if not for yourself, then for those around you.
Your hearing loss can significantly affect the quality of your life, and your family’s lives as well.
My father’s father had profound hearing loss toward the end of his life.
My grandfather believed his children were plotting to hurt him.
He did not know what they were “whispering about.” Feeling left out led to paranoia.
Use this guide to understand your behind-the-ear hearing aid options to help you get the right hearing aid for your needs.
Introduction to Behind-the-Ear (BTE) Hearing Aids
Behind-the-hear (BTE) hearing aids are a type of hearing aid that is designed to sit behind the ear.
They are made up of a small, curved case that fits snugly behind the ear, with a tube that extends into the ear canal.
The tube is connected to a custom-molded earpiece that sits comfortably in the ear canal.
Behind-the-hear hearing aids put the bulk of the hearing device outside of the ear.
This allows manufacturers to add features to BTE aids that you don’t always see in in-the-ear (ITE) aids.
What you get in features, you give up in discretion.
BTE hearing aids are less discrete (easier to see) than ITE aids.
How BTE Hearing Aids Work
BTE hearing aids work by amplifying sounds that enter the microphone located in the hearing aid’s case.
The sounds are then processed by a microchip in the hearing aid, which analyzes the sound and adjusts the volume and frequency of the sound based on the user’s hearing needs.
The processed sound is then sent to the earpiece, where it is transmitted to the ear canal, allowing the individual to hear more clearly.
Types of BTE Hearing Aids
There are different types of BTE hearing aids available, including:
Mini BTE Hearing Aids
Mini BTE hearing aids are smaller than traditional BTE hearing aids and are designed to be more discreet.
They have a slim tube that fits into the ear canal and a small casing that sits behind the ear.
Receiver-in-Canal (RIC) Hearing Aids
RIC hearing aids are similar to mini BTE hearing aids, but the speaker is located in the ear canal instead of the casing.
This design allows for a more natural sound and better sound quality.
Power BTE Hearing Aids
Power BTE hearing aids are designed for individuals with severe to profound hearing loss.
They are larger and more powerful than traditional BTE hearing aids and can amplify sounds at higher volumes.
Benefits of BTE Hearing Aids
BTE hearing aids offer several benefits, including:
BTE Hearing Aids Are Comfortable
BTE hearing aids are designed to be comfortable, with a custom-molded earpiece that fits snugly in the ear canal.
BTE Hearing Aids Are Durable
The casing of the BTE hearing aids is made of sturdy material, making them more durable than other types of hearing aids.
BTE Hearing Aids Are Flexible
BTE hearing aids can be programmed to meet an individual’s specific hearing needs, making them a flexible option.
BTE Hearing Aids Can Have Improved Sound Quality
BTE hearing aids can provide high-quality sound, thanks to their advanced processing capabilities.
How BTE Hearing Aids Differ from Other Types
BTE hearing aids differ from other types of hearing aids in several ways, including:
BTE Design
BTE hearing aids are designed to sit behind the ear, whereas other types of hearing aids can sit inside the ear canal or partially inside the ear.
BTE Power
BTE hearing aids are available in more powerful options than other types of hearing aids, making them suitable for individuals with severe to profound hearing loss.
BTE Connectivity
BTE hearing aids can often connect to other devices, such as smartphones or televisions, allowing for more seamless integration with technology.
BTE Size
While mini BTE hearing aids are available, BTE hearing aids can still be bulkier than other types of hearing aids, making them more visible.
BTE Aids Work for Certain Types of Hearing Loss
Because BTE hearing aids have flexible power settings, they are appropriate for several types of hearing loss.
Mild to Severe Hearing Loss
According to the American Speech-Language-Hearing Association, BTE hearing aids are suitable for individuals with mild to severe hearing loss. They can amplify sound and help individuals hear better in various environments[1].
Conductive Hearing Loss
Conductive hearing loss occurs when there is a problem with the middle or outer ear, which affects the ability to conduct sound. BTE hearing aids can be beneficial in this case as they can amplify sound and bypass the problem area, according to The Hearing Review’s article “The Role of Behind-the-Ear Hearing Aids in Treating Conductive Hearing Loss [2].
Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is damage to the inner ear or auditory nerve. BTE hearing aids can help by amplifying sound and improving speech comprehension, according to Starkey Hearing Technologies’ 2021 article “What is Sensorineural Hearing Loss?” [3]
Mixed Hearing Loss
According to The Hearing Review’s 2016 article “Combining Hearing Aid Technology for Mixed Hearing Loss, mixed hearing loss is a combination of conductive and sensorineural hearing loss. The Hearing Review states that BTE aids can help people with mixed hearing loss improve overall hearing ability [4].
