You’ll need to choose between In-the-Ear and Behind-the-Ear when shopping for a hearing aid. We discuss Behind-the-Ear in The Ultimate Guide to BTE Hearing Aids for Seniors (opens in a new window).
In-the-ear (ITE) hearing aids are a type of hearing aid that is custom-made to fit entirely inside the ear canal. ITE hearing aids are good for moderate hearing loss. They are discreet and comfortable. Most people find them to be easy to use and maintain.
Compare ITE to behind-the-ear (BTE) hearing aids. BTE aids sit behind the ear, rather than in the ear. BTE aids are connected to the ear canal by a tube. ITE aids do not need a tube as they are already inside the ear.
Choose From In-the-Ear and Behind-the-Ear Hearing Aids
Of all the choices you’ll make when acquiring hearing aids, choosing ITE or BTE is one of the most important. The choice you make affects both your comfort and the quality of your hearing aid solution.
You already know that hearing aids are devices designed to improve hearing ability for individuals with hearing loss. They work by amplifying sounds or by enhancing certain frequencies of sound.
Audiology.org points out that hearing aids allow individuals with hearing loss to more easily communicate with others, whether it’s in social situations or at work[1].
Most of all, they contribute to your quality of life.
When my dad’s father lost his hearing, he didn’t just withdraw socially.
He accused his children of plotting to hurt him.
The paranoia that the deafness created was devastating to my dad and his siblings.
Whether you choose ITE or BTE, do choose to get help with your hearing.
A hearing aid helps you feel more connected to the world[2].
An ITE or BTE hearing aid also makes it possible to hear important sounds, such as alarms, sirens, or truck backup signals.
A hearing aid will also support your cognitive health.
The Journal of the American Medical Association points to studies showing that untreated hearing loss can lead to cognitive decline and an increased risk of conditions such as dementia.
Using a hearing aid can help mitigate these risks and keep the brain active and engaged[3].
Here is what you need to know about In-the-Ear hearing aids.
Types of In-the-Ear (ITE) Hearing Aids
There are several different types of in-the-ear (ITE) hearing aids, each with its unique features and benefits.
The most common types of ITE hearing aids include:
- Completely-in-Canal (CIC) hearing aids
- In-the-Canal (ITC) hearing aids
- Half-Shell (HS) hearing aids
- Full-Shell (FS) hearing aids
Completely-in-Canal (CIC) ITE Hearing Aids
Completely-in-canal (CIC) hearing aids are the smallest and most discreet type of ITE hearing aid, as they are designed to fit entirely inside the ear canal.
CIC hearing aids are custom-made to fit the shape of your ear canal and are almost invisible when worn.
In-the-Canal (ITC) ITE Hearing Aids
In-the-canal (ITC) hearing aids are slightly larger than CIC hearing aids but still fit entirely inside the ear canal.
ITC hearing aids are custom-made to fit the size and shape of your ear canal and are less visible than other types of hearing aids.
Half-Shell (HS) ITE Hearing Aids
Half-shell (HS) hearing aids are slightly larger than ITC hearing aids and sit partially in the ear canal.
HS hearing aids are custom-made to fit the shape of your ear and are a good choice for people with slightly larger ear canals.
Full-Shell (FS) ITE Hearing Aids
Full-shell (FS) hearing aid is the largest type of ITE hearing aid and sits in the outer part of the ear.
FS hearing aids are custom-made to fit the shape of your ear and are a good choice for people with larger ear canals or more severe hearing loss.
What are the Benefits of the In-the-Ear Type of Hearing Aid?
ITE hearing aids are harder to see than Behind-the-Ear (BTE) hearing aids.
This makes them more discrete.
Some people find BTE hearing aids to be more comfortable than ITE hearing aids.
ITE Hearing Aid Discreetness
ITE hearing aids are custom-made to fit entirely inside the ear canal, making them almost invisible when worn.
ITE Hearing Aid Comfort
Because they are custom-fit, ITE hearing aids are often more comfortable to wear than other types of hearing aids.
ITE Hearing Aid styles
ITE hearing aids come in a range of styles and sizes to fit different ear shapes and hearing needs.
ITE Ease of Use
Many ITE hearing aids have simple controls and features that make them easy to use and maintain.
What are the Disadvantages of ITE Hearing Aids?
