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What to consider when buying custom-made in-the-ear hearing aids?

Updated: Jan 15

Custom-made hearing aids have been and still are very popular. I received a few patients to our Crystal Palace clinic for custom-made hearing aids in December and this signalled to share some tips in this post. Read this article to learn more about the points to consider when buying your next custom-made in-the-ear hearing aids.



Signia Insio ITE and ITC rechargeable in the ear hearing aids on sale on hearingnow


Custom-made hearing aids are popular among people who want invisible hearing aids, or those who wish to leave the area behind their ears available for glasses, or facemasks, for example for occupational reasons (doctors, construction workers,...). People who have an active lifestyle may also want to have in the ear custom-made hearing aids. These types of hearing aids are less at risk of loss when the wearer runs, jumps or does regular physical activities (e.g. yoga instructors, mountain bikers, etc.).


The other group of people who custom-made ITC and ITE would suit very well is the group of patients with dexterity issues. For some patients with arthritis or shaky hands, it would be difficult to put on and remove behind-the-ear hearing aids (including RIC and BTE). Most of the patients in this category might choose a rechargeable ITE or ITC for the same reason as replacing batteries of the hearing aids could be quite challenging for them.


The 3rd group of people who might be keen on custom-made hearing aids are those whose pinna (the outer part of the ear) is not in a way to accommodate a RIC or BTE hearing aid (e.g. their pinna is bending forward too much, or the pinna has been damaged and out of form as a result an accident).





Here is a list of questions to reflect on when buying a new pair of custom-made hearing aids:


  1. Should I buy IIC, CIC, ITC, or ITE custom-made hearing aids?

  2. Will my custom-made hearing aids be powerful enough for the level of my hearing loss?

  3. Should I buy a rechargeable in-the-ear hearing aid or a battery-powered one?

  4. Should I ask for a push button on my in-the-ear hearing aid?

  5. What will be the vent size in my new in-the-ear hearing aids?

  6. What colour to choose for my custom-made hearing aids?

  7. Should I go for a wireless Bluetooth custom-made in-the-ear hearing aid?

  8. Is there any Bluetooth enabled invisible in the canal IIC hearing aid?

  9. What technology level in-the-ear hearing aid is good for my hearing loss?



custom-made hearing aids in London by hearingnow


Should I buy IIC, CIC, ITC, or ITE custom-made hearing aids?

Let's be on the same page with these abbreviations first:

  • IIC - Invisible In the Canal

  • CIC - Completely in the Canal

  • ITC - In the Canal

  • ITE - In the Ear


Now, the answer to this question is twofold. One is about your lifestyle and I elaborated on some of the reasons why custom-made hearing aids could be a good choice for you at the beginning of this post.


The other aspect of these styles of considering this style of hearing aids is the size of your ear canal. If your ear canal is not large enough then your audiologist might not be able to make an IIC or CIC hearing aid, but you'll still have a good chance of having ITC or ITE. The reason is that in the case of IIC and CIC the majority of the electronics and the speaker itself will be in your ear canal. A small ear canal simply does not have room for them, but these elements can be



Will my custom-made hearing aids be powerful enough for the level of my hearing loss?

The IIC and CIC hearing aids could usually hold up to SP speakers which could be good enough for Severe hearing loss. If your hearing loss is at highs of Severe or Severe to Profound then you may have no choice but to consider ITC or ITE hearing aids. The ITE and ITC hearing aids can hold up to UP (Ultra Power) speakers should your ear canal allow and can handle Severe to Profound hearing loss. Your audiologist will be able to run your hearing loss on your choice of hearing aid brand to assess the suitability of different custom-made hearing aids for your level of hearing loss.





Should I buy a rechargeable in-the-ear hearing aid or a battery-powered one?

Up until the date of this post, the industry has yet to introduce rechargeable IIC and CIC to the market. If you suffer from arthritis, have dexterity issues, or have eyesight problems then rechargeable ITC or ITE would be a great choice as you don't have to deal with replacing batteries.


Battery-powered custom-made hearing aids might be a good option for those with severe tinnitus who need to wear hearing aids all the time to alleviate their tinnitus. This group of patients wear hearing aids while sleeping. Young mothers with severe hearing loss could also benefit from battery-powered hearing aids in general as they need to wear them when sleeping to be able to wake up with the sound of the baby.


Please refer to my other articles at the bottom of this page for more on rechargeable versus battery-powered hearing aids.



