SERINITI works in close collaboration with ENT doctors and specialized engineers to develop high-performance hearing aids that meet the qualitative, aesthetic and financial requirements of millions of people around the world. Our Orison (CIC) and Azur (rechargeable mini-BTE) hearing aids have been specially designed to compensate for presbycusis - hearing loss linked to age and the natural aging of the auditory system - and to provide immediate listening comfort at a fair price
CE • ISO 9001 • ISO 13485 - Sale over-the-counter • Satisfay or 20 days money-back guarantee • 2 years legal guarantee
How do I know if I need a hearing aid ?
This is a question that few people ask themselves, for 2 main reasons : either the person is severely or profoundly deaf (about 900,000 people in the UK) either the person have presbycusis (about 10 million people in the UK, with mild to moderate haring loss).
In the case of severe to profound deafness, the question is not asked because it is not the hearing disorder that is suspected at the beginning : the child (generally) consults many doctors in search of a psychiatric, psychological or psychic problem, until one of the healthcare professionals hypothesizes a severe hearing disorder (often on the basis of an attitude or specific reactions of the child). An ENT doctor is then consulted, who will perform an audiometric evaluation and additional tests then refer the patient to a hearing aid acoustician. In France, it is estimated than 90% of people with severe to profound deafness are fitted with a hearing aid. The treatment process is long (the deafness must be detected) and regulated (with the creation of an MDPH Disability-Deafness file giving access to excellent economic support from the public services and mutual insurance companies). Without hearing aids, these people are not able to acquire language, socialize or live normal life. In the UK, 151,000 people are BSL (British Sign Language) users and 12,000 use cochlear implants.
In the case of presbycusis (mild to moderate hearing loss), which occurs gradually with age and affects everyone after 60, the awareness is different. For years, the people concerned have evolved without hearing impairment and, therefore, do not realize that they hear / understand less in certain situations or sound environments. Most often, it is the people around them who, tired of repeating, incite the individual to consult an ENT doctor : in France, it is estimated that 40% of presbycusis sufferers consult an ENT doctor under pressure from their relatives. However, it is not uncommon for people who realize that they have to make an effort to understand conversations in restaurants, during meetings or while watching television, to find out more on the Internet and become aware of their hearing problems. The wearing of the sanitory mask, during the COVID-19 episode, generated a massive awareness by the people concerned. Why ? Because the mask slows down the diffusion of sounds and, in addition, the fact that unconciously, we could no longer read the lips of our interlocutors, which sometimes helps to understand the words. In the United Kingdom, it is estimated that 8 million people over the age of 60 are affected by mild to moderate presbycusis.
You need a hearing aid if :
- You have difficulty understanding dialogue on television ;
- You consider that "young people no longer articulate" ;
- You complain not of "mishearing" but of "misunderstanding" ;
- You have difficulty understanding words and conversations in noisy environments such as restaurants, outdoors, business meetings, open space activities for example ;
- You give up following a conversation in a noisy place and isolate yourself ;
- You often make those around you repeat themselves especially women and children ;
- You do not want to ask others to repeat what was said, even if you did not understand it, and you isolate yourself ;
- You confuse, more and more often, certain words.
Hearing test / audiometric evaluation : should I see a doctor or a hearing aid acoustician ?
In France, the law is very clear on this subject : only an ENT doctor is authorized to perform a hearing test / audiometric evaluation. The Public Health Code, which governs the profession of hearing aid acoustician, strictly prohibits certain sales practices, in particular that of "draining the clientele (...) by substituting themselves for doctors through the illegal practise of clinical audiometry, in accordance with the decree of May 2nd, 1973 (J.O of 18-05-1973)".
Without this list being exhaustive, the hearing aid acoustician is not allowed to make "hearing test / audiometric evaluation proposals (...), the hearing aid acoustician can only intervene in execution of a medical prescription and a hearing test / audiometric evalutation can only be performed by an ENT doctor. By performing a hearing test, the hearing aid acoustician replaces the practitioner and can be prosecuted for illegal practice of medicine (...)."
This prohibition aims at protecting the consumer from potential abuses : indeed, no one should be a judge (quantifying a hearing loss by performing a hearing test) and a party (selling, then, the hearing aid that would suit this hearing loss), at the risk of increasing the hearing loss in order to refer the patient to a more expensive hearing solution.
What is the benefit of wearing a hearing aid ?
When hearing loss is present and results in daily discomfort, wearing a hearing aid helps maintain a good quality of life and prevents premature aging of the brain as well as the risk of dementia and neurodegenerative diseases (Alzheimer). It also allows you to gradually get used to a hearing solution.
