Receiver-in-the-ear (RIE) and Behind-the-ear (BTE) hearing aids: Which one is right for you?

Size

BTEs are typically larger than RIEs. BTEs contain all the electrical parts of the hearing aid (the microphone, receiver and processor) inside the encased portion sitting on top of your ear. This requires more space to fit all the parts in one place. BTEs are also the most powerful hearing aids available. Maximizing the volume of a hearing aid means a larger receiver is needed, along with a big battery to power all that sound.

While a larger hearing aid is a downside for many people – especially those with smaller ears or who want a sleeker, more modern look – it can help a device feel sturdier on your ear. Larger hearing aids like BTEs can be easier to put on and take off your ear, especially if handling small objects is difficult for you. Keep in mind your hands and arms rise above your shoulders anytime you put on, take off or touch your hearing aid while it’s on your ear. But this may not be much of an issue if you use the ReSound Smart app to adjust your hearing aid via your smartphone once you’ve got it in place on your ear.

Longevity

Once you invest in hearing aids, you want to be able to rely on them every day for years to come. But after so much time sitting on your body, the tiny electronics inside can become damaged from moisture, sweat, earwax and rough handling. While all hearing aids require care and a bit of maintenance to stay in good working order, BTEs typically require less intervention than RIEs to stay in top shape.

It’s the location of all those electronics inside the body of the BTE that protects them so well. That portion of the hearing aid has a water-resistant nanocoating and sits above the ear, relatively far away from the ear canal. If the earpiece or tubing of a BTE gets clogged with earwax, they can be removed and thoroughly cleaned. On the other hand, the receiver of the RIE sits right next to all that wax. You can prevent wax from entering the receiver by regularly cleaning out the wax “trap”. But, if wax or moisture finds its way into the receiver, it will eventually need to be replaced by your hearing care professional. You may also need to replace your receiver if you use the tubing to remove your hearing aid – since there are wires connecting the receiver to the body of the hearing aid and they can break with repeated pulling or tugging.

Sound

The physical location of the hearing aid receiver impacts the way your hearing aid sounds. The quality of sound often improves when the receiver moves away from the hearing aid body and closer to the eardrum. This more closely matches how we hear without hearing aids, so it can contribute to a more natural sound quality with hearing aids. This is a big reason why RIEs are so popular!

RIEs can help reduce feedback – those annoying squeals or whistles you sometimes hear while wearing a hearing aid. Feedback occurs when amplified sound comes out of the receiver and is picked up by the microphone, creating a “loop” of re-amplified sound. The (relatively) large distance between the microphone and the in-ear receiver of a RIE helps prevent that loop from forming. This, in turn, allows many people to wear it with a smaller earpiece that feels less full or plugged-up in their ears while still remaining feedback-free.

At ReSound, we were able to further enhance sound quality by adding an extra microphone to the in-ear receiver. This combined in-ear Microphone and Receiver (M&RIE) is an even closer representation of how we hear without hearing aids than a RIE device, because sound is first filtered by your own individual ear shape before it is detected by the hearing aid. The ear canal also acts as a natural shield from wind noise, making for less wind noise in outdoor situations, compared to other BTEs and RIEs. In situations where M&RIE may not be advantageous – for instance, when there is a lot of surrounding noise – the in-ear microphone simply turns off and the hearing aid operates like a typical RIE. This is a good example of how it can be easier to innovate solutions with RIEs over BTEs. While the technology used in BTEs is updated just as it is in RIEs, the physical location of its major parts remains the same and there is less room – literally – for coming up with creative solutions like the M&RIE.

Now it’s your turn

Hopefully you now feel more confident in choosing the hearing aid that is the best fit for you. Keep in mind that the pros and cons of both BTE and RIE hearing aids can vary a bit from the descriptions here, based on your hearing abilities and other factors unique to you. Your hearing care professional will be able to help you navigate through these options and can advise you on finding the best hearing aid for you. The figure below summarizes the points made that can help you determine if a BTE or RIE may be better suited for you.