Envoy Esteem hearing implant

1 10 2011

Envoy’s Esteem implant is not a hearing aid. It’s an implant for people with a hearing loss and a working cochlea and middle ear, who wish to have an invisible device which allows them to hear quite naturally. The battery is replaced every 5 years or so. The implant has two leads which extend into the middle ear and sense sound vibrations, and sends energy to the cochlea which is then translated into sound.

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A video was posted online on Monday from Sarah Churman, a 29 year old  from Texas, who hears her voice for the first time with an Envoy Esteem implant. She is currently being flown to New York and will appear on NBC Today on Monday morning. Envoy Medical will be implanting Sarah’s second Esteem for free!

Captioned video : How the Esteem works.

You can read another Esteem Envoy recipient’s story here.

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47 responses

1 10 2011
Dan Schwartz, Editor, The Hearing Blog

The publicity surrounding this video going viral is a big win for hearing health. Friday night, it had 330,000 hits; but by noon (NYC time) it had crossed the 2 million mark. You can follow Sarahs’ adventure on her Facebook wall (open to all to read). She will also be on ABC & CNN; and on the Ellen [Degeneris] Show.

However, even a casual viewer of the video will notice things don’t quite add up, with the excellent quality of her speech, indicating lifelong hearing aid use, vs “me hearing myself for the first time.”

This is not the first time NBC Today has been tripped up on a dodgy story regarding hearing loss & hearing aids: Just back on August 10th Dr Shelley Borgia presented Jim McDade as having noise-induced hearing loss, when in fact his loss extended back to his early childhood, which I documented in our
Less-than-honest NBC Today segment on hearing loss article.

We will be watching the NBC Today & other segments closely, with our crap detectors turned up to maximum.

For interested readers, there is also the Envoy Esteem Patients group on Facebook interested readers can visit.

By the way, the other blog you cite is for Mandy: I sent you a Facebook friend suggestion.

Dan Schwartz,
Editor, The Hearing Blog
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6 03 2012
jen

Well said Dan. There has been a lot of misleading information about the Esteem, I am very sad to say.

24 03 2012
discpad

Here is a new interview of Sarah in a German magazine. She had her second Esteem implant switched on about 3 weeks ago

http://radioneuss.wordpress.com/2012/03/24/interview-sarah-churman-das-youtube-video-was-um-die-welt-geht/

1 10 2011
Candysblog (@Candysblog)

I don’t think a profoundly deaf person can benefit from this. I was interested in this one a while back because it seems to be made for hard of hearing people rather than profoundly deaf? I mean, it will explain how she has excellent speech.

And, hey! I know of a few profoundly deaf people with excellent speech!

My question now is, what are the criteria to get this kind of implant?

1 10 2011
Tina

Eligibility does in part depend on the type of deafness. See http://www.envoymedical.com/indications-for-the-esteem

1 10 2011
Dan Schwartz, Editor, The Hearing Blog

Just within the last few minutes, this explanation from TIME appeared on the Envoy Esteem Patients group on Facebook:

In response to how well she speaks having never heard her own voice, she said she’d gotten by in life by reading lips. “My whole life I’ve been complimented on how well I speak,” she wrote. “I don’t really have an answer for you other than I have always had a passion for reading, grammar, and English. My hearing loss was/is considered severe to profound. I’ve worked very hard to be able to interact and blend in…only thing I can say is ‘God is good.’”

Dan Schwartz,
Editor, The Hearing Blog
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13 07 2013
David Dishongh

I can personally testify for that. I grew up with 50% hearing loss, and while it is not profound as hers, I forced myself to read more and focus on proper pronunciation. I am actually more conscious of trying to enunciate even though I cannot physically hear the difference most of the time.

I even pastored a marriage recently and I was complimented on how well I speak. If I speak normally or don’t focus that much on how I am speaking though, I have to constantly repeat myself.

The confusing part for most people is that they say “why don’t you speak louder so you can hear yourself, why do you mumble?” There are physically certain sounds and frequencies I cannot hear. I say things the way I hear them and my body picks up sounds better when I say them versus when I hear them from other medians. For instance I cannot say the word “Fuck!” without sounding weird.

I am trying to get more info on the esteem as I want to be able to function normally, thanks for this.

