Does Style Matter?

Q: Is there a big difference between this “Open Fit” style of hearing aid and the in the ear types? I would think that the fact that you have a part that goes over the back of the ear makes them more noticeable.

A: There are several reasons one may choose an open fit, (otherwise known as RITE, RIC or slim tube style; all are a little different but based on the same idea), and the first is the type of hearing loss one has. Anyone who has normal, or close to normal hearing in the lower frequency range but has a loss primarily in the mid to high frequency range would benefit from wearing this style. The slim tube or receive in the ear type allow for free flow of the the lower frequencies into the ear, and therefore a much more natural sound in those pitches. The point of this style is to emphasize the higher frequencies, where the bulk of the trouble is, and let the low frequencies take care of themselves.

For those who do have some low frequency hearing loss that goes along with the highs, there are different tips which can be used to close off the ear canal and allow more low frequencies to be amplified through the hearing aid. The problem with this is that it’s not really what they were designed for. Open fit was designed with high frequency losses in mind, whereas in the ear types are more suited to the flat or low frequency losses below the level of mild.

That’s not to say that it doesn’t work, for some people the slim tube style with a large closed receiver works well, but you have the two parts to contend with. In these cases I would offer both that and an in the ear style instrument for consideration. The in the ear instruments are just a little better at attacking those low frequencies.

Having said all this, there are times when using an over the ear hearing aid with a slime tube is still better for a particular patient, regardless of the hearing loss. I was taught a valuable lesson this week by a patient who has been a long time sufferer of Cerebral Palsy. His hands don’t function very well; they have little to no sense of feeling and are awkward for him to move at the best of times. I have known this person since I was a child and he has always had these issues. Based on this I recommended in the ear hearing instruments with the thought that they are generally easier to handle since there is only one part to them.

The first thing he noticed is what everyone first notices – his own voice. Then he had trouble hearing the radio. Aside from that he had trouble fitting them in because the insertion of in the ear type hearing instruments has to be much more precise than open domed instruments. Three weeks after his initial fitting I switched him to RITEs and he has been much happier with them.

The lesson: there are so many different things to consider when purchasing hearing aids, and even we can make assumptions that we shouldn’t. Don’t be afraid to tell your practitioner if you feel something should be changed, after all, in spite of over 20 years’ experience, I too am sometimes still a student.

Happy Autumn.