Why You Should Wear A RIC

Someone was asking about RIC technology in another thread and I thought I would put a brief post together here for those considering new technology and wondering why RIC hearing aids have taken the industry by storm in the past five years or so.

Here are my thoughts on why RIC technology is so popular, and so successful.

A Receiver In Canal hearing aid is typically a small capsule resting on the top of the ear, with a tiny plastic coated wire running from the capsule into the ear. The ear piece can be custom designed to the shape of the ear or can be a soft rubber fitting, often with holes around it to allow natural sound to get in (and escape).

So why should you want one?

  1. They are usually a standard design, unlike a CIC or other custom product. So the components in the capsule are always placed in the same place in each device. This eliminates the problems associated with having to design each hearing aid to the shape of your ear. This should really help ensure greater longevity.

  2. Good RIC hearing instruments have their power determined by the receiver (loudspeaker) placed in the ear. Therefore, should your hearing get worse, it should be possible to upgrade the power output considerably without buying a new hearing aids. New receivers should be a nominal cost and should be fitted by your hearing professional, without having to send your aids in for repair. So a good RIC can fit the most mild of losses, right up to an incredibly severe loss.

  3. Because of their standard design, should the aids ever fail, your hearing professional should be able to easily arrange for you to have loaner hearing aids while your aid(s) are being repaired.

  4. Because they are often a little bigger than a custom product in terms of component real estate they should be able to include tricks like Bluetooth compatibility, ear to ear communication, telecoil compatibility, media streaming, and remote control access.

  5. They not only have the ability to adjust to perhaps one of the widest range of hearing losses of any style, but it should be possible to download new software on to them as improvements are made.

  6. The increased space between microphones and receiver should, together with a sophisticated electronic filter, help make feedback issues a thing of the past. Issues of mechanical feedback where vibrations in the shell of a custom aid can cause problems is also not a problem thanks to this separation.

  7. Many models are now available that are waterproof. Or at the very least far more water resistant than other styles of hearing aid. This should ensure greater longevity, and a more ‘hardy’ hearing aid.

  8. If you somehow manage to get wax or other ear debris beyond the wax guard and damage the receiver, it should be easily replaced or repaired, by your hearing professional in his or her office, without needing to send them away.

  9. The device should be very lightweight and comfortable if fitted properly.

  10. Because the receiver is in the ear canal, the distance from the sound source, and your ear drum is small, so therefore less power is needed to provide sufficient help. Less power usually means less distortion.

  11. Cosmetically, this is one of the most discrete hearing aids you can get. Especially if you have hair near your ears.

  12. There is space for two microphones on most RIC hearing aids, and this in turn allows additional tricks to help you in a background noise, including directional amplification.

  13. The thin tube that runs into the ear can be made incredibly small, and so is less of a hindrance to wearing glasses than a traditional BTE.

  14. The amount of ear blockage on the smallest and most open fitting is perfect for typical noise induced or high frequency losses where the patient has good low frequency hearing and is susceptible to occlusion (blocked up sensation when wearing hearing aids).

  15. The standard design usually ensures good access for programming cables for adjustments, if the aids cannot be wirelessly programmed.

Well that’s all I have time for. 15 good reasons to consider a RIC.

I just got my new ReSound Alera ITC with the remote microphone and love, love, love them. I had used Starkey analogs, then Seimens digitals for the past 10+ years and these are so much better. I connected my cell phone wirelessly without any problems, but can’t get my iPod to recognize my Bluetooth phone clip. Anyone have any suggestions. The only complaint I have is with the phone clip and that is the fact that I can’t tell if it is on or off.

This is a great article. Many thanks for taking the time to write it.

Is another possible reason, that, in the case of people with a moderately severe/severe loss - not just in the high frequencies - that the loud speaker in the ear provides a more discreet solution than a standard BTE with an ear mould ?

Hey Gulfmiss. My daughter was just down there a few days ago in Gautier (“go-shay” for everybody else), looking for a job. We lived in Mobile for 10 years.

Glad things are going well with the ITC model but I think the RIC is winning me over. I’m trying out the Resound Future from Costco (similar to the Alera).