While there are many benefits to choosing in-the-ear (ITE) hearing aids, there are also some drawbacks to consider. These may include:
- Limited Amplification
- Earwax Issues
- Cost
Limited Amplification
Because ITE hearing aids are custom-fit to the ear canal, they may not provide as much amplification as other types of hearing aids.
Behind-the-Ear (BTE) hearing aids are capable of more power and amplification.
Earwax Difficulties
ITE hearing aids sit entirely inside the ear canal.
Ear wax can build up around them, ironically creating hearing loss as it blocks the eardrum.
How Do In-the-Ear (ITE) Hearing Aids Work?
ITE hearing aids are custom-made devices that fit into the ear canal, allowing for a discreet and comfortable listening experience.
ITE Hearing Aid Construction
An ITE hearing aid is made up of a microphone, an amplifier, a speaker (also called a receiver), and a battery.
The microphone picks up sound from the environment, which is then amplified by the device.
The amplified sound is sent to the receiver, which converts it into a digital signal and sends it into the ear canal.
ITE Customization
The amplification process can be customized to the individual’s hearing needs. For example, if someone has difficulty hearing high-pitched sounds, the device can be adjusted to amplify those frequencies more than others.
This customization is often done through a process called “fitting,” where an audiologist tests the individual’s hearing and adjusts the hearing aid settings accordingly.
ITE Advanced Features
In addition to amplifying sound, many ITE hearing aids now come with advanced features such as noise reduction, directional microphones, and Bluetooth connectivity.
Noise reduction helps to filter out background noise, making it easier to hear speech in noisy environments.
Directional microphones can focus on specific sounds, such as someone speaking directly in front of the wearer.
Bluetooth connectivity allows the hearing aid to connect wirelessly to a smartphone or other device, enabling hands-free phone calls and streaming of music or other audio.
Who Should Wear an In-the-Ear (ITE) Hearing Aid?
In-the-ear (ITE) hearing aids are a good choice for people with mild to moderate hearing loss seeking a device that is difficult to see.
I put the resources I used for these answers at the bottom of this section.
Discreetness and Comfort
ITE hearing aids are more discreet than Behind-the-Ear (BTE) hearing aids.
They are inside the ear where they are harder to detect.
Some people find ITE hearing aids more comfortable than BTE hearing aids; for others, the opposite is true.
Mild to Moderate Hearing Loss
In-the-ear (ITE) hearing aids can be a good option for people with mild to moderate hearing loss, but they may not be suitable for everyone.
The suitability of an ITE hearing aid depends on several factors, including:
- the type and severity of the hearing loss
- the shape and size of the ear canal
- the individual’s lifestyle and communication needs
ITE hearing aids work by amplifying sound and sending it into the ear canal.
This amplification can be customized to the individual’s hearing needs, but there are limitations to how much amplification can be provided.
For people with severe hearing loss, ITE hearing aids may not provide enough amplification to be effective.
Ear Canal Shape and Size
The shape and size of the ear canal can also affect the suitability of ITE hearing aids.
Since these devices are custom-made to fit inside the ear canal, there needs to be enough space for the device to fit comfortably without causing discomfort or irritation.
People with very narrow or irregularly shaped ear canals might not be able to use ITE hearing aids.
User Lifestyle Needs
Finally, lifestyle and communication needs can also play a role in determining the suitability of ITE hearing aids.
For example, people who are very active or participate in sports may find that ITE hearing aids are more prone to falling out or getting damaged than other types of hearing aids.
Similarly, people who frequently communicate in noisy environments may benefit from hearing aids with advanced noise reduction features that are not available on all ITE devices.
Resources for Learning More about ITE Hearing Aids
- Types of Hearing Aids: In-the-Ear by the American Speech-Language-Hearing Association (ASHA)
- In-The-Ear (ITE) Hearing Aids by the Better Hearing Institute (BHI)
- In-The-Ear (ITE) Hearing Aids: Pros, Cons, and Costs by Everyday Hearing
- In the Ear (ITE) Hearing Aids by the Hearing Loss Association of America (HLAA)
How Much Do ITE Hearing Aids Cost?
ITE hearing aids range from about $500 to $1500. When comparing ITE to Behind-the-Ear, the ITE is usually more expensive.
| Features of Cheaper ITE Hearing Aids | Benefits |
|---|---|
| Amplification | Basic amplification but not software-based control |
| Microphones | Basic models use microphones that pick up sound from the environment without discriminating where the sound is coming from |
| Volume Controls | Basic models have a volume selector dial or buttons |
| Customization | Basic models have limited customization to keep costs low |
| Discreet design | Basic ITE hearing aids are hard to detect |
| Hearing Loss Type | Basic models are good for moderate hearing loss. Expensive ITE as well as the Behind-the-Ear (BTE) hearing aids are better for profound hearing loss. |
| Features of Expensive, High-End ITE Hearing Aids | Benefits of Expensive, High-End ITE Hearing Aids |
|---|---|
| Noise Reduction | High-end ITE hearing aids use software algorithms to detect and eliminate noise. This reduces background noise and increases speech clarity. |
| Microphones | Expensive ITE hearing aids use directional microphones to avoid picking up sounds you don’t want to hear. |
| Connectivity | Higher-end ITE hearing aids allow you to use the hearing aid as a Bluetooth earbud for TV and phone calls. |
| Customization | Expensive BTE aids allow you to choose from colors and materials. |
| Feedback | Software prevents feedback noises including whistling |
| Hearing Loss Type | Expensive ITE hearing aids help with more profound hearing loss. |
Do ITE Hearing Aids Require Special Cleaning or Maintenance?
Like all hearing aids, in-the-ear (ITE) hearing aids require regular cleaning and maintenance to ensure optimal performance and longevity.
Here are some tips on how to care for your ITE hearing aids.
Daily Cleaning
Clean your hearing aids daily using a soft, dry cloth or a special hearing aid cleaning brush to remove dirt, wax, and debris from the surface and crevices of your hearing aids.
Avoid using water or cleaning solutions, as they can damage the electronic components.
Batteries
ITE hearing aids typically use small, button-style batteries that need to be replaced every few days to a week, depending on usage.
Check the battery level regularly and carry spare batteries with you.
Make sure to remove the batteries when not in use to avoid corrosion and damage.
Avoid Moisture
ITE hearing aids are susceptible to moisture and humidity, which can cause malfunctions or damage.
Remove your hearing aids before showering, swimming, or engaging in water sports.
Consider using a dehumidifier or drying kit to remove moisture from your hearing aids overnight.
ITE Storage
When not in use, store your hearing aids in a cool, dry place, preferably in a protective case. Avoid leaving them in direct sunlight, high temperatures, or humid environments.
Common Complaints about ITE Hearing Aids
While in-the-ear (ITE) hearing aids can greatly improve hearing and quality of life, there are some common complaints that users may experience.
Here are some of the most common complaints about ITE hearing aids:
Discomfort or Irritation
Some users may experience discomfort or irritation in the ear canal or outer ear due to the size and shape of the hearing aid or the material of the ear mold.
This can lead to soreness, itching, or even infection if left untreated.
Feedback or Whistling
ITE hearing aids may produce feedback or whistling sounds if they are not fitted properly or if there is a blockage or buildup of wax or debris in the ear canal.
This can be annoying and distracting and may require adjustments or cleaning.
Inconsistent Sound Quality
Some users may experience inconsistent sound quality or volume levels with their ITE hearing aids, particularly in noisy or crowded environments.
This can make it difficult to follow conversations or hear important sounds.
Limited Battery Life
ITE hearing aids require small batteries that may need to be replaced every few days to a week, depending on usage.
This can be inconvenient and costly, especially if the user forgets to carry spare batteries.
Maintenance Difficulties
Like all hearing aids, ITE devices require regular cleaning and maintenance to ensure optimal performance and longevity. Some users may find it difficult or time-consuming to clean and maintain their hearing aids, which can lead to malfunctions or damage.
What are Some Resources to Learn More about ITE Hearing Aids?
What resources are available to assist me in learning more about ITE 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 ITE 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 ITE hearing aid for your specific needs.
ITE Hearing Aid Manufacturers
Most ITE 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 ITE hearing aids from other users.
Hearing Loss Support Groups
Local or online support groups can provide a community of people who have experience with ITE 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 ITE hearing aids, and to share their experiences and recommendations.
The CDC’s List of Hearing Support Resources
The CDC lists several excellent resources for learning about ITE hearing aids and hearing loss. Resources listed include non-profits, universities, and support groups.
You can see the CDC’s list here.
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