The Esteem System: a totally implantable hearing device

The Esteem totally implantable active middle ear implant is a new technology to augment hearing in patients suffering from moderate-to-severe and severe sensorineural hearing loss. In contrast to conventional (acoustic) hearing aids, the system uses two piezoelectric transducers (PZTs). PZTs are used as the sensor and driver to replace the function of the middle ear. Sound is received via a PZT sensor that picks up eardrum vibrations, following the piezoelectric principle, and transforms them into an electric signal. This signal is filtered, modified, amplified and transferred to a PZT driver, which mechanically drives the stapes and thereby the inner ear. The sound processor also contains a power source, which is an implantable lithium iodide battery. All components of the hearing restoration system are totally implantable to offer good sound fidelity and reduce hearing aid stigma caused by the visibility of conventional and semi-implantable hearing systems. Our experience shows that this system can provide considerable benefit to patients with sensorineural hearing loss.