Yep, not only more discrete, but with the loudspeaker closer to the drum, it doesn’t have to be as powerful, since the sound doesn’t have to travel down a bunch of tubing to reach the drum. Less power usually means less distortion, less battery drain, and a smaller aid.

A reason not to use RIC. It hurts. I have used BTEs with closed hard molds for years. I don’t like the molds but they are more comfortable than the RIC mold made for me. The plastic on the RIC mold is incredibly hard and after a day of wearing them, it hurts.

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I like getting most of the benefits of an RIC and the lower maintenance of my open fit acoustic thin tube BTE’s. I’ve worn a couple of RICs in the past, and the receiver seemed to fill my canal and create slightly more occlusion than the tulip domes I’m wearing; the ease of removing wax from thin tubes is a plus, too.

Of course, the BTE itself isn’t as small, and the receiver isn’t right next to the ear drum, so there are trade-offs.

YOU FORGOT ONE…it’s way easier/much less work for the dispenser to fit. :slight_smile:

Well that may be true of the specific model you tried, but there are many types of materials used to make a custom ear piece if you need one, and also many different techniques used to make them.

Comfort is determined by:

  1. Quality of the impression taken.
  2. Technique used for impression taking.
  3. Materials used for impression taking.
  4. Method of going from impression to mold (was it laser scanned in 3D or made manually from a mold of the impression).
  5. Quality of the manufacturing process.
  6. Constraints of the technology (some lessor models from some less advanced companies require a tight fit because their feedback cancellations software sucks).
  7. Material used to physically make the ear mold.
  8. The shape of your ear canal and sensitivity of the same.
  9. How well the hearing professional documented the physical shape of your ear, along with texture of the ear.
  10. The movement of the ear canal and size change based on things like jaw movement and face movement.

That’s just 10 off the top of my head. Just because you have tried one doesn’t mean your experience is universal. There are as you can see a lot of factors that can have a major impact on the success and enjoyment of that type of ear fitting.

Oh ever the cynic :stuck_out_tongue:

It can be easier, but if you are doing a custom ear fitting, it is just as time consuming as pretty much any other device.

Until 3 years ago I wore Sebotek’s RIC aid. I purchased the Oticon Epoqs without the RIC but with Bluetooth technology which Sebotek did not offer at the time (or so I was told). I have found the hard mold to be less comfortable than the soft piece that covers the receiver and in addition has required more power to allow me to hear well (I have a profound hearing loss in both ears). Hopefully my next set will be a RIC if not a MaRic (see ExSilent). I am a fan of the RIC.

ZCT, Well yeah but at that point you’re basically wearing a CIC along with a capsule behind your ear, connected by a plastic covered wire!

My mom SWORE she would never wear a CIC…but after trying a RIC she quickly changed her mind. (and I figured she’d prefer the RIC).

I just hate it when professionals (non wearers) promote a style and deny or downplay the drawbacks. Plus I think it’s a sore spot for me because invariably dispensers try and sell me on RICs because they are an easy fit. Argh!!!

With the benefits a CIC cannot provide such as ear to ear communication for better background noise suppression, dual microphones for better directionality and reduction of unwanted noise in a social situation, longer battery life, and the ability to replace a broken receiver at little to no cost without sending the aid off for repair. And speaking of repair, if you need to send your aids off for repair a non-custom design can easily be substituted for a loaner aid.

Well that’s statistically meaningless, no offense to your mom. There is a reason the industry is swinging hard towards RIC, and it’s not that hearing professionals are all lazy and can’t be bothered to make custom aids any more. Back in the 90s the swing was from BTEs to custom products because at that point we could put more advanced and better customized technology in a non-BTE product. Now the RIC is helping people that would have been horrible to try and help five years ago.

Well all hearing aids have drawbacks. RICs are a wonderful solution to many types of hearing problem. You have the high frequency loss patients, the noise induced loss patients, then you have the power users that were traditionally saddled with large ugly BTE devices. The RIC has something for almost every level of user.

Like I said, the trend isn’t just convenience it is versatility. I also suspect that the more uniform design coupled with waterproofing technologies and interchangeable receivers will make RIC aids outlast their custom counterparts in terms of longevity.

I don’t mind discussing with you the merits and drawbacks of various types of aid, but I resent the notion that hearing professionals are all just greedy corporate stooges who jump on the bandwagon out of laziness and because their corporate overlords told them to. That’s a very jaded and cynical view of the world that I cannot share with you.

