Envoy Medical has developed a middle ear implant that utilizes the natural eardrum, middle ear bones, a receiver, and a transducer to send amplified signals to the cochlea (inner ear).
How We Hear
- Naturally, hearing starts off with sound entering the earcanal as acoustic energy. This sound then vibrates the eardrum which transduces the acoustic energy into mechanical energy.
- The eardrum then puts into motion a series of very small bones in the middle ear: the malleus, incus, and stapes (aka hammer, anvil, & stirrup).
- The stapes footplate then pumps the fluids of the cochlea (inner ear) like a hydraulic system. The waves of fluid movement then stimulate thousands of hair cells called stereocilia.
- The stereocilia then convert that hydraulic energy into electrical impulses which are then sent along the auditory nerve, via the brainstem, to the auditory cortex where meaning to sound is achieved.
The Esteem does not utilize conventional microphone, amplifier, and speaker components. Instead, it relies on the natural eardrum to act as the microphone. The vibrations are then sent through a processing/amplifying process and the stapes bone is directly stimulated and its vibration enhanced. The battery is said to last up to 9 years.
This technology, which is not available to the general public yet; however Envoy Medical claims that this product can fit approximately 80% of all individuals with sensorineural hearing loss. The process requires surgery of the implant and estimated costs are around $25,000. Envoy states that they will not pursue the insurance companies for coverage because they do not want the insurance companies to delegate how much reimbursement this device should receive.
My Opinion
One of the advantages I currently see in the Esteem over current technologies is that it uses the natural eardrum to pick up sound information and does not have to rely on the fidelity of a microphone.
However, a sensorineural hearing loss is a sensorineural hearing loss is a sensorineural hearing loss! Due to damaged sensory cells, nerve degeneration in the inner ear and beyond, sensorineural hearing loss adds a distortive component to all sound coming into the inner ear. My criticism is this: how is a middle ear implant going to significantly outperform a traditional hearing aid for individuals with sensorineural hearing loss when the problem is not the outer or middle ear…. it’s the inner ear! Either way, the distortion is still going to be there!
For individuals with certain middle ear/outer ear related issues, this product will most likely outperform a traditional hearing aid. Because it is bypassing what the hearing aid cannot.
Finally….
Envoy Medical’s Esteem product definitely provides some interesting ideas into the hearing solutions industry. Is it worth pursuing? I would wait… see the results… and then wait until there’s a second or third generation of the product. The launch of a new product is often accompanied by problems and issues. Just look at the start of the cochlear implant industry and the meningitis scare… whew! Glad that’s over….
Here are some questions that I still have regarding this product.
Is there a digital processor?
Does it use compression/expansion for loud and soft sounds? I would like to know a little more about the processor.
Does it have to be explanted if the batteries run out?
3 out of 100 patients had to be explanted… seems like quite a lot…that’s 1 out of every 33 patients had to have surgery again to explant… what’s the comparison w/ other middle ear surgeries?
Hello,
Your article is acurate & interesting. I have the Envoy Esteem implanted hearing aid & it had been a miracle for me. I am so glad I decided to do this ! The Envoy Compamy has been following us faithfully over the course of the clinical trial, & the Dr. who implanted it is amazing. We are praying this device gets FDA approved soon, so that those who have the hearing loss we did can be helped & thrilled with the same results I have. My hearing went from 75% loss in both ears to NORMAL hearing with the esteem & a regular aid in the other ear. After retreating into a shell since I couldn’t hear well, I am now able to sing professionally, speak in public, and I even started my own business! This implant is my MIRACLE !!!
So, why only an implant in ONE ear? If this is so successful why only ONE ear? I know that nothing is 100% good. What are the cons?
It sounds like she was participating in a trial.
Do you really hear like normal? I wear a hearing aid in both ears. They never seem to be adjusted right. Can you sleep in your hearing aid on?
Where did you have the implant done?
