Hearing aids, implants and other devices

If you have hearing loss, there are a number of technology-based aids that can help you to hear better, communicate more confidently and live more independently.

On this page, we’re going to look at:

Hearing aids 

Hearing aids can be helpful if you were born with a hearing impairment or your hearing has deteriorated but you have some hearing left.

What can hearing aids do for me?

Hearing aids won’t completely restore your hearing. But they can help you to hear better and feel more confident about communicating with people.

With hearing aids, you may:

  • Enjoy conversations more.
  • Hear better on the phone.
  • Hear everyday sounds like the doorbell.
  • Enjoy music, TV and radio more clearly and without needing to have it at high volume
  • Hear quieter sounds more easily.

What types of hearing aids are there?

Hearing aids all use microphones to pick up noises and adjust sound digitally to make it louder and clearer.  Hearing aids are personalised to your hearing and use your hearing test results to know which sounds to make louder and clearer. 

There are lots of different types of hearing aids available.

Your audiologist will talk you through the options of what will be best for you and your hearing loss.  Not all hearing aids will be suitable for your needs and there are different considerations to take.

These include the level and type of your hearing loss, the situations you want to be able to listen better in, the health of your ear and your dexterity.  The main types of hearing aid are:

  • Behind-the-ear hearing aids (BTE): these are the most common type of hearing aid you will see.  They have a microphone unit that sits behind your ear, with a tube and ear piece that go into your ear.  There are different types of ear piece that you might be offered depending on your level of hearing and health of your ear.   Some hearing aids will have an open fitting, which is where a thin tube has a small soft tip that goes into your ear canal, others will have a custom made earmould.
  • In the ear hearing aids (ITE): rather than having a microphone unit behind the ear, in the ear hearing aids sit in your ear.  There are different sizes and types of ITE depending on the level and type of hearing loss that you have.

Where do I get hearing aids from?

Hearing aids are available free of charge on the NHS, or you can choose to pay privately. 

If you would like to get your hearing aids on the NHS, you will need a referral from your GP to the local Audiology department.  Some departments will also let you contact them directly, this is called self-referral. 

There are many private hearing aid providers available.   You don’t need a referral to access these services. 

Why go with the NHS?

With NHS hearing aids:

  • All your appointments are free, as are the hearing aids.
  • You can get free batteries and repairs from the NHS hearing aid service that fitted your hearing aids. Just ask your audiologist.
  • Your local hearing aid service can also replace hearing aids that have been lost or damaged, although there may be a charge for this.

Why go privately?

If you’re happy to pay privately for hearing aids, you can pick from a wider range of models, including smaller, less-visible models.

However, if you do go private:

  • Look carefully into the costs of hearing aids and aftercare – you can pay from £500 to £3,500 or more for a single hearing aid.
  • Shop around to see which types are available from different providers – and at what cost.
  • Remember the cost of batteries and check if you can change them easily.
  • If you need your hearing aid repaired or replaced, you may have to pay if this isn’t included in your payment plan. Always check.

Top tips for getting used to hearing aids:

  • Slowly spend more time using your hearing aids, from once or twice a day for just an hour or two. Do this in quiet surroundings.
  • The more you wear your hearing aids, the faster you’ll get used to them. So, wear them for as long as you can.
  • As your hearing aids start to feel more comfortable, wear them outdoors and get used to keeping them on all day.
  • When you practise using your hearing aids outside, you might hear sounds such as birds chirping and traffic noise more than you’re used to.
  • If you have two hearing aids, wear them both at the same time.
  • Don’t wear them for showering or while sleeping.
  • Listen to everyday noises such asthe kettle boiling, the fridge humming, and doors opening and closing.
  • Remember: your brain adjusted to hearing with your hearing loss, so it might need time to re-learn which sounds are important and which can be ignored.
  • Use your hearing aids when you watch TV to adjust to different sounds.
  • Try watching TV with the sound at different volume levels. Compare your usual volume level to what sounds better now.
  • Try having a conversation with one person – you may find you hear your own voice more than you’re used to, a bit like an echo. Don’t worry, you’ll soon get used to it the more you wear your hearing aids.
  • Also, in conversation with one person, choose a quiet place with good light, with the other person facing you. This makes it easier to lipread them. Explain that you’re getting used to wearing your hearing aids and ask the person to be patient.
  • Try group conversations – you might find that you can follow conversations much easier and enjoy group situations more.
  • In group conversations, explain that you’re getting used to your hearing aids, and remind people they still need to get your attention before speaking to you. You can then turn and face them, which will help you hear better with your hearing aids.
  • When you feel ready, use your hearing aids in difficult, noisy placeslike restaurants or train stations. The more you’ve worn them, the better you’ll manage with background noise.