How BTE Hearing Aids Perform During Physical Activity
BTE hearing aids can be worn during physical activities as they are designed to stay securely behind the ear.
Many hearing aid manufacturers offer protective covers that can help protect the hearing aid from sweat, moisture, and dust during physical activity.
Regular cleaning can help prevent moisture and sweat from accumulating inside the hearing aid, which can damage the device over time.
If you’re engaging in high-intensity activities that involve a lot of movement or impact, such as running or contact sports, it’s a good idea to remove the hearing aid to avoid the risk of it falling off or getting damaged.
BTE Hearing Aid Maintenance and Cleaning Requirements
BTE hearing aids require regular cleaning and maintenance, such as cleaning the earpiece and casing with a soft, dry cloth and changing the batteries as needed. Your hearing healthcare professional can provide specific cleaning and maintenance instructions.
BTE hearing aids are delicate electronic devices that require regular maintenance to ensure optimal performance and longevity. The following are some maintenance requirements for BTE hearing aids:
BTE Cleaning
BTE hearing aids should be cleaned regularly to remove dirt, earwax, and other debris that can accumulate in the device. A soft, dry cloth or a specialized cleaning tool can be used to clean the exterior of the device, while a wax pick or brush can be used to clean the receiver and tubing.
BTE Storage
BTE hearing aids should be stored in a dry, cool place when not in use, preferably in a protective case. This helps prevent damage from moisture, heat, and dust.
BTE Batteries
BTE hearing aids typically use small, disposable batteries that need to be replaced periodically, depending on usage. It is important to replace batteries regularly to prevent damage to the device from leaking batteries.
BTE Servicing
BTE hearing aids should be serviced by a hearing healthcare professional at least once a year to check for proper functioning, replace parts that have worn out, and make any necessary adjustments to the device.
BTE Repairs
If a BTE hearing aid is damaged or not functioning properly, it may need to be repaired. It is important to have repairs done by a qualified technician to ensure that the device is properly repaired and functioning optimally.
Advantages of BTE Hearing Aids
BTE hearing aids can be more comfortable and flexible than other types of hearing aids. Here are some features to expect when buying a BTE hearing aid.
BTE Comfort and Durability
Firstly, BTE hearing aids are known for their comfort and durability. They sit behind the ear, with a small tube or wire connecting to an earpiece that sits inside the ear canal. This design allows for a more comfortable fit than other types of hearing aids, which can sit inside the ear canal and cause discomfort or irritation. Additionally, BTE hearing aids are often more durable than other types of hearing aids, as they are less likely to be affected by moisture or earwax buildup.
BTE Flexibility
Another advantage of BTE hearing aids is their flexibility. They are available in a variety of styles and colors, and can be customized to fit the specific needs of the individual wearer. Additionally, BTE hearing aids can be programmed to amplify certain frequencies or sounds, making them suitable for individuals with different degrees and types of hearing loss.
BTE Sound Quality
In terms of sound quality, BTE hearing aids are known for their superior performance. They can provide a high level of amplification, even for individuals with severe to profound hearing loss. Additionally, BTE hearing aids can often filter out background noise and enhance speech, making it easier for the wearer to understand conversations in noisy environments.
BTE Connectivity
BTE hearing aids also offer several technical advantages over other types of hearing aids. They can often connect to other devices, such as smartphones or televisions, allowing for more seamless integration with technology. Additionally, BTE hearing aids can be programmed remotely by a hearing healthcare professional, making it easier to adjust the settings to meet the wearer’s specific needs.
Types of BTE Hearing Aids
When it comes to choosing a behind-the-ear (BTE) hearing aid, there are several styles and designs to consider. Each style has its own unique features and benefits, allowing individuals to select the option that best fits their specific needs and preferences.
Standard Behind the Ear Hearing Aids
One common style of BTE hearing aid is the standard BTE. This design features a small, curved case that sits behind the ear and is connected to an earpiece by a thin tube or wire. This style is known for its comfort and versatility, as it can be worn by individuals with a variety of ear shapes and sizes. Additionally, standard BTE hearing aids can be customized to fit the specific degree and type of hearing loss.
Receiver in Canal (RIC) BTE Hearing Aids
Another style of BTE hearing aid is the receiver-in-canal (RIC) or receiver-in-the-ear (RITE) hearing aid. This design is similar to the standard BTE hearing aid, but the speaker or receiver is placed directly in the ear canal instead of in the case behind the ear. This allows for a more natural sound and a less visible design. RIC/RITE hearing aids are also known for their durability and moisture resistance, as the electronic components are located away from the ear canal.
