Middle Ear Implants Offer Potential: New breed of devices may stimulate compliance, experts say

The advantage of this approach, he said, is more clarity than that achieved with traditional hearing aids.

“Because of the direct movement of the ossicular chain, you don’t have the feedback issues, which is one of the key benefits over hearing aids,” said James Douglas Green, Jr., MD, FACS, founder and president of the Jacksonville Hearing and Balance Institute in Jacksonville, Fla., who has been working with MEIs for nearly 20 years. “You get great clarity and you get gain in some ways that you can’t get with other systems.”

Carl Geisz, sales manager at Envoy, said one advantage of the Esteem’s design is that it uses the patient’s eardrum as the microphone, letting the system take full advantage of the natural acoustics of the outer ear and, therefore, delivering a more natural sound.

Four Iranian scientists recently published the results of a clinical trial of Envoy Medical’s Esteem middle ear system in an article in European Archives of Otorhinolaryngology, which appeared online on Feb. 17. Lead author Faramarz Memari, MD, who is on the faculty of the department of otorhinolaryngology at the University of Medical Sciences and Health Services in Tehran, noted that while the 10 subjects experienced gain similar to that experienced with their own conventional aids, they reported better subjective hearing quality.

“Some patients who did not have better thresholds in their post-op audiogram compared with their hearing aids were still very happy,” he said in an interview with ENT Today. “One patient stated that he hated washing dishes while using conventional hearing aids, because the sound of dishes bothered him. But now he enjoys washing dishes because that sound doesn’t bother him and instead he can hear the sound of water running very well.”

Representatives of other companies, however, contend that middle ear systems with digital processors (Esteem uses an analog processor, for example) can simply use processing to substitute for the benefit of natural pinna and ear canal effects.

Darla Franz, director of education and corporate communications at MED-EL, said that the target market for her company’s Vibrant Soundbridge system consists largely of “people who either are medically unable to wear a hearing aid, or who have tried a lot of hearing aids and spent a lot of money and for whatever reason are never able to achieve adequate benefit. They have reached the end of their tolerance with traditional treatment.”