Help and support

You might find hearing aids difficult at first. It may take you a few weeks or months to get used to them.

You’ll have follow-up appointments after they’re fitted to check how things are going.

But if you have any problems, get in touch with your audiologist.

The following organisations also offer further information, help and support:

You can also find out about using hearing aids with assistive technology, including computers, hearing loops, telephones, alert systems and other devices that help you get on with everyday life.

Surgically implanted hearing devices

Bone anchored hearing aids

A bone anchored hearing aid (BAHA) is really a type of surgical implant. They are also known as bone conduction hearing devices.

If you have problems in your outer or middle ear, with sound unable to reach the inner ear, and hearing aids don’t work for you, a BAHA may be an option.

BAHAs are also suitable for children who cannot use hearing aids because their ear canal or the outside parts of the ear have not developed.

They are also suitable for children who have a certain type and level of hearing loss.

A BAHA connector is attached to your skull during a minor operation. It picks up sound and sends it to your inner ear by vibrating the bones near your ear.

A young child will start with a soft band worn around the head. Find out more about children and BAHAs.

A BAHA can be clipped on and off, so you can remove it at night and when you take a shower or go for a swim.

There are two types:

An abutment BAHA

This has the implant coming through the skin of your scalp. A connecting abutment is attached to the implant, which attaches it to the sound processor – a small box.

A magnet BAHA

This contains an implant magnet in the shape of a flat disc, about the size of a two pence coin.

This sits completely under the skin. The sound processor and sound processor magnet sit on the skin of your scalp, held in place by magnetic attraction.

Pros and cons

Abutment BAHA:

  • More likely to have a better effect on your hearing loss.
  • You can still have magnetic resonance imaging (MRI) scans.
  • Risk of complications at the implant site, such as skin irritation, infection and breakdown of the device.

Magnet BAHA:

  • The effect on your hearing loss might not be as good.
  • The magnet is under the skin, so there’s less risk of complications at the site of the implant.
  • You may have difficulties with MRI scans.

Cochlear implants

A cochlear implant is a hearing device that is surgically implanted.

These are usually only suitable if you have severe to profound hearing loss in both ears and hearing aids don’t really work for you.

They can help you to hear and understand speech, allowing you to communicate more confidently and feel more independent.

How do cochlear implants work?

A cochlear implant has a part worn outside the body (external), and a part placed under the skin during the implant operation (internal).

The external part contains:

  • A microphone to pick up sound waves and pass them to the sound processor.
  • A sound processor to convert the signals from the microphone into digital signals and pass them to the transmitter coil.
  • A transmitter coil, which transmits the digital signals received from the sound processor to the internal parts of the implant.

The transmitter sits flat against the skin, a little behind the ear. The sound processor sits either behind the ear (in a device that looks like a hearing aid) or in a single unit with the transmitter coil.

The internal part contains:

  • A receiver/stimulator with a magnet – fitted under the skin, behind and above the ear. The magnet holds the external transmitter coil directly over the implanted receiver.
  • A set of electrodes – inside the cochlea (the spiral cavity of the inner ear).

The receiver picks up the digital signal from the transmitter coil and sends it to the electrodes inside the cochlea.

The electrodes do the job of the damaged or missing hair cells in the cochlea, sending electrical signals along the hearing nerve to the brain. The brain learns to recognise these signals as sounds.

How can I get cochlear implants?

If you have severe to profound deafness and want to know whether a cochlear implant could help you, your GP, audiologist (hearing specialist) or your ear, nose and throat (ENT) specialist can refer you to a cochlear implant centre for an assessment.

Can my child have cochlear implants?

Cochlear implants may also be suitable if you have a child with severe to profound permanent deafness who gets little or no benefit from hearing aids.

Usually, the younger a child is when they receive a cochlear implant, the more likely they are to get the most benefit from it.

It’s now common for children to have a cochlear implant before they’re 12 months old.

