The Latest Innovation in Open Fit Hearing Aids: Speaker-in-the-Ear Hearing Aids

Currently, there is a trend in the hearing aid industry toward smaller and more discreet hearing aids, including the recent development of open fit hearing aids (also known as open ear hearing aids). Open fit hearing aids have one major limitation, however; they are not appropriate for many people with a more severe hearing loss and are best used by those with high frequency hearing loss and normal low frequency hearing.

This means that those with severe hearing loss inquiring about this new technology may have either been steered toward more traditional hearing aids (which also have their benefits) or been improperly fitted with open fit hearing aids. However, a recent modification to open fit hearing aids, known as speaker-in-the-ear (SIE) hearing aids, can make these nearly invisible hearing aids available to people with more severe hearing loss.

The Technical Side of a Speaker-in-the-Ear Hearing Aid

Speaker-in-the-ear hearing aids (also known as a receiver-in-the-ear hearing aid, or RITE) are extremely lightweight and are essentially invisible hearing aids, just like standard open fit hearing aids. They consist of a small plastic casing that sits on top of and behind the wearer’s ear and that houses all of the electronic components of the hearing aid (except for the speaker). A thin clear tube is attached to this case, through which very thin wires are run to attach to the speaker, which is located in the end of the tube. From this sound tube, there is a retention line that rests in the bottom of the bowl of the user’s outer ear, keeping the hearing aid securely in place.

The Benefits

The speaker-in-the-ear hearing aid can be programmed to accommodate two distinct hearing losses, a sloping high frequency loss and a more severe hearing loss covering a wider range. As with open fit hearing aids, this type of hearing aid does not require an earmold, so it leaves the ear canal unoccluded, providing a more natural sound quality to the user’s own voice. For those who have a high frequency loss, the unoccluded ear will hear low frequency sounds naturally, through the ear canal, offering a more natural sound quality than a hearing aid that fills the ear canal.

For individuals who have a wider range of severe hearing loss, meaning that there is a loss in the low frequencies as well as the high frequencies, having the receiver placed down in the ear canal will provide more gain and thus fit a greater hearing loss than standard open fit hearing aids. Because the speaker is in the ear canal, the sound does not need to travel down the acoustic tube, which means that these nearly invisible hearing aids are able to provide improved sound quality for those with this type of severe hearing loss.

Another benefit of a speaker-in-the-ear hearing aid is that it is much easier to insert into the ear than a custom hearing aid, because the speaker-in-the-ear hearing aid is one-third the size of a custom fitting. This means that this hearing aid can now be an option for users with severe hearing loss and limited mobility.

The Fitting Range

The fitting range for a speaker-in-the-ear hearing aid for a wide range hearing loss would be a maximum of 60dB in the low frequencies and 80dB in the high frequencies. Those with more severe hearing loss and that require this greater gain can still take advantage of a speaker-in-the-ear hearing aid with the addition of a dome tip ear plug, or custom earmold, which other open fit hearing aids may not allow. While other users may not require an earmold with this type of hearing aid, the addition of one can help to meet the increased gain requirement of those with severe hearing loss with less risk of feedback.


If you are interested in purchasing a speaker-in-the-ear hearing aid, make sure that you shop around to find the best price and the highest quality product. These nearly invisible hearing aids should not cost much more – if anything – than traditional in-the-ear hearing aids or standard open fit hearing aids. Because this technology is still new, it is important to work with a vendor that has a full understanding of its limitations (particularly for those with severe hearing loss) and abilities. Make sure that you ask many questions before making a final purchase to ensure that you feel comfortable with the vendor that you have chosen.


A speaker-in-the-ear hearing aid can offer the benefits of open fit hearing aids to people with moderate to severe hearing loss. These lightweight, nearly invisible hearing aids can be used with or without an earmold and can provide superior results. Those who were previously told they could not use open fit hearing aids should investigate this new option, carefully choosing the vendor with which they will work.

About the Author

Henry Smith is the founder of America Hears, a leading manufacturer and distributor of digital hearing aids for over 26 years. Henry started the company in 1979, following a 15-year career at the Pennsylvania School of the Deaf, including his work as an Acoustic Technician. Henry is a pioneer in the use of computers and the Internet to allow customers to have a hands-on approach to the tuning and adjusting of their electronic hearing devices. He strives to be customer-centric in all aspects of his work.

Thanks for the informative article. I’m intrigued with these new aids as my loss precludes the use of open fit molds.
The main issue is the 80dB loss limit at higher frequencies that is now imposed by most of these aids. Phonak’s microPower is the only one I’ve seen that fits up to a 100dB loss at high frequencies. When a person’s high frequency loss is 70-80dB, even the “mini-molds” with the speaker-in-ear look like a risky proposition.
Does anyone with a severe high frequency loss have experience with these?
Please comment.

Yes, the Micro Power’s are about the only ones I have seen with enough gain and power for severe losses.

I have fit many of the Micropower’s and am looking forward to also using their new Micropower III, which is based on the Extra platform and should retail in the $1400-$1900 range, with the same power output!

They are great, provided there is enough room in the ear to fit the receiver, as the receiver unit is the biggest I have ever seen and cannot fit some very small ears.

Your audi should have a tool to measure the size of the ear to check to make sure that the Micro Powers fit your ears.

I’m a70 yr. old male. My hearing is normal in lo. freq. then drops steeply to 70db@3k.Both ears have a similar loss. From a dispenser,I tried 3 premium open fit hearing aids.2 of them had feedback and sound quality problems.The 3rd(a very expensiveSIE design)sounded better and had very little feedback.It did have other problems which precluded purchase. Posters on another forum had good things to say about AmericaHears products.I checked them out and,after consultation with Frank(at AH),ordered FreedomAD SIE hearing aids. The presentation of both printed and hard goods is first class! Manual,Quick Guide,Programer,Aids,everything was included. I have only minimum computer skills,but buy carefull study of the furnished materials,following instuctions and some consultation with Frank And Carter Smith;I obtained excellent results.Sound,voices,music all are much better than any of the aids I tried before. Also no feedback. AmericaHears products are superb!
One more thing.I have no connection to AmericaHears except that of a very satisfied customer!