Hearing aids have been around for a very long time, but over more recent years they have become more pleasing to the eye and in some cases, you can’t even see them! Everyone can think of the old hearing aids their grandfather used to wear. They used to be big and bulky, and often only came in an ugly tan color. Any time he would put them in his ears they would make a high-pitched squealing sound that everyone within a football’s field distance could hear. Thankfully, hearing aid technology has improved drastically both in the internal computer chips and their overall physical design. Current hearing aids come in a variety of styles: some that sit behind the ear, some that fill the entire concha bowl of the outer ear, and some that fit snugly within the ear canal and are barely visible. This article is going to discuss the smallest of the small hearing aids, and what makes you a good or bad candidate for these devices.
What is a hearing aid?
In general, what is a hearing aid? A hearing aid is a device that manipulates acoustic sound waves into a digital signal which then provides amplification to specific frequencies where the listener has hearing loss. Think about dyeing your hair a different color. When you go to your hairstylist, you will tell them you want brown hair. They consider your current hair color, and then mix together creams and chemicals to create the new brown color, and then apply it on your head where needed. Hearing aids do the same thing: they consider your hearing loss across low, middle, and high frequencies, they mix acoustics sounds to create a modified sound that is audible to the listener, and then apply it through the device into the listener’s ear. This gives the listener access to sounds they may not have heard in a long time. When experiencing new sounds there is an adjustment period. It will vary in length from person to person. Some patients immediately acclimate and have no difficulty in the transition to new sounds. Other patients take a little more time to acclimate and adjust. Adjustment periods are completely normal and not a reason to be disappointed! Our sense of hearing is not like our sense of vision. When we first put on glasses with the appropriate correction we can immediately see better! Hearing aids require a few weeks, sometimes longer, to get used to the difference in sound, as sounds travel from healing aid, to ear, up to your brain! Hearing is a very personalized sense and we all have different preferences. After the first few weeks you will love your “new ears!”
How do you know if you need hearing aids?
To determine if you need hearing aids in the first place, you should see an audiologist. They will perform a diagnostic hearing evaluation to determine the degree and type of hearing loss. Overall, most hearing aids all work in a similar fashion as described above, but the audiologist can make changes in how the hearing aid manipulates the acoustic sound signal. They can also activate extra features depending on your hearing health needs. The most common style of hearing aid are large hearing aids, or behind-the-ear (BTE) hearing aids. These come in two styles: traditional BTE devices or receiver-in-the-ear (RITE) devices that include the base of the hearing aid that sits on top of your pinna, and a small tube or wire that connects to a dome or earmold that sits within your ear canal. These large hearing aids can fit a wide range of hearing losses and have many extra features including rechargeability, connectivity, streaming capabilities, tinnitus sound generators, and noise reduction. Small hearing aids are the less common option, but still readily available. Small hearing aids come in two main styles: completely in the ear canal (CIC), and invisible in the canal (IIC). Both are custom devices that require taking earmold impressions of your ears. These hearing aids will sit deeper within your ear canal, and are commonly known as the most invisible style of hearing aids.
Types of styles
When choosing a small hearing aid style, there are many considerations to keep in mind. These devices are very small, typically the size of nickel or smaller. Therefore, if you have any concerns for dexterity, this may not be the right choice for you. In order to insert them correctly, you must have control and feeling in your fingertips. Vision sometimes also plays a role since the devices are so small and the replacement parts such as wax guards and smaller batteries can be trickier to see. The severity of hearing loss also plays into account device selection. If you have normal or near normal hearing in the low frequencies, you may not like these small devices as they plug up your ear canal. This may cause you to feel like you are underwater or down in a barrel. This can usually be resolved by adding a vent, or opening, but with the small size of the device this is not always an option. Individuals with severe to profound hearing loss are not good candidates for these small devices as well, as they do not have enough room to provide adequate technology to give such powerful amplification.
Also, as the device itself gets smaller the room for the operating computer chip gets smaller as well. This means that smaller devices sometimes have poorer sound quality because the amount of noise reduction and ability to manipulate parameters is sacrificed in order to fit within such a small shell. Think about hearing aids as tiny computers. The chip inside the hearing aid is the brain and provides all functionality to the hearing aid. The larger the brain, the more it can do. Therefore, the larger BTE hearing aids can do more because they have larger brains. The smaller hearing aids have smaller brains and therefore sacrifice its ability to do as much. This does not mean that smaller hearing aids are bad or not beneficial, but that depending on your wants and needs they may not be the best fit for you.
Determining which style of hearing aid, either CIC or IIC, will work best for you depends on the features that you want. Typically, due to size limitations, both devices are battery operated and do not come in rechargeable options. There are a few rechargeable options on the market, but this may limit you to a specific manufacturer and price point. CIC devices can include Bluetooth technology for direct streaming, while IIC devices cannot unless you use an additional device. CIC devices will fit directly within your ear canal, but the faceplate of the hearing aid will be visible right at the opening. IIC devices are completely invisible, meaning the faceplate is also within the ear canal. But both devices also include a removal chord string that sticks out of the ear canal, and to some people are very noticeable. IIC devices are not suited for everyone and depend highly on your anatomy. If you have very narrow ear canals or sharp twists and turns, this style may not be available because it will not be able to fit comfortably or stay within your canal. Determining which style is best for you can be made with your audiologist.
Pros and cons of smaller hearing aids
Although determining if you are a candidate for small hearing aids can be long, it is worth it if this is the device that suits your lifestyle best. As all technology does though, these hearing aids have both pros and cons. Some pros of smaller hearing aids include that they are not easily visible to those around you, are very compact, and fit deep within your ear canal so chances of them falling out or being in the way of something like glasses, masks, hats, etc… are slim. Some cons to the smaller devices include less connectivity options, less extra features like on-ear volume control, tinnitus management, they can be more difficult to insert and remove especially with dexterity or vision concerns, and they can be easier to lose due to small size. A major negative about custom small hearing aids is that if any part or piece breaks on the device itself, it cannot be repaired in the audiology office. It must be sent into the manufacturer for repair and since it is made custom to your ear, we cannot provide a loaner device in the same style. This means that you may have to be without your hearing aid for a few weeks while it is being repaired. For some people, this is not a major concern but for others their hearing aids are crucial to effective communication.
Small hearing aids are a great advancement in hearing aid technology. It allows the listener to be wearing devices that are essentially invisible while still getting access to sound around them. Technology continues to advance allowing more features within the devices, like rechargeability and connectivity, but this may come with an extra cost. If you fit within the candidacy criteria and invisibility is the most important aspect to you, small hearing aids like CICs and IICs are the way to go!