Mini Behind the Ear Hearing Aids
A third style of BTE hearing aid is the mini BTE. This design is similar to the standard BTE hearing aid, but with a smaller case that sits behind the ear. The earpiece is connected to the case by a thin tube, which is less visible than the thicker tubing used in standard BTE hearing aids. Mini BTE hearing aids are known for their discreet design and comfortable fit, as they are lightweight and sit snugly behind the ear.
BTE Hearing Aid Price Ranges
BTE hearing aids can range in price from $500 to $5000 per device.
Cheaper BTE Hearing Aid Features
When purchasing a $500 BTE hearing aid, buyers can generally expect a basic model with fewer features. These hearing aids may have limited amplification capabilities, basic noise reduction, and may not be able to connect to other devices wirelessly. They may also have a shorter lifespan than more advanced models and may require more frequent maintenance and repairs.
| Features to Expect in a Cheaper Behind the Ear Hearing Aid | |
|---|---|
| Feature/Benefit | Description |
| Affordable | Cheaper BTE hearing aids are typically more affordable, making them a good option for those on a tight budget. |
| Basic Amplification | Cheaper BTE hearing aids typically have basic amplification capabilities, which can help improve overall hearing ability. |
| Easy to Use | Basic models are typically easier to use, with fewer complicated settings and options. |
| Easy to Maintain | With fewer features, basic BTE hearing aids can be easier to maintain and repair. |
| Comfortable Fit | Many basic BTE hearing aids come with multiple earbud sizes to ensure a comfortable fit for the wearer. |
Expensive BTE Hearing Aid Features
Advanced BTE hearing aids come with custom fit, wireless connectivity, advanced noise reduction, and directional microphones.
A custom-fit allows the clinician to mold the BTE hearing aid to the wearer’s ear. The wireless feature connects the BTE to the phone and TV.
The advanced noise reduction uses software to dampen unwanted sounds.
Directional microphones give the BTE the ability to focus on the desired sound and exclude other noises.
| Features to Expect in an Expensive Behind the Ear Hearing Aid | |
| Feature/Benefit | Description |
| Advanced Amplification | High-end BTE hearing aids typically have advanced amplification capabilities that can help improve speech clarity and sound quality. |
| Noise Reduction | High-end models often have advanced noise reduction capabilities that can help reduce background noise and improve listening comfort in noisy environments. They use software to process noise and fitter out unnecessary sounds. |
| Directional Microphones | Many high-end BTE hearing aids have directional microphones that can help focus on specific sounds, such as the person speaking, and reduce background noise. |
| Wireless Connectivity | Many high-end models have wireless connectivity options, such as Bluetooth or Wi-Fi, which allow the wearer to connect to other devices, such as smartphones, televisions, or music players. |
| Customizable Settings | High-end BTE hearing aids may have customizable settings that allow the wearer to adjust the sound and settings based on their specific hearing needs and preferences. |
| Longer Battery Life | High-end BTE hearing aids often have longer battery life, reducing the need for frequent battery changes. |
| More Durable | With higher-quality materials and construction, high-end BTE hearing aids are typically more durable and can withstand daily wear and tear better than cheaper models. |
| Better Aesthetics | High-end BTE hearing aids often have a more discreet design, with smaller or more hidden components, making them less noticeable when worn. |
| Automated Volume Control | In higher end BTE hearing aids, you might find a software controlled volume control to keep the volume range within safe and hearable end points |
| Frequency Response | With a frequency response feature, the BTE hearing aid amplifies frequencies based on the user’s hearing loss, to fill in the gaps. This feature is essential for clear voices that mask out background noise |
| Telecoil | Some models have telecoil settings that allow the wearer to pick up sounds from loop systems in public spaces, such as theaters or churches. |
| Program Settings | Some BTE hearing aids have multiple program settings that can be customized for different listening environments, such as a noisy restaurant or a quiet room. |
| Feedback Reduction | Many BTE hearing aids have feedback reduction features that help prevent whistling or other feedback noises that can be uncomfortable or distracting. |
Comparing BTE Hearing Aid Costs to Other Hearing Aid Types
BTE hearing aids are generally priced in the mid to high range of the hearing aid types you might buy.
In-the-ear (ITE) hearing aids, for example, are typically less expensive than BTE hearing aids, but may not be as versatile or effective for individuals with more severe hearing loss.
