BTE hearing aids: Receiver-in-the-aid vs. receiver-in-the-ear

Hearing Aids
#1

At one time all BTE hearing aids had a built in receiver in the HA body, which was located behind the ear. Then (as far as I know) in the early 2000’s a switch was made to remove the receiver from the HA and relocate it inside the ear mold. The rationale behind the move was too locate the receiver closer to the ear canal, ear drum, inner ear thus improving hearing aid performance. At the time it was some what of a radical change that I’m not sure all HA manufactures followed.

Now fast forward to 2020 and I believe some HA manufactures are only offering “receiver in HA body” to be worn behind the ear. Which is very confusing to me. I’ve trialed M90 to be told receiver is in HA body and when receiver wears out it has to be sent to shop for replacement. I also think Widex has gone back and forth (depending on Widex aid) with receiver in aid versus receiver in mold.

So my question is why the ping-pong back and forth and uncertainty as to the proper location of a HA receiver? Also if one has worn a ITE receiver (in custom mold) for years, would it be hard to adapt or accept a power hearing aid with receiver back in the HA body? Based on the assumption that the location of a HA receiver will impact one’s level of hearing.

So now it seems we are “back to the future” and I wonder if the jury’s out as to the best location of receiver with a behind the ear hearing aid.

#2

There are several types of hearing aids, and that hasn’t changed in at least a decade. There are several types of custom in the ear aids, and several BTE types. There’s RIC, with the receiver in the ear, acoustic thin tube, which is an open fit design with the receiver in the HA body, and traditional BTEs with the receiver in the HA body.

The traditional and acoustic thin tube aids transmit the sound through tubing into the ear. The tubing needs to be replaced ever few weeks to months.

There’s been no ping-ponging or uncertainty; just a few different approaches to dealing with hearing loss.

#3

But my question was - which approach is best from a “hearing stand point”. RIC can be various sizes, attempting to adapt to one’s hearing level loss. I’m not sure a receiver in BTE has that capability to change sizes (due to internal spacing limitations). And to add to the equation

RIC can many times can be replaced by Audi in office
BTE receiver has to go to shop for replacement - time delay

Does a BTE receiver last longer then a RIC? Etc. So even beyond “my hearing level question” there are several other issues related to receiver longevity and cost to replace. And “who” does the replacement, etc. Just seems to me this matter should be closed by now since we’ve had both types of HA’s for decades, yet no clear answer as to which of the two is the best to chose.

#4

The terminology is a bit confusing. RIC aids have the Receiver In the Canal, and that is quite descriptive. However the hearing aid is located behind the ear, which can cause some some confusion. What are commonly called BTE aids or Behind the Ear distinguish themselves by using a tube instead of a wire to get the sound to the ear. The receiver is located in the hearing aid. I believe it has been that way for many ears and manufacturers have made both types.

The advantage of a BTE aid is that they typically can provide more power up into the ultra power range. Perhaps that is because the receiver can be bigger as it is located in the hearing aid. However, most do not need that kind of power, so they are overall less popular. With a BTE type they can fit in a very small ear canal so someone that is limited by canal size may find them better.

The disadvantage of a BTE is as you have determined is that they are not easy to switch receivers with, if you need more power, or they fail.

Which is best will depend on the person’s needs. From your audiogram, you may need the UP power of a BTE using a larger tube size.

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#5

Wouldn’t the receiver in the canal be more susceptible to ear wax and moisture, thus the need for that filter that’s not really a filter but has a tendency to clog. I’ve never had that problem with everything behind the ear and have asked the audi to remove that little so called filter

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#6

I wear ITE hearing aids and while I do have to change the wax filters normally monthly. I clean my aids every night and place them in a dryer and I have had much less issues with them than I did with the receiver in the canal hearing aids that had the electronics behind the ear. I sweat so much, and live in a humid area of the country. I have never had my ITE aids fail due to moisture, but I have had my BTE Rite aids fail way to much.

#7

It is very easy to change the wax guard on a RIC style aid. Costco will do it for you if you bring the aids in, but that is much more bother than just doing it yourself.

