Appearance of HAs / going against audi form factor recommendation

I have large BTEs with full shell moulds because of the level of my loss, but I do get people who on noticing my hearing aids automatically think that I can hear normally. I explain that I’m deaf and need to have them face me when they speak and if they don’t then I start signing at them (I do use British Sign |language as well) and that soon takes them down.

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So are you saying a BTE tube does not go into the ear canal? I’m asking because I have a huge problem with trying to fit Ric receivers in my ears…

Yes, it does. But not the receiver.

Terminology evolved in bits by different developers so terms are inconsistent.

We have to get sound from amplifier through speaker to ear. What matters to you is: where is the speaker? (Our HAs’ tiny speakers are called “receivers” from very old times.)

The older BTE had the receiver in the body of the Instrument behind the ear. Sound was fed through a tube to the ear. I have never seen the term “RII” but that’s what it is, Receiver In Instrument.

Tubes suck sound. A slim tube absorbs the higher-pitch sounds. If the user does not need a lot of high-boost this can work OK. This was the usual HA most of the late 20th century.

Getting the receiver closer to the ear promises better sound, also less bulk behind the ear. Improved electronics made this happen.

A classical receiver is awful big for any ear-hole, but can be put in the concha with tip extending into the canal. (Signal comes via electric wire, normally sheathed in a tube.) RIE, Receiver In Ear. I have an OTC RIE and just the weight bothers me (but the whole instrument was in the concha).

Newer receivers can be made 5mm by 3mm and can fit IN the canal. RIC, Receiver In Canal. At least it fits some people.

In any case we need some form of “tip” to hold the tube or receiver and to more-or-less seal the ear to control sound flow. This can range from a tiny “open dome” to a custom-fit “impression”.

Moving from RIC to RIE “seems” an easy in-office change. Moving from RIC/RIE to receiver in the over-ear instrument means new instruments.

BTE, behind the ear aids have tubes that go into the ear canal with a dome or ear mold.

RIC receiver in the ear aids have wires with a hunk of metal (receiver) the goes in the ear canal with a dome or ear mold.

Some people with very small ear canals can not wear RIC aids.

A friend of mine used to have a clinic in Oregon. He had a judge come in with a hearing loss and wanted the “biggest clunkiest hearing aid available”. When asked why, he replied that if he asks an attorney to please repeat a statement, it almost seems like he did not believe the statement. With a big clunker on, now all he had to do was turn his head so the hearing aid was visible and the attorney repeated the statement and actually talked a little slower. Being visible is not always a bad thing.


Please give an example, make, model of a RIE. Thanks.

I heard that BTE’s go into the ear canal just as far as RIC’s. There is no difference. Is this true? t/u.

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That is true.
The sound comes out of a sound tube with BTE aids and the sound comes out of a receiver (speaker) with RIC aids. Both go in the ear canal the same.
A BTE aid with a slim tube is almost indistinguishable from a RIC aid.

I feel that with the ITE hearing aids and the mics in the Ear that all sound is more like normal hearing, because the hearing aids use the ear which the natural way we hear. The mics behind the ear too me just doesn’t sound the same.

The tube is slimmer than most receivers.

Quite true. There is a fairly standard correction, which can be refined with real-ear tests. The cochlea has a complex organic directional pattern, microphone directionality is simple (though clever processing may make it more-like a human cochea). But it isn’t the same.

5 years ago I had same concern and while I was not happy with previous Resound Linx2, barely someone noticed it.
Now with the OPN S, I went to a walk-in clinic for some flue and while this doctor knows me since 2 years ago she discovered I have HA only when she asked to check my ears for fluid. She even asked me about brand / type and performance as her husband have same concerns which hold him if getting HA.
Several dispensers and ENT told me that the IIC is only suitable for mild HA and not Even recommended for moderate loss.

They can make that argument, but they are full of it!! I KNOW from experience!!!