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In order to be fit with a MEI (or a binaural fitting), one requires a purely sensorineural hearing loss. Since MEIs are better at generating mid and high frequency gain than low frequency gain, the optimal hearing loss should be sloping. Many MEIs can be digitally programmed or are in fact digital. With the extra control that these technologies afford, other sensorineural configurations can be fit. I doubt if any new hearing aid users would be MEI candidates. Although the various surgeries are not complicated, they can be lengthy (up to 3 hours) and like any surgery, can be traumatic. A MEI candidate is therefore one who has tried conventional hearing aids and was unsuccessful either because (1) they were not able to obtain as much high-freuency amplification as required, or because (2) the occlusion effect (Vagal response) could not be resolved to the satisfaction of the patient. While the cosmetic issue is important, I am not convinced that this should be the primary deciding factor, given that CIC hearing aids can be made quite small with the newer technology.

There was a panel session, chaired by myself and Dr. Jon Spindel, at the 2001 AAA meeting in San Diego. In addition, part of the August 2001 issue of Hearing Journal was dedicated to this topic, with myself and Jon as co-editors.