Esteem ear implants

stream2525 said:
Esteem isn't for deaf people. It is only for hard of hearing people .You need to have good speech scores to get these.
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You are correct that the FDA recommends the Esteem for those with moderate to severe hearing loss and (hearing-aided) word recognition scores at no less than 40%. However, there is mounting evidence that Middle-Ear-Implants such as the Esteem can treat severe-to-profound hearing loss in the upper pitches better than hearing aids. And considering that you would be the one to pay for these (not covered by any insurance), the FDA guidelines are only that: guidelines. Not rules. It's up to you and the doctor.

I didn't say that the Esteem was for deaf people. I said that it has shown particular promise for people like you and I who have usable hearing in the lower pitches but profound hearing loss in the upper pitches, who find little benefit from traditional hearing aids. (Pardon me if I am being presumptuous based on your posted audiogram.)

See the following clinical trial results from December 2010:

http://www.orl.net.br/uploads/artigo_59.pdf

Summary:

Objective: This study seeks to assess the efficacy of the Envoy Esteem totally implantable hearing device in treating profound high-frequency sensorineural hearing loss.

Patients: Five patients with profound high-frequency hearing loss participating in a prospective, multi-center, nonrandomized Food and Drug Administration clinical trial.

Intervention: Implantation with Esteem totally implantable hearing device and comparison to baseline unaided and aided conditions.

Main Outcome Measure: Speech reception threshold and word recognition scores (WRS) at 50 dB HL presentation level.

Results: Preoperative speech reception threshold improved from an unaided 65 dB and aided 48 dB average to 26 dB with the Esteem at 12 months. WRS at 50 dB scores improved from an unaided 10% and aided 23% average to 78% postoperatively.

Conclusion: The Esteem totally implantable middle ear hearing device provides appreciable functional gain and improvement in WRS to rehabilitate hearing in patients with a profound high-frequency sensorineural hearing loss
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I am putting down my deposit for the Esteem tomorrow. Hopefully I'll have surgery scheduled within 6 weeks.
 
Envoy Medical poised to alter hearing loss device market



By LYNN YOFFEE



Medical Device Daily Staff Writer

Just about anyone with hearing loss will tell you that hearing aids never restore natural hearing and the only alternative, cochlear implants, have so far failed to deliver on the promise of either sound clarity or being a totally implanted device (Medical Device Daily, April 2, 2009).
A totally implanted device similar to pacemaker technology, Esteem has two transducers – a sensor and a driver that extend into the middle ear from the sound processor which is implanted just behind the ear. Sound waves travel into the ear canal and set the ear drum into motion causing the bones of the middle ear to vibrate. The device senses these movements and delivers a dose of energy to the cochlea, which then transmits the signals to the brain.

A small remote control device allows users to turn the Esteem on or off at will, adjust volume if needed in different settings. Spearman said one of the biggest complaints that traditional hearing aid users have is that they can't filter out background noise like a natural ear. So if a TV is running in the background or if the person is in a noisy crowded room, it's difficult to hear a person speak even if they are very close. Esteem apparently subverts that problem.

There are two types of hearing loss: conductive, which is a problem in the outer or middle ear, and sensorineural, which typically involves a problem with the inner ear, and usually is permanent. Common causes of sensorineural hearing loss are excessive noise and aging.

Spearman said the Esteem would work for about 80%, or 24 million, of the 30 million Americans with sensorineural hearing impairment. "Cochlear implants were the first devices used that replaced a human sense," Spearman said. "But Esteem brings people back to levels of hearing where they were before, something that cochlear implants can't do. It's really touching and this really is something that will benefit society in a big way."


According to the article, about 80 percent (or 24 million) Americans can get the Totally Implantable hearing aids. Who does that leave out?!! The rest of the 20% (profoundly deaf). NO Totally Implantable devices for the profoundly deaf. They are the 20 percent that are cut off from this Incredible technology.

My third grade teacher used to say, WHO SAID THAT LIFE'S FAIR?!!! GET BACK TO THE END OF THE LINE!!!!!"

I'm applying this unfair principle to the Totally Implantable Cochlear Implant technology, since the cochlear companies have remotely made no progress at all.
 