When it comes to life quality, wearing a hearing aid helps to avoid the progressive isolation of the individuals, particularly in noisy environments, where hearing discomfort is significant, for example : in restaurants, the individual isolates himself / herself from conversation to avoid having others repeat themselves ; during professional meetings or in open-space, the individual feels additional fatigue due to the extra cognitive effort required to understand the discussions and may be led to isolate himself / herself. Without a hearing solution, the risk is to gradually get used to isolation and a certain "silence", which will make it difficult, in the long term, to wear a hearing aid because the sound amplification will be perceived as an aggression. This is why it is essential to get a hearing aid at the first sign of discomfort. People who are reluctant to wear a hearing aid can perfectly well opt, at first, for a unilateral hearing aid (on one ear only), which makes the object itself less dramatic and allows them to get used to the amplification provided by the latter.
At the cerebral level, hearing loss leads to changes in the structure of the brain (read our article on this subject). Recent studies show that the decrease in sound stimulus leads to insufficient cortical stimulation which, in turn, leads to a decrease in neuronal activity. Thus, in a vicious circle, hearing loss leads to functional changes in the brain and the cognitive decline associated with aging promotes hearing loss.
Should I choose a Completely-In-the-Canal (CIC) hearing aid or a Behind-The-Ear (BTE) hearing device ?
Generally speaking, there are 2 main types of hearing aids :
- The Completely-In-the-Canal hearing aid or "CIC" (ORISON),
- The Behind-The-Ear hearing aid or "BTE" (AZUR).
People concerned with severe or profound deafness (900,000 in UK) will be referred to a BTE hearing aid, while people with presbycusis hearing loss (10 million in UK) will have the choice between a CIC hearing aid and a BTE hearing aid, depending on their desires.
- The Completely-In-the-Canal (CIC) hearing aid
A Completely-In-the-Canal (CIC) hearing aid fits in the ear canal and is very discreet. It is defined by the location of the circuit board 1-2mm from the meatus of the external ear canal (Gudmundsen, 1994). For years, this hearing aid design has been the standard for near-invisible hearing aids. Numerous articles describe the advantages of such positioning, such as :
- Decreased occlusion effect (Mueller, 1994),
- Increased user satisfaction (Ebinger, Mueller, Holland & Holland, 1994),
- Decreased amplification of wind noise as the microphone is protected by the ear canal (Fortune & Preves, 1994),
- Improved localization of sound in space, as the pinna (anatomical amplifier) is used (Best, Kalluri, McLachlan, Valentine, Edwards & Carlile, 2010).
CIC hearing aids are ideal for mild to moderate hearing loss and are suitable for people with presbycusis who want a discreet hearing aid. CIC hearing aids represent 20% of worldwide hearing aid sales.
- The Behind-The-Ear (BTE) hearing aid
A (mini) Behind-The-Ear (BTE) hearing aid consists of a case that sits behind the auricle, from which a clear plastic tube (sound tube) extends over the auricle and conducts sound to the ear canal. This type of hearing aids is larger and easier to handle than the CIC hearing aid and is suitable for mild to profund hearing loss (presbycusis as well as severe to profund deafness). It is particularlly suitable for people with reduced maual dexterity, shoulder mobility problems, small ear canals (into which a CIC hearing aid does not fit) or for people who prefer an over-the-ear (OTE) rather than an in-the-ear (ITE) hearing solution.
In conclusion, to compensate for presbycusis, both CIC and BTE hearing aids are ideal : the choice is up to the user.
ORISON (CIC hearing aid) ou AZUR (mini-BTE hearing aid) ? What is the best hearing aid for me ?
According to what we have mentioned above, a person experiencing age-related hearing difficulties (presbycusis) will have the choice between a CIC hearing aid (ORISON) and a mini-BTE hearing aid (AZUR). In order to clarify this choice, we have prepared a comparative table of the technical characteristics of our ORISON and AZUR hearing aids.
|Type||Completely-In-the-Canal (CIC)||Mini Behind-The-Ear (BTE)|
|Preconfiguration||Yes, by ENT doctors||Yes, by ENT doctors|
Sale by unit
|Sale per pair|
Mild to moderate presbycusis,
|Mild to moderate presbycusis,|
less than or equal to 90dB.
