WebMD Logo Icon
WebMD Connect to Care helps you find services to manage your health. When you purchase any of these services, WebMD may receive a fee. WebMD does not endorse any product, service or treatment referred to on this page. X

In-The-Ear Hearing Aids: Pros, Cons, and Alternatives

By Stefanie Sandler Billette, MS, ACE-CHC
Medically Reviewed by Jordan Glicksman, MD, FRCSC, MPH on March 16, 2021
Millions of American adults experience hearing loss. In-the-ear hearing aids don’t work for everyone, but they could be right for you.

Studies have linked untreated hearing loss to serious health problems including depression and anxiety. A hearing aid may help. The two broad categories of hearing aids to be familiar with are: 

  • In-the-ear (ITE) 
  • Behind-the-ear (BTE)

Benefits of In-The-Ear Hearing Aids

How do they work?

A hearing aid is a battery-powered electronic device with three parts: a microphone, amplifier, and receiver. Hearing aids help people who have sensorineural hearing loss — nerve damage in the inner ear. 

In-the-ear hearing aids sit in your ear canal and a hard plastic case contains the electronics. They are customized to fit your ear. 

Which hearing loss patients are they for?

A 2018 study in theInternational Journal of Audiology showed that, among first-time hearing aid wearers, young adult patients were more likely to choose and benefit from in-the-ear hearing aids. These patients typically show moderate hearing loss and have the dexterity to insert the small ITEs into their ears.

Behind the ear hearing aids have long been more popular than ITEs because they can be purchased off the shelf. But more recently, ITEs have become the preferred choice, especially since the COVID-19 pandemic.

“More patients have come in asking for ITEs over the past nine months than they have in the past ten years because of masking. Wearing a mask with ear loops and having a BTE hearing aid is cumbersome”, Jessica Galatioto, AuD, Director of Audiology and Assistant Professor of Audiology at Columbia University Medical Center (CUMC) tells WebMD Connect to Care. 

Drawbacks of In-The-Ear Hearing Aids

Are there any side effects?

The receiver of an in-the-ear hearing aid can get clogged with earwax and moisture. “There is also an occlusion effect with ITEs. Patients with mild hearing loss may not choose an ITE because the whole ear is plugged up. Everything is altered. RIC (receiver-in-canal) hearing aids do not completely plug up the ear and more natural sound passes through”, Galatioto says. 

Which patients can’t benefit from them?

A Consumer Reports survey found that 53 percent of hearing aid wearers said that a rechargeable battery is a top feature they look for when purchasing a hearing aid. 

“Since ITEs sit within the ear, there is a limit to how much technology can fit inside the case of an ITE. Some newer ITEs have Bluetooth and rechargeable batteries, but these are not as discrete”, Galatioto says. 

Behind the ear hearing aids are often used to treat severe to profound hearing loss since there is more room for advanced technology.

ITE hearing aids also don’t work well for children because their ears are still growing and the casings need to be replaced as the ear grows.

Other Hearing Treatment Solutions

There is a limit to the amount of amplification a hearing aid can offer. Also, if the inner ear is too damaged, hearing aids may not help. If a hearing aid does not work for you, there are other treatment options for hearing loss:

  • Cochlear implants can help with severe hearing loss. A cochlear implant is surgically placed under the skin behind the ear. A cochlear implant bypasses damaged hair cells and sends signals to the auditory nerve.
  • Alerting devices can connect to a doorbell, telephone, or alarm that emits a loud sound or blinking light to let someone with hearing loss know that an event is taking place.
  • A bone-anchored hearing aid is surgically implanted in patients with single-sided deafness or ear malformations. 

Hearing Loss Can Be Treated and Managed.

In many cases, hearing loss is a treatable condition. It is worth taking the time out to get the answers and treatment you or your loved one deserves. Don’t wait. Start today.