Hearing aid styles

Hearing aids can vary a great deal in size and the way they’re placed in your ear. The following are common hearing aid styles, beginning with the smallest and least visible in the ear.

Completely in the Canal (CIC)

A completely-in-the-canal, or CIC, hearing aid is custom molded to fit inside the patient’s ear canal. It can be used to fit mild to moderate hearing loss in adults.

A completely-in-the-canal hearing aid:

  • Is the smallest and least visible type of hearing aid
  • Uses very small batteries, which have shorter life and can be difficult to handle
  • Cannot contain extra features, such as volume control or a directional microphone
  • Is susceptible to earwax clogging the speaker

In the Canal (ITC)

An in-the-canal, or ITC, hearing aid is also custom molded to the patient’s ear, but fits partly in the ear canal. This style can be used to fit mild to severe hearing loss in adults.

An in-the-canal hearing aid:

  • Is less visible in the ear than larger styles
  • Includes features that won’t fit on CIC hearing aids, but may still be difficult to adjust due to its small size
  • Is susceptible to earwax clogging the speaker

In the Ear (ITE)

An in-the-ear, or ITE, hearing aid is also custom made to the patient’s ear, but can come in two styles — one that fills most of the bowl-shaped area of your outer ear (full shell) and one that fills only the lower part (half shell). Both are helpful for adults with mild to severe hearing loss.

An in-the-ear hearing aid:

  • Includes features that can’t fit on smaller style hearing aids, such as a volume control and program change button
  • Is be easier to handle due to its larger size
  • Uses a larger battery for longer battery life and easier handling
  • Is susceptible to earwax clogging the speaker
  • Is more visible in the ear than smaller devices

Behind the Ear (BTE)

A behind-the-ear, or BTE, hearing aid hooks over the top of the ear to rest behind it. A tube then connects the hearing aid to a custom-made earmold that is used for retention in your ear canal. This type is appropriate for people of all ages and for those with almost any type of hearing loss.

A behind-the-ear hearing aid:

  • Traditionally has been the largest type of hearing aid, though some newer mini designs are streamlined and barely visible
  • Is capable of more amplification than are other styles
  • Is easier to handle due to its larger size
  • Generally uses a larger battery for longer battery life and easier handling

Receiver in the Canal (RIC)

The receiver-in-the-canal, or RIC, style is similar to a behind-the-ear hearing aid, however, the speaker or receiver is in the canal instead of in the hearing aid body itself. A tiny wire, rather than tubing, connects the two pieces. This style of hearing aid can be used to fit people with mild to severe hearing loss.

A receiver-in-canal hearing aid:

  • Has a less visible behind-the-ear portion than BTE hearing aids
  • Doesn’t plug the ear like the small in-the-canal hearing aids do, making your own voice sound better and more natural to you
  • May be more difficult to handle and adjust due to small parts
  • Is susceptible to earwax clogging the speaker



The audiologist will recommend a style based on several factors during the Hearing Aid Consult appointment. These factors include degree and configuration of hearing loss, lifestyle needs, desired features, dexterity, and vision of the patient. If you would like to further discuss which hearing aid style is most appropriate for your needs with an audiologist, please do not hesitate to contact our clinic.

Bone-Anchored Hearing Devices (BAHD)

What are Bone-Anchored Hearing Devices (BAHD)?

While hearing aids and cochlear implants are better known options for assisting those with hearing impairments, there is another device that may be more appropriate for your hearing loss. A BAHD, also known as a bone-anchored hearing aid (BAHA), is made up of a surgically implanted portion and a removal external processor. These devices are unique in that they send signals to your inner ear via vibrations. These vibrations are interpreted by your inner ear the same as any other sound signal.

As you can see in the above below, the sound processor sits just behind the ear.


Who is a candidate for the bone-anchored hearing device?

Patients with middle ear issues (chronic ear infections, previous surgeries, etc.) are often successful users of a BAHD because it bypasses the middle ear and directly stimulates the inner ear. The device is also beneficial for those with single-sided deafness. The BAHD is placed on the side of the head with the severe-to-profound hearing loss and the signal is sent to the better hearing ear.


