Buying hearing aids

Flat-behind-the-ear hearing aids

Last update on Mar, 06, 2025

Wondering about the pros and cons of hearing aids that sit behind your ears? In this post, we’ll look at popular behind-the-ear hearing aid styles and help you understand more about the available options.

Dr. Thomas Tedeschi, Au.D.

Chief Audiology Officer, Miracle-Ear

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Key takeaways

Behind-the-ear (BTE) hearing aids feature a flat component that sits behind the ear, and is connected by a tube or wire to a piece that fits inside your ear.
Mini behind-the-ear hearing aids, also called receiver-in-canal (RIC), are a style of open-fit hearing aids.
Traditional behind-the-ear hearing aids (BTEs) are larger than mini BTEs/RICs.
Open-fit hearing aids have grown in popularity in recent years due to the fact that many people find them comfortable and discreet.
Open-fit hearing aids have several pros and cons, including comfort, fit and sound quality.

What are flat-behind-the-ear hearing aids?

There are a couple of different styles of flat-behind-the-ear hearing aids. They’re generally referred to as either traditional behind-the-ear (BTE) hearing aids or receiver-in-canal (RIC) hearing aids, but you might also hear RICs referred to as mini BTE hearing aids. This increasingly popular style features a receiver that sits in the ear and is connected by a small wire to a slim body or shell that houses the microphones and sits behind the ear.

The in-ear receivers are covered by flexible, vented ear domes that help them sit comfortably and securely in many different ear sizes and shapes, which is why they are referred to as open-fit hearing aids. This is different from traditional BTE hearing aid models that use custom earmolds fitted to an individual’s unique ear shape. Many people prefer the mini BTE (or RIC) over the traditional BTE style since it’s less bulky, more discreet and offers more natural sound.¹

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Pros of flat-behind-the-ear hearing aids

There are several benefits of flat-behind-the-ear hearing aids that make them enormously popular:

Finding a comfortable hearing aid is a top priority for many people. When it comes to flat-behind-the-ear hearing aids, mini BTEs are typically smaller than traditional BTEs because they house fewer components, which can make them more comfortable, depending on your ear size and shape. Additionally, many people find open or vented domes more comfortable because they allow airflow into the ear.

Many people worry that their hearing aids will be visible or draw attention. However, mini BTE hearing aids and some traditional BTEs have just a thin, discreet wire connecting the shell behind the ear to the domes that sit inside the ear canal. This makes for a nearly invisible hearing aid. In fact, an article from The Hearing Journal describes how mini BTE hearing aids have been helping people get over the stigma of wearing hearing aids, due to the fact that they’re less visible than older models.³

When it comes to finding the most natural sounding hearing aids, mini BTEs or traditional BTE hearing aids with vented domes rather than earmolds can be a good choice. The vents allow natural, ambient sounds to more easily enter the ear and can help prevent the occlusion effect in which you hear your own voice too loudly.

Users who have hearing aids with vented domes report having increased clarity of sound, including speech, when compared to other styles of hearing aids.⁴They also tend to have less feedback.

Considerations for flat-behind-the-ear hearing aids

Because of ongoing innovations that make them smaller and more comfortable, flat-behind-the-ear hearing aids are often one of the first choices people consider. They can be a great option, especially those who are concerned about comfort and visibility. However, it’s best to remember that there is no one-size-fits-all option when it comes to hearing aids. There are some instances where a person might not be a good candidate for an open-fit hearing aid or mini BTE hearing aid. Here are a few things to keep in mind as you’re weighing your options:

While mini BTE hearing aids offer quality sound that many people find to be more natural, they might not be powerful enough for people with severe hearing loss. People with more extreme hearing loss may need hearing aids with earmolds that allow increased amplification.

Hearing aids such as traditional BTE styles with custom earmolds may be a better fit in these instances. Be sure to talk with a hearing care professional (HCP) to determine which type of device is right for you.

When wearing an open-fit hearing aid, ambient noise may be picked up more easily due to the fact that more outside sound is allowed into the ears. This might affect your ability to isolate voices over noise that gets picked up from the background. For people who already struggle with hearing conversations over background noise, an open-fit hearing aid might not be the best option.

Many people are concerned that an open-fit hearing aid or mini BTE hearing aid might not be compatible with glasses for two reason:

First, there are concerns about comfort, with both the hearing aid shell and the arms of your glasses sitting behind your ears.
Second, for people who wear readers or take their glasses off and on a lot, there might be concerns about knocking hearing aids out of place.

These are valid concerns and you should discuss them with your HCP. Your eye doctor may also have suggestions on what glasses work best with hearing aids. The good news is many people find it possible to wear glasses with flat-behind-the-ear hearing aids.

For those who have highly active lifestyles or play sports, flat-behind-the-ear hearing aids may not be the best choice. With components that loop behind the ear, they can be more prone to being knocked out of place. Talk to your HCP about your specific activities and hobbies to make sure that you won’t run the risk of damaging or losing your hearing aids.

Your hearing needs are unique

Prescription hearing aids aren’t one-size-fits-all — and that’s the point. Working with a certified hearing care professional means you’ll get personalized guidance, a precise fitting, and ongoing support to help you hear your best. Speak with an expert today to take the first step toward better hearing.

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Open-fit vs closed-fit BTE hearing aids

When it comes to BTE hearing aids, there are two different types—open vs closed. Open-fit mini BTE hearing aids feature flexible, vented ear domes; they deliver a more natural listening experience since they do not fully block the opening of the ear and let in more ambient sounds. Closed-fit styles, however, are the traditional BTE models which have a custom earmold. This provides a seal over your ear so that outside noise will interfere less with the sound that the microphone picks up.

There are also different options when it comes to open-fit hearing aids with hearing aid domes — open vs closed. Open domes have small openings which let more air sound through, while closed domes do not have these vents. Ask your hearing specialist about which kind of domes would be right for your particular hearing loss.

Looking for flat-behind-the-ear hearing aids?

If you’re looking at hearing aid styles and considering open-fit, flat-behind-the-ear hearing aids, visit a Miracle-Ear hearing aid center to speak with a hearing expert. We can help you find the devices that match your needs. Schedule an appointment at a location near you to get started.

Patients visiting a hearing care professional

But before you make the leap into mini BTE hearing aids, Tedeschi does recommend booking an exam with a hearing care professional.

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Sources

¹ Hearing Aids. National Institute on Deafness and Other Communication Disorders. Accessed November 22, 2024. https://www.nidcd.nih.gov/health/hearing-aids.

² Hearing Aids Market Size, Share & Trends Analysis Report By Product Type (BTE, Canal Hearing Aids), By Technology (Digital, Analog), By Sales Channel, By Region, And Segment Forecasts, 2024 - 2030. https://www.grandviewresearch.com/industry-analysis/hearing-aids-market.

³Victorian, Brande. Spreading the good (mini-BTE) news. The Hearing Journal 64(3):p 4, March 2011. | DOI: 10.1097/01.HJ.0000395475.86206.77. https://journals.lww.com/thehearingjournal/fulltext/2011/03000/Spreading_the_good__mini_BTE__news.1.aspx.

⁴Prabhu P, Barman A. Effectiveness of Low Cut Modified Amplification using Receiver in the Canal Hearing Aid in Individuals with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol. 2017 Jul;21(3):243-249. doi: 10.1055/s-0036-1593471. Epub 2016 Nov 22. PMID: 28680492; PMCID: PMC5495591. https://pmc.ncbi.nlm.nih.gov/articles/PMC5495591/.