Types of hearing aids
Styles
Where each style sits, and what that changes
Hearing aid styles are named for where they sit. The abbreviations look like jargon but each one is simply a description of position. This page explains what each one is. It does not recommend any of them, and it does not name brands or models — which style suits a person is a clinical decision made with an audiologist after a hearing test.
Behind-the-ear (BTE)
The case sits behind the ear, and sound travels through a tube into an earmould or dome in the ear canal.
Because the case sits outside the ear it can be larger, which means more room for components and controls. The earmould is usually custom-made from an impression of the ear.
Handling: there are two parts to manage — the case behind the ear and the mould in it.
Receiver-in-canal (RIC or RITE)
Similar in appearance to a BTE, with one key difference: the receiver — the small speaker — sits in the ear canal itself rather than in the case, connected by a thin wire.
Because the wire is thin and the case can be small, it is relatively discreet.
Handling: the part in the canal is exposed to wax and moisture, so it needs cleaning and the receiver may need replacing periodically.
In-the-ear (ITE)
A custom shell that fills the bowl of the outer ear, made from an impression of your own ear. Nothing sits behind the ear.
Being larger than canal styles, it is generally easier to pick up and insert, and has more room for controls.
In-the-canal (ITC)
Smaller than an ITE and seated in the opening of the ear canal rather than filling the outer bowl.
Less visible than an ITE, and a little more fiddly to handle as a result.
Completely-in-canal (CIC) and invisible-in-canal (IIC)
The smallest custom styles, sitting further into the canal — IIC deepest of all, and largely out of sight.
Their size is the point, and also the trade-off: smaller devices have less room for batteries and physical controls, and not every ear canal suits them.
CROS and BiCROS
These work differently from the styles above. They are designed for people whose two ears differ substantially — typically where one ear has very little usable hearing.
A microphone is worn on the poorer-hearing side and sends what it picks up across to a device worn on the better-hearing side. The sound is not being delivered into the poorer ear; it is being routed to the ear that can use it.
CROS is used where the better ear needs no amplification of its own. BiCROS is used where the better ear also has some hearing loss, so that ear is amplified as well as receiving the routed sound.
Comparing the styles
| Style | Where it sits | Visibility | Handling |
|---|---|---|---|
| BTE | Case behind the ear, tube and mould in the canal | Most visible | Largest parts, generally easiest to handle |
| RIC / RITE | Small case behind the ear, receiver in the canal | Fairly discreet | Thin wire and small parts; canal receiver needs cleaning |
| ITE | Custom shell filling the outer bowl | Visible in the ear | Larger custom style, easier to grip than canal styles |
| ITC | In the opening of the canal | Less visible | Smaller, more fiddly |
| CIC | Further into the canal | Barely visible | Small; limited room for controls |
| IIC | Deepest in the canal | Largely out of sight | Smallest; not every ear canal suits one |
| CROS / BiCROS | A device on each side, routing sound across | As per the style used | Two devices to manage |
This table describes form and handling only. Which style is appropriate for a given person depends on their hearing, ear anatomy and dexterity, and is decided with an audiologist — not from a table.
Common questions about styles
What is the difference between BTE and RIC?
Both have a case that sits behind the ear. In a BTE the speaker is inside that case and sound travels down a tube. In a RIC the speaker sits in the ear canal itself, connected by a thin wire. That is the defining difference, and it is why RIC devices can have a slimmer case and a less obvious connection.
Are invisible hearing aids as good as larger ones?
We will not rank them, because "better" depends on the individual. What can be said factually is that smaller devices have less physical room — for batteries, for controls, and for some features — and that not every ear canal will accommodate the smallest styles. Those are trade-offs to discuss with an audiologist rather than a simple ranking.
Which style is most common?
Receiver-in-canal styles are very widely fitted. That reflects a balance of size, handling and flexibility rather than any judgement that they suit everyone.
Do all styles need an ear impression?
Custom styles — ITE, ITC, CIC and IIC — are made from an impression of your ear, so yes. BTE devices often use a custom earmould, which also requires an impression. Some RIC fittings use a ready-made dome instead, so no impression is needed.
Can I change style later?
People do change over time, often because their hearing, dexterity or circumstances change. It is a conversation with your audiologist rather than something fixed forever at the first fitting.
What do CROS and BiCROS do?
They route sound from the side with little usable hearing across to the better-hearing side, so that sound arriving at the poorer side is not simply missed. CROS is used when the better ear needs no amplification; BiCROS when it does.
If you want your own hearing checked
Book a hearing appointment
This page is general information. A hearing test measures your own hearing and is the only way to know where yours sits.
Sources
- NZAS — Hearing aids
- New Zealand Audiological Society — About hearing loss
- Health New Zealand — Hearing loss in adults
This page is general information, not a diagnosis or individual advice.
Hearing with Heart
Audiology & Ear Hygiene
Unit 34, The Acres,
Halswell, Christchurch 8025,
New Zealand