2 10 2011
Richard N. Williams

Dan–
I understand that the Envoy Esteem requires sensorineural hearing loss and if she is severe to profound, she is hearing and conversing. With work, her understanding and speech can appear near normal in certain situations. They should not have said “deaf” (as in “stone”) but profound and near deaf. Right? Wrong?
I hope this is clarified on the Today Show 10-3-11.
Rich Williams

2 10 2011
Judy Martin

I have a severe to profound sensorineural hearing loss (leaning more towards profound). I did not qualify for this device and now have a cochlear implant. I agree with Rich the use of the word “deaf” is a complete misnomer. Unless the company changed its eligibility requirements, I’m sure the woman had a moderate to severe loss. Nothing else makes sense.

2 10 2011
Howard Samuels

Here are the indications for the Esteem:

http://www.envoymedical.com/indications-for-the-esteem

In particular, you need ‘unaided speech discrimination test score greater than or equal to 40%.’ That is enough of a hearing loss to interfere with your life, but certainly not close to what most people think of when they hear the word ‘deaf.’

13 07 2013
David Dishongh

That is more than enough to interfere with your life.

3 10 2011
Dan Schwartz

Here is the URL of Sarahs’ appearance on NBC Today:

http://today.msnbc.msn.com/id/26184891/vp/44755372#44755372

Unfortunately, the video has the captions for the hearing impaired stripped out.

Dan Schwartz,
Editor, The Hearing Blog
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5 10 2011
David Luerman

I too have a severe to profound sensorineural hearing loss (right is profound and left is severe). I had the Esteem implanted (off label due to not meeting the requirements of the Esteem) in my right ear in November 2010 by Dr. Shohet. My pre-implant un-aided SRT scores were 36% at 108dB (right ear) and 52% at 100dB (left ear). At turn on Dec.30th my implanted right ear SRT score was 28% at 80dB. After my 1st adjustment in March, my SRT score was 20% at 70dB.and 2nd adjustment no SRT test was performed. On 8/29 my audiologist tested my implanted ear with an SRT score of 16% at 45dB. My Pure Tone average has greatly improved from pre-implant of 70dB @250Hz sloping down to 110dB@1500Hz to my latest score of 30dB@50Hz sloping down to 95dB@4000Hz. So you see I have achieved approximately a 40-50 dB gain in the lower tones and gained high end tones I hadn’t been hearing. Though my speech scores did not improve as hoped, I feel I am doing as well as I had with a hearing aid. My next step is to try coupling the Esteem with a hearing aid to see if I will gain any additional speech understanding.
Richard………I agree. Sarah should have corrected her statement of being deaf to instead say she is hard-of-hearing. Most people associate deafness as meaning totally lacking hearing ability.
Judy……You can have the Esteem implanted off label if you don’t fully meet the criteria, but your doctor believes there is enough reason you may do well with the implant. I am proof of that.
Sarah’s speech was quite good. Mine is equally good. People also comment to me about my perfect speech with no hint of having been unable to hear throughout life. I too have been wearing hearing aids all of my life (now 56) and have never referred to myself as deaf. I believe what Sarah meant to say when she said she was hearing her own voice for the 1st time was meant to be she was hearing for the 1st time since implantation 8 weeks earlier. I hope the rest of the uninformed world will realize the Esteem is not for “deaf” people. I have not seen any of here appearances on any of the networks, but I hope she clarified her statement to say she was hard-of-hearing. She should advocate the Esteem as it is a wonderful device for most hard of hearing people, but hopefully she speaks/spoke honestly about her true hearing loss condition.

4 04 2012
Gordon

How long have you had the Esteem and are your still pleased? I would like to hear from people who have worn the esteem longer period of time.Thanks

7 11 2013
jennifer

my husband had the esteem implanted and it DOES NOT WORK….i’d love to hear from anyone else that has had the device implanted….thank you

8 10 2014
Barbara Hamilton

I had the esteem implanted in 2011. I did not receive any benefits from it and had a very difficult time with background noise, was not able to enjoy social settings.
Two months ago I had cochlear implant surgery in the other ear and it has been wonderful. I can hear words, my understanding is so much better than before. It is still difficult to hear in noisy environments, but I am very happy I did this.

4 06 2013
LDH

The word is “hearing-impaired,” not “hard-of-hearing.” Time to leave past labels behind.

5 03 2014
Ken

Actually, LDH, the correct term is “hard of hearing” not “hearing-impaired” which focuses on what we CAN’T do. Hearing-impaired is a PC term that ended up being far more insulting than hard of hearing.

