ITE or BTE for new hearing aid

Hello everyone, I’m having a difficult time trying to decide between a Phonak ITE half-shell or full-shell, or the BTE microM or microP for my mom’s first hearing aid. She’s almost 70 yrs. old. Here are the results of her test:

0250 40 40
0500 55 50
1000 65 60
2000 65 60
3000 65 55
4000 65 55
6000 65 55
8000 70 70

0500 50 50
1000 65 50
2000 60 60
4000 60 50

SRT L/R = 55dB/50dB
DS Unaided L/R = 60% at 90dB/96% at 85dB

She had a hearing test done about 10 years ago and it was a cookie-bite pattern, now it’s much flatter. I also noticed the audiologist didn’t test 750 or 1500k frequencies. Is that OK?

The audiologist said a full ear mold is required instead of open-fit domes. Will this result in a plugged-up feeling? And will a 4-channel device be adequate or does she need 6-channels?

For the ITE, how often does wax and moisture cause the aid to fail? For the BTE, is it cumbersome to put them on and take them off? My mom wears reading glasses sometimes.

This looks like a great forum and I appreciate any feedback or suggestions. Thanks very much!

When you feel plugged up, it’s because the 250 freq is good. If the 250 freq has a hearing loss then normally you won’t feel plugged up.

BTE aids are less fiddly for elderly people. I wear BTE aids with sunglasses and have no trouble what so ever.

ITE aids are known for needing more repairs rather then BTE aids.

You can ask for a small vent to be put in maybe into the BTE mold? To help with feeling plugged up.

Rasmus braun

I am myself quite elderly and I have worn first BTE and later, ITE for extended periods of years. I prefer ITE because I find them less of a fiddle to get in and out, and I think that sounds heard directly from the transmitter are a bit clearer than sounds heard through a plastic tube.

However, I have to admit that I have to check a bit more often and if necessary to clear the entry passages of wax. Ears (and people) vary in this respect. My right ear seems to produce more wax than my left. With BTE, it is easier to see what you are doing when removing wax, but arthritic fingers (if your mum has them) would make it difficult to disconnect and reconnect the tube from the instrument - not always necessary!

250 500 1000 1500 2000 3000 4000 6000 8000
L 30 20 30 50 65 65 70 90 ∆
R 25 25 35 50 50 50 100 100 ∆
Starkey X Series 70

Thanks for the replies. Turns out we have to go with BTE because my mom’s insurance reimbursement is higher for BTE than ITE. Code V5261 versus V5260.

So my question is now what type of earmold to get. For a full earmold, should it be completely non-vented, or can it have a small vent? Also what about the SmartTip from Phonak? Is that a possible alternative to a full earmold? Thanks again.

Will all depend on her loss and what the Audi says.

Here’s what google says so you have some idea.


Advantages and Disadvantages to Venting
Venting Advantages:

Reduce unnecessary low frequency gain and output
Allow unamplified sound to enter the ear canal
Reduce occlusion effect
Relieve the feeling of pressure in the ear
Reduce moisture build-up in the ear canal.
Venting Disadvantages:
Too much venting can combine with the ear canal cavity to produce a Helmholtz resonator effect (increased gain in the 250-1000 Hz region), resulting in an echo or barrel effect when the patient speaks.
Feedback. As vent size increases, acoustic leakage increases, and therefore the probability of feedback increases.
Parallel vs. Diagonal Vents

Parallel vents are generally used, because not only do diagonal vents decrease low frequency gain like parallel vents, diagonal vents also decrease mid frequency (630-1600 Hz) gain by up to 10 dB. Therefore, unless you want to decrease mid frequency gain, parallel venting should be used.

The Effect of Parallel Vent Diameter/Canal Length
The rule of thumb is that as the parallel vent size increases (1 to 3mm), low frequency gain decreases (up to 30dB) at 500 Hz and below, and mid frequency gain 630-1600 Hz increases (up to 10 dB). As canal length increases (6 to 22 mm), the effect of venting is reduced. Thus, low frequency gain decreases are less (15 dB versus 30 dB) with long canals, and mid frequency gain will decrease as well (in fact, there may be no increase in mid frequency gain at all).*

So, what does this mean to you? If you want to increase the mid frequencies, and decrease the low frequencies, you should order a short canal (6mm) and a large vent (3mm). A long canal (22mm) with a large vent (3mm) will not reduce the low frequencies as much as a short canal (by as much as 10 dB), and the mid frequencies will be reduced more with a long canal than a short canal. Pressure equalization vents (.06-.8mm) on the other hand, no matter what the canal length is, generally only decrease gain up to 6 dB below 250 Hz.*

A Venting Selection Guide
In general, if the hearing loss below 1000 Hz is 25 dB or less, an open mold (large vent (3.0 mm) or acoustic modifier) is recommended. If the hearing loss is 30-45 dB in the low frequencies, an acoustic modifier or medium vent (2.0mm) is recommended. If the hearing loss is 50-60 dB in the low frequencies, a small vent (1.0 mm) or pressure vent (.06-.88 mm) is recommended. When the loss exceeds 60 dB, we usually do not put in a pressure vent, unless the patient is occluded or their voice bothers them. When in doubt, put in a pressure vent, and plug it if it causes problems with feedback. The “Rule of Thumb” is that it is easier to plug a vent than it is to drill a vent. We use cushion grip, a denture adhesive, to plug vents. However, before plugging the vent with cushion grip, which is hard to get out of a vent, plug the vent with Fun Tak or clay to make sure the patient is not bothered by a plugged vent. If plugging the vent does not bother the patient (occlusion, resonance in his voice, etc.), then plug the vent with cushion grip. Note, we generally plug the lateral portion of the vent, since patients feel less occluded than when we plug the medial portion of the vent. However, if feedback is still an issue after plugging the lateral portion of the vent, try plugging the medial portion of the vent at the tip of the canal. Generally, feedback is less when the medial portion of the vent is plugged. If you need to remove cushion grip from the vent, just heat it with a hair dryer. Cushion grip can be obtained at most drug stores.