The Envoy Esteem® Hearing Implant
Hearing aids have evolved significantly since the use of ear trumpets in the seventeenth century and vacuum tube amplifiers in the early twentieth century. Advances in technology have led to the development of devices that are considerably smaller and more powerful than those that were first marketed to the hearing impaired. However, despite these improvements, a substantial portion of patients with hearing loss are not regular hearing aid users, citing concerns over cost of purchase and device maintenance, cosmetic appearance, discomfort and ear canal irritation, signal distortion, feedback, and insufficient gain . The impetus for the development of active middle ear implants was to overcome many of the drawbacks of conventional air conduction hearing aids [2–4]. Theoretically, a totally implantable system would afford complete concealment and improved freedom, permitting water exposure and use during sleep. Furthermore, by utilizing an implantable microphone and vibromechanical transducer, the ear canal can be effectively bypassed and feedback minimized. The Envoy Esteem® remains the first and only completely implantable hearing aid to have approval by the United States Food and Drug Administration (FDA) for patient use. The Esteem utilizes a unique implanted piezoelectric sensor and driver system that receives, processes, and amplifies sound. This chapter will address the history of the Esteem® Hearing Implant and provide a summary of its surgical implantation and clinical outcomes.
KeywordsTympanic Membrane Cochlear Implantation Ossicular Chain Otitis Externa Functional Gain
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