Implantable hearing devices: an invisible solution for an invisible disability
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Welcome to today's episode of Lexicon. I'm Christopher McFadden, contributing writer for Interesting Engineering. In this episode, we're joined by Brent Lucas, CEO of Envoy Medical, to explore the future of hearing health and the groundbreaking technology behind fully implanted hearing devices.

We discuss the hidden impact of hearing loss on mental health and cognitive decline, Apple's entry into the hearing aid market, and how Envoy Medical is disrupting the industry with innovative 24-7 hearing solutions. Gift yourself knowledge. RU+, is a premium subscription that unlocks exclusive access to cutting-edge stories, expert insights, and breakthroughs in science, technology, and innovation. Stay ahead with the knowledge that shapes the future. Brent, thanks for joining us. How are you today?

I'm fine. Thank you. Thanks for having me. Our pleasure. For our audience's benefit, can you tell us a little bit about yourself, please? Sure. My name is Brent Lucas. I'm the CEO of Envoy Medical. We're traded on the NASDAQ under the ticker COCH. Sometimes that's an easy way for people to follow us and learn a little bit more about us.

We are a hearing implant company that is focused on fully implanted hearing devices. So we have two devices. One is the Esteem that has been FDA approved since 2010. That's a fully implanted active middle ear implant. Still remains the only one of its kind to have U.S. FDA approval.

And then we have an investigational cochlear implant called the Acclaim, which is a fully implanted cochlear implant. And we will be starting clinical trials anytime now. So by the time this comes out, we may have already started. Fantastic. Is your ticker a play on cochlear? It's a little bit, yeah. We are the underdog. We are a company...

That is a 30-year-old startup company, but we have a very large competitor, Cochlear Corporation in Australia. And so part of me being sort of cheeky, I guess, is we made our ticker symbol COCH in part because we're trying to let people know that we're very interested in disrupting the cochlear implant market. Fantastic. That's a good choice. Sometimes I had to find the tickers for companies. That's, yeah, not to forget, really.

So hearing loss is often called an invisible disease. Can you explain what that means regarding its social, psychological and economic impact on individuals and society, please? Pass the mouthful. Yes, it is an invisible disability. And what that means to a lot of people is, you know, if you see somebody even with eyeglasses, bad eyesight,

you know they have bad eyesight. Unless somebody, or you see somebody in a wheelchair, more is a, you know, more obviously amputation, an amputated limb,

These are obvious disabilities that people sort of see you and they understand that you have some sort of limitation due to your disability. Hearing loss, especially for those that don't treat it, is completely invisible. You wouldn't know I have hearing loss unless I continue to say what after everything that you say or I'm constantly telling you that I have hearing loss. So it is an invisible disability. And the real problem with that is that people begin to isolate themselves

themselves. So when you begin to isolate and pull back from society because you're very frustrated that you can't hear, other things begin to happen. You begin to have anxiety, depression. You don't exercise as much. You don't get out and enjoy the world. And that really has a lot more impact on your overall health and well-being than you think.

On top of that, you also have the economic downfalls, you know, loss of employment. Maybe you don't get promoted as quickly because you're not pushing yourself that you may otherwise have if you didn't have the hearing loss. So it is very much an invisible disability that unless somebody is telling you about it, you might not know how that person is being hindered.

And I don't know too much about it, but is it kind of a gradual loss for most people or like an instant, well, it could be deafness, but is it something you notice? There are various types. So one of the things that I've learned as I've become a public company CEO talking about hearing loss in the public forum more often is

is that everybody sort of assumes that hearing loss is just one category, but there's a variety of different types and levels of hearing loss. So yeah, some people gradually lose it. We call that progressive hearing loss. A lot of times that's genetic and just sort of slowly happening to you over the lifetime. There is something that's called sudden hearing loss, where somebody will literally wake up one day and they can't hear at all out of one ear. And sometimes that's not a

They don't know why. It's not easily diagnosed. Why? There could be ototoxicity. So that's, you take a certain drug, certain chemotherapies cause hearing loss. COVID apparently caused hearing loss in some people. So it could have, and then there's just the good old fashioned, you listen to music too loudly and you've done your own damage. Yeah. So it comes from all angles, I should say. Okay. All right. Okay.

I believe something like 13% of people in the US experience hearing loss in both ears. Why do you think hearing health doesn't receive as much attention as vision or other medical concerns? You kind of answered that. I think part of it is because it's not well understood in some regard. Also, because of that sort of embarrassment that people have about getting older, I think hearing loss is just tied to

you know, visions of your grandfather or your grandmother losing their hearing, and people just don't want to admit they're getting old. But there's a lot of other reasons that people get hearing loss, and they really should address it because there's more and more data coming out to suggest if you don't treat your hearing loss, you could have early cognitive decline. And there is a correlation. We're not so sure it's a causation, but there's a correlation now between untreated hearing loss and early cognitive decline. In fact,

there's been a paper or two put out to suggest that hearing loss is one of the top two modify modifiable risk factors that you could, you could change to, you know, to, to avoid early cognitive decline. Diabetes has been tied to hearing loss again, correlation, not causation, people falling down more often requiring hospital stay. So,

There is absolutely a lot of reason to believe that people should address their hearing loss and that society should care about it. It's one of my big frustrations that there's not enough people out there talking about it. So with a sign of cognitive decline, so it's a symptom of that, not obviously the cause of it. Am I understanding? Yes. So there's been a gentleman named Dr. Franklin out of Johns Hopkins University has said

published a few papers on this with his colleagues. And there is a correlation. Some theories that I've heard have been sort of a use it or lose it idea, where if your brain is not getting that information, you could sort of start to atrophy a little bit. But I also think it's tied to, and this is just me being, I'm not a doctor, I'm a lawyer. So don't trust me, I guess. But

But there's also, I think it ties into that social isolation, right? Where if you start to pull yourself away from society a little bit, you start to not engage socially. You could see how your brain just maybe isn't firing the way it used to be. And that's kind of how I think about it. Similar to any muscle movement.

