Totally implantable active middle ear implant: Hearing and safety results in a large series

Abstract

4. Laryngoscope, 2018.

Implantable Hearing Aids: Where are we in 2020?

“…49,54 The largest review of patients fit with Esteem also confirmed surgical safety with minimal reported adverse events as well complete resolution of tinnitus for many patients after implantation. 49 A few attempts have been made to complete metanalyses of implantable hearing aid performance compared with both conventional hearing aid and unaided performance. Most independent investigations could not be directly compared because of a lack of standardization in performance outcome measures.…”

“…The implanted sound processor receives the signal from the sensing lead and filters and amplifies the acoustic signal. [48][49][50][51][52][53][54] The unique feature of this device is the utilization of the tympanic membrane as the "microphone" of the system, allowing the device to be completely implantable. 55 Unfortunately, this utilization of the intact middle ear system as a microphone pick up source necessitates a healthy eardrum and ossicular chain, limiting indications to patients with normal middle ear anatomy 53 (see Table 2).…”

“…Other limitations of the procedure include the non-rechargeable battery, which must be replaced at regular intervals. 49,53,54 The company suggests battery life is between 4.5 and 9 years, 50 and with one study reporting an average time of 4.9 years before battery replacement is required. 56 An additional concern regarding the Esteem device is related to the surgical procedure itself.…”

“…Several outcomes studies have been published evaluating the benefits of implantable hearing aids. While only a few provide direct comparison between performance with conventional hearing aids, 45,49,57 most of the investigations have demonstrated improvement in hearing performance over the unaided condition, 45,52,57 low complication rates, 49,52 and high subjective satisfaction scores. 22,24,25,54,58 Single-institution reviews have been completed for each of the above-mentioned individual devices.…”

“…64 High cost-utility has been demonstrated for traditional candidates with pure sensorineural hearing loss, 63,65 as well as those with chronic otitis externa for whom consistent use of conventional hearing aids may prove challenging. 64 The potential for significant quality of life improvement, [63][64][65] coupled with relative low complication rates, 49,52,63,64 suggest that future investigation of the middle ear implant performance and continues device development and optimization provide an important alternate treatment option to conventional hearing aids. used, or years of hearing aid use, has yet to identify any positive correlation with implanted device benefit.…”