Summary: A new study highlighted advancements, challenges, and breakthroughs in fully implanted cochlear implants (FICI).


  1. The development of fully implanted cochlear implants (FICI) has been significantly influenced by advancements in middle ear implants (MEIs) and various microphone technologies.
  2. Envoy Medical’s Esteem device, a fully implanted active middle ear implant, was designed with innovative sensor technology.
  3. The Acclaim cochlear implant by Envoy Medical features a larger rechargeable battery in the pectoral region, designed to meet patient preferences for longer intervals between charges.

Envoy Medical highlighted a recently published article in the Current Otorhinolaryngology Reports. The article, titled, “Fully Implanted Cochlear Implants,” was authored by Eric Babajanian, MD, James Dornhoffer, MD, and Colin Driscoll, MD, from Mayo Clinic in Rochester, Minnesota. The authors describe it as a review of the current state of fully implanted cochlear implants, including some of the challenges, limitations, and breakthroughs.

Middle Ear Implants and Cochlear Implants

The authors discuss the important influence middle ear implants (MEIs) have had on the development of fully implanted cochlear implants (FICI): “Many of the advancements in this area have contributed to the development of a FICI, primarily with the development of various microphone technologies that bypass the need for a separate external microphone.”

Envoy Medical Hearing Technology

The article goes on to detail Envoy Medical’s fully implanted active middle ear implant (FI-AMEI), the Esteem device, a fully implanted active middle ear implant. Envoy Medical believes its commercial experience with the Esteem fully implanted sensor technology provides it with an important competitive advantage in the marketplace.

“Envoy Medical is a leader in fully implanted hearing devices and we owe that leadership to our many years of experience with our fully implanted sensor technology,” says Brent T. Lucas, Envoy Medical’s CEO. “We have always believed that leveraging the outer and middle ear anatomy makes a lot more sense than sticking a microphone under the skin somewhere behind the ear. One of the benefits of leveraging the outer and middle ear anatomy is that the ear can still be used for other accessories and electronics, including headphones, ear buds, and even hearing aids.” 

Further reading: Envoy Medical Awarded New Patent for Implantable Cochlear Systems

Cochlear Implant Power Supply

The article also notes the importance of an implantable power supply for a fully implanted cochlear implant. For its investigational fully implanted Acclaim cochlear implant, Envoy Medical chose an architecture with a larger rechargeable battery in the pectoral region, versus a smaller rechargeable battery in the head.

“When faced with design choices, we felt that patients would rather go several days between charges. Our device was designed with patient preference in mind, and I believe we are headed in the right direction,” says Lucas. The complete article can be found under the citation: Babajanian, E.E., Dornhoffer, J.R. & Driscoll, C.L.W. Fully Implanted Cochlear Implants. Curr Otorhinolaryngol Rep (2024).