Hearing loss has been a problem that has plagued mankind for thousands of years. As a consequence, people have been trying to address this condition for centuries. Hearing enhancement devices have been around for hundreds of years. One such device, which many people are familiar with and which was quite successful at the time, was the trumpet. This device consisted of an extended brass tube with a small end that flared out at a larger end. The larger end of the device resembled the end of a trumpet, hence its name. To use it, place the small end in your ear and point the larger bell end in the direction of the sounds you want to amplify. The trumpet hearing aid was one of the first successful portable devices ever made to treat hearing loss.

Harvey Fletcher of Bell Laboratories developed the first transistorized hearing aid in the 1950s. Initially, these were bulky units consisting of an earpiece connected by a cord to a box that was about the size of a pack of playing cards. The earpiece contained a small speaker, while the case contained the amp, battery, and controls. The case can be worn on your belt or around your neck. Initially, these devices had various problems with amplification and interference that slowly began to improve over the years. Although bulky, these types of devices are still being manufactured and used today. Its appeal is that a body-worn device, albeit bulky, can provide the user with higher amplification and longer battery life, all at a much lower cost than the latest miniaturized devices.

With the advent of the integrated circuit and the miniaturization of the transistor, a new type of device appeared on the market, the BTE or behind-the-ear. This hearing aid consisted of a case, an earmold or dome, and a connection between the two components. The case contained the electronics, controls, battery, and speaker. The amplified sound could be acoustically or electrically routed to the ear. Patients can use BTE for mild or severe hearing loss. It is common for children to wear a BTE hearing aid due to its great durability. Another breakthrough was the development of the mini BTE. This version fits behind the ear but is much smaller than a normal BTE. Mini BTEs allowed for a reduced feeling of packing for the patient along with increased comfort and fewer feedback issues.

As the miniaturization of circuitry continued, so did the advancement of smaller, less conspicuous hearing aids. Two new devices that will hit the market are the ITE or in-ear device and the IIC or in-channel device. The ITE fits into the outer bowl of the patient’s ear. They are custom molded to fit each individual ear and can be used for mild to severe losses. Because feedback can sometimes be a problem with this device, some of the modern circuitry can also provide feedback regulation or cancellation. Invisible aids in the canal are virtually undetectable, even when looking directly into the ear. Each device is custom molded to the ear and is most appropriate for middle-aged patients.