To the person who wrote on November 20, 2009. I have questions that I would like to ask you directly, if you would be so kind. (antonlittau@gmail.con, typo on con should be com, deliberate on my part)
I would really like to hear from someone who is not happy with the results of the implant, often much more can be learned from them.
Thanks
Does insurance cover the esteem implant? What is the total cost?
Where is the surgery done?
Thank you.
Gayle Teague
my husband loss his hearing sinse he was about 50th,he is 73 years old.
I’d like to have more information about this new technology.
kay from MICHIGAN
Kay, here is our website: http://www.hearingaiddocs.com
You can contact us at 866-284-5577 with ANY questions! We’d love to help you!
Regards,
Dr. Kim
I am scheduled for implantation end of Oct. and very excited until an audiologist posed some questions that have created doubt. My audiogram is tragic as I hear nothing much above 1000 hz with a sensorimeural hearing loss.
I am interested in any information available to make sure that I am making a good choice.
Thanks
How did the Esteem implant go? Are you happy with it? Please let me know for I am scheduled to have the procedure done in June. thank you!
If you would like to have a discussion I would be happy to talk to you.
J
I am thinking about getting this. I have the top of the line hearing aid but I never seem to hear right. It is either to loud or now loud enough. I love to hear music but I have a hard time . I feel very left out. With TV I can never get the sound right. Are you still happy with yours and have you had any problems?
I’m also contemplating having this procedure and spoke with two people who the company referred me to. However, I’d be more interested in speaking with people who aren’t being promoted by the company and might be willing to disclose any complaints they have.
Did you complete this procedure in October?
Your help is greatly appreciated.
Has anyone heard from someone that is not with the company?
jan, I am also interested to know how is it going with you with esteem implants. Are you happy with your expectation? Is it helping you? I just attended a seminar in Chicago and am excited about it. I will have to get a loan for $30,000 to start the implan process. Is $30,000 for both ears or one? Is esteem better than today’s hearing aids? Thanks!
Jan – I am scheduled to have the implant this week and I would very much like to have a discussion. Please write me at jpagett@yahoo.co m . Thanks, Jerry
I wonder, when you are talking about $30,000 for the whole works, is that ONE ear only or BOTH ears? UNfortunately, no insurance ever covers hearing loss. My hearing aids last about 3 years but the hearing specialist NEVER gets the adjustments right. I can never turn them up loud enough without getting feedback..whistling. This last pair is digital, supposedly doesn’t have feedback, which is a bunch of bull. I lost the majority of my hearing in the Army during Vietnam rifle training, which has been denied of course. So, I get no help but have been waiting forever for something that makes hearing more natural. Mechanical hearing hears some things normal people don’t and it is aggravating. So, because of my loss, I have to work in a noisy environment…power plants. But, I’m still not even sure if the esteem works for nerve damage. I mean, it is moslty quiet when I take my aids off, so I obviously need amplification. So, will these work? And what happens when the battery goes dead?
Perhaps you would do better with a doctor of Audiology vs. a hearing specialist.
I can’t hear hardly anything and am always shouting when I talk people say. I tried a few off the shelf aids and they help make sounds louder but I still can’t make out what people are saying sometimes. But $30,000.00 that is what I make in a year, almost; so I reckon I will wait until this product has been out for a few years and hope the price comes down where I can afford it, you know like plasma TV, digital watches and all the new technologies when they first come out the cost an arm & leg but after the newer what ever hits the market the price drops. THAT’S WHAT I’M WAITING FOR!!!!
I don’t think the price will ever drop for these implants because they require surgery and all medical surgeries get more expensive, they never get affordable.
I did not have the implant done for several reasons. One of which is a question regarding if it will actually make a significant difference given the extent of my hearing loss and also because it is too new. Thirdly, I would have to travel by plane to a location very far from my home and I would have to do 3 trips. One for implantation, second to active and third to fine tune.
