Behind-the-Ear Hearing Aids: The Most Powerful Hearing Aids, Explained

Behind-the-ear (BTE) hearing aids are the most popular types of hearing aid in America and across the world. They have two main parts: a small unit that sits behind the ear; and an even smaller plastic mold that fits inside the ear. Together, these components are discreet, comfortable and powerful enough to help people with even profound hearing loss.

All hearing aids work in essentially the same way, by amplifying some sounds and minimizing others, to help clarify what the wearer can hear. You can now buy tiny “invisible” hearing aids that sit deep inside your ear canal; but behind-the-ear hearing aids remain the best option for people with moderate to severe hearing loss.

In this article, we’ll explore the advantages and downsides of BTE hearing aids compared with other types of model, and look at their latest advanced features and costs. We’ll also reveal the best behind-the-ear hearing aids you can buy today.

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How do behind-the-ear hearing aids work?

All the electronic components of a BTE hearing aid are contained within the unit that sits behind the wearer’s ear. This unit may be as small as an inch long on some contemporary models, but it contains multiple electronics including:

• A microphone, which picks up sound and converts it to electrical energy.

• An amplifier, which receives this electrical energy and processes it to a digitized signal.

• A receiver, also known as the speaker. This delivers the enhanced sound to the user’s ear via a hollow tube that attaches to a small earpiece.

• A battery, to power the hearing aid. Depending on the model of hearing aid, the battery can be removable and non-rechargeable, or built-in and rechargeable.

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Should I have a custom-made or standard earpiece?

All BTE hearing aids have a small earpiece that sits in the wearer’s ear canal to transmit sound, but these come in different types. Some are custom-made to fit the wearer perfectly, while others are a standard fit and look a little like earbuds. There are pros and cons to each type.

A custom-fitted earmold is more suitable for people with severe hearing loss, and helps to prevent feedback. However, a sealed earmold can create a hollow booming effect known as “occlusion”, which is a risk present with all audio devices that seal your ear canal.

A standard earpiece may be more comfortable, especially if you haven’t worn a hearing aid before. Air can move a little more freely, which can prevent that blocked feeling. What’s more, because these earpieces don’t have to be custom made, they tend to be cheaper and can be worn immediately after your appointment.

What are the advantages of BTE hearing aids?

While BTE hearing aids are much smaller than they used to be, they’re still the largest type of hearing aid available – and their size brings many advantages, including:

• More sound-enhancing power than smaller hearing aids such as in-the-ear (ITE) and invisible-in-canal (IIC) hearing aids. Not only does this make BTE hearing aids a great choice for people with moderate to severe hearing loss, but it also means that they offer flexibility for worsening hearing loss down the years.

• Extra features such as telecoils, multiple noise environments and push-buttons for easy volume and program adjustments are more common in BTE hearing aids than in smaller models, because there’s more room for the necessary electronics. They’re more likely to have built-in rechargeable batteries, too.

• Easier to clean and handle than invisible hearing aids, for example, especially if your fingers aren’t as nimble as they once were. This makes them suitable for people who have trouble with moisture buildup or draining in their ear canals. In addition, because the unit is behind the ear, it’s less exposed to wax and moisture than smaller in-ear models.

• More affordable than smaller hearing aids that offer similar sound-enhancing power. However, BTE hearing aid prices cover a huge range, and the most powerful models are among the most expensive hearing aids you can buy.

What are the disadvantages of BTE hearing aids?

Their relatively large size means there are some drawbacks, as well as advantages, to BTE hearing aids. Here are a few of the tradeoffs to bear in mind:

• BTE hearing aids will be visible to other people, especially if you have short hair. If you’re self-conscious about your hearing loss and would rather wear a hearing aid that no-one can see, then a BTE model probably isn’t the best option.

• Larger BTE models may feel uncomfortable behind the ear, especially if you’re not someone who is used to wearing anything behind your ear such as glasses. Which brings us to…

• Glasses and hats can be difficult to wear comfortably with BTE hearing aids. There’s only so much room behind your ear.

How much do BTE hearing aids cost?

Behind-the-ear hearing aids can set you back anything from $1,000 for a prescription pair to well over $5,000/pair for a premium model such as the Phonak Audeo Lumity 90.

The price of prescription BTE hearing aids is high, but it normally includes hearing tests, fittings and follow-ups from a hearing care professional. The more you pay, the more you’re likely to get for your money in terms of advanced features, sleek design and audio power for people with severe hearing loss.

You can save money by buying over-the-counter (OTC) hearing aids without a prescription. OTC hearing aids are more than just amplifiers; they function in the same way as prescription hearing aids, but they don’t require a test or fitting.

For example, Lexie Hearing’s Lumen self-fitting BTE hearing aids cost $700/pair online from Walgreens. They come with an app that checks your hearing and automatically adjusts the hearing aids to match your hearing profile, and can help people with mild to moderate hearing loss.

How do I choose the best BTE hearing aid for me?

Choosing the best hearing aid for you requires the help of a trained audiologist. They can accurately measure your hearing loss and type, and take into account the factors that most affect you.

If you’re looking for a BTE hearing aid with a custom-fit earmold, your audiologist can help with that too.

Having taken an accurate mold of your ear, they will use it to build a hearing aid earpiece that fits your ear perfectly.

Use our quote-finder tool to discover the type of BTE hearing aid that would best suit you, and to discuss the best options for helping you hear more easily and clearly.