Similarly, completely-in-the-canal (CIC) hearing aids may be less visible and more discreet, but may not provide the same level of amplification as BTE hearing aids.
While the initial cost of a BTE hearing aid may be higher than other types of hearing aids, they can often be a worthwhile investment due to their durability, versatility, and ability to accommodate a wide range of hearing loss types and degrees.
Common Complaints About BTE Hearing Aids
Despite their many benefits, BTE hearing aids may occasionally present some issues or complaints for users. The following are some of the most common complaints or issues associated with BTE hearing aids, along with potential solutions:
Feedback and/or Whistling
Feedback or whistling can occur when the sound from the hearing aid is amplified and then picked up by the microphone, creating a feedback loop. Feedback can be caused by a loose-fitting hearing aid, earwax buildup, or incorrect placement of the device. Solutions include properly fitting the device, cleaning the earwax from the ear canal, or repositioning the device.
Discomfort and/or Irritation
BTE hearing aids may cause discomfort or irritation, especially when first worn. This can be due to the device’s fit, the materials used in the device, or an allergic reaction to the device. Solutions may include adjusting the device’s fit, using hypoallergenic materials, or consulting a hearing healthcare professional.
Poor Sound Quality
BTE hearing aids may produce poor sound quality, which can be caused by a variety of factors such as the device’s settings, the user’s hearing loss, or background noise. Solutions may include adjusting the device’s settings, using noise reduction features, or trying different listening environments.
Short Battery Life
BTE hearing aids require batteries to operate, and users may experience issues with batteries not lasting long enough. This can be caused by high usage or the use of batteries that are not compatible with the device. Solutions may include using high-quality batteries or using rechargeable batteries.
Malfunction
BTE hearing aids are complex electronic devices that may occasionally malfunction. This can be due to a variety of factors such as wear and tear, moisture exposure, or damage to the device. Solutions may include having the device serviced or repaired by a qualified technician.
In general, most complaints or issues associated with BTE hearing aids can be addressed by consulting with a hearing healthcare professional. These professionals can help diagnose the issue and provide solutions to ensure the user’s BTE hearing aid is functioning optimally.
The Effectiveness of BTE Hearing Aids
BTE hearing aids are highly effective in improving hearing loss for many individuals. However, the effectiveness of these hearing aids can vary depending on a range of factors.
Hearing Loss Severity
One of the most significant factors impacting the effectiveness of BTE hearing aids is the severity and type of hearing loss. BTE hearing aids are generally effective in treating mild to severe hearing loss, but they may not be as effective for those with profound hearing loss.
Hearing Loss Type
Additionally, the specific type of hearing loss can impact the effectiveness of BTE hearing aids. For example, if an individual has difficulty hearing high-frequency sounds, a BTE hearing aid with specialized settings for high-frequency sounds may be more effective for them.
User’s Comfort with BTE Controls
Another factor that can impact the effectiveness of BTE hearing aids is the individual’s ability to adjust to wearing and using the hearing aid. Some individuals may find the adjustment period challenging and may require more time to adapt to the hearing aid.
User’s Lifestyle
Additionally, the individual’s lifestyle and environment can impact the effectiveness of the hearing aid. For example, if an individual frequently participates in noisy activities, such as concerts or sporting events, a BTE hearing aid with advanced noise-reduction features may be more effective for them.
More BTE Hearing Aid Resources For You
What resources are available to assist me in learning more about BTE hearing aids, and where can I find reliable reviews and recommendations from other users?
There are several resources available for individuals who want to learn more about BTE hearing aids, as well as to find reliable reviews and recommendations from other users. Some of these resources include:
Hearing Healthcare Professionals
A licensed hearing healthcare professional can help you understand your hearing loss and recommend the best BTE hearing aid for your specific needs.
BTE Hearing Aid Manufacturers
Most BTE hearing aid manufacturers have websites that provide information on their products, including features, benefits, and pricing.
Consumer Review Websites
Websites like ConsumerReports.org and HearingTracker.com provide reviews and ratings of BTE hearing aids from other users.
Hearing Loss Support Groups
Local or online support groups can provide a community of people who have experience with BTE hearing aids and can offer recommendations based on their personal experiences.
Online Question/Answer Forums
Reddit and Quora provide a platform for people to ask and answer questions about BTE hearing aids, and to share their experiences and recommendations.
The CDC’s List of Hearing Support Resources
The CDC lists a number of excellent resources for learning about BTE hearing aids and hearing loss. Resources listed include non-profits, universities, and support groups.
You can see the CDC’s list here.
