Choosing the best hearing aid for you

Even if you only have a small amount of hearing loss, it's worth considering hearing aids. Your audiologist can help you to choose from the hundreds of different models and types to find the one best for you. Here are some facts about hearing aids you may not have known.

All hearing aids have a microphone, an amplifier, a receiver (like a miniature loudspeaker), a battery and a made-to-measure ear mould. When you get your new hearing aid, your audiologist will adjust the settings so that different sounds are always heard at levels that are comfortable for you. But it can take several visits before your aid fits and works just right. Some aids allow you to switch between different settings for different conditions; others automatically self-adjust to different sound environments.

Some aids improve your ability to hear clearly in noisy situations by incorporating directional microphones, which amplify sounds selectively from one direction. And some have a "T" setting that picks up signals from a loop system or hearing aid-compatible telephone.

Aids can be broadly categorized according to where you wear them — behind the ear or in the ear. Some specialist aids conduct sound through bone instead of air.

These are the most common type of aids. An ear mould inside your ear transmits sounds, while the rest of the device sits behind your ear, with a plastic tube connecting it to the ear mould. It can be programmed and coupled to other devices such as phones and loop systems.

One version, called an open ear fitting, has a smaller, softer earpiece that doesn't require an ear mould — so it's less conspicuous — and it can give a very natural sound. These are usually suitable only for milder forms of hearing loss, but some types can be used for quite severe loss and can then be modified to include a mould if hearing becomes worse and you need more help.

These are used when someone cannot wear conventional aids or has such severe conductive hearing loss that sound cannot be transmitted through the ear canal. A small bone vibrator sits behind the ear and sends sound vibrations through the skull, which are detected directly in the inner ear. Bone-conducting hearing aids can be held in place with a headband, or you can have a safe operation to implant a "bone anchored" aid permanently. It avoids the discomfort of wearing a headband and the sound result is vastly superior, as sound is transmitted directly to the bone without having to go through skin and tissue.

Sometimes called "custom" hearing aids, these are small enough for all the gadgetry to fit inside the ear mould, which then sits inside your ear — so they are less noticeable than BTE aids. Some fill up the outer ear and so can be seen from the outside, but the smallest fit right inside the ear canal and are almost invisible — a huge advantage if you are embarrassed or self-conscious about hearing aids, though many users believe that they are more difficult to insert and operate.

ITE aids are not suitable for everyone. You may not be able to use one if you have very narrow ear canals, and in general the greater your degree of hearing loss, the larger your aid needs to be. Because some ITE devices are very small, it may not be possible to have a "T" setting.