Introduction
Hearing aids are life-changing devices for people with hearing loss. Among the various styles available, Behind-The-Ear (BTE) Hearing Aids remain one of the most popular choices due to their versatility, power, and reliability. While these devices offer excellent performance, their comfort depends greatly on how well they’re fitted to the individual user. A properly fitted BTE hearing aid should feel so comfortable that you barely notice it’s there, allowing you to focus on the sounds around you rather than the device itself.
Understanding BTE Hearing Aids
BTE hearing aids sit behind or on top of the outer ear, with a tube connecting to an earmold or dome that fits in the ear canal. These devices come in various sizes, from mini-BTEs to larger, more powerful models for severe hearing loss. Their position behind the ear makes them sturdy and easy to handle, which is particularly beneficial for people with dexterity challenges.
The basic components of a BTE hearing aid include:
- The case (behind the ear) containing the microphone, processor, and controls
- The tube or wire connecting to the ear
- The earmold or dome that sits in the ear canal
One close relative of traditional BTE hearing aids is the Receiver-In-Canal (RIC) Hearing Aid. While similar in appearance to BTEs, RIC devices place the speaker (receiver) directly in the ear canal instead of in the behind-the-ear portion. This design creates a more open feeling and often improves sound quality, though the fitting considerations remain similar to traditional BTEs.
Also Read Advantages of Behind the Ear (BTE) Hearing Aids
Why Custom Fitting Matters
A proper fit is essential for several reasons:
Comfort: Ill-fitting hearing aids can cause discomfort, skin irritation, or even pain, discouraging regular use. When devices aren’t worn consistently, hearing benefits are lost.
Sound Quality: The placement and seal of the earmold or dome in the ear canal directly affects sound quality. Poor fits can cause feedback (whistling), sound leakage, or inadequate amplification.
Stability: Hearing aids that don’t fit well may shift position or even fall out during daily activities, increasing the risk of damage or loss.
Appearance: Well-fitted BTEs sit discreetly behind the ear, while poorly fitted ones may stick out awkwardly or draw unwanted attention.
Hear Expert professionals emphasize that custom fitting is not a luxury but a necessity for optimal hearing aid performance and user satisfaction. The time invested in achieving the right fit pays dividends in comfort, sound quality, and overall hearing experience.
The Custom Fitting Process
Creating a comfortable, effective BTE fitting involves several key steps:
1. Comprehensive Hearing Evaluation
Before fitting begins, audiologists conduct thorough hearing tests to determine the type and degree of hearing loss. This assessment helps them select the appropriate hearing aid model and features for the individual’s specific needs.
2. Ear Impression (for Custom Earmolds)
For many BTE users, especially those with more severe hearing loss, custom earmolds provide the best fit and sound quality. Creating these involves:
- Placing a soft protective block deep in the ear canal
- Injecting a silicone-based material into the ear
- Allowing the material to set (usually 5-10 minutes)
- Carefully removing the hardened impression
- Sending the impression to a lab where the custom earmold is created
This process captures the exact shape of the ear canal and outer ear, allowing for a precise fit that contours perfectly to the individual’s unique ear anatomy.
3. Selection of Appropriate Components
For those using non-custom domes or tips:
- Selecting the correct dome size (usually small, medium, or large)
- Choosing the right dome style (open, closed, or power)
- Determining the appropriate tube length and thickness
4. Initial Fitting and Adjustments
Once the hearing aids arrive:
- Verifying physical fit by checking pressure points
- Ensuring the hearing aid sits securely without movement
- Adjusting the tube length if necessary
- Checking for feedback (whistling sounds)
- Programming the device settings based on hearing test results
5. Real-Ear Measurement
Many audiologists use real-ear measurement, placing a tiny microphone in the ear canal to verify that the hearing aid delivers the correct amount of amplification at different frequencies. This objective measurement confirms that sound is reaching the eardrum as intended.
6. Follow-Up Fine-Tuning
The fitting process doesn’t end with the initial appointment. Follow-up visits allow for:
- Addressing any comfort issues that emerge with extended wear
- Fine-tuning sound settings based on real-world experiences
- Making physical adjustments to improve fit and comfort
- Verifying that the user can properly insert and remove the devices
Hearing Aid Movement
Problem: The BTE portion shifts or bounces during movement. Solutions:
- Adjusting the tube length to better balance the device
- Using hearing aid retention accessories like clips or sports locks
- For children or active adults, considering hearing aid sweatbands that hold the device in place
Special Fitting Considerations
For Children
Children present unique fitting challenges:
- Their ear canals grow quickly, requiring frequent earmold replacements
- Safety features like tamper-resistant battery doors may be needed
- Brightly colored earmolds or hearing aids often help with acceptance
- More frequent follow-up appointments ensure proper fit as they grow
For Elderly Users
Seniors may need special accommodations:
- Larger controls or remote options for those with dexterity issues
- Softer earmold materials for sensitive skin
- Clear instructions and demonstrations for insertion and removal
- Consideration of arthritis or limited hand mobility in the fitting process
For Active Lifestyles
People with active lifestyles require:
- Secure-fit options that stay in place during movement
- Water-resistant features for those who perspire heavily
- Protective covers or sleeves for outdoor activities
- More durable tubing and connections
When to Seek Professional Help
While minor adjustments can be made at home, certain situations require professional attention:
- Persistent pain or irritation that doesn’t resolve with simple adjustments
- Recurrent feedback despite proper cleaning and insertion
- Visible skin irritation or allergic reactions
- Significant changes in hearing that affect device performance
- Damage to the earmold for hearing aid components
Conclusion
The comfort of BTE hearing aids depends largely on proper fitting, which should be viewed as an ongoing process rather than a one-time event. Through careful initial fitting, regular follow-ups, and necessary adjustments, users can achieve a comfortable fit that enhances their hearing experience.
The investment in proper fitting pays dividends in increased device use, improved hearing outcomes, and overall satisfaction. By working closely with hearing professionals and being proactive about addressing comfort issues, BTE hearing aid users can enjoy the full benefits of these remarkable devices without distraction from physical discomfort.