Which style is easiest to handle for someone with arthritis or low vision?

Behind the ear, generally. Its larger case and buttons are simpler to grip, insert, and clean than the smaller shells used by in the ear devices, and dome and receiver wire replacement does not require handling the whole device at once. Anyone shopping primarily on handling rather than appearance is usually better served starting there.

Can an in the ear device handle severe hearing loss?

Generally no. In the ear shells, especially the smallest in canal and completely in canal sizes, have less room for amplification hardware and typically top out around moderately severe loss. Severe to profound loss is usually addressed with a behind the ear device fitted with an ultra power receiver, and that fitting is a prescription and professional matter, not a self-fit choice.

Do behind the ear and in the ear devices use different batteries?

Often, though not strictly. Behind the ear devices commonly use size 13 or 675 batteries, or larger rechargeable cells, while in the ear devices more often use size 10 or 312, the smallest cells in the standard lineup. Larger in the ear shells can still take a size 13 battery, so the specific device's own specification is the final word.

Which style is most discreet?

A completely in canal (CIC) device is the most discreet, sitting almost entirely inside the canal. In the canal (ITC) and receiver in canal (RIC) styles are the next least visible, and a traditional behind the ear case is the most visible of the group. Discretion generally trades off against handling ease and available power, so it is worth weighing against dexterity and the degree of loss.

Behind the ear against in the ear hearing aids

Quick answer

Behind the ear devices, including the receiver in canal style, win for easier handling, a wider range of available power up to severe and profound loss, and access to swappable domes and larger batteries. In the ear devices win for being nearly invisible and for a slightly more natural own-ear sound, at the cost of being smaller to handle and generally topping out at a lower power range. Dexterity and eyesight usually decide this before appearance does.

"In the ear" is really a family of shapes, not one device: in the ear (ITE), in the canal (ITC), and completely in the canal (CIC) all put the entire hearing aid, microphone, processor, receiver, and battery, into a single custom shell that sits in the outer ear or canal. "Behind the ear" (BTE) puts the electronics in a case that sits behind or on top of the ear, connected to the ear canal by a tube or a thin wire. Receiver in canal (RIC or RITE) is technically a member of the behind the ear family: the case sits behind the ear the same way, but the speaker, called the receiver, sits down in the canal at the end of a thin wire rather than in the case itself.

That construction difference drives every real tradeoff between the two families: how large a battery fits, how much amplification is available before feedback becomes a problem, how visible the device is, and how easy it is to handle for someone with limited dexterity or eyesight.

Behind the ear against in the ear, by what actually differs

Trade convention Taught everywhere in the clinic and the trade, and published as a standard by nobody. Useful, and not a standard.

Behind the ear handles more easily and reaches higher power; in the ear is smaller and less visible.

Behind the ear against in the ear hearing aids
	Behind the ear (BTE, including RIC)	In the ear (ITE, ITC, CIC)
Where the electronics sit	In a case behind or on top of the ear, with sound carried into the canal by a tube or a thin wire	Inside a single custom shell in the outer ear or canal
Visibility	The case is visible behind the ear; RIC wires are thin and easy to miss	The smallest sizes (ITC, CIC) are close to invisible
Typical battery size	Size 13 or 675, and larger rechargeable cells, per the standard battery chart	Size 10 or 312, the smallest cells in the lineup, though larger ITE shells can take size 13
Available power range	The widest range; ultra power BTE receivers reach severe to profound loss	Generally mild to moderately severe loss; the smallest shells have the least room for amplification
Handling and dexterity	Larger parts and buttons are usually easier to insert, remove, and clean	Smaller parts can be harder to handle with limited dexterity or eyesight
Fitting hardware	Domes and receiver wires are swappable and separately replaceable	The shell is custom made to one ear and is not interchangeable

Style and venting choices here are a trade convention, not a fixed rule. A hearing care provider or a self-fitting device's own software makes the actual match against a full hearing profile.