]I understand that the cost is $30,000 per ear but if you consider the cost of hearing aids 5-6,000 and they only last 3-5 years the implant may be worth consideration depending on your age. I am waiting for some final results which should be available March of 2012 and then if feasible, I will reconsider the implant.
Hi Jan,
When you say final results, what do you mean? Additional studies?
George
Yes. I am also waiting to find someone closer to home.
Kay Lee: Did your husband ever get the Esteem implant? My mother is 76 years old and wants to get one. I am concerned about her going in for a 4-6 hour surgery for something that isn’t medically necessary. I would like to know if you, or anyone else out there, have any thoughts about someone that age getting the implant.
This is a discussion that might best be had with your mother’s primary care doctor.
Interesting article. I researched into this as my sister was born deaf but were advised to go through the cochlear root as she had profound hearing loss. because esteem doesnt necessary work well When it comes to hearing loss because of damaged nerves etc. My sister was implanted at 9 months and she is now 3. And has caught up with her listening and speech. I guess living in the UK helps as the health service supply everything as these treatments can cost 50,000 per ear and thank god she got both. I strongly believe in the cochlear even though I hated the fact they’re physically there my sisters speech is like any other child’s. And the great thing about cochlear is that it has been around for many years and you can find adults with it who can tell you how it was the good n bad. And theres upgrades available which shows the cochlears being much smaller. Anyway just wanted to give my feedback from a personal experience and sorry about my typo.
I was implanted in May 2011 and activated on July 28, 2011. I am loving being able to hear again. If anyone has any questions, please feel free to check out our Envoy Esteem Patients Group on FaceBook. There are many of us who have the implant and are more than willing to answer any questions.
Have been in contact with several people who have the implant who have had significantly less than anticipated results. Despite the hype from the Envoy company, this IS an implanted HEARING AID. It AIDS hearing. At least a slight majority hear better than a conventional hearing aid and at least a slight majority have better word recognition. 30k is high price to pay for this.
Dear ME, It is not a hearing aid. Do your research. Also do your research and know that the majority of patients have great results. Don’t comment on something you clearing do NOT understand.
And there are those who did not benefit from the esteem to begin with. I was told that I was perfect for the esteem. I had an average of 75 db hearing loss and my word recognition was 60. No one knows why it did not work. It just simply wasn’t giving me what my hearing aids were able to. I was very stressed about having it removed because at least I could hear, just not as well as my hearing aids. I was told that the reversal process would take me back to what I had. It has been 5 months, and I am doing far worse than I ever did. I used to be considered moderate to severe, but now I am profoundly deaf.
I couldn’t agree more! It is Not all that Esteem claims. I am worse off now than ever before. It has affected my life in so many ways..my job, my children..and I continue to spend thousands to try to hear what I used to. Even when this all began for me, the engineer who was supposed to activate me said their representatives were giving false hope of a miracle. . It is not a miracle. It is a risk. Unfortunately, it did not work out for me.
I have to say this is very expensive. Someone isn’t doing their math correctly. A digital hearing aid is around $3000 per ear. From what I read on here, a person pays $30,000 for ONE ear and a hearing aid on the other ear. What is that purpose? Yes, a digital might perform well for 3 to 5 years. But, the Envoy battery lasts UP TO 9 years. Then what? So, it is STILL much cheaper for a digital hearing aid. And, what about nerve loss? No hearing aid or implant can get around that.
George, I have the medical esteem implanted last year in June. The battery cost 2,000-3,000 to replace. But its well worth it. If you do the math of how much you spend on hearing aide batteries over the next 6-8 years on batteries. You will be amazed much much more you spend vs. the one time batterie. =)
Where do you get a price of 2-3,000 to replace the battery? Everything I am reading clearly says in the range from 6-10,000! Also, how does one know when the Battery is going out? Does it just stop, or like a hearing aid, volume decreases? Does it Beep, or give you some kind of signal like a hearing aid does?
