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The pros and cons of very small hearing aids in your ears.

Time to Read: 8 minutes

Many people want the smallest, best, cheapest and most reliable hearing aids all in on product. Unfortunately, such a single product does not currently exist.

Small hearing aids such as completely-in-the-canal (CIC) or the newer, smaller Invisible-in-the canal (IIC) devices are very popular in the client’s mind, but they do come with some caveats, that far too few people are aware of when they first get them.

This in part is the clinician prescribing these devices’ fault, but is often also a decision the client makes without fully appreciating what is being sacrificed in order to obtain the least visible device possible.

  • So what do you get with the smallest hearing aids on the market today?
  • What are the catches of these small wonders?
  • So how do I pick?
  • If the cons are just too much for you, then you still have options available to you

So what do you get with the smallest hearing aids on the market today? (pros of invisible hearing aids):

  • Confidence in knowing that no-one should notice you are wearing anything
  • Some brands offer wireless connection to mobile phones etc. with these – although the antenna required makes it a little bigger than the smallest ones on the market.
  • One model – the Siemens Insio 7 Bx even allows directionality for significant improvement in hearing in background noise. It is quite an expensive premium option though.
  • Improved hearing in quiet
  • The ability to wear headphones over the hearing aids -comfortable
  • Easy, natural use of the phone
  • Excellent Bass reproduction due to blocking off the ear – great for some hearing loss and actually problematic for hearing loss, where the low pitched hearing is normal or close to normal.

What are the catches of these small wonders? (Cons of invisible hearing aids)

  • Reliability – As these devices are worn in wet (sweat & wax), hot (core body temperature) and oily (ear wax) conditions, they tend to fail to the extent of requiring repairs up to 10 times more than other styles of hearing aids. This might mean that you will be without your hearing aids up to 2 or 3 times a year as they go in for repair. Other styles may only need one repair every 3 or so years.
  • Requires vigilant care, cleaning and maintenance to try and avoid the above mentioned repairs.
  • Strength – These hearing aids are normally encased in a thin acrylic custom made shell. These shells are kept thin to ensure the small size while still being able to accommodate the electronics and acoustic tweaks, required for different hearing loss. These shells are prone to cracking and breaking over time, so it is not unusual to have to have the aid reshelled a few times during its working life at around $200 a time.
  • Batteries – to keep these devices small, they use the smallest batteries. This means a battery might only last 4 or so days, compared to a larger battery which might give 8 days. So your battery costs will be higher too.
  • Compromise – Due to its small size, certain very useful hearing aid technologies such as directional microphones (the only proven technology to improve speech understanding in noise) cannot fit. Sure, Siemens’ Insio Binax 7 has found a way to use wireless technology to achieve something akin to traditional directionality. It does however come at a premium price and its performance in noise is about as good as a lower mid-range hearing aid in another style.
  • Blocked up ears - If you have fairly normal hearing in the low frequency range of your hearing, then wearing these small hearing aids, that fill your whole ear canal, can cause a blocked feeling (Occlusion). This feeling is akin to having a bad flu and means you might not be able to tolerate the echo in your own voice. We will try to alleviate this by adding venting to the aid, but the size of the vent is limited by the size of your ear. Occlusion is not such an issue if your loss is greater than about 45db in the low frequencies (250 & 500Hz)

So how do I pick?

The intention of this is certainly not to discourage you to use hearing aids. Any hearing aid is better than nothing at all and saying that, a hearing aid you are willing to wear is much better than the best hearing aid sitting in the drawer because you are too self-conscious to use it.

I have found through many years of clinical practice, that all these things are manageable as long as you, the wearer is fully aware of the expectations.

If the cons are just too much for you, then you still have options available to you:

Make sure your audiologist gives you at least 60 days money back guarantee, with the option to exchange for another model if things don’t work out.

I usually recommend you try the device with the most benefits first and only if you end up finding you cannot use it confidently, then consider the smaller model.