Older children can also benefit from cochlear implants, such as those who become deaf after learning to speak, e.g. following meningitis, and those with progressive or acquired hearing loss who get less benefit from their hearing aids.

If you think your child might benefit from a cochlear implant, speak to your ENT consultant, paediatrician or audiovestibular physician for a referral.

Help and support

The following organisations also offer further information, help and support:

Middle ear implants

Middle ear implants (MIEs) are suitable if you have mild to moderate:

  • Conductive hearing loss – sound cannot get through the outer and middle ear.
  • Sensorineural hearing loss – caused by damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain.
  • Mixed hearing loss – both of the above. 

An MEI may be an option if you cannot use a regular hearing aid because you have earmould allergies, skin problems in your ears, outer-ear infections, narrow, collapsed or closed ear canals, or malformed ears.

An MEI may also be an alternative to a BAHA if you have any of the above problems as well as healing issues, problems using your hands or difficulty keeping a BAHA clean.

An MEI has two main parts:

  • A device attached to the skin that picks up sound and turns it into an electrical signal.
  • A device under the skin that picks up these signals and sends them along a wire to the small hearing bones deep in the ear, causing them to vibrate.

Vibrating the hearing bones means that sound can travel into your inner ear and brain.

This will not fully restore your hearing but it can help make sounds louder and clearer.

Auditory brainstem implants

If your auditory (hearing) nerve is damaged, hearing aids and cochlear implants can’t help you.

An auditory brainstem implant (ABI) might work for you. Your brainstem is the lower part of your brain connected to your spinal cord.

ABIs are new and still in development. They work by bypassing the ear and auditory nerve and directly stimulating the auditory brainstem directly to give you a sensation of hearing.

How does an ABI work?

An ABI has two parts:

  • The external part: a microphone and speech processor (which you can wear on your body or place behind your ear), a lead and a transmitter coil.
  • The internal part: a receiver and electrodes that directly stimulate your brainstem to provide a sensation of hearing. This is surgically implanted directly onto your brainstem, bypassing the cochlea and auditory nerve.

A few weeks after the internal part has been implanted, the external parts are fitted and your implant is switched on.

Over a period of time, the speech processor is tuned to meet your needs.

Help and support

You will get long-term support from hearing healthcare professionals to help you to listen to and understand the signals from your ABI.

Making the most of your hearing device

Connectivity

Lots of hearing aids, cochlear implants and other devices now come with Bluetooth connectivity as standard.

This means that you can use other technology devices, such as remote microphone systems with them.  Some devices also have phone apps that enable you to change the volume and settings of your hearing device.

You should speak to your audiologist about the different connectivity options, and what you might want to consider. 

Hearing loops

A hearing loop (sometimes called an audio induction loop) gives you a direct link to a sound source such as a microphone, sound system to television. It cuts out background noise so that you can hear clearly what you are trying to listen to.

The loop allows your hearing device to pick up sound from the loop system microphone, rather than all noise in the area.

To use a hearing loop, switch your hearing device to the hearing loop setting (the ‘T’ position). Check with your audiologist that this has been activated. 

Hearing loops are available: 

  • In various public places, e.g. banks and theatres. Look for the ‘T’ sign. Check with staff that it’s switched on.
  • With your landline phone. 
  • With your smartphone. 
  • For your home, to use with your TV or radio.

You may need additional equipment to use hearing loops with your phone or in your home. You can find out what products are available from suppliers such as Connevans.

Most theatres, cinemas and conference venues have loop systems available.  Sometimes you may need to request a special headset from the venue to use the loop when you are there. 

FM systems

An FM system uses radio waves to send sounds from a transmitter to several people at the same time.

These are normally used in schools or offices. You may also find them available for group tours, and at conferences and lectures.

Several FM systems are available and can be used with any hearing aid. You’ll need a compatible receiver, which is usually attached to the bottom of your hearing aids.

Your audiologist may need to link your hearing aids to the FM system and tell you which receiver you need.

Assistive listening devices

Alongside hearing devices there are other pieces of technology that you can get to help with your hearing.  Some will work with your hearing device, and some don’t require you to have one. 

Examples of assistive listening devices include:

  • Remote microphone systems.
  • Personal amplifiers.
  • Portable loop systems.

See also

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This content was last reviewed in April 2022. We’ll review it again next year.