New options with the BAHD!

Previously, the BAHD could only be worn by attaching it to an abutment that projected out from under the skin or by wearing a headband. There is now an option for attaching the external processor to the internal implant via a magnet. The image on the left demonstrates the magnet attachment.



In addition to the new wearing options, BAHDs have Bluetooth capabilities!


If you and your family are interested in learning more about BAHDs and want to know if you are a possible candidate, please do not hesitate to contact our clinic at 904-399-0350.


The Value of an Audiologist

What is an Audiologist?

When a hearing loss or balance disorder is suspected a decision must be made regarding where to seek help. An audiologist is a health care professional who provides patient centered care in order to identify, diagnose and treat hearing loss and balance disorders using evidence based practice. An audiologist aims to provide personalized services to minimize the negative impact of hearing loss and ultimately lead to improved quality of life.


Audiologists are required to hold a doctorate degree in audiology ( Au.D.) through an accredited university graduate program. They must also pass board examinations to receive licensing and accreditation.  In addition, audiologists are required to earn continuing education credits in order to remain knowledgeable of the most current research  based practice and rehabilitation methods. Based on their level of education, certification and licensing requirements, audiologists are the most qualified  professionals to complete diagnostic tests, refer for medical intervention and provide rehabilitation services.


How can an Audiologist help my hearing?

A hearing aid is often used to manage hearing loss. A hearing aid is very sophisticated and tiny computer that analyzes sound in the environment and provides amplification to the sound to overcome the hearing loss. An audiologist uses the results from a comprehensive evaluation to determine what part of the hearing system is affected and to what degree. This is an important step because the results will allow the audiologist to determine whether a hearing aid is an appropriate treatment or not. If hearing aids are recommended the audiologist uses the test results combined with information about the patient’s lifestyle and communication needs to determine the most appropriate style and power level of hearing aid in order to best help the patient with their listening difficulties.  Another crucial role of an audiologist is to provide personalized counseling to help educate the patient regarding their specific type and degree of hearing loss. This allows the patient to establish realistic expectations regarding their potential benefit from hearing aids. Information is also provided regarding communication and self-advocacy strategies in order to give the patient control over their hearing experience and help maximize hearing aid benefit.


Audiologists and hearing aids

One of the most important components of the hearing aid process is the follow up care provided by the audiologist. Best practice methods include programming hearing aid settings based on verification measures (objective data) and patient feedback regarding their experience (subjective data). Verification of the hearing aid settings using a tiny microphone in the patient’s ear allows the audiologist to ensure proper programming based on the patient’s hearing loss and the anatomy of their ear canal. Incorporating the patient’s report and feedback ensure that their specific needs are met. A hearing aid is an investment in your health and wellness and when thinking about purchasing hearing aid it is important to find out the types of services and the level of care that you will receive with your purchase. Many audiologists include programming adjustments, verification tests and counseling in the cost of the hearing aids. This helps to ensure the patient receives high quality of care tailored to their specific needs.

Hearing loss: Listening to the signs

Ever wonder when you should go get your hearing tested? Or what that testing will encompass? A very informative article has been circulating throughout the internet as well as multiple newspapers. The article can help you understand the signs to recognize that your hearing needs to be tested along with the process of testing.


What do I do if my hearing aid stops working?

Hearing aid repair options offered by The Hearing Center

In a previous blog (, we explored different ways a hearing aid user could try to troubleshoot their devices at home. Many times, users are able to solve the problems on their own by cleaning or changing the battery. If at home service of your devices does not fix the problem, there are a few ways The Hearing Center at Jacksonville Hearing and Balance Institute can help to get your hearing aids working properly again.

Schedule an appointment with your audiologist or audiology assistant

  • Any time a problem with your hearing aid arises, an appointment can be scheduled to secure a spot on our schedule for you. To see your audiologist, you will need to make an appointment based on his/her availability. If you need a quicker option, you can typically get an appointment with our Audiology Assistant, Lou Venturello, within 24-48 hours of your call.