|Amplification||From 10dB to 33dB||From 12dB to 36dB|
|Sound distortion||< 0,2%||< 0,3%|
|Amplification programs||1||3 (classic, quiet, noisy)|
|Sound restitution||< 0,8ms (immediate)||87ms (immediate)|
|Noise reduction||Automatic, 13dB||Automatic, 12dB|
|Wind noise reduction||Not necessary|
|Sudden noise reduction||Not necessary|
|Power supply||1 x 10a battery||Rechargeable|
|Charging time||-||5 hours|
|Device autonomy||1 week with a 10a battery||16 to 20 hours|
|Standards||CE, ISO 9001, ISO 13485||CE, ISO 9001, ISO 13485|
Defects of conformity
|Commercial warranties||Sérénité 1.1 ; Sérénité 1.2|
Health insurance : Possible
|Health insurance : Possible|
Generally speaking, what is the best hearing aid ?
The best hearing aid, whether it is a custom-made hearing aid or a preset device, whether it is a CIC hearing aid or a BTE device, is the one that fits you, that gives you real hearing comfort and that you will enjoy wearing every day. In France, many hearing aid acousticians offer a 30-day free trial (without obligation). At SERINITI, we offer a "Satisfied or Refunded" for 20 days : we encourage everyone to use wisely these opportunities and try several types of hearing solutions, to find the one that suits you the best.
Should I choose a custom-made hearing aid or a preset (OTC) hearing aid ?
Regardless of the design (CIC or BTE hearing aid), there are 2 types of hearing aids : the traditional "custom-made" hearing aid and the preset hearing aid, commonly called "listening assistant" or "sound amplifier".
First, few words about the name. The law, throught the ANSM (France), reminds us that "terms such as "listening assistant, hearing assistant, external hearing aid, sound amplifier, hearing aid, audioprosthesis, etc." cannot by themselves describe the destination and the regulatory statuts of a product (medical device or not)." Thus, distinguishing a custom hearing aid from a preset hearing aid by calling the former a "hearing aid" and the latter a "listening assistant" is nothing more than a marketing strategy aimed at avoiding explaining to consumers the facts : all hearing aids - custom-made or preset and regardlesse of price - are sound amplifiers ! Indeed, when the hair cells (the hair cells are responsible for the transduction of sound-evoked mechanical vibrations into electrical signals that are then relayed to the brain) of the ear are damaged or destroyed (with time), they do not grow back and the only possible solution to regain listening comfort is to amplify the sounds on the damaged hearing frequencies. It is fundamental to understand this, because it also means accepting that, whatever its price, a hearing aid is an imperfect solution that will never give you back the hearing you had in your youngers years.
- The custom-made hearing aid
The custom-made hearing aid is exclusively delivered by an audioprosthesist, on medical prescription. In France, it is partially reimbursed by public health instutions and mutual insurance companies because it meets the 3 conditions : sold on medical prescription ; registered on the LPP list ; sold with an additional 4-year follow-up service (learn more on this page). If custom-made hearing aid are indispensable in the case of severe to profound hearing loss / deafness (atypical hearing loss, specific to each individual, greater than 90dB - with individuals using BSL and / or lip reading), they are not indispensable in the case of presbycusis for a reason : presycusis is a classic hearing loss with a standard audiometric curve, common to everyone. This allow for the proposal of a hearing aid finely preset on the auditory frequencies damaged.
- The preset (Over-The-Counter) hearing aid (ORISON, AZUR)
In 2012, a double-blind, placebo-controlled U.S clinical trial (available here in french and in the source for the english version) completely overturned conventional wisdom in prebycusis hearing aids, highlighting the reality that preset hearing aids are as effective as traditional hearing aids and, by their price, can significantly increase the affordability of hearing aids for millions of adults worldwide.
The preset hearing aids (in the case of ORISON and AZUR, the preconfiguration was carried out by ENT doctors and engineers), are exclusively intended to compensate for presbycusis. They are immediate hearing solutions, at the right price :
- Sold without a prescription (OTC), their acquisition is free of a medical consultation that can take up to 6 months in some regions ;
- Preset, their use is simple and does not require any follow-up or trips to the audioprosthesist to adjust their functioning, which is a significant asset for people with reduced mobility. This also allows to be free of follow-up costs (which represent up to 40% of the total bill for a custom-made hearing device, according to the September 2015 study by UFC Que Choisir) and to be sold at the right price.
As a conclusion : while a person with a severe to profound hearing loss / deafness would not feel any difference wearing a preset hearing device, a person with presbycusis finds immediate listening comfort with this type of hearing aid, because it is specially designed for his / her needs (hearing loss) and requirements (aesthetics, price, immediacy, ease of use).