5 10 2011
Dan Schwartz

Noted Audiologist Dr Wayne Staab, whom I’ve personally known over 25 years & who trained me on the Philips XP Peritympanic hearing instrument, just weighed in on our Sarah Churmans’ experience with her Esteem hearing implant; and it goes a long way to explaining what we saw and read… The Cliff Notes version is what you saw & read is legitimate.

From Hearing Health Matters:

…But one of my fellow editors, Dr. Wayne Staab, sent me a response that I found particularly insightful. I would like to share part of with you.

Wayne, who is editor of the Wayne’s World blog at Hearinghealthmatters.org, pointed out that people outside the hearing care field often use terms more loosely than audiologists do. For example, he said:

“Patients often refer to their hearing loss as deafness, even though it isn’t, by definition. [Patients] who have heard their voices for the first time without the occlusion effect will often say that this is the first time they have heard themselves ‘normally,’ which could be what this is referring to. I have seen people cry when this happens.

“And, it is not uncommon for them to exaggerate, even though unintentionally, because they are hearing something different and are excited about it.

Wayne added: “I found out a long time ago that it is important to listen to the patient, even when we don’t believe or understand fully what is happening. To them, something is happening that is different, and which we may later find to have legitimacy. I know for certain that this is what happened with the first cochlear implants. Most laughed at Dr. John House—then.”

As for Sarah Churman, he commented: “She may be more emotional than someone else, but that happens. The procedure may have turned out better than she had anticipated. Will all patients react this way? I suspect not, just as all of your patients do not cry when you fit them properly (and even in some cases improperly) with traditional amplification.”

Dan Schwartz,
Editor, The Hearing Blog

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5 10 2011
Dan Schwartz

One Other Thing: Unlike Cochlear and Advanced Bionics, the people at Envoy Medical are truly appreciative of their patients. One need look no further than Sarahs’ appearance on The Ellen Show:

http://www.hulu.com/embed/f7jYjeT3TD2j3KMXiyrDOQ?shared_ad_id=60811

[I hope the video will embed directly]

Dan Schwartz,
Editor, The Hearing Blog

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6 10 2011
altroyan

Lately, there has been lots of rumor, speculation, and hints of some exiting new totally implantable cochlear implant hearing technology. This means we are only a year or two away from a totally implantable cochlear implant for the profoundly deaf to be real news. There are numerous patents filed already and many work on the same principle as Envoy. The battery power was the main concern for a microphone driven processor, but that has been resolved with analog energy conservation and better processing algorithms. All four of the big name brands have been neck in neck to see who gets the clinical data to the appropriate EEU Health Council. This is for real, so mark this post because within a year or two you will be hearing a lot about the totally implantable cochlear implant. I saw the same feeds for Envoy in 2005 before it came to fruition, same deal now for stronger CI’s.

6 10 2011
Deb

David,

Thanks for your update with the Esteem! I have CI’s and wouldn’t have qualified for the Esteem if I wanted one, but find it interesting! I met Dr. Shohet for a CI consult at UCI in 2002. I ended up going to USC instead (insurance) but liked Dr. Shohet. He’s a very well respected surgeon. We lived in Carlsbad.

Dan, how can you make such a weird blanket statement like that “the CI companies don’t appreciate their patients”? Coming from a person who passes himself off as a hearing professional, I think you should rethink your stance on that. I know AB is a very caring company, and the AB users are highly appreciated.

I think the “all implantable” CI will be approved before too long. The problems were not just the battery packs, the microphones under the skin gave sounds/speech a muffled, underwater quality. The “beta testers” were not keen on the sound quality.

I had a CI back in 1985. Can’t say I am sorry I did it, the Storz 4-channel was interesting, only 16 ever implanted, but it was very experimental and I used it less than a year. The device did damage my right ear and my 2008 replacement bilateral device only has 6 electrodes that made it in and there was a lot of other damage. It took two surgeons 6 hours to get those electrodes in me.

I would not want to be first getting the all implantable device. We only have two ears to mess up!

Deb

11 10 2011
Dan Schwartz

@Deb McClendon: When was the last time Advanced Bionics donated even a single CI to a needy patient? I know Cochlear only donates two per year worldwide, and they are five times the size of AB.

Envoy certainly knows a good thing when they see it: They picked up the tab — $60 grand — for BOTH of Sharlas’ implants & surgeries.

11 10 2011
Deb

Dan,

AB has done that numerous times over the years. I don’t recall dates or what the situations were, but I remember reading about it. AB doesn’t really advertise they do that on occasion. I think they have donated to children, but right off the top of my head I can’t remember the details. I am sure all the CI companies have done the same under different circumstances. One child AB donated to was flown to the US for the surgery and AB picked up the tab for all of it, including having parents along for the ride.