Should I ask for a push button on my in-the-ear hearing aid?

My advice to patients at the time of consultation for custom-made hearing aids is to go simple, hence not ask the lab to install a push button on the faceplate of the hearing aid. The reasons for such advice are:

  1. Depending on the ear impression there may not be a lot of room on the faceplate left for a button especially when the 312 battery door takes a lot of areas

  2. Often patients can press the button accidentally when putting on and removing the aid which is annoying as it might change a program or change the volume.

  3. The button is a mechanical thing that may reduce the robustness of the aid in the long run.


After all, this is your choice to have a button if you need to adjust the volume of the hearing aids up and down, or change the preset programs.


I need to remind you that volume control and program change can be done on the hearing aid app (on your smartphone), and also through remote control of the hearing aid if you decide to purchase one.





What will be the vent size in my new in-the-ear hearing aids?

The vent size of your custom-made hearing aids is to serve three purposes:

  1. allow low-to-mid frequency sound to travel straight to your eardrum when your low-to-mid frequency hearing thresholds are good and do not require a lot of amplification

  2. establish some air circulation in your ear canal

  3. reduce the occlusion effect (hearing your voice loudly)


In any case, the hearing aid manufacturing lab technician will pick the right size of the vent for each side based on the level of your hearing loss, the geometry of your ear canal and other technical aspects of the hearing aid.



What colour to choose for my custom-made hearing aids?

The good news is that there is not a ton of variety in the colour of custom-made hearing aids so choosing one is usually quick. Black is picking the pace in popularity among patients who go for custom-made hearing aids. Skin or beige and brown are also classic and always popular.


In addition, my advice is to ask the lab to make the inner section of the custom-made hearing aids Blue and Red (for the left and right sides respectively) which make life easy when you want to put them on in the morning.





Should I go for a wireless Bluetooth custom-made in-the-ear hearing aid?

I'd say yes. Signia, Phonak and Resound offer Bluetooth-enabled ITE and ITC hearing aids. Bluetooth hearing aids would enable you to hold hands-free phone calls, listen to your favourite podcast, or radio and also would enable your audiologist to provide remote support and reprogram your hearing aids remotely. The good news is that having Bluetooth in your custom-made hearing aids does not make it more expensive for you.



Is there any Bluetooth enabled invisible in the canal IIC hearing aid?

No, the industry has yet to introduce a Bluetooth-enabled IIC hearing aid to the market. The closest invisible Bluetooth hearing aid is Starkey Genesis Ai CIC Bluetooth. Please contact us in case of any questions about this product.


Note: Please be cautious with CIC with Bluetooth hearing aids as you might need to adjust your expectations in terms of the range and reliability of the Bluetooth streaming on any CIC product simply because of the compact size of the product that the majority of the product will be placed in your ear canal hence the reception signal might be lower compared to your Bluetooth experience in RIC or BTE hearing aids.





What technology level in-the-ear hearing aid is good for my hearing loss?

Your level of hearing loss has little to do with the choice of technology level in your custom-made hearing aids.


Usually, hearing aid manufacturers offer their hearing aids in 3 or more technology levels. The technology level determines the ability of the hearing aid to provide a better speech understanding in noisy environments with different techniques including noise reduction and advanced sound processing algorithms.


A rule of thumb is that if the budget is not an issue always aim for the top of the range to ensure your hearing aids are equipped with the best algorithms that a specific model and design can offer. If the budget is a problem you may step down on the technology level to satisfy your wants and needs.



References

  • Thomas Clasen, Vibeke Vesterager & Agnete Parving (1987) In-The-Ear Hearing Aids A Comparative Investigation of the Use of Custom-made versus Modular Type Aids, Scandinavian Audiology, 16:4, 195-200, DOI: 10.3109/01050398709074940

  • Konkle DF, Bess FH. Custom-Made vs Stock Earmolds in Hearing Aid Evaluations. Arch Otolaryngol. 1974;99(2):140–144. doi:10.1001/archotol.1974.00780030146016

  • Convery E, Keidser G, Dillon H, Hartley L. A Self-Fitting Hearing Aid: Need and Concept. Trends in Amplification. 2011;15(4):157-166. doi:10.1177/1084713811427707

  • Manufacturers News. The Hearing Journal 72(10):p 47, October 2019. | DOI: 10.1097/01.HJ.0000602928.29685.69










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