To clarify, "in the ear" (ITE) typically describes any "custom" hearing aid in which an ear-mold impression is taken and the entire hearing aid is encapsulated inside of it. Basically, anything that is not a "Behind the Ear" (BTE) hearing aid. That being said, there are many ITE hearing aids that can reach a profound high frequency loss, but I'm assuming you're probably referring to a small invisible or near invisible device. The "invisible" ITE, usually known as an Invisible in Canal (IIC) hearing aid, is most likely out of the question. All of the ones that I have worked with go up to a moderate- severe, to possibly a severe loss. The next size up, is referred to as a Completely in Canal (CIC). Most manufacturers have CIC's which can reach profound loss in the high frequencies. The only other variable that would come into play here is the actual size of your canal. Depending on the size of your ear canal, it may only be able to accommodate a receiver up to a certain size, which may mean that you still couldn't reach the profound ranges. If that's that the case, then you would just move up a size again, to In the Canal (ITC). This would, in most cases, take you up to a standard size 312 battery rather than the size 10 in the previous 2, but would be a little more visible from the side. Hope that helps.
l would suggest a Resound custom hearing aid with a remote microphone. This unique design has the advantage of placing the microphone outside the hearing aid and tucked discreetly up in the helix portion of the ear. By taking the mic out of the aid allows for more vent space to prevent occlusion and less feedback. Resound has frequency lowering technology and the Microphone-in-helix (MIH) style can also be made with wireless connectivity and Made for iPhone technology.
As Dr. Rachel Faivre indicated, above, the likely best solution if you have a profound high frequency hearing loss is the use of a product with "Frequency Lowering" technology, and most manufacturers have this available. It essentially works by assuming there is little residual hearing in the range where it is profound, and shifts the sounds that you'd normally hearing in that area to the range where you have better hearing. Research has shown that this use of this technology can improve word recognition by as much as 20% when compared to hearing aids that do not utilize this technology.
Since you asked about in-the-ear products, one careful consideration should be about how good you hear in the lower frequencies. Should you have only a mild hearing loss or even normal hearing in the low frequencies, you may end up with a side effect known as "occlusion"; plugging the ear with plastic devices could negatively impact the sound quality and your perception of loudness for your own voice, a common complaint for situations with minimal loss in the low frequencies. This can be offset by having large vents, but in doing so it could make the hearing aids prone to acoustic feedback (whistling). This is where frequency lowering can also be beneficial, since most feedback occurs as a result of high frequency amplification, and frequency lowering focuses more on amplification to the mid frequencies. With some in-the-ear hearing aids, particularly completely-in-the canal instruments (CICs) there is little room for proper venting, so occlusion may be unavoidable. For patients with near-normal hearing in the low frequencies and profound hearing loss in the high frequencies, an "open" fitting with miniature behind-the-ear instruments have become the accepted practice and best solution.
Frequency lowering is amazing for people who have a lot of hearing loss in the high frequencies. Better speech understanding can be achieved and a whole lot less feedback. Your audiologist should be able to find a product that works for you that is and ITE. Technology today is so much better than it was in the past.
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