The Envoy is not covered by insurance, so I would think the company would be doing Sharla a favor and also doing themselves a favor by donating the devices AND getting all the favorable publicity.

You are pretty quick on the trigger to try to make CI companies look bad. All you had to do was Google it up and find some information…for instance,

http://www.reuters.com/article/2008/11/13/idUS271715+13-Nov-2008+BW20081113

4 12 2011
Jazel C. Ladores

My daughter got her right ear cochlear implant (MED-EL) when she was 2 and 1/2. She is now 4 and 1/2 and I can she her progress,she’s doing quite so well. Envoy Esteem Hearing Implant seems interesting. Of course I want my child to hear when she is sleeping and swimming. The battery of Envoy is replaced every 5 years..how is it? where is the battery if it doesn’t have outer device? is another operation needed or every 5 years the patient must have operation for the battery to be replaced?

8 11 2014
Ally

Jazel,
It is inside your head so surgery is needed for each battery replacement. In the future hopefully the battery will last longer so there is less surgery.

24 03 2012
josh

i have hearing aids but they just dont work for me they are phonaks i want to go to college and make something of myself but im finding that impossible i can hear i just have a hard time understanding speech. it really makes my life hard to deal with on so many levels im 26 and my hearing has been getting progressive i need help.

24 03 2012
Tina

Hi Josh, what does your audiologist say? Can you opt for a middle ear or cochlear implant?

26 04 2012
Profoundly deaf in need of Invisible CI ASAP

I’m profoundly deaf. I want the totally implantable cochlear implant right now. No waiting.

Moderate to severe hearing loss= Totally Implantable Envoy

Profoundly deaf= no Totally Implantable CI

How is this fair?

2 01 2013
Recent Esteem Implant Recipient

I just had the Esteem implant surgery in November 2012. The surgery was long (6 hrs), but everything went well. Just thought I would tell a few things that I wasn’t aware of until either just before or after the surgery. This is not any fault of Envoy. There is just so much to learn. So far I would still have the surgery with this new information, but just thought I would share to try to provide a more detailed picture of the procedure. Part of your incus bone is removed. The surgery is reversible, but you would be implanted with a prosthetic incus bone if you chose to reverse it. In order to reach the areas involved in the surgery one of my taste nerves had to be removed. I was told this during my pre-op appointment the day before the surgery. Apparently it is very common. So, now food on the left side of my mouth taste like metal. I actually like that side effect because I don’t have as much desire to eat…. I needed that help. : ) It’s not a big deal at all. After the surgery, my right arm was very very sore. It turns out I was turned on my right side during the surgery so I was laying on my arm for I guess the entire surgery. Again, not a big deal but you will be sore in other places than your ear. The incision was much bigger than I thought. It is from slightly below the top of my head to below the back of my ear. Again, no big deal… It’s just that I thought it was going to be about an inch long. It makes perfect sense now that I think about what was done, just kind-of freaked me out when I first saw it. I have lots of hair, so no one can see it at all. I can even wear my hair in a ponytail and it’s not noticeable. And, of course, the hair is growing back, so eventually I will not even be able to see it. I could not open my mouth very wide until this week. Every time I tried it would make my temple next to my implanted ear hurt really bad. Again… that was good too… I have been eating a little less. The thing that bothers me is that I can completely feel the implant with my hand. It sticks out in the back. It is flush with my head on the side, but sticks out about a centimeter at the back of the implant. No one but me would ever know, but it just freaks me out when I touch it and also I can feel it touching my pillow if I lay on my back or on the implanted side. Currently I would say that’s the only place I feel any discomfort at this time. I was told they drilled for 2 hours in my mastoid bone to create the well for it to sit in. I guess this is common, but would like to hear from others who have the implant. I would like to know if you can feel your implant and if you eventually forgot about it.
I’m looking forward to my turn on date. Nervous, but ready to join the hearing world!

23 02 2013
Slavomir

Hello,
would it be possible to have your email to discuss your experiencie and compare it with my case? I would like to find out more.

Thank you
Slavomir

23 02 2013
Tina

Hi

I don’t have an Esteem implant. Try this group for support from users. https://www.facebook.com/groups/241235109304753/?fref=ts

7 11 2013
jennifer

we would love to hear how things are working for you….my husband had the esteem implanted and it does not work

24 02 2014
Ross

I had the implant Feb. 2012 After four return trips to Chicago Dr Marzo removed it said I couldn’t use it. My hearing even with a new hearing is not as good as before I had the operation. Ross

6 11 2014
Ally

I can feel mine too.. I definitely didn’t expect that.