If you don't use it, you start to atrophy. So it's good to stay active. I think the same thing applies to our brains. But again, I'm not a doctor. Blimey. You've got me thinking now, not so much damage to the hearing, but some people suffer a lot from earwax buildup.

Without taxi hearing, and like you say, you start isolating, you could give yourself a problem, couldn't you? Yeah, you absolutely could. And I mean, it's been known for a very long time that anxiety and depression, people with

significant hearing loss, they have an increased level of anxiety and depression, or they report that. So it's a fair amount of people. And I will tell you, the patients that I've talked to where they get our devices, I just sat down with three of our patients in our first clinical study on the Acclaim. All three patients talked about the level of anxiety when you can't hear well is just very high,

Uh, cause you're always looking around, you're, you know, you're, you're kind of on that, uh, fight or flight almost all the time. And you could just see how for some people, I don't think it's a huge sort of logical jump to think, oh, that could, I could see how that would impact my sort of brains functioning and how that could tie into other things. So I, that's, that's my sort of, um,

you know, armchair, uh, doctor thought on the process. Definitely. Definitely. Yeah. Yeah. It's a lot of research now. So if somebody is interested, I mean, Dr. Franklin's a good way to start Johns Hopkins. Um, but there's been a couple of papers published on it. It's definitely a growing area of interest. Okay. All right. Um,

Changing tracks a bit. Apple's AirPods Pro 2 now comes with a clinical grade hearing aid mode, apparently. How significant is this for the hearing health industry? And do you see this as a challenge or an opportunity for companies like Envoy Medical?

So for Envoy, I believe it's a good thing. I think there are hearing companies out there where it's not such a good thing that Apple came into the market. I mean, you know, Apple is one of the top 10 most valuable companies in the world, has a very big

very strong brand recognition. So if I was a hearing aid manufacturer, I might be a little nervous about it. But as a hearing implant manufacturer, the design of our device, we use the ear to pick up sound. So we don't have any external microphones. We don't have even a subdermal microphone. We have a piezoelectric sensor that sits on our incus, which is the... Behind your eardrum, you have three tiny bones, the malleus, the incus, and the stapes.

Our sensor sits on that middle bone and picks up the vibration. So we're very unique to the other companies in that regard. But the reason I bring it up with the Apple AirPods is our patients can put whatever they want in their ear. So you can have our hearing implants sort of in your day to day. And then you could throw in an AirPod if you want to and, you know, get a little extra boost or connect to your phone.

So I'm pretty interested in the long-term sort of symbiotic relationship that could be between Envoy Medical and some of these consumer electronics. And then the final thing I would say about it is, you know, we sort of touched on this earlier, but there's not a lot of talk about hearing health. And when you bring a company like Apple into the fold, you're not only saying that this should be talked about, right, because this is the biggest company, one of the biggest companies in the world, right?

But you're also lending credibility to the industry, which I have to say, I think the hearing industry has not had a lot of credibility because of just some of the business model aspects. So bringing somebody like Affle into the fold, I think is going to be a very positive development for us. That's a very good answer. With your implant then, does it require invasive surgery or not? Yes, yes. Our...

You know, full disclosure, both of our products require an invasive procedure under general anesthetic. So if you were to choose either of our devices, you would go to an ENT surgeon. Well, first, you would go see an audiologist. They would tell you hearing aids are no longer doing enough for you. They would then refer you to either their own ENT colleague or another ENT colleague. You'd go in, you'd get worked up.

if you decided to pursue it on surgery day, you'd check in general anesthetic. It's a couple of hours. So for one of our devices, it takes about three to four hours. The other one, it takes about two

You get, you know, you wake up, you have this implant, and then it takes about four weeks to heal before it's activated. The good news is that once, you know, once you've gone through that surgery, it's with you all the time. So you don't really need to think about taking it off at night, putting it on. It's really becomes part, it's a prosthetic. It becomes part of who you are.

which I think is really interesting. And a lot of our patients talk about one of the best parts being they no longer have to think about their hearing loss with our device. But with traditional cochlear implants or traditional hearing aids, you really do have to almost always be aware that you have this big thing on the side of your head, right? So I think it lets our patients, you know, my sort of thesis is it lets our patients live a better quality of life. And I hope to prove that out with some clinical data as we go forward.

Fantastic. So it's not an exact analogy, but it's like difference between glasses and laser surgery. I think that's a fine analogy and one I use a lot. And one of the other analogies I use is also, if you're familiar with sleep apnea devices, you have the CPAP machines that are like Darth Vader masks that you put on at night. And then there's a company that has a fully implanted device now. And there's a couple other competitors that are starting to come after them.

So the idea being, you know, some people might want to choose a non-surgical alternative, right? But other people want something more and we're here to give those people the option. I think if I ever suffer from this, I'd probably go down this route personally. That's just me. Yeah.

Since we're on the subject then, do you want to talk a bit more about Esteem and Acclaim, how these technologies work and what makes them different from traditional hearing aids and other cochlear implants? Sure. So I'll sort of talk about the similarities between the two because there are plenty and then I will go into the two differences. So both of our devices rely on this sensor, the piezoelectric sensor that sits on the incus.

And that's really the beauty of Envoy Medical's technologies, because we're using the ear to pick up sound. We're not using an external microphone or a subdermal microphone. We're truly using the eardrum basically as nature's microphone. So, you know, our big floppy ