Ask An Audiologist: If I have really bad hearing, will I need a big hearing aid?

In the past, hearing aid size was largely dependent on the degree of hearing loss. Those with more hearing loss required more amplification. Is this still true? Our audiologist answers your questions in this new bi-weekly series!

In the past, hearing aid size was largely dependent on the degree of hearing loss. Those with more hearing loss required more amplification. The power necessary to “crank up the volume” meant larger hearing aid receivers and batteries, which in turn drove up the size of the hearing aid. As a result, those with severe or profound hearing loss were told that they were limited to bulkier and more visible Behind-the-Ear (BTE) or In-the-Ear (ITE) models.

However, thanks to recent innovations in miniaturization, it is now possible for those with more severe hearing loss to be fit appropriately with smaller and more discreet hearing aid models, such as Receiver-in-Canal (RIC). As the name suggests, RICs have receivers that are positioned in the wearer’s ear canal and connected to the main hearing aid housing via a very thin tube. This solution significantly reduces the size of the hearing aid housing, which sits behind the ear. While it’s good news that the degree of hearing loss is no longer the main restricting factor in hearing aid size, there are other perceived advantages of slightly larger hearing aids:

  • Ease of handling, Smaller hearing aids such as RICs require greater patient dexterity and visual acuity for daily handling, maintenance, and usage compared to larger BTE and ITE models
  • Durability Models that have receivers inside the ear canal (e.g., RICs and ITEs) have a delicate and sensitive component that is exposed to earwax. While interchangeable wax guards and domes go a long way to protect the receiver, these models may still require more professional service and repair over their lifetime. This consideration becomes even more relevant when the wearer has difficulty keeping their hearing aids as clean as possible due to dexterity or vision limitations.
  • Technology While many hearing aid components have been miniaturized, some hearing aid features still require extra physical components inside the hearing aid housing. For example, a telecoil is a component that allows the wearer to connect to many landline phones and looped sound systems found in public spaces like theaters and churches. Some smaller hearing aid models might not have the physical space to include a telecoil.

In short, even if your hearing loss is significant, you may no longer be limited to “big” hearing aids. Nevertheless, it is important to evaluate multiple aspects of your lifestyle and hearing needs beyond the size of the hearing aid. Whatever your needs, a hearing care professional is the best person to recommend the most suitable options for you.


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