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).