Eric, when the Esteem battery is getting low, the remote that you use to change settings will give a double beep. Usually, you will have a couple of weeks before it actually goes out. I have a friend who just had hers replaced and it was $5,000. Some others have said $7,000. That is the highest I’ve heard of so far. It may be who you see and where you live. Not sure yet. I’ve had mine activated since July 2011.
I can do the math pretty easily since I am a machinist and I majored in math. It is MUCH cheaper to buy batteries for hearing aids than to get an implant. It will cost you more to change the battery in the implant than it would cost you in hearing aid batteries for 60 years! The only purpose to have the implant would be NOT to have to wear hearing aids. We who wear hearing aids can’t sleep in them so you are deaf when you sleep. I actually had someone break into a trailer I rented years ago and I slept through the who thing! That was an eerie feeling. And the other advantage would be if you hear better. Like I said, I have nerve damage and I don’t think they can help me.
Steam cleaners can be used to dry your parasites (I don’t know If you’ve
noticed yet, but also in my opinion they don’t such as the heat) and then for any eggs they may have lain inside your furniture (gross, right. Only rent minimal-used and cleanest cleaner available so that you could get ignore the’s worth.
So, the subsequent time you’re planning on investing in a tool to offer cleaning in your dwelling, you may perhaps wish to acquire a steam cleaner. The other major reason that I chose this type of model was the price tag. The powerful mix of sanitization and deodorizing actions ensure higher quality air.
I can’t believe the negative comments above. First I’m not from the Esteem company and I paid the $30k fee to have the implant done in my left ear. I had the implant surgery done in San Jose October 29, 2011, and I’m contemplating having another implant done on my right ear. I haven’t always suffered with deafness, mine came from a car accident in 2007 woke up the next day deaf, never had an ear infection in my entire life. Of course audiologists are against the implant, first off most are not deaf and don’t know how you feel, and second they don’t want to lose your business when you go back to them to spend another $5k on new hearing aids, you are a repeat customer to them and they don’t want to lose you. My audiologist said it may only increase my hearing 10% if that, and I hear good enough with aids so why bother. Thing is with aids you can’t sleep in them, or do anything with them really, I’ve already spent a fortune on aids. I have more success going to the hearing center in Costco’s, seems strange but their aids are half the price and are better as they come with blue tooth remote for my cell and t.v. my audiologist never provided anything like that, only took my money. So I honestly didn’t care if my hearing only increased 10%, the thing is I’d be happy to have a 10% increase without aids. After the implant was turned on I went back and had my hearing tested, amazing my speech recognition was a 100%, I went from 55% hearing to 80%, so a 25% increase not no 10% my audiologist stated. I’m happy with my implant and want to complete my hearing to my right ear so I can get rid of wearing the aid in my right ear. I sometimes use a headset but only in my left ear, I hear perfectly but of course the right can’t be used because of my aid so it dangles and gets tied up. My audiology report doesn’t lie, if anyone wants to contact me I’ll email you back my report so you can look at it yourself. epoulsen60@gmail.com
Esteem has been great and I’m happy with my implant and nobody is paying me to say this.
Awesome to hear of your happiness with the Esteem Eileen. I love mine even though it isn’t 100% perfect. I just love the freedome from that stupid hearing aid that was holding me back from so many things. If you haven’t already, I’m inviting you to join up with more Esteemers on Facebook on the “Envoy Esteem Patients Group”.
Sharla
It is also possible that Zynga’s chosen advertising network is to blame if we consider the case of the New York Times’ website agbgffeakaad
It works. Big plus is there is no microphone. My battery has exceeded expectations. No microphone=No Occlusion. Worth it at any price. Anything new is expensive at first. I believe this will change after the IPO. There is financing available to those with good credit. This is a product prescribed by the doctor. Not everyone will benefit. That is why there is a prescription.
obviously like your website but you have to check the spelling on several of your posts. Several of them are rife with spelling problems and I find it very bothersome to tell the truth nevertheless Ill definitely come back again. gfaeeeekddgb