Wow, I don’t remember saying that hearing professionals are all just greedy and lazy corporate stooges. There are some, though…make no mistake…just as EVERY profession has its share of greedy and lazy corporate stooges. The fact is that RICS and BTEs are easier to fit, which is one of their strong points. Make of that what you will.

Not true about “better directionality.” Using CIC’s allows the pinna (the outer portion of the ear, to “collect sound, and perform spectral transformations to incoming sounds which enable the process of vertical localization to take place.[1] It collects sound by acting as a funnel, amplifying the sound and directing it to the auditory canal. While reflecting from the pinna, sound also goes through a filtering process, as well as frequency dependent amplitude modulation which adds directional information to the sound (see sound localization, head-related transfer function, pinna notch). The filtering effect of the human pinna preferentially selects sounds in the frequency range of human speech.” This is a known benefit of the CIC aid and the IIC aid.

“Statistically meaningless?” That made me laugh. I couldn’t give a flip about “statistics” when choosing what model aid to wear, especially since I don’t fall into the segment of the population the manufacturers are targeting. I’m not a baby-boomer. And I don’t usually speak for other people, but I’m certain my Mom doesn’t care about statistics, either!

I’m not slamming RICS at all, I am simply and honestly describing the drawbacks I experience while using them.

ZCT, you make some very valid points about RIC aids and Melissa makes herself an easy target when she paints all in the industry with the same brush. I have spoken to many, many hearing aid salespeople, some were audis some not, and most seemed to be more concerned about maximizing the price vs my need and ability to pay. In addition, in most cases I had more knowledge regarding the technology available with each manufacturer. You seem to have a great deal of knowledge about this industry and can probably enlighten us as to why the manufacturers have been slow to embrace these technological advances (or so it seems). I’ve worn aids for 17 years and as someone who spends a great deal of time on the phone it has been difficult at times having good communication over the telephone. Still is at times.

Hz…250…500…750…1K…1.5K…2K
R…25…40…50…65…90…105
L…35…50…80…100…N/A…N/A

I’m not sure I’d agree that the industry has been slow to introduce new technology. When I qualified in 1994 I didn’t have a computer in my office. Today I use two computers, and can program my computerized hearing aids wirelessly and even flash the eprom in them with new software as we develop it.

Frankly the speed that we have embraced technology has scared the crap out of some of my older colleagues!

If I had to guess as to how long it has taken to get where the industry is today, I’d probably argue that unlike the iPhones of this world, there is less money to go around in terms of R&D, it’s a way smaller market than cell phones and people in that market are notoriously difficult to persuade to tackle their problem, as many still feel there is a stigma with hearing loss and refuse to admit it.

Apple have a ton of people from all age groups just dying to buy their latest phone. You never see a line around a hearing aid office when Siemens does a new hearing aid product launch do you?!?

So I think that the industry has developed at the speed it has been allowed to. If my company sold as many hearing aids as Apple sold iPhones, you could expect them to be even more impressive even quicker. But that’s not going to happen.

How in the world have I painted everyone in the industry with the same brush?! How have I done anything but point out the same thing you have, in your post…that many seem much more interested in maximizing price with as little work as possible? And TRUST ME, plenty of professionals do this. If you don’t believe me, ZCT, it’s because you aren’t out there, buying aids for your hearing loss.

Perhaps I should step out of this forum. I thought people were interested in truth, not in worrying about offending or stepping on the professionals’ toes. The truth is that the industry has huge numbers of professionals who are taking advantage of people, which is why there are laws (in most places) to protect the hard of hearing. Does that mean I’m painting everyone with the same brush? No, but whatever.

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All I am saying is I don’t think this is a primary attraction to them. When I first saw them, I thought it was kind of cool that you could stock them in an office and test and dispense the same day. Frankly though, I still preferred to bring people back for a separate fitting so I could cover all that important information in more time.

What drew me to the RIC and the OTE that came before it was how effective the devices were with patients that had good low frequency hearing. Almost over night, occlusion was a thing of the past. That was what sold me. As a Hearing Instrument Specialist, my primary client base are retirees, either with presbycusis or noise induced hearing loss. Many of these people find conventional hearing aids occluding, even with an IROS vent.

