Behind-the-Ear (BTE) devices are one of the most widely used and resilient styles of amplification technology. The main body of the device rests discreetly behind the outer ear, or pinna. This style functions by capturing and processing environmental sounds, then directing the amplified sound into the ear canal. It remains a common recommendation from hearing healthcare professionals due to its consistent performance and adaptability.
Physical Structure and Sound Pathway
The BTE hearing aid consists of a hard plastic case that sits behind the ear, connected to an earpiece that fits inside the ear canal by a slender piece of tubing. The main casing houses the three primary electronic components: the microphone, the digital processor or amplifier, and the receiver. Sound waves enter the device through the microphone, which converts acoustic energy into electrical signals for processing.
These electrical signals are sent to the amplifier, which processes and boosts the signal’s strength according to the user’s specific hearing loss prescription. This digital processing allows for features like noise reduction and directional sound focus before the signal is converted back into an acoustic sound wave by the receiver, sometimes called the speaker. The receiver is located within the housing behind the ear in a traditional BTE model, unlike some newer styles where it sits in the ear canal.
The sound travels out of the main housing through a clear, flexible tube that hooks over the top of the ear. At the end of the tube is a custom-molded earmold or a soft dome that sits snugly in the ear canal. The earmold is precisely shaped to the user’s ear, ensuring the amplified sound is delivered directly and efficiently into the ear canal. This seal is important for preventing acoustic feedback, which is a whistling sound that occurs when amplified sound re-enters the microphone.
Suitability for Different Hearing Needs
The physical architecture of the BTE style makes it suitable for a wide range of hearing loss severities, from mild to profound loss. The larger housing accommodates a more robust amplifier and a larger battery, generating the higher power output required for severe to profound hearing loss. This ability to deliver significant amplification is a primary reason audiologists recommend this style.
The larger size provides a distinct advantage for users who have difficulty handling small items, such as older adults or those with limited manual dexterity. The controls and battery door are easier to manipulate compared to smaller, in-the-canal devices. Furthermore, the electronic components are housed outside the ear canal, minimizing exposure to earwax and moisture, which are common causes of malfunction in smaller devices.
This style is particularly well-suited for pediatric users because the earmold is separate from the electronic body and can be quickly and affordably replaced as a child’s ear grows. The separate components allow for simple updates to the earpiece without needing to replace the entire, costly electronic unit. The larger components also allow for the inclusion of advanced features, such as larger telecoils for loop systems or direct audio input ports, which expand the device’s functionality and connectivity.
User Care and Troubleshooting
Maintaining the BTE hearing aid requires attention to the earmold and tubing to ensure clear sound transmission. Users should detach the earmold and tubing from the plastic housing before cleaning, as the main electronic unit must never get wet. The detached earpiece and tubing can be washed weekly in warm, soapy water to remove earwax and debris. They must then be completely air-dried, ideally overnight, before reattachment.
Daily maintenance involves wiping the outer shell of the hearing aid with a soft, dry cloth to remove dirt and moisture. Storing the device overnight in a container with a desiccant, such as a drying box or dehumidifier, is recommended to draw out accumulated moisture. This practice extends the lifespan of the internal electronics and prevents performance issues.
Battery management is a practical user task, especially for devices using disposable zinc-air batteries. These typically last between five and fourteen days depending on the device’s power demand. If the sound becomes weak or intermittent, the first troubleshooting step is replacing the battery. For a new disposable battery, peeling off the protective sticker and allowing it to sit exposed to air before insertion can maximize its operating life.