Ear Center: Hearing Implants
About Active Hearing Implants
Recent advances in cutting edge technology now permits our surgeons to offer hearing improvement for many patients whose hearing could never be helped surgically only a decade ago. Our new hearing technology is comprised of various types of "Active Implantable Hearing Devices." Each type of new implantable hearing device has specific indications for specific types of hearing impairment. Over the last decade, active implantable devices have sorted out into identifiable categories:
Cochlear Implants (Cochlear, ABC, MedEL) [adults and children > 1 year]
Osseointegrated Implants (BAHA, Ponto) [adults and children > 5 years]
Semi-implantable Hearing Devices (Maxum & SoundBridge) [adults >18 yrs]
Totally Implantable Hearing Devices (ESTEEM) [adults > 18 years]
Navigate this page:
- Cochlear Implants (Advanced Bionics & Cochlear Americas)
- Osseointegrated Hearing Implants
- Semi-implantable Hearing Devices (Ototronix MAXUM & MedEl Vibrant SoundBridge)
- Totally Implantable Hearing Devices (Envoy ESTEEM) (not being implanted at The Ear Center)
- Cochlear implants by Advanced Bionics, Cochlear Americas, MedEL
- Semi -implantable devices for severe-to-profound hearing loss with less than 40% understanding ability
- External processor and rechargeable power supply (ear level BTE type or body worn processor)
- Approved by most third party payers and Medicare (except the hybrid devices)
- Many patients are now being recommended for cochlear implants to be implanted into both ears (binaural implants), either the same day (simultaneous) or staged on different days (synchronous)
- Cochlear Americas and Advanced Bionics cochlear implants are being implanted at The Ear Center.
- Hybrid cochlear implants (investigational devices by Cochlear Americas & MedEL undergoing multi-center clinical trials) consisting of acoustic stimulation (conventional hearing aid) combined with simultaneous intra-cochlear electrical stimulation (cochlear implant).
- The concept is to: (1) stimulate intact, residual low frequency hearing with a conventional acoustic signal provided by the hearing aid component of the system and to (2) stimulate high frequency residual spiral ganglion cells with direct electrical stimulation from intra-cochlear electrodes provided by the cochlear implant component.
- Semi -implantable devices for mild-to-profound hearing loss characterized as steeply sloping high frequency hearing loss and intact low frequency hearing
- Short (Cochlear Hybrid inserted through a separate cochleostomy) and long (MedEL Hybrid inserted through the round window) insertion electrodes
- External sound processor providing simultaneous acoustic and electrical stimulation
- Rechargeable power supply (ear level BTE type processor)
- Current research results (as of January 2010) reveal that approximately 25-30% of patients are losing approximately 30% of their residual hearing, usually in a delayed fashion. However, 70% of patients do not lose their residual hearing.
- Clinical trial leaders include The University of Iowa (Cochlear Hybrid Device) and The University of North Carolina-Chapel Hill (MedEL Hybrid Device)
- Hybrid Electro-Acoustic Cochlear Implants are investigational devices and are not currently being implanted at The Ear Center.
Dr. Kraus has been implanting cochlear implants in Greensboro since 1986.
- Titanium fixture (BAHA 3, BI300) with transcutaneous abutment implanted into the skull behind the ear(s)
- External, wearable, digital BAHA 3 processors attach to the abutment ( BP-100 and BP-110 Power programmables, Intenso, Cordelle II processors available) with power supply
- Two built-in directional microphones (BP-100 and BP-110 Power processors)
- Audiologist adjustable (BP100 and BP-110 Power programmable)
- FDA approved for monaural and binaural conductive hearing losses, congenital atresia, with cochlear reserve 45 dB or better
- FDA approved for single-sided deafness
- Approved by Medicare, Blue Cross Blue Shield of North Carolina, and the North Carolina State Employees' Health Plan
- BAHA processors have standard and extended warranty options available
- BAHA implants are being implanted at The Ear Center - click here
- An alternative to the BAHA style osseointegrated implant
- Ergonomic sound processor design with angled microphone ports
- Adjustable abutment angle to improve directionality
- Ponto countersink with stop to improve safety during implantation, countersinking is limited to 0.3mm.
- Ponto dermatome
- Ponto soft band - can be used for bilateral use, easily adjustable, six colors, built-in safety release, latex/Velcro free design
- Ponto sound processor has an outward facing, large program button that is easily accessible and easy to use
- Ponto sound processor has a "surround" coupler, rather than a "snap" coupler, for ease of coupling to the abutment
- 10 kHz bandwidth sound processor with 15-channel processing and 10-band frequency response flexibility
- Dedicated fitting modes using the Genie Medical fitting software for conductive losses versus single-sided deafness
- Ponto sound processor features include:
- Automatic Wind Noise Reduction
- Manual Multiband Adaptive Directionality
- Wind Noise Reduction
- Output AGC
- Up to 4 programs
- Volume Control
- Start-up Delay
- Mute/Stand-by Function
- Low Battery Warning
- Telecoil/DAI/FM input
- Fitting software, Genie Medical
- Available as right and left models
- Available in 3 colors (Chroma Beige, Mocca Brown, Diamond Black)
- Ponto Pro sound processor has the same features as the Ponto with the addition of:
- Automatic Multiband Adaptive Directionality
- Tri-State Noise Management
- Data Logging
- Learning Volume Control
MAXUM Hearing Implant
- Manufactured by Ototronix®, LLC, Houston, TX
- Based on original SoundTec™ technology and FDA approved
- Implantable middle ear magnet
- 1 hour surgical procedure under local anesthesia as an outpatient
- Externally worn, custom fit, digital, electromagnetic sound processor
- Increased gain (+60 dB) and wide bandwidth
- No acoustic feedback
- Vibrant SoundBridge™ = floating mass transducer attached to incus or round window membrane
- External processor with power supply, internal hardware
- The Vibrant SoundBridge is not currently being implanted at The Ear Center.
- Envoy ESTEEM® Totally implantable hearing device was approved by the FDA in 2010 and in Europe, CE mark, in the Summer of 2006)
- Totally implanted components (Sound Processor + two piezoelectric transducers, a Sensor and a Driver)
- 4.5 - 9 year, non-rechargeable battery life prior to needing to be replaced.
- No externally worn components
- Personal Programmer remote controlled
- For moderate-to-severe sensorineural hearing loss with 40% or better discrimination (word recognition scores)
- The Esteem hearing implant is not currently being implanted at The Ear Center.
Otologic Carina™ (currently an investigational device not approved by the FDA)
- Electro-mechanical device manufactured by Otologics
- Currently an investigational device undergoing clinical trials in the U.S.
- Electro-mechanical transducer interfacing with the incus or (second hearing bone)
- Post-auricular, subcutaneous microphone
- Rechargeable battery requiring frequent recharging
- The Carina is an investigational device and is not currently being implanted at The Ear Center.
1. Tysome JR, Moorthy R, etal. Systematic review of middle ear implants: do they improve hearing as much as conventional hearing aids? Otol Neurotol 2010:31(December):1369-1375
2. Kraus EM, Shohet JA, Catalano PJ. Hearing Results with the ESTEEM Totally Implantable Middle Ear Device: Phase II Trial-1Year Results. Otol Head Neck Surgery 2011;145(1):100-109.
3. Shohet, JA, Kraus EM, Catalano PJ. Profound High-Frequency Sensorineural Hearing Loss Treatment with a Totally Implantable Hearing System. Otology Neurotol 2011;32:1428-1431.
If you would like to learn more about active implantable hearing devices, please contact our office at (336) 273-9932 and ask for our Audiology Department.
Last revised May 31, 2012