Utilize walk-in clinic

  • The Hearing Center at JHBI offers a walk-in clinic for our hearing aid patients. It is held every Tuesday (10:00 am-11:30 am) and Thursday (1:00 pm- 2:30 pm) to help with general hearing aid care, use, and troubleshooting. The clinic is run on a first-come, first-served basis, so no appointment is necessary. When you arrive at the clinic during the designated times, you will be asked to fill out a brief form describing your current problem and a provider will see you in the order you arrived.

Drop your hearing aid off

  • If making an appointment or attending walk-in clinic during the designated times is not a convenient option for you, we offer drop-off service for your devices as well. When you arrive at The Hearing Center you will be asked to fill out a brief form describing your current problem and leave your hearing aid with us. Our Audiology Assistant will troubleshoot your device and see if the problem is something that can be fixed in office. If not, he will take the appropriate measures to make sure your device is sent off to the manufacturer for repair. He will call to update you on the status of your device once the evaluation has been performed and inform you of any additional fees if the device needs to be sent to the manufacturer for repair. Turn around time on a device that is sent to a manufacturer is typically 8-10 business days. You will be promptly called for pick-up of your device when the problem has been resolved.


At The Hearing Center at JHBI we strive to provide our patients with outstanding care throughout your hearing aid journey. If you have any questions or concerns regarding your hearing aids, please contact our office at (904) 399-0350 ext 246.

Communicating on the telephone with hearing loss

Overcoming the stresses of talking on the phone

Individuals with hearing loss will often find that it is quite difficult and can be frustrating to hear on the phone. Often times the sound quality on the phone will be poor and degraded and sometime people do not speak as clearly while talking on the phone. There are also no visual cues to help out. Even with properly fit hearing aids, cochlear implants, or other amplification devices, hearing on the telephone can still become a difficult task. Below you will find some tips and tricks to help hear on the phone.

  1.  Try using speaker phone. If you utilize two devices (one in each ear) the speaker phone may be the best option for you. This allows you to hear the person speaking with both ears rather than just one. Listening with two ears is always an advantage.
  2. Try an amplified or captioned phone. If a speaker phone is still hard to hear your loved ones with, an amplified or caption phone may be helpful. An amplified phone makes the signal louder and a caption phone has captions just like TV. Both of these phones may be independently purchased or obtained from state programs
  3. An important point to remember is to make sure where you are holding your phone is in the correct place for your device. Some types of amplification have microphones that are located behind the ear. It is important to hold the phone near the microphones rather than at ear level if you are wearing a behind-the-ear device. If the devices that you use are in-the-ear devices, you can continue to use the phone at ear level
  4. If your device has telecoil enabled, try using it. The telecoil picks up the electromagnetic field from the phone and may provide a clearer signal. If you are interested in trying the telecoil, ask your audiologist to activate the telecoil options.
  5. Try accessories. Many devices now have the option to use additional accessories to help people hear better on the phone. These accessories have the ability to stream a phone call directly to your hearing aids just like a Bluetooth headset. Using a streaming device will let you hear the phone in both devices, which takes advantage of binaural listening.

Ear-Friendly Holiday gift giving guide

Gift giving ideas

With the holidays just around the corner, it’s time to start thinking of gift ideas for those closest to you. This year, why not consider giving your loved ones a unique but useful hearing related gift? Whether they are hearing impaired or have normal hearing, below is a list of gift ideas that they are sure to love.



Custom hearing protection- Custom hearing protection is a great gift for so many different people in your life. Hunters, musicians and avid concert goers, to name a few, can all benefit from custom earplugs. Hearing protection can be made completely solid to block all sound (great for sleeping plugs!) or with various filters to let in animal noises or vocals in music. Custom plugs can also be made into earbuds/headphones, which are a great option for anyone on your list.



Hearing Aid Dryers – Hearing aid drying devices are a great gift for loved ones who use hearing aids. Dryers range from minimal to more advanced options that plug into the wall and use a germicidal lamp to disinfect. A drying device will extend the life of hearing aids, keep the user’s ears dry and clean and provide storage options both at home and while on the go.



