The History of Hearing Aids: Key Innovations That Changed Hearing Care

• Hearing aids have evolved dramatically with major innovations improving sound quality, comfort, connectivity, and personalization over time.
• There is no single “best” hearing aid for everyone; the right device depends on your type and degree of hearing loss, lifestyle, dexterity, cosmetic preferences, and technology needs.
• Working with an audiologist is essential, as they help identify your hearing loss, guide you through styles and features, ensure proper fit, and support you through the adjustment process for long-term success.

Hearing loss has been a part of human history for centuries, and starting with the advent of the ear trumpet in the 17th century, inventors and innovators have created devices to aid those who experience hearing loss.

The following table lists major hearing loss innovations by date:

• 1670: The first ear trumpet was invented
• 1600s to 1900: The age of trumpet hearing aids. Trumpet hearing aids simply amplified and directed sound into your ear
• 1898 to 1920: The first electronic hearing aids were developed based on the telephone principle
• 1904: Oticon was established in Denmark. They continue to sell hearing devices today
• 1920 to 1940: Vacuum Tube hearing aids that can address more serious hearing loss were created
• 1926: First U.S. patent for a custom ear mold was granted
• 1950 to the 1980s: The invention of the transistor allowed for more portable hearing aids to be developed. The first BTE and ITE hearing aids began to surface, and analog hearing aids were developed
• 1980s to 1990s: Digital Signal Processors were introduced. Additional sound amplification and filtering became possible.

While that timeline leads up to the turn of the century, from 2000 on, hearing aid technology has exploded at the same rate as computers, smartphones, and Artificial Intelligence (AI) technology. By 2005, 80% of hearing aids sold were digital.

Today, almost all of them have powerful microchips and microprocessors as well as Bluetooth capability. It seems like every new hearing aid released is easier to use because they offer more powerful features, stronger processing capability, smaller device size, and increased battery life due to the advent of the lithium battery.

From the huge ear trumpet of the 1700s to the tiny miniature computers that people place in their ears today, hearing aid technologies have increased and improved at mind-boggling rates. They continue to get smaller, more discreet, more aesthetically pleasing, and most of all more powerful than ever before. In addition, the styles of hearing aids available reflect these significant technology changes.

This article is a description of different types of hearing aids with the goal of helping you determine which device would be optimal for your hearing loss.

What Is The Best Hearing Aid For Me?

If you are experiencing hearing loss of any form, you should make an appointment to see an audiologist sooner rather than later. Beginning the process early and finding the right device for your ears is vital. You will take into account comfort, design preferences, level of hearing loss, and additional variables when selecting the proper hearing aid. It is important to have an expert assist you in evaluating all of the options available.

Your hearing is unique, and when you experience hearing loss in any form, your hearing aid should have the features and technology that you need.

One of the most important decisions you will make is the style of hearing aid that works best for your situation and is the most comfortable in your ears. There are two basic types of hearing aids on the market:

In-The-Ear (ITE)

A hearing aid that sits inside your ear and is not connected to another piece of equipment outside of it. These are the most discreet and often are not noticeable to other people. Because of the size and shape of ITE hearing aids, features, such as battery strength, may not be as powerful as those available in BTE hearing aids.

ITE hearing aids are for people with mild to moderate hearing loss who want to still be able to use their natural hearing in addition to their hearing aid. There are a number of different ITE styles that are available, ranging from very small, also known as invisible-in-the-canal, to larger full shell sizes, which may be a great option for people with dexterity issues.

Behind-The-Ear (BTE)

With a BTE (or Receiver-In-The-Canal, also known as RIC) hearing aid, the hearing device/processor sits behind your ear and is connected, usually by wire or tubing, to a universal dome or custom earpiece inside your ear where the processed and amplified sound is released. BTE hearing aids usually have stronger and/or rechargeable batteries and can handle any level of hearing loss from mild to profound.

They are referred to as being less discreet than ITE hearing aids; however, RICs are often less noticeable with the small size of many of today’s microprocessors. If your hearing loss exceeds the mild to moderate level, BTE/RIC hearing aids are probably the way to go, and even more so if streaming, connectivity, Bluetooth, and other technology are important to you.

What Kind Of Hearing Loss Do You Have?

There are different types and degrees of hearing loss. When selecting a proper hearing aid to meet your needs, it is important to understand both your type and degree of loss.

Types of Hearing Loss

There are three main types of hearing loss that people experience:

Conductive: Conductive hearing loss can usually be treated by surgery or medicine and is caused when something is stopping sound from passing through the outer or middle ear.

