Full-time Hearing Using Your Own Ear:

The Esteem® fully implanted* active middle ear implant (FI -AMEI) is the first and only FDA-approved, completely internal hearing device for adults diagnosed with moderate to severe sensorineural hearing loss.

*Once activated, the external Esteem Personal Programmer is not required for daily use.

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What sets the Esteem implant apart from other hearing solutions?

*Please note the external Esteem Personal Programmer is not waterproof

  • It requires no externally worn components in the ear canal or elsewhere to hear, eliminating discomfort and the inconvenience of loss and damage caused by wax and moisture
  • It uses the eardrum instead of an artificial microphone
  • It requires no daily maintenance
  • It allows for full-time hearing, all day and all night
  • It has a battery that last years
  • It's 100% waterproof* and submersible to a depth of 33 feet

The Esteem Implant

The Esteem implant is the world’s first and only completely internal* hearing device that works with your ear’s anatomy to let sound in the way nature intended. Unlike hearing aids, which use an artificial microphone, the Esteem technology uses the eardrum as a microphone allowing the ear canal to remain open.  The device’s three components work together with the ear's anatomy to let sound in similar to the way nature intended.

  • Esteem Sensor
  • Esteem Sound Processor
  • Esteem Driver


*Once activated, the external Esteem Personal Programmer is not required for daily use.

The Esteem Implant's Natural Hearing

Sound enters your outer ear and funnels down your ear canal causing your eardrum to vibrate. All as nature intended.

  • The Esteem Sensor then converts the vibrations into electrical signals that are sent to the implanted Esteem Sound Processor.
  • The Esteem Sound Processor receives, adjusts and intensifies the signals to fit your unique hearing needs.
  • The Esteem Driver translates these customized signals to intensified vibrations. The vibrations are transferred to the inner ear where the cochlea cells are stimulated, causing you to hear more natural sound.
  • The external Personal Programmer lets you make adjustments for the specific hearing situation. (not shown)

Frequently Asked Questions

If you’re curious about what to expect from the Esteem implant procedure, here’s a link to a brief Q&A on the procedure from Dr. Jack Shohet. Dr. Shohet is a neurotologist who has completed over 200 Esteem cases, more than any other active surgeon in the U.S. To date, there have been more than 1,000 Esteem devices implanted worldwide, and many of the original clinical trial patients have had their devices for more than 14 years.
Click here to see What to Expect from the Esteem® Procedure and Recovery
As Dr. Shohet comments in the Q&A above, the success rate is high, as 97% of patients implanted after the FDA approval show a demonstrable improvement in their audiometric evaluations. The three percent with less than successful results were caused by infections and poor audiological performance. The technology is very reliable, with a failure rate of less than one percent. As you know, patient satisfaction rates are more subjective and dependant on preoperative expectations.

When considering options, it's always helpful to learn what an experienced Esteem surgeon has to say! 
The Esteem device is implanted during surgery that takes, on average, 3-4 hours. The two transducers are implanted in the middle ear. The Sensor is attached to the incus, and the Driver is attached to the stapes bones in the ossicular chain. The Sound Processor is implanted behind the outer ear in the temporal bone under the skin. The surgical procedure takes place under general anesthesia and is typically outpatient.
After the surgery, you will not be able to hear with the implanted ear until the device is turned on, which typically occurs at 8 weeks post-surgery. After any middle ear surgery, it is normal for the middle ear space to fill with fluid. You may feel a sensation or notice snapping or popping noises. This is usually normal and a sign of fluid still being in the ear. The area around the implanted Sound Processor may be tender as your incision heals. Your surgeon will provide post-surgical instructions.
Yes. The Esteem battery and software are housed together in the Sound Processor piece which sits in the temporal bone. The battery lasts an average of five years. *battery life may be reduced to 2.8 years if continually exposed to very loud sound levels using the highest gain settings.
After a healing period determined by your surgeon, typically eight weeks, you will return to the surgical center for a follow-up appointment. Your audiologist will activate or turn on your Esteem implant and program it to your preferences, customizing three different programs that you can switch between with your own personal programmer.
When the battery begins to deplete you will notice the confirmation tone changing from a single tone to a dual tone when changing programs with your programmer. Also, the Esteem low battery LED light on the lower right of the programmer will illuminate. When this happens, you will contact Envoy Customer Service and we will assist you in locating the closest surgical site to schedule a battery replacement procedure.
The Esteem software and battery are housed together in the Sound Processor piece which sits in the temporal bone. A battery replacement requires removing the Sound Processor piece and replacing it with a new one. The procedure is typically an outpatient procedure that takes place under local or general anesthesia depending on the surgeon’s preference. The procedure typically takes about an hour and afterward, the device is typically turned on right away.
Getting the Esteem

What do patients say?


"After I got the [Esteem] implant, my life completely changed. I was finding myself going out in public more often, becoming much more social."

From Mom to Mrs. Nebraska
Implantee for 14 years


"It's very difficult to swim with 5,000 other people and not be able to hear!"

Business Director, Tri-athlete, Father of Two, California
Implantee for 14 Years


“It’s changed how I interact with my kids, my community and really how I feel about myself, immensely. I feel like I have a new lease on life with this [the Esteem] device and I really, truly feel like I can do anything I want to do.”

Social worker and mother of two becomes  
Envoy Medical Hearing Counselor 
Bilateral implanted - Left: 14 years, Right: 9 years

The information presented or discussed is for general information purposes and may not be representative of all patient outcomes. It is not intended to substitute for professional medical advice and should not be interpreted to contain treatment recommendations. Each person’s situation is unique, and risks, outcomes, experience, and results may vary. Talk to your healthcare professional about which product or treatment may be right for you. Please see complete product instructions for use, including all product indications, contraindications, precautions, warnings, and adverse events. Please view important safety information www.envoymedical.com/safety-information. These individuals received the product through participation in a clinical trial.

Do you qualify for the Esteem implant?