@daveshaw Cochlear implants, like hearing instrument technology are continuously evolving. Reality. Yes, some day in the future there may be something better than there is today.

It's a reality that hearing instruments do not 'fix' hearing loss. They help in some situations. Hearing in specific frequencies varies individually. Many of the new hearing aid models have adjustments that can be set by a professional audiologist to help improve those frequencies. Still, nearly everyone with hearing loss whether it is conductive or sensorineural will have difficulty hearing well when there is background noise.

I manage that as best I can by using a hand held microphone that works with my CI processor and my hearing aid. Not perfect; but far better than without it. It shows to use. People see it and ask questions. As far as I'm concerned, that's a good thing as I can explain it in hopes it might help them or someone they know.

Regarding the Envoy Esteem Middle Ear Implant which is being developed by Envoy Medical Corporation, 4875 White Bear Parkway, White Bear Lake Minnesota 55110. Yes, this may be a device of the future for adults diagnosed with moderate to severe sensorineural hearing loss. It is fully implanted. It is very new.

I picked up literature at the national HLAA Convention in Indianapolis that explains it. I have yet to meet anyone who has had this system implanted. While this devices is fully implanted, it requires a battery to function. That battery needs to be replaced periodically in an outpatient surgical procedure. In the literature it says the battery life is 4.5 - 9 years, but then in smaller print it says it may be reduced to 2.8 years depending on the settings of the device.

This device does have FDA approval. However, the literature I have also lists quite a few Contraindications for the Esteem. You may want to request literature from the Envoy Company.

Choosing to wait if one qualifies for a cochlear implant is a personal choice. What is available and in use now from 3 different CI manufacturers has a very high rate of success. We all have choices to make. As I've said several times, my only regret is that I didn't have my CI surgery done sooner. I waited a decade after seeing the success others had. The remarkable difference this has made for me is wonderful. It took me less than a month to experience the improvement with the CI.
I had a friend who was an MD, who decided not to get a CI. He struggled for years while he waited for a 'cure' that he believed would come in his lifetime. Sadly, he passed away from a sudden illness shortly after he retired. I can't help wondering how much better his life would have been had he gone the CI route. We'll never know.

I wish you luck with hearing aid trials. There are many good products out there. The fitting of those products is the game changer in most cases.