Sensorineural: Sensorineural hearing loss is caused by the way the inner ear or hearing nerve works and usually comes on later in life. Sensorineural hearing loss is usually treated either with hearing aids or cochlear implants.

Mixed: Mixed hearing loss is a combination of conductive and sensorineural. Oftentimes the conductive hearing loss is addressed prior to focusing on the sensorineural.

Degree Of Hearing Loss

The most common way to define hearing loss is in terms of the lowest decibel (dB) levels that a person can hear. For instance, if the quietest volume that a person can hear is 15 dB, then that person falls within the normal hearing range. The following is a table that contains one of the more common systems of classifying hearing levels:

Another way to classify hearing loss is by understanding the frequency range that a person can hear. The higher the frequency, the higher the pitch. Below is a chart of the high-end frequencies by age. Those who can not hear the range appropriate for their age should see an audiologist.

Every hearing aid on the market is developed for a specific situation. For instance, if you have hearing loss in both the low and high sounds, a more occluding fit from a Completely-In-the-Canal (CIC) or In-The-Canal (ITC) style will help process sound while still being quite discreet. On the other hand, if your hearing loss is mostly in the higher frequencies, many Receiver-In-Canal (RIC) hearing aids will allow some of the ambient noise in so that you are hearing both processed noises from your hearing aid and the natural sound around you.

Do All Hearing Aids Work The Same Way?

The short answer is no. Within the two types of hearing aids mentioned above, BTE and ITE, there are a few different styles that are preferred depending on your situation.

Here is a non-exhaustive list of those styles.

Hearing Aid Styles within the ITE (in-the-ear) category

IIC – Invisible in the Canal

The smallest custom device available, they sit inside your ear canal and are virtually imperceptible to those around you. They are comfortable and discreet, but do not offer the same technology and connectivity that you find in BTE hearing aids. They can also be difficult to work with if you have dexterity issues or very small ear canals. They do not work well if you have much more than mild hearing loss.

Pros

• The most discreet style of hearing aid on the market
• Greatly reduce the sensation of occlusion if fitted correctly, especially when it comes to hearing your own voice louder in your head
• Great sound quality, partly because of how deep they sit in your ear

Cons

• Connectivity to wireless devices is not available
• They only really fit well in certain ear shapes and sizes
• Do not work well for anything more than mild hearing loss

CIC – Completely in the Canal

The only real difference between CIC and IIC devices is that CIC are a little larger so they can be a little easier to work with and have more room for technology. Again, they only work well if you have mild to moderate hearing loss.

Pros

• They are very discreet and offer great cosmetic appeal
• May have manual buttons if your ear is not too small
• Good sound quality especially because of how deep they sit inside the ear canal
• They are very lightweight and comfortable
• Your ear shields them from excessive wind noise

Cons

• If you have severe or profound hearing loss, CIC hearing aids will not work well for you
• They may be difficult to get in and out of your ear

ITC – In the Canal

They are larger, easier to access, usually have manual buttons, and can handle more severe hearing loss than the CIC and IIC. They also have the space to add a directional microphone and other features that you will not find in the other ITE options. While they are larger and sit on the outside of your ear, you can find them in any skin-tone color so they are still discreet.

Pros

• The slightly larger size gives them increased features
• They have bigger batteries than the CIC models that last longer and need to be changed less frequently. A few companies are also beginning to offer rechargeable options.
• They are easier to adjust and maneuver than other ITE devices
• Even with the larger size, the design and colors available can help them stay discreet and difficult to see in your ear

Cons

• The larger size adds occlusion and can make people feel “clogged up”
• You may get some of the benefits of BTE hearing aids, like connectivity, but you may lose some of the cosmetic benefits that smaller ITE devices provide.

Hearing Aid Styles within the BTE (behind-the-ear) category

RIC – Receiver in the Canal

This is the most common BTE hearing aid and the style that offers the most advanced technological features like AI, Bluetooth, connectivity, etc. Even though RIC sits outside of your ear, many are very discreet yet still quite powerful.

Pros

• The portion of the hearing aid that is on the outside of the ear is usually really small and not as noticeable
• The speaker can usually be replaced separately without having to purchase a whole new unit, and the work can usually be done locally
• This style is the most likely to be technologically advanced with features such as Artificial Intelligence (AI) and streaming/connectivity
• Can usually be controlled either on the device or through an app
• Typically has multiple microphones for better directionality
• Widely available in both rechargeable and standard battery options

Cons

• The portion that sits behind the ear is visible
• Natural hearing may be compromised with more fitted dome or custom in the ear pieces

M&RIE – Microphone and Receiver in the Ear

These are powerful, discreet, and offer one of the best natural hearing experiences because of the third microphone in the ear canal. However, they do not work well for profound or severe hearing loss.

