Invisible hearing aid: New choice for patients

Considered biggest breakthrough since cochlear implants

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TUCSON, Ariz. - Hearing loss is the third most common physical condition after heart disease and arthritis. Hearing aids used to be the only option for those with moderate to severe hearing loss, but now an invisible device is giving patients a new choice.

Along with super strength, the Bionic Woman has super hearing. It's something LoriAnn Harnish has always dreamed of.

"For some reason I have always had the vision that I would become a bionic woman," said Harnish.

At five years old, a fever cost Harnish 65 percent of her hearing. Now, something you can't really see is taking her hearing to a new level.

"Every day it's something new," Harnish said.

"I think this is the biggest breakthrough we've had in terms of rehabilitating hearing since cochlear implants," explained Abraham Jacob, MD, Director at the University of Arizona Ear Institute.

Jacob says the invisible device, known as the Esteem, is implanted behind the ear and turns parts of it into a microphone.

"The device uses the eardrum and native hearing bones to sense sound energy," Jacob said.

That energy is sent to the inner ear for interpretation, creating a clearer, more natural sound.

"The patient is able to go in the shower, wear it at night, and wear it in the pool. It's a completely different way to hear from them because they can hear all the time if they want to," Jacob explained.

For Harnish, it's meant a new hobby that's literally music to her ears.

"It's enriching my life in ways I had not expected," Harnish said.

Right now, Harnish has the invisible hearing device in her left ear. She's planning on having one implanted in her right ear as well. The device isn't cheap. It costs about $35,000 per ear and is not yet covered by insurance.

Additional Information:

About 17 percent of adults in the United States report some degree of hearing loss. At age 65, one out of three people has  hearing loss.  Gradual hearing loss can affect people at any age.  Depending on the cause, it can be mild or severe, temporary or permanent.  Some people are born without hearing, which is called congenital hearing loss.  The most common causes of hearing loss for adults are aging and noise.  In age-related hearing loss, also known as presbycusis, changes in the inner ear that happen as you get older cause a slow but steady hearing loss.  It may be mild or severe, but it is always permanent.  For older people, hearing loss is often confused with conditions like dementia.  Noise-induced hearing loss can happen slowly or suddenly.  Being exposed to everyday noises, like loud music or a noisy work environment, can lead to hearing loss over many years.  Other causes of hearing loss can include: earwax buildup, injury to the ear or head, an object in the ear, a ruptured eardrum, ear infection, allergies, perforated eardrum, benign tumors, fluid in the middle ear from colds, and other conditions that affect the middle or inner ear.  (Source:

TYPES:  There are three types of hearing loss:

  1. Conductive hearing loss:  when hearing loss is caused because of problems with the ear canal, ear drum, or middle ear, and its bones.
  2. Sensorineural hearing loss:  when hearing loss is caused by problems to the inner ear, also called nerve-related hearing loss.
  3. Mixed hearing loss:  refers to a combination of conductive and sensorineural hearing loss, meaning there may be damage in the middle or outer ear and in the inner ear or auditory nerve. (Source:

TREATMENT:  Hearing aids are often the most effective treatment option.  Cochlear implants are medical devices that bypass damaged structures in the inner ear and stimulate the auditory nerve directly.  They are surgically implanted in people who have severe hearing loss.  They are not recommended for people who function well with hearing aids.  Assistive listening devices are another option for people with hearing loss.  They expand the functionality of hearing aids and cochlear implants by helping the patient separate the sounds they want to hear from background noise.  (Source:

NEW TECHNOLOGY:  Another option for people with hearing loss is the Envoy Esteem.  It is the world's first FDA-approved totally implantable hearing device.  It is implanted under the skin behind the ear and in the middle ear space.  It is completely invisible, which allows the Esteem to overcome limitations of hearing aids; including the discomfort of feeling something in the ear, infection, wax buildup, and acoustic feedback.  It can be worn 24/7, in the shower or at night.  It uses the ear canal and ear drum, allowing for a more natural sound.  The Esteem has a non-rechargeable battery with a life span of five to nine years.  When the battery does die, the sound processor and battery are replaced during surgery.  The Esteem is activated at least eight weeks after it is surgically implanted to allow time for the incision to heal.  Candidacy criteria includes: no conductive hearing loss, adults with stable bilateral moderate to severe sensorineural hearing loss, medical/cardiac clearance to ensure you are healthy enough to undergo surgery, reasonably good speech discrimination scores (40 percent or greater in unaided condition), no external or internal anatomical abnormalities that may restrict surgery (determined by physical examination of the ear and temporal bone CT scan), and minimum 30 days experience with appropriately fit conventional hearing aids.  (Source:

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