Bluetooth Accessories- Bluetooth Accessories are a great option for someone that already has hearing aids. Bluetooth packages allow hearing aid users to “stream” or directly connect to audio from cell phones, television, iPads or remote microphones. These gifts are especially useful for anyone who is struggling to understand with his or her hearing aids. For more information on Bluetooth, please see on of our earlier blog posts on the topic (



TV Ears- TV Ears are ideal for someone who doesn’t have hearing aids but still struggles to understand the television or likes the volume turned up very loud. TV Ears are easy to use and can provide excellent sound quality at a reasonable cost. They are available in many different styles depending on preference.



Vibrating Alarm Clock – There are a lot of household accessories available for people who are hard-of-hearing or deaf to make daily life easier. One example is a vibrating alarm clock, which uses a bed shaker to wake someone from sleep instead of sound. Bed shakers and vibrating watches can also pair to cell phones, doorbells and landlines to alert someone of visitors or incoming calls.



Toys and Comics featuring hard of hearing or deaf characters – If you have a child on your buying list who has hearing loss, a hearing related gift might be just right for them. Marvel Comics has recently introduced Blue Ear and Sapheara, two super heroes who wear hearing aids and cochlear implants. American Girl Dolls has also introduced hearing aid accessories for any of their 18” dolls. These options and others like them (including a host of different books) are relatable and educational for children with hearing loss, and may even help them to accept their hearing aids and cochlear implants.


The gift of better communication is one of the best gifts you can give this year. The above options are just a small sample of some of the ways you can use gift giving to help a loved one reconnect to the world of sound this holiday season.

The Dos and Don’ts of Cleaning Your Ears

Earwax, or cerumen, is a naturally occurring substance in the ear canal that protects against bacteria, fungi, and insects. The earwax naturally migrates out of the ear canal, but can build-up over time. An excessive build-up can cause you to notice a decrease in hearing.

If you have turned on a television or opened a magazine, you have most likely seen some form of earwax removal tool being advertised. The products range from wax candles to devices that attempt to flush the wax from your ears. The most commonly used tool is, of course, the Q-tip.  It can be hard to decide when it is time to remove wax and what the safest way is to remove it.  It is important to reiterate that a little earwax is natural and constant cleaning of the ears is unnecessary. You should never stick or jab anything into the ear canal. At best, you may push the earwax deeper into your ear. At worst, you may earn yourself a trip to the doctor with a punctured eardrum.


Safe options for keeping your ears clean:

-Use wax removal tools around the outer ear, but never enter the ear canal

-Over-the-counter wax softeners, such as Debrox

-Visit your healthcare professional for removal.

If you have further questions, you can schedule an appointment at the Jacksonville Hearing and Balance Institute by calling (904) 399-0350.


Making the Most of Your Hearing Aids or Cochlear Implant

Hearing loss is one of the most prevalent health issues in the world today.  Over 48 million people in the United States experience significant hearing loss. Studies have shown that untreated hearing loss can have detrimental effects on a person’s social and emotional health. Listening with a hearing loss requires increased cognitive effort which often leads to exhaustion by the end of the day. The impact of untreated hearing loss leads to an overall poorer quality of life when compared to individuals with treated hearing loss. Hearing aids and cochlear implants that are recommended and appropriately programmed by an audiologist can help regain the joys of life that are found in connecting with family and friends through conversation. However, it is important to remember that although hearing aids and cochlear implants are significant components of the rehabilitation process, they will not lead to perfect speech understanding in all situations. Even with the use of hearing aids and/or cochlear implants there may still be environments that interfere with the ability to understand speech. The most common situations where hearing aid users may have difficulty include loud and noisy environments (i.e. restaurants), listening at a distance (i.e. large meeting room) reverberate or echoic environments (i.e. worship center) on the telephone and the television.