Pros

• Offers one of the most natural listening experiences possible
• The third microphone adds a level of directionality that you cannot find in other styles
• They are usually pretty small and discreet for the technology they contain
• They allow sound to enter your ear naturally and it combines that natural hearing with what you get out of the device
• Use the natural shape of your ear to aid in hearing

Cons

• Not very accessible or available yet
• They do not work well for severe or profound hearing loss

BTE with custom earmold

These devices can accommodate any level of hearing loss from the most profound to the mildest case. They are large enough to house a lot of technology, and they can change and adapt to your hearing by simply changing out the earmold rather than purchasing a whole new device.

Pros

• Often, these are the more technologically advanced devices and they can amplify sound enough to help, regardless of the level of hearing loss
• Great for children because you can change just the earmold as they grow
• Most have great connectivity to other wireless devices
• More room for bigger batteries, which are more powerful and last longer. Many have rechargeable batteries.

Cons

• They are a more noticeable option among the hearing aid styles
• More likely to experience occlusion and feel more “clogged up” with these than with other styles if you have a milder hearing loss.

Which Hearing Aid Will Work Best For Me?

Choosing the right hearing aid is a very difficult process. The best thing you can do to determine the correct hearing aid for your comfort and your situation is to schedule an appointment with a local audiologist. The audiologist is an expert both on hearing loss and on the different types of hearing aids available so they will be able to match your symptoms and level of hearing loss with the device that best suits you.

At the same time, there are some things you can do to help yourself select the best hearing aid. This article has shown you features, styles, and types of hearing aids available in hopes that you will be able to use that information and make an informed decision. It is also important to note that as you age, your hearing loss will likely change. Purchasing a hearing aid is not a one-time decision, but it is a process of learning which device is best for you throughout your life.

Here are a few tips:

• If you have dexterity issues, BTE hearing aids or ITEs that are larger in size will generally be easier to maneuver.
• If you suffer from profound hearing loss, usually the bigger and more advanced the hearing aid, the better.
• If you do not want people to know that you are using a hearing aid, a CIC or IIC hearing aid may be the way to go.
• If you want to be able to connect to other wireless devices with Bluetooth technology or you like the idea of streaming audio to your advice, most of the BTE/RIC hearing aids are stronger in these features.

How Can I Adjust To My Hearing Aid?

Utilizing the support and expertise of an audiologist is the best step you can take to adjust to your new hearing aid. They can modify your settings, fit your device, and even give you advice on the features and accessories that you desire.

The second most important thing to keep in mind is that it will take time to adjust to your new hearing aid. Not only will other people’s voices sound different, but even the sound of your own voice may seem unrecognizable at first. With those things in mind, here are some things to remember:

• Hearing aids will not give you a return to your “normal” hearing; they will simply improve your current hearing ability.
• It takes patience and persistence over time to learn how to use your hearing aids to their maximum ability.
• Practice makes perfect. Make sure to test your hearing aid in different environments and at different times so you get used to the features, settings, and technology of your hearing aids. Adjustments to hearing aid settings may be needed as you adapt.
• Seek support both from fellow hearing aid wearers and your audiologist.
• Go back for follow-up visits. Your hearing may change for a variety of reasons, and it is important to schedule follow-up visits as a way for you and your audiologist to make sure your hearing aid continues to work properly for your hearing loss.

Closing Thoughts

Choosing the right hearing aid can feel overwhelming, especially with so many styles, features, and technologies available today. From behind-the-ear models to nearly invisible custom-fit devices, each type offers unique benefits depending on your lifestyle, hearing needs, and personal preferences.

While learning about the different options is a great first step, nothing replaces the insight of a qualified professional. An audiologist can help you navigate your choices, perform precise hearing tests, and recommend the best hearing aid for your individual situation. They’ll also ensure a proper fit, provide personalized programming, and offer ongoing support to help you get the most out of your device.

Don’t make this decision alone. If you’re exploring hearing aids, schedule a consultation with an audiologist. Their expert guidance can make all the difference in finding a solution that improves your hearing and your quality of life.

Use our Find An Audiologist tool to find one near you!