The Esteem is very expensive, and for most hearing aid users it is simply not worth the cost and inconvenience of surgery. However, for those like me, who derive little benefit from hearing aids but aren't deaf enough for cochlear implants, the Esteem may be a solution. The fact that it is totally implantable is nice, but I am more excited about the prospect of finally being able to hear high-pitch sounds without having to completely plug my ear canals, or dealing with the distortion and feedback that comes with 50+ db of sound amplification.

As for totally-implantable cochlear implants, I believe the microphone continues to be the biggest issue. Perhaps Envoy Medical is onto something with their method of amplifying vibrations as opposed to sound. If a cochlear implant manufacturer were to use the vibrations of the eardrum or the incus instead of trying to invent an internal microphone, maybe they would get around the issues they are currently having.
 
There is a reason that there is not much feedback re. the Esteem from implantees. I have contacted a significant number of implantees and followed their blogs (very awesome that people are willing to share their experience) and the results are NOT as good as most had hoped for. Yes, it's awesome technology and a breakthrough in hearing technology. Yes Envoy is a good company with a good product that met FDA requirements. And yes, desite the company games with semantics, it IS an implanted "hearing aid". It AIDS hearing with results that on average are minimally better than a conventional aid with the benefits of being completely hidden. In their quest for revenue (which is understandable if you understand anything about bringing a product to market), they have a website filled with only upper tier success stories and have pushed the envelope in implanting patients with severe SNHL. This latter group has NOT had anywhere near the success that the patients anticipated. So the jury is still out on this in terms of costs, degree of success, and battery life. Like anything in life, buyer beware, talk to implantees NOT on the official Envoy website to make an informed decision.
 
Perhaps one day, someone will become a member of the first ad, implanted as a self-esteem of the Special Envoy of the HP 97 wearer to join.
 
edlmct said:
There is a reason that there is not much feedback re. the Esteem from implantees. I have contacted a significant number of implantees and followed their blogs (very awesome that people are willing to share their experience) and the results are NOT as good as most had hoped for. Yes, it's awesome technology and a breakthrough in hearing technology. Yes Envoy is a good company with a good product that met FDA requirements. And yes, desite the company games with semantics, it IS an implanted "hearing aid". It AIDS hearing with results that on average are minimally better than a conventional aid with the benefits of being completely hidden. In their quest for revenue (which is understandable if you understand anything about bringing a product to market), they have a website filled with only upper tier success stories and have pushed the envelope in implanting patients with severe SNHL. This latter group has NOT had anywhere near the success that the patients anticipated. So the jury is still out on this in terms of costs, degree of success, and battery life. Like anything in life, buyer beware, talk to implantees NOT on the official Envoy website to make an informed decision.
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This is a fair assessment. The caveat I would include is that the Esteem has tested very well in terms of quality of sound and user satisfaction. Also, the technology is improving, they are only on the 2nd generation of the device.

There is a user-created facebook group with dozens of Esteem recipients, and most of them are extremely happy with the results, if not the cost of the device.

The Esteem is perfect for those HoH people who are hard to fit with traditional hearing aids. People with ski-slope hearing loss and those who are very active. For those who are doing well with traditional hearing aids, it might not be worth the cost.

I go in for surgery in mid-May. Will report back.
 
Wirelessly posted (Blackberry Bold )

MosDeaf said:
edlmct said:
There is a reason that there is not much feedback re. the Esteem from implantees. I have contacted a significant number of implantees and followed their blogs (very awesome that people are willing to share their experience) and the results are NOT as good as most had hoped for. Yes, it's awesome technology and a breakthrough in hearing technology. Yes Envoy is a good company with a good product that met FDA requirements. And yes, desite the company games with semantics, it IS an implanted "hearing aid". It AIDS hearing with results that on average are minimally better than a conventional aid with the benefits of being completely hidden. In their quest for revenue (which is understandable if you understand anything about bringing a product to market), they have a website filled with only upper tier success stories and have pushed the envelope in implanting patients with severe SNHL. This latter group has NOT had anywhere near the success that the patients anticipated. So the jury is still out on this in terms of costs, degree of success, and battery life. Like anything in life, buyer beware, talk to implantees NOT on the official Envoy website to make an informed decision.
Click to expand...


This is a fair assessment. The caveat I would include is that the Esteem has tested very well in terms of quality of sound and user satisfaction. Also, the technology is improving, they are only on the 2nd generation of the device.

There is a user-created facebook group with dozens of Esteem recipients, and most of them are extremely happy with the results, if not the cost of the device.