Listening in a noisy environment is difficult because the noise tends to “wash over” the soft high pitched sounds necessary for the clarity of speech. In addition, a hearing loss leads to difficulty with differentiating speech versus unwanted noise making it hard for the brain to focus.  Studies also show that individuals with hearing loss need speech to be much louder than the noise in order to understand the message compared to an individual with normal hearing.

Distance and Reverberation

Listening to a talker standing at a distance is difficult because a hearing aid is most effective when the sound source (the talker’s voice) is within several feet of the hearing aid microphone. The further away the talker is the softer and less clear the signal will be. Environments such as a worship centers often lead to reverberation due to the lack of carpet and/or upholstery and the use of high ceilings; these factors combined cause sound waves to bounce off the walls and can lead to echoic and distorted sound quality before the sound is even picked up by the hearing aid or cochlear implant.

Telephone and Television

Understanding on the telephone can be difficult due to the lack of visual cues. During face-to-face communication we often rely on visual cues to help the brain “fill in the blanks” if certain sounds are not heard however, these cues are not available when using the telephone. In addition, the signal heard from a telephone is a filtered signal and different from a natural voice. Television shows and movies can be difficult due to the music added to the background of the spoken dialogue. In addition, many times the individual with hearing loss prefers the volume at one level while family members prefer a different volume which often leads to unpleasant watching experiences.

Wireless Accessories

One of the great benefits of digital hearing aids today is the ability to take advantage of wireless technology. The use of wireless accessories can increase the benefit received from hearing aids. All of the major hearing aid and cochlear implant companies offer wireless accessory devices to help bridge the gap between the listener and the talker regardless of background noise, echo or distance. Many companies offer a device that acts as a tiny microphone and is worn by the talker. The microphone picks up the talker’s voice and sends the signal to the hearing aids or cochlear implants.  This technology allows the talker’s voice to be heard louder relative to any background noise. The microphone will also transmit the signal over an average distance of 30 feet which leads to better understanding when seated far away from the talker. In addition, since the signal travels from the microphone to the hearing aids or cochlear implants wirelessly it is not affected by echo.

Another wireless accessory is a device that connects via Bluetooth to a smart phone and allows for phone calls, music and other media to stream from the phone directly to the hearing aids. This allows the listener to hear the signal in both ears at once which creates an easier listening experience. The microphones on the hearing aid or cochlear implant are turned down so the primary signal heard is from the mobile phone. Similarly there are also devices that plug into the television and allow for shows and movies to stream directly to the hearing aids or cochlear implant. This allows the user and the family member to independently set the volume to a comfortable level.

The combination of hearing aids or cochlear implants, wireless technology and communication strategies allow for the individual to maximize their benefit from amplification in order to achieve increased understanding of speech and an easier listening experience.



For more information on hearing loss and hearing aids, visit or If you think you or a loved one needs to consider amplification, the first step is a comprehensive hearing evaluation. Call us at 904-399-0350 to schedule an appointment today.

Rechargeable hearing aids

Phonak Audeo BR

In September 2016, Phonak, one of the major global manufacturers of hearing aids, released its next generation of hearing aid technology. The new product line features the Audeo BR, the first hearing aid to house a built-in lithium-ion rechargeable battery. Currently, the rechargeable option is only available in RIC (receiver in the canal) technology. To learn more about styles of hearing aids, see our previous blog post on the topic

The Phonak Audeo BR boasts 24 hours of hearing with a full charge, and the ability to reach a full charge within three hours. In addition, the 20 minute fast-charging option is able to provide up to 6 hours of immediate use. With a rechargeable hearing aid comes freedom from changing disposable batteries every 4-10 days, making hearing aids significantly more accessible to patients with dexterity issues or arthritis. The new technology is also environmentally friendly and significantly reduces the number of disposable batteries that are thrown away each year. The Audeo BR offers several charging options, from full size to mini, including the portable charger case which is able to provide power for seven full charges of two hearing aids when no power source is available.

If you, or someone you know, might be interested in a rechargeable hearing aid option, the audiologists at JHBI would be happy to show you what technology is available right now. Please visit our websites, or, for more information on the practice or to schedule an appointment. To schedule an appointment by phone, please call 904-399-0350.