When behind the ear wins

Behind the ear, including the receiver in canal style such as a receiver in canal device, wins whenever handling matters as much as hearing does. Larger parts are easier to insert, remove, and clean for someone with arthritis, reduced fine motor control, or limited eyesight, and the swappable dome and receiver wire mean a fitting can be adjusted or repaired without replacing the whole device. It is also the only practical route to the highest power range: ultra power receivers built for severe to profound loss are a behind the ear feature, not an in the ear one.

When in the ear wins

In the ear wins on one axis clearly: visibility. A completely in canal device such as a completely in canal model sits almost entirely out of sight, which matters to someone whose main objection to a hearing aid has been appearance rather than price or performance. The tradeoff is real, though: the smallest shells are harder to insert and remove, hold a smaller battery, and generally cover a narrower power range than a behind the ear device. Anyone for whom dexterity or eyesight is already a daily challenge is usually better served choosing behind the ear first and revisiting appearance later.

A pick from each style

Beginner Behind the ear, easiest to handle

MDHearingAid

MDHearing VOLT MAX 2

$597.00

FDA regulated OTC hearing aid

Published specs

A behind the ear, self-fitting device from an established American brand, the easiest style in this comparison to insert, remove, and clean.

Best for: A buyer who wants a behind the ear device from an established American brand with phone support.

Check price on Amazon

Intermediate Receiver in canal, still swappable domes

Ceretone

Ceretone Horizon

$226.99

FDA regulated OTC hearing aid

Published specs

A dual microphone receiver in canal device, smaller than a traditional behind the ear case while keeping swappable domes and a receiver wire.

Best for: A buyer who wants the receiver in canal form without the premium price.

Check price on Amazon

Expert Completely in canal, the most discreet option here

Ceretone

Ceretone Core One Pro

$299.00

FDA regulated OTC hearing aid

Published specs

A completely in canal device for a buyer whose main objection to hearing aids has been appearance; smaller parts mean more handling is required.

Check before buying: A very small in canal device is harder to handle and to insert than a behind the ear one. If dexterity or eyesight is a limitation, the smallest device is usually the wrong choice regardless of how it looks.

Best for: Someone whose main objection to hearing aids is appearance rather than price.

Check price on Amazon

Common questions

Is a receiver in canal (RIC) device behind the ear or in the ear?: Behind the ear. The case sits behind or on top of the ear the same way a traditional behind the ear device does; what changes is that the speaker, called the receiver, sits down in the canal at the end of a thin wire instead of inside the case itself. RIC is a smaller-looking member of the behind the ear family, not the in the ear one.
Which style is easiest to handle for someone with arthritis or low vision?: Behind the ear, generally. Its larger case and buttons are simpler to grip, insert, and clean than the smaller shells used by in the ear devices, and dome and receiver wire replacement does not require handling the whole device at once. Anyone shopping primarily on handling rather than appearance is usually better served starting there.
Can an in the ear device handle severe hearing loss?: Generally no. In the ear shells, especially the smallest in canal and completely in canal sizes, have less room for amplification hardware and typically top out around moderately severe loss. Severe to profound loss is usually addressed with a behind the ear device fitted with an ultra power receiver, and that fitting is a prescription and professional matter, not a self-fit choice.
Do behind the ear and in the ear devices use different batteries?: Often, though not strictly. Behind the ear devices commonly use size 13 or 675 batteries, or larger rechargeable cells, while in the ear devices more often use size 10 or 312, the smallest cells in the standard lineup. Larger in the ear shells can still take a size 13 battery, so the specific device's own specification is the final word.
Which style is most discreet?: A completely in canal (CIC) device is the most discreet, sitting almost entirely inside the canal. In the canal (ITC) and receiver in canal (RIC) styles are the next least visible, and a traditional behind the ear case is the most visible of the group. Discretion generally trades off against handling ease and available power, so it is worth weighing against dexterity and the degree of loss.

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Last updated 2026-09-17.