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View Full Version : A Look at Open Fit Hearing Aids vs. Standard Hearing Aids: Which Are Best for You?


Henry_Smith
03-12-2007, 09:11 AM
When you find that you need a hearing aid, you may be aware that you currently have two categories from which to choose: standard hearing aids (in-the-ear or behind-the-ear hearing aids) or open fit hearing aids (also known as open ear hearing aids). Each of these types of hearing aids has both pros and cons, but, more importantly, each type is most beneficial for a particular type of hearing loss. It is important to research both in order to determine which will work for you.

In-the-Ear and Behind-the-Ear Hearing Aids: An Overview

Standard hearing aids have come a long way from the days of body or eyeglass hearing aids. Those old-style products were large and bulky and usually inconvenient to wear. Thanks to the miniaturization of electronics, today’s in-the-ear and behind-the-ear hearing aids are available in extremely small sizes. In-the-ear hearing aids can be so small that they fit completely within the ear canal and are nearly invisible, while even behind-the-ear hearing aids have become so small as to be difficult to see. However, the greater the gain required for the user, the larger the hearing aid must be in order to accommodate it. Yet even the largest behind-the-ear hearing aids still are much more discreet than their predecessors.

Open Fit Hearing Aids: An Overview

Open fit hearing aids are also extremely small and nearly invisible to an observer. They work via a clear tube that comes from behind the ear and rests in the ear canal. However, unlike with standard hearing aids, there is no earmold to occlude the ear canal when open fit hearing aids are worn – the clear tube is extremely thin and leaves the canal open. Open fit hearing aids are also lightweight – many users find that after a few minutes of wearing them, they cannot feel them at all.

Standard Hearing Aids: Pros and Cons

Standard hearing aids have many benefits for the wearer. Both in-the-ear and behind-the-ear hearing aids are ideal for anyone who does not have normal low frequency hearing. In addition, because of their size, even as small as they have become in recent years, in-the-ear and behind-the-ear hearing aids have room on them to fit many options: telecoils, volume controls, and memory push buttons.

However, no matter how small in-the-ear or behind-the-ear hearing aids have become, both types will always occlude the ear canal to some extent. This means they are not well suited for someone who has good low frequency hearing, because the occlusion causes what some call the “barrel effect” – sounds are muted and the user may feel like he or she is listening to the outside world from inside a barrel. However, for someone with poor low and high frequency hearing, behind-the-ear or in-the-ear hearing aids are often the best choice.

Open Fit Hearing Aids: Pros and Cons

The biggest benefit to open fit hearing aids is that they have no occlusion. For those who have normal low frequency hearing but who are experiencing problems with high frequencies – which usually occurs with early hearing loss – open fit hearing aids are ideal. They are extremely lightweight and nearly invisible as well. And although they utilize the latest technology, they should not cost much more than in-the-ear or behind-the-ear hearing aids, and may even cost the same. If you find that you are a candidate for open fit hearing aids, make sure that you shop around to find the best product at the price, as you would for any large purchase. Open fit hearing aids are also easier to fit because they are not custom made, unlike many in-the-ear hearing aids; they work directly out of the box.

Because of their size, open fit hearing aids cannot offer some of the options that behind-the-ear or in-the-ear hearing aids have available, such as telecoils. In addition, they are fully automatic and so do not offer volume control, which may be seen as a benefit for some users but a negative for those who want more control over their hearing aids.

Similarities

Both standard and open fit hearing aids are made with the same type of technology. Both types of hearing aids are available from some manufacturers with directional microphones, which can be a benefit for users who may encounter noisy situations, such as being in a restaurant or sitting with more than one person at a time, and who want to be able to hear individual speakers better. Behind-the-ear hearing aids, in-the-ear hearing aids, and open fit hearing aids may all also offer multiple memory options.

In addition, open fit, in-the-ear, and behind-the-ear hearing aids are all easily adjustable. Some manufacturers may even offer the option of adjusting the hearing aids over the Internet, as well as in person, at a store or an audiologist’s office. Open fit hearing aids can be as easily adjusted as behind-the-ear hearing aids.

Conclusion

While open fit, in-the-ear, and behind-the-ear hearing aids each offer pros and cons, the bottom line is that it is important to find the product that is best suited for your type of hearing loss. Make sure that any type of hearing aid you purchase leaves you with room for adjustment if your hearing changes over the next few years. And as always, make sure that you work with an audiologist that you trust when purchasing your hearing aids – do not ever feel bullied into buying one or the other type of hearing aid unless you are sure that it will offer you the appropriate benefits. If you do your research, you are sure to find the right hearing aid that will improve your quality of life for years to come.