Do I need to see a doctor if I choose a preset hearing aid ?
Why is there such a difference in price between a custom-made hearing aid and a preset hearing aid ?
This is a question we are regularly asked and, surprisingly, it comes most often from people who - for a time - were fitted with traditional custom-made equipment and who, when it came time to renew, chose to try our preset hearing solutions. This question most often comes from people who felt cheated by having spent so much previously and who want to understand why there is such a price difference between traditional custom-made hearing aids and our preset hearing solutions that bring them satisfaction. Here we try to provide some answers based on studies that are not our own.
- The custom-made hearing aid
According to the UFC Que Choisir study (2015) previously cited, the average selling price is 1,550€ per hearing aid ; 80% of sales being bilateral fittings, the average price is 3,100€ for a complete hearing equipment. This price includes :
- The hearing aid itself,
- Appointments with the audioprosthesist for the fitting of the hearing aid,
- Appointments with the audioprosthesist for the follow-up of the adjustments.
In France, in order to be partially reimbursed by Social Security and mutual insurance companies, the hearing aid must be sold with follow-up services : in other words, whether or not the user uses it, he / she pays, in advance, for a follow-up service over several years. These services have been estimated at 15 hours of work - for the life of the hearing aid (4 years) - for a bilateral fitting and represent 40% of the total amount of the invoice.
On August 6th 2015, the "Macron law" (in its Article 44) removes, from the Social Security Code (Article L165-9), the necessarily inseparable character of the fitting, adaptation and follow-up. This would have allowed everyone to pay for a hearing aid at a fairer price and, if the need arose, to go to the hearing aid specialist of their choice to have the fitting adjusted or to benefit from follow-up care. However, the Health Insurance, in its LPP list, did not record this modification and things remained as they were.
The production cost of a hearing aid varies between 80€ and 250€. Throughout the resale chain, this cost is multiplied by 10. In addition to the adjustment and the 15 hours of follow-up over 4 years, the client also pays the salary costs, the operating costs and the marketing strategy of the brand. Plus the upstream medical consultation, the charger, the insurance and any repairs to the hearing aid during its lifetime.
- The preset (OTC) hearing aid (ORISON, AZUR).
A preset hearing solution is sold without a prescription (OTC) : no upfront medical expenses or waiting time for a medical consultation. The selling price charged is the price of the hearing aid. No additional follow-up services are included in this price. In case of necessary follow-up (breakage, adjustment problem, maintenance), our prices are published and applied.
What makes the performance and the quality of a hearing aid ?
2 elements make the quality and the performance of a hearing aid :
- The microphone
The microphone is one of the most important parts of the hearing aid. The microphone picks up sounds direclty from your environement : the clearer the microphone picks up sounds, the more accurately it will be able to reproduce them to the processor. It is important to clean the microphone regularly to avoid deposits on it.
- The processor
The processor processes sounds and distinguishes between speech and noise. It is also very important because it helps to clarify your sound environment and to improve your ability to hear speech in noise.
The number of frequency channels is often mentioned to explain the different price ranges of hearing aids. In reality, professionals agree that 12 frequency channels are more than enough for presbycusis. Especially when the noise reduction is high (from 12dB). In addition, the experience of many individiduals has shown that they made no difference between a device with 16 frequency channels and a device with 12 frequency channels (except for the price). On the other hand, when it comes to custom-made hearing aid, one must keep in mind that the more frequency channels there are, the higher the risk of settings errors (which is common sense).
Noise reduction is also an important element in the fitting of presbycusis. Many "entry-level" hearing aids costing close to 1,000€ reduce noise by 9dB... to 15dB on hearing aids costing more than 1,550€. We do not work like this : this is why our AZUR and ORISON devices automatically reduce the ambient noise by 12dB to 13dB.
Why do all the CIC hearing aids have the same outer shell, regardless of their price (10€ or 1,000€) or brand ?
The biomedical plastic outer shell of hearing aids (CIC or BTE) - regardless of the price or the brand - is manufactured in Hong-Kong in large volumes. There are only 2 manufacturers of hearing aid shells in the region, which explains the similarity between many hearing aids, even though their selling price and technical characteristics differ widely. The outer shell does not determine the quality of a hearing aid. As previously mentioned, what makes the quality of a hearing aid is, on the one hand, the microphone and the processor (in the case of SERINITI, our on-board components are made in Europe and benefit from the CE standard) and, on the other hand, the fineness of the amplification curve of the preset device (in the case of SERINITI, this amplification curve was developed by ENT doctors and engineers, after 2 years of research and development).