The Esteem is perfect for those HoH people who are hard to fit with traditional hearing aids. People with ski-slope hearing loss and those who are very active. For those who are doing well with traditional hearing aids, it might not be worth the cost.

I go in for surgery in mid-May. Will report back.
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I hope it works well for you.

Unfortunately most of the reviews I've hear have been very disapointing - people saying that they heard better with traditional HAs than with the implantable - and they're sorry they bothered.

I really hope it works out for you!
 
Anij said:
Wirelessly posted (Blackberry Bold )



I hope it works well for you.

Unfortunately most of the reviews I've hear have been very disapointing - people saying that they heard better with traditional HAs than with the implantable - and they're sorry they bothered.

I really hope it works out for you!
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Results of Word Recognition (WRS)
Overall, 93% of Esteem® recipients scored equal to or better than their pre-implant hearing aid.

•7% Scored less than their pre-implant hearing aid (0%-20% depending upon clinical site)
•37% Scored equal to their pre-implant hearing aid ( 17%-53% depending upon clinical site)
•56% Scored better than their pre-implant hearing aid (27%-83% depending upon clinical site)
Results of APHAB (Abbreviated Profile of Hearing Aid Benefit)
Overall, 80% of Esteem® recipients rated Esteem® better than or equal to their pre-implant hearing aid in the APHAB questionnaire.

•19% Rated Esteem® below the hearing aid
◦(7%-33%, depending upon clinical site)
•21% Rated Esteem® equal to the hearing aid
◦(11%-29%, depending upon clinical site)
•60% Rated Esteem® better than the hearing aid (56%-64%, depending upon clinical site)


Results of Quality of Life (QOL) Measurement
The results of the questionnaire indicate that a strong majority of patients consider the Esteem® somewhat or much better than their hearing aid.

Activity Level:

•85% somewhat-much better;
•11% equal
•4% somewhat-much worse


Feeling of Confidence:

•84% somewhat-much better
•8% equal
•8% somewhat-much worse


Clarity of Sound:

•78% somewhat-much better
•7% equal
•15% somewhat-much worse


Natural Sounding Voices:

•76% somewhat-much better
•11% equal
•13% somewhat-much worse


Understanding Conversation:

•72% somewhat-much better
•17% equal
•11% somewhat-much worse


Ability to Understand Speech in Noise:

•69% somewhat-much better
•13% equal
•18% somewhat-much worse


Benefit of Invisibility:

•66% somewhat-much better
•17% equal
•17% somewhat-much worse
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Benefits Provided by Esteem®
 
Anij said:
Wirelessly posted (Blackberry Bold )



I hope it works well for you.

Unfortunately most of the reviews I've hear have been very disapointing - people saying that they heard better with traditional HAs than with the implantable - and they're sorry they bothered.

I really hope it works out for you!
Click to expand...

Doesn't surprise me. Just a buncha hype.
 
MosDeaf said:
This is a fair assessment. The caveat I would include is that the Esteem has tested very well in terms of quality of sound and user satisfaction. Also, the technology is improving, they are only on the 2nd generation of the device.

There is a user-created facebook group with dozens of Esteem recipients, and most of them are extremely happy with the results, if not the cost of the device.

The Esteem is perfect for those HoH people who are hard to fit with traditional hearing aids. People with ski-slope hearing loss and those who are very active. For those who are doing well with traditional hearing aids, it might not be worth the cost.

I go in for surgery in mid-May. Will report back.
Click to expand...

MosDeaf,
I'm excited for you and hope you get great results from this. I have been following middle ear implant/cochlear/hybrid cochlear technology for a while now (I have moderate to moderate/severe SNHL that is stable to slow in progression) and I hope I didn't come across too negative on the Esteem. I guess the post shows my disappointment and sadness for those who have paid (now $33,000) and had less than optimal results and my concern that I might not get a good result (I will likely be implanted in the next few years). Very much look forward to hearing about your experience. Thank you.
 
deafdyke said:
Doesn't surprise me. Just a buncha hype.
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Funny how you blindly accept secondhand anecdotal evidence, and then completely ignore the Esteem clinical trial results under a controlled environment, per FDA laws.

Confirmation bias at work.
 
Wirelessly posted (Blackberry Bold )

Even looking at the "official trial data" you can see that many people arent pleased with the results.