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#8

Sierra - thanks for replay since this issue is confusing on many levels. When I received my Widex Super 440 hearing aids back in 2012 there were various receiver sizes you could chose from to use/fit in a custom ear mold. Obviously the largest size receiver was the choice for my hearing loss, with wire connection. So for what ever reason back in 2012 Widex felt the HA receiver should be in the ear and not behind the ear. In fact all HA dealers/Audi’s I talked to said the RIC was the way to go and allowed for better hearing over the BTE HA with receiver tubing.

Now I’m just trying to figure out what has changed where you and others claim (in 2020) there are different approaches to the receiver location. Has something changed over the last 4, 5, 6 years to make HA manufacturers rethink their power aid receiver location? Also - and I think this point is pretty critical. If someone has worn a RIC power aid for 5, 10, 15 years will they have difficulty adjusting to using a power aid HA with receiver in HA body/BTE? Maybe that’s all answered during a HA trial period but as we all know - our brain becomes programmed some what to hear the way we’ve been hearing over the last several years. So switching back and forth between receiver location and wire connection versus tubing when buying a new aid seems another “hurdle” that needs to be jumped - when if fact it should of been jumped and cleared years ago. As in the “real winner” is ???

#9

Technology is changing rapidly and the manufacturers try to follow what people want more than what people need

#10

I think it is a potentially a progression issue for you. Perhaps in the past a RIC power was enough. It may not be any longer. I am not sure there is any reason you could not handle a switch to BTE. As they are less popular manufacturers tend to be slower to move the latest technology (like wireless streaming) to the BTE aids, but they are still credible aids. I have a friend that had $10,000 or so BTE aids years ago (was then on a Cadillac insurance plan), and more recently he has moved (primarily due to cost) to Costco RIC style aids. He says his older BTE aids actually worked better for him.

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#11

With a BTE, you lose some high frequency gain as the sound travels down the tube. You don’t have that problem with a RIC. However, there are limits to how powerful a receiver you can put in a RIC. Sierra is probably correct that your having gone BTE–>RIC–>BTE probably has to do with the progression of your hearing loss.

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#12

I wear Phonak M90s, and the receiver is in the ear canal – RIC.

(“Receiver” is a confusing term for those of us who first used it for a piece of audio entertainment equipment; originally it applied because the primary purpose of that piece was receiving FM radio. For HAs, it basically means “speaker,” or more generally, “receiver of the output of the amplifier.”)

Also, for RICs the receiver doesn’t have to be in a mold. It can be, but it might have only a rubber dome attached.

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Why is a hearing aid speaker called a receiver?
#13

It may be easy but they always seem to be a problem at the most inopportune time. And with my list a blocked filter means deaf.

#14

How does removing the filter prevent wax blockage of what it is removed from?

#15

These filters aren’t really filters but instead do something to affect the sound you hear. People just assume they are filters. I have never ever had a wax blockage reach my behind the ear aids. The molds themselves may develop a blockage. I had more of a problem with filters when I wore ite aids but those days are long over. I’m just saying that when I trialed my phonak naidas and saw those little paper things I just asked that they be removed. I just felt it was one more thing to go wrong. But yes if you wear ite aids they come in handy. But for bte aids where everything is enclosed in the aid I find them to be useless. But again my audi explain that on the naidas they’re not really wax filters. That’s a misconception. Instead they are there to do something to the sound. I couldn’t get the sound to balance so I asked him to remove them. That solved the balancing problem and I didn’t notice any difference in sound. But I remember from ite days when those paper filters clogged I was deaf and changing them out wasn’t always convenient.

#16

We may be talking about different things. I use Cerustop Wax Guards. They don’t affect sound. They’re little gizmos that go into a small “tunnel” just outside of the speakers in the receiver. What they do is protect the receiver speakers from becoming “waxed”. It’s much easier to remove/replace the guard than it would be to clean the wax from an unguarded receiver.

#17

Yeah that’s a little wire spring like thing right at the start of the ite aid to protect the aid from wax. There used to me a paper filter in the ear hook for bte aids. It was always getting clogged by either moisture or wax. Hadn’t seen one in years.

#18

Yeah, the hook filter isn’t for wax. It’s to smooth out the peakiness of the sound at particular frequencies. It’s not as necessary now that we can adjust the sound digitally in a fairly fine way. For many people it is never a problem, but for people with significant moisture it is one more point of failure.

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