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Correct orientation of behind-the-ear hearing aids

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Edited

Using new pair of Rexton Adore Li. Seems to me they ride high on my ears. Certainly much higher than my old Starkey devices. How is fit determined for BTE devices? What guidance do audiologists use? Want to know for discussions at my first recheck.

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They can be adjusted by changing the length of the wire on the receiver. If you look at the side of the receiver it will have a number and a letter on it. The number is the length (in cm I believe), and the letter is the power of the receiver. A “3M” for example would be a M power receiver with a 3 cm wire. You should ask your fitter if they have receivers with longer wire lengths. At some point the directionality of the microphones may be affected if they are too far back and too low. You fitter should know where they are best positioned. If I look in the mirror, I just see the tip of the hearing aid appearing above my ear.

That’s what I’m looking for. Information on how audis are trained about the trade-offs of position, mic performance versus, wearability, vs whatever. How SHOULD the proper wire length be determined?

Over the years I’ve had several different aids. All have been large standard size aids connected to earmoulds by clear plastic tubing.

Whenever I’ve needed the moulds re-tubing or when I’ve gotten new aids my audiologists have always sat the aids on my ears without the moulds attached and then put the moulds in my ears and cut the tubes to the right length at the point where the tube fits onto the aid.

That way my aids have always sat correctly on my ears and the tubes have been the right length so that my earmoulds fit correctly and comfortably in my ears.

But what I want to know is, what is the correct orientation for the device? When your audiologist sat the aids on your ears, how did they know they were placed correctly? What is the guidance for placement? How far back on the ear? I’m asking because I think mine are too high, landing more on top than behind.Before I go back for my recheck, I’d like to know what my audiologist is taught, what she’s going to say, about placement.

As a final follow-up, on my recheck, my audiologist went with longer wires not for performance but for comfort. I mentioned that my new sometimes made the top of my ear hurt. She noticed the device was putting a crease in the top of my ear. The final placement with the new wires put the devices just a tad further back than some of the guidance given in this discussion (above) but the comfort level went way up. Thanks to all for your input.

I don’t have a lot of room behind my ears. Consequently, in the past I’ve had to accept a less powerful hearing aid which is narrower than say a sp or up hearing because they would bend my ear out from my head causing pain. Fortunately this problem has all but gone away because sp aids are now much thinner. If you look at the shape of a bte aid the thickest part of the aid is usually at the top. So sliding the aid further back on the ear would put the aid in a wider area between ear and head. My concern would be in a voice with sound program which is very directional and by sliding the aid further back on the ear you’ve changed the angle of the microphone which would now be angled more upward than straight ahead. Does this make sense?

I recently bought shorter receivers for directionality reasons. By moving the aids from behind my ears to more up on my ears I have noticed an improvement to directionality. I used to hear behind me really well.

I wear hearing aids, and I have always wore ITE aids except for on set of Rite aids. With the ITE aids I feel like my hearing is more balanced all around me. When I had the Rite aids I felt like you said that I could hear more from behind and not so much from in front of me. And I also felt like I was not understand speech as well.
My Word recognition scores were much higher before the Rite aid than at the time I got my next ITE aids. And my Word recognition scores were back up some at the time I get the aids I wear now. So I am a believe that ITE aids if setup correctly are better than behind the ear aids. Now I have never worn or , always ITE half shell aids which have always had 2 mics and not one like the CIC or IIC.

Unfortunately bte aids are pretty much a necessity and not an option for someone with a profound loss.

In reply to @Neville

@Neville said:

If you scroll down here there’s a picture of correct placement.

That link seems to have expired. I found a post that might have a similar image:

Question for users of Phonak Sphere Infinio
Yes, I’ve found that even traditional (non-AI) noise reduction and directivity (Speech in Noise program) are excellent in Sphere, even with a dome instead of an earmold! I have Sphere since 4th March and compare it to the Paradise 90-RT. What’s more, I use Sphere only monaurally, so I do not have access to StereoZoom 2.0 and the Speech in Loud Noise program. So the directionality of Spheres could be even better in binaurally fitted patients. The only drawback I see is that the feature is very…

I also found an article on how the wire should fit / seat:

Adding a current link that explains & microphone position in a bit more detail. With diagrams:

Providing Some Direction – Beamformers Explained -Article 2626027

Directional microphone technology in hearing aids is a common method for improving hearing in noise in the near-field. This paper describes the various possible behaviors of directional microphone and how these provide benefit to the wearer, as well...

@kgmgpm said:

My Audi uses a template she put over the ear, this measures the correct distance between ha’s and ear hole giving the length of the wire

That is a great starting point and just might be perfect but the final answer is how the aid sits on the ear and your comfort.

Edited

In reply to @kgmgpm

@kgmgpm said:

My Audi uses a template

@Raudrive said:

That is a great starting point

I’ll use pictures of myself as an example as to demonstrate as it is not always simple as it seems. I printed the gauge using a PDF template from Jabra - (sorry I can’t find the link right now)

(on edit: adding in I’m wearing the Jabra enhance pro 30s)

Sometimes your anatomy is different (my left ear), sometimes you can’t see what you are looking for (my right ear). The Q-tip is showing the top of my ear canal.

Left_Close_Up

Left_Seated

Right_Close_Up

Right_Seated

Pages 21 & 22 of the Enhance Select User Guide available here https://cdn.jabraenhance.com/shared/userguides/enhance-select-700.pdf5 shows where Jabra thinks the hearing aid should be sitting.

User guide - enhance-select-700

I’d be interested in hearing what both the users and experts have to say from these pictures and diagrams.

What wire sizes for each ear do you think I might need for a proper fit?

Do you think the current fit for each ear is correct?

Both left and right aids need shorter receiver wires to move the aids higher on the ear.

Think about the aid microphones. They need to gather sound from all places for you to hear best. On top or close to top is best for all directions.

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