Esteem® Active Middle Ear Implant versus Conventional Hearing Aids: Long-Term Performance

Area of Science:

• Audiology
• Biomedical Engineering
• Otolaryngology

Background:

• The Esteem totally implantable active middle ear implant is a potential alternative for moderate-to-severe sensorineural hearing loss.
• Conventional hearing aids (cHAs) are the standard treatment for such hearing impairments.

Purpose of the Study:

• To compare the long-term performance of the Esteem implant with conventional hearing aids (cHAs).
• To evaluate audiological outcomes in patients with symmetric hearing loss treated unilaterally with Esteem and contralaterally with a cHA.

Main Methods:

• Ten subjects with unilateral Esteem implantation underwent audiological assessment.
• Evaluations included pure tone audiometry, speech audiometry in quiet, and adaptive speech testing in noise (Matrix test).
• Outcomes were compared between unaided, Esteem-only, cHA-only, and combined Esteem + cHA conditions.

Main Results:

• Esteem device significantly improved speech intelligibility in quiet and noise compared to unaided and cHA-only conditions.
• Binaural stimulation (Esteem + cHA) yielded the highest speech intelligibility scores.
• The Esteem device, particularly with binaural use, demonstrated a significant reduction in the deviation from normal hearing thresholds.

Conclusions:

• Binaural stimulation enhances speech recognition in noise more than monaural stimulation, especially when using only a cHA.
• The Esteem device provides audiological benefits superior to cHAs for severe to profound hearing loss.
• Esteem implant performance approaches that of cochlear implants in specific cases.