The use of the phrase "somewhat-much better" means that it includes everyone who indicated the implant was even the teenist better than their current HA (which may or may not have been any good - aka, miracle ear, songbird etc).

The fact that there are only three choices, rather than a scale of 1 to 10 is an indicator itself that most people who choose "somewhat-much better" likely choose that option not becuase it was a significant improvement, rather it was marginally better.

And yes, I trust real world users opinions much more than company propaganda aimed at promoting and selling their product.
 
edlmct said:
MosDeaf,
I'm excited for you and hope you get great results from this. I have been following middle ear implant/cochlear/hybrid cochlear technology for a while now (I have moderate to moderate/severe SNHL that is stable to slow in progression) and I hope I didn't come across too negative on the Esteem. I guess the post shows my disappointment and sadness for those who have paid (now $33,000) and had less than optimal results and my concern that I might not get a good result (I will likely be implanted in the next few years). Very much look forward to hearing about your experience. Thank you.
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Thank you. Like you, I've done my research. I know that the Esteem is not a miracle device. It is very expensive, and anyone thinking of getting it should be fully informed.

What swayed me was a paper written by my prospective surgeon, studying patients with ski-slope hearing loss who had trouble with hearing aids. This subset of patients showed remarkable gains with the Esteem. I am in this category, with a sharp ski-slope hearing loss that is tough to fit with hearing aids. If the Esteem can allow me to function better in group settings and noisy environments, it'll justify the cost.

Scan up and click the pdf if you're interested.
 
Anij said:
Wirelessly posted (Blackberry Bold )

Even looking at the "official trial data" you can see that many people arent pleased with the results.

The use of the phrase "somewhat-much better" means that it includes everyone who indicated the implant was even the teenist better than their current HA (which may or may not have been any good - aka, miracle ear, songbird etc).

The fact that there are only three choices, rather than a scale of 1 to 10 is an indicator itself that most people who choose "somewhat-much better" likely choose that option not becuase it was a significant improvement, rather it was marginally better.

And yes, I trust real world users opinions much more than company propaganda aimed at promoting and selling their product.
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AMEN!!!!!!!!!!!!!!!!!!!! Thank you for bringing that up. Again I gotta be VERY skeptical of the New Technology.
 
MosDeaf said:
Thank you. Like you, I've done my research. I know that the Esteem is not a miracle device. It is very expensive, and anyone thinking of getting it should be fully informed.

What swayed me was a paper written by my prospective surgeon, studying patients with ski-slope hearing loss who had trouble with hearing aids. This subset of patients showed remarkable gains with the Esteem. I am in this category, with a sharp ski-slope hearing loss that is tough to fit with hearing aids. If the Esteem can allow me to function better in group settings and noisy environments, it'll justify the cost.

Scan up and click the pdf if you're interested.
Click to expand...

I think although I am skeptical overall, that it will be something revolutionary for HOH folks as a whole, it MAY be a really good option for SOME people with a particular loss.
On the other hand, NO device will be able to allow you to function well in group setttings and noisy enviroments. Even someone with unilateral loss will have major issues in those settings. It's just a part of being HOH!
 
There's a remarkable and distinct difference between a hearing aid and an Esteem implantable "hearing aid." For one, the Esteem uses the ear as a natural way to pick up sound and the processor picks it up and then feed it back to the stapes (electromechanically) and to the cochlea producing a natural sound without the sound distortion you can get with a regular hearing aid. To say that the Esteem Envoy is a hearing aid would be incorrect because it does not have a microphone. It's an implantable hearing device.

Esteem® uses your own eardrum as a natural microphone, picking up sounds through the ear canal, thereby using the body’s natural anatomy to reduce the background noise, distortion, and acoustic feedback that people experience with conventional hearing aids.
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The Esteem Hearing Implant is 100% implantable. The Implant is completely unaware of its presence in their body. The product is maintenance free for five to nine years after which the battery is replaced and the patient will continue enjoying the Esteem Hearing Implant benefits. Thanks a lot!
 
Idea:​


1) Hermetically seal the cochlear implant speech processor inside the head (Totally Implantable)


2) Hook up the cochlear implant's microphone to the eardrum (like the Envoy)


3) Replace the Implantable Battery every other 5 years



This is called a "Totally Implantable Cochlear Implant". It should have already been done years ago.
 
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