About the Author

Henry Smith is the founder of America Hears (http://www.americahears.com/), a leading manufacturer and distributor of hearing aids online (http://www.americahears.com/hearing-aids-online.shtml) for over 26 years. Henry started the company in 1979, following a 15-year career at the Pennsylvania School of the Deaf, including his work as an Acoustic Technician. Henry is a pioneer in the use of computers and the Internet to allow customers to have a hands-on approach to the tuning and adjusting of their digital hearing aids (http://www.americahears.com/). He strives to be customer-centric in all aspects of his work.

DAW
04-15-2007, 05:00 AM
Henry,
Would you mind taking a look at the the thread I posted in the Digital Hearing Aids forum titled "Challenging loss to fit". I'm looking for suggestions.
Thanks,
Dave

fitfren
04-15-2007, 07:06 AM
Thanks for the article and information. Very helpful to those of us who know nothing to little about hearing aids. I also notice from the America Hears website an At-Home programming option. Thanks again.

rhythm
09-03-2008, 04:19 PM
Henry, thanks for putting my mind at rest with your post.

I was in particular trying to find the answer for the fact that if someone's hearing is good in lower frequencies then in-the-ear might not be a best fit which you describe as a barrel effect.

I am still struggling to understand that is it not possible to programme the in-the-ear aid so as to give the right effect at the lower frequencies?

I might not have been able to put it properly but in short can you please please elaborate on barrel effect.

I am buying a hearing aid soon and need the advice so desperately.

Thanks in advance

Hearcare
09-05-2008, 02:25 AM
Rythm..open fit custom aids (ITC/CIC) are now available thru some manufacturers due to their superior feedback systems...in practice wearers notice little if any occlusion!

ebrose
09-05-2008, 10:55 PM
I might not have been able to put it properly but in short can you please please elaborate on barrel effect.

Occlusion is often referred to as the "barrel effect". Occlusion is a complaint made by some wearers of hearing aids that their own voice sounds like they are talking in a barrel. The complaint is mostly heard by new hearing aid wearers.

Occlusion occurs when an object fills the outer portion of an ear canal, and that person perceives "tinny" or "echo-like" sounds of their own voice. What's really occurring is that bone-conducted sound vibrations are reverberating off the object filling the ear canal.

You can duplicate the effect by putting your fingers in your ears and talking. Notice how your voice sounds "tinny".

Vented earpieces that are found on many of the lessor expensive open fit hearing aids can greatly reduce occlusion. The vented pieces allow the air to flow in and out of the ear.

DoubleL
09-26-2008, 11:51 AM
Henry Smith says, "Because of their size, open fit hearing aids cannot offer some of the options that behind-the-ear or in-the-ear hearing aids have available, such as telecoils. In addition, they are fully automatic and so do not offer volume control, which may be seen as a benefit for some users but a negative for those who want more control over their hearing aids. "


While Henry Smith has much good information. One item is in error, "In addition, they (open fit) are fully automatic and so do not offer volume control---"

My Phonak Exelias have multiple programs and volume control, either on the BTE open unit, or by the myPilot remote. The remote allows single or both control and zoom which controls front back, left or right.

carolo
09-26-2008, 12:59 PM
I'm currently wearing a loaner pair of Phonak MicroPower BTE open fit. First visit to new audi, and she programed these and out I went a happy camper. She also gave me a remote to use w/ them to control volume and although they automatically switch in different environments, I also have one option on the remote for music that she programmed for me.

I have severe hearing loss in lower frequencies as well as high. In L ear the lower frequency loss is much worse. Ear specialist was doubtful that HA in L ear would help, but it surely does.

Audio quality admittedly not as good as Exelia but even 'tho I'm very picky about quality of music the MicroPower surprised me. I'm looking forward to trying Phonak Exelia P on Monday. Have never had the "P," only the "M" and because I was allergic to ear molds, I sadly had to return them during trial period. We're going to also try acrylic mold. However, the open fit solution in the MicroPower by Phonak will work if nothing else does. At least I think they fall under "open fit," even 'tho the receiver is in the canal and the rest behind the ear in very small package. There is a soft silicone "globe" over the receiver. I think the reason the soft silicone works for me is that it is made by injection molding process unlike the silicone used in molds from custom casting.

I'm a new HA user w/ so much to learn. Best explanation of my audiology report came from a member of this Forum!