4 01 2013
Gary

I’m considering Esteem Implant. and found your comments extremely helpful. Can’t wait to see what you think of implant when it gets turned on.

7 11 2013
jennifer

wondering if you had this done….my husband had it done a year ago

19 11 2013
A. Short

My husband had Esteem Implant done August, 2012. After activation it worked great for about 2 months, then the problems started. Our surgeon, Dr. Murray, did the surgery in Houston, TX. He no longer goes to Houston for surgeries, because Envoy sold the surgery center he was operating at. Envoy says they sold it because he no longer wanted to come to Houston to operate – the doctor says he quit coming to Houston because they sold the surgery center. How do you know which one to believe? There lies the problem, our surgeon is in California, we are in Texas. In order to be serviced he wants us to go to Ca., we can’t do that very easily. We have a ranch to run and we can’t just up and go out there. We have tried everything. His main problem seems to be fluid in the ear where the implant is. He has been on 5 rounds of antibiotics in the last 6 months, and we have been out several thousand dollars from seeing several different doctors. None of the doctors can seem to get rid of the fluid. We had a tube put in the ear, at Dr. Murrays recommendation, but it soon came out. After talking to Envoy, they say the problem is really between us and our surgeon. Dr. Murray seems to think the problem could be that the implant has an infection in it, or that it was faulty to start with. Envoy’s giving us the cold shoulder, and Murray says to come see him, so he can look at it. What about all the other patients Dr. Murray operated on in Houston, are they having any problems, and what are they doing? The implant is a tremendous amount of money. My husband says he actually heard better with his hearing aids, which he had before surgery. Think long and hard before you consider doing this. I wish we had waited a while, to let them gets all the kinks out of it before we did it. My e-mail is ashort@totelcom.net

21 01 2014
john mccusker

can u have esteem fitted in uk i crrentky have cochlear implant due to car crash

21 01 2014
Tina

Hi John,
As you have a cochlear implant, you can’t have an esteem implant in that ear as it needs a working cochlea. Perhaps in your other ear? It’s best to clarify this with your audiologist.

12 03 2014
Recent Esteem Implant Recipient

I was getting a lot of feedback once my implant was turned on. The engineers could not turn it up very loud at all. It turned out I had scar tissue. My surgeon had to go in through my ear canal and separate the scar tissues (not remove them) behind my ear drum. Afterwards, the audiologist was able to turn up my implant. I am experiencing a “bubbling” sound. It’s very hard to explain the sound. Maybe it’s my eustachinan tube vibrating??? I try clearing my ears by holding my nose and trying to blow out my nose. Sometimes it helps for a few seconds, but then the “bubbling” sound comes back. It isn’t a constant sound, but very very frequent. If I bite down on my back teeth I can usually hear it. Is anyone else experiencing this or know what it is or if it can be fixed?

12 03 2014
Tina

Have a word with your audiologist. I had bubbling sounds after my cochlear implant operations, it was a period of the fluids settling down after the operation, perhaps it is the same thing. It did go away after a while.

12 03 2014
Recent Esteem Implant Recipient

Thanks Tina. It’s been 9 months since the last surgery. How long did it take for the fluid to settle down for you?

12 03 2014
Tina

I can’t remember exactly. I’d say maybe 6 months? Have you tried asking about this on Hearing Journey or any of the CI Facebook groups, or Pardon on Facebook?

30 08 2014
Barbara Hamilton

I had the esteem implanted 3 years ago. It is about as good as my hearing aid was, and I’m thinking I should have not been a candidate. The part I do like about it is not having to change batteries all the time, or put in and take it out a hearing aid every day. I am disappointed with my results, butt I have two friends who were implanted with esteem and they have had wonderful results. I guess it’s the type of hearing loss you have that makes you a good candidate.

30 08 2014
Barbara Hamilton

(my surgery was done in Houston by Dr. Murray. I haven’t had any problems, physically…..only with clarity)

6 11 2014
Ally

I also had my surgery in Houston by Dr. Murray. I did have one revision surgery but still do not have clarity at all. I don’t think I was a good candidate either. My esteem hearing is NOT nearly as good as it was from wearing hearing aids. Considering getting it removed but am worried about losing more of my hearing! My battery is dying soon so I will have to decided quickly what to do.

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