Do you wear a hearing instrument that fits behind your ear and it has a really thin wire inside of a skinny little tube that runs down to a rectangular box that goes into your ear? On the end of the “little box” there is a little rubber ear bud. This type of hearing instrument is called a RIC (receiver-in-the-canal).

To break this down a little bit: The part that sits behind or on top of your ear is the hearing instrument. This component houses the computer chip for sound processing, microphones to pick up the sounds, amplifiers, processors for background noise, buttons for user control, magnetic telecoils battery compartments or rechargeable cells, and antennas for Bluetooth or wireless connectivity. So in other words, this part picks up the sound and processes the speech and the various environmental sounds to deliver to the patient their corrective hearing prescription.

Once the “hearing instrument” does its job then it has to transfer that information into the ear canal onward to the eardrum. This transfer is completed as the signal is sent down the electrical wire to the receiver box. Some people will relate to the part in the ear as a “speaker.” Just like with a stereo system, you have the “tuner” with AM/FM radio, CD player or record player and then you have the speaker wire that runs to the speaker that sends out your music. We all know that if one of our speakers gets “blown” or fails that the sound coming out of the stereo is awful. It’s scratchy, garbled and weak.

The “little box”/speaker/receiver that sits in your ear canal is actually a very, very important part of your hearing instrument. It is called a “receiver” because it receives the signal from the hearing instrument/computer behind your ear. When it receives the signal it then provides the appropriate amount of power to deliver your hearing prescription. Yes, the part in your ear actually controls the amount of the power coming from the part behind your ear.

With this in mind, it is necessary to understand physical acoustics. If you are wearing a little rubber ear bud on the end of that receiver then it allows the ear to remain more open than if you have a custom piece that was made specifically for you from an impression that was taken from your ear. The receivers that use the ear buds are considered to be a “stock receiver,” while ones made from impressions are called “custom receivers.”

Stock receivers can not provide as much power as can be built into a custom receiver. Custom receivers can be small and fill up just your ear canal. Typically, they will go a little further down into the ear canal, thus getting the sound closer to the eardrum. For someone who has a severe to profound high frequency hearing loss, it may be necessary to build a custom receiver that can deliver all of the high frequencies. Sometimes, earbuds may allow part of their prescription to leak out of the ear. Custom receivers also have specific size venting depending upon acoustic needs of the hearing loss.

Which is better? How do you know? There are many stipulations as to which will work best. Needed gain ... how much power do you need? Can you hear and understand without feedback? Does the earbud stay in your ear ... if no matter what size earbuds are on? If they don’t stay in then you may want to consider a custom receiver. If you have chronic ear infections then the disposable earbud may be a better choice.

Many patients start out with an earbud if their hearing needs are within the acoustic properties of the stock receivers. However, in the event prescriptive targets are not met then a custom receiver will be the choice. Many variables dictate what is the best type of receiver to produce the best hearing and speech understanding. Your hearing health care provider along with your ever-so-important input will help to determine the best solution for your meeting your hearing targets. Remember, better hearing is a journey you will take together. To hear better is to live better!

Roseann B. Kiefer, B.A., BC-HIS, is owner of Lampe and Kiefer Hearing Aid Center, Sebring. This information is not intended to prevent, diagnose, treat or cure your condition. Always talk to your doctor before following any medical advice or starting a diet or exercise program.

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