So it wasn’t about ease for me, it was about solving a problem that had not previously been easy to solve. Sure we used to have a Helix aid or an open fit style mold for a BTE, but that was nothing compared to this type of technology.

With the greatest respect, I have been a hearing professional for going on twenty years. I understand localization of sound.

You know what else they used to say about the CIC? They said it would make occlusion a thing of the past because of the fact it sat in the boney portion of the ear canal. Nice on paper, not true in real life.

Yes you do get some natural localization of sound from the pinna, sure. But the brain is tuned in to the way the ear was without a lump of plastic in the ear. The mic in a CIC is not placed at the precise point where the human ear picks up sound (the TM), and you lose the natural effect of the ear canal shape and length too.

So while the CIC is better than say a conventional single mic BTE or ITE for directionality, I believe that a modern RIC can actually one up the CIC in terms of directionality. If you have dual mics, industry leading artificial directionality with over a 6dB of extra help for what’s happening up front in noise AND add binaural spacial mapping where the aids can talk to each other and devise a plan for noise, you can actually achieve some pretty impressive directionality indeed.

From what I have seen on many levels the RIC seems to out perform a CIC despite the pinna advantage. But even if you consider them about the same, I think the longer life of a RIC, the comfort of an ear bud (which probably 80% of typical patients can enjoy), the replaceable receiver, the waterproof design, and the possibility of Bluetooth, telecoil and ear to ear communication and streaming, outweigh the benefits of picking a CIC.

Well we were talking about the industry as a whole, and why there was a swing towards RIC technology. In the grand scheme of things your mommy is irrelevant to that discussion. It would like me saying my mother doesn’t like to fly, so we may as well cut back on the number of flights offered.

I understand some of what has happened to you, based on what you have shared on this forum. But that doesn’t mean it applies as a general rule.

For instance, I believe that you once shared with me that you had been told by a hearing professional told you that ear buds were no use and uncomfortable. I’ve found the opposite to be true. I’d say 80% of the people I see can use them, and the design my company has are effortless to wear. Most patients don’t even feel them at all, significantly more comfortable than any CIC.

And I get that, and you have some valid points. I just didn’t accept your assertion that manufacturers and hearing professionals are pushing these devices for unethical reasons.

All hearing aids have drawbacks, as no hearing aid can truly restore hearing to perfection. So as hearing professionals we have to weigh the advantages and disadvantages of each style. In this day and age it is becoming less and less common for there to be a price difference between styles, its more about technology level now. So I don’t really care, from a profitability perspective, which shape the hearing aid is. I just want it to have the most chance of success for the patient.

Well, ZCT, you certainly put me in my place. You’re are absolutely right about everything. RIC’s are better and provide much better directionality. The studies and other professionals are wrong. My “mommy” and I are also wrong! The professional who told me he found his clients had comfort issues with earbuds? Also wrong! You must be right! You have been a professional for many years, and I am only hearing impaired. My Mommy and I will go away now and have our opinions elsewhere. Foolish, foolish me.

Go back and read my posts. I never said the manufacturers were pushing anything for unethical reasons. EVER.

I am in the 1 percent of hearing loss levels that are extremely difficult to fit and I believe this group of profound hearing loss is now the orphan child of the hearing aid industries, especially since many of us can be fitted with cochlear implants if the aids ard not deemed effective. I also am very lucky that my speech discrimination scores are very good and I barely suffer from recruitment so powerful aids work fairly well for me. With the right model and CROS technology, digital technology allows me to take advantage of directionality in noisy places. I am truly surprised how well they work in these current versions.

I also need to let you know that I am a life long user of aids going on 60 plus years now. As crude as those body aids were in the 50’s, learning language skills early on was a benefit that I use to this day. Being a strong lip reader is a plus, no doubt.

Where I am going with this is that the BTE offers a great number of options, features and power I could never achieve in the new renditions of aids that are so very popular now. Lets face it; it’s also as much about vanity and appearances that drive the hearing aid market today. I am beyond that vanity and I am proud of my new generation of aids that help me so well. BTE still have their place and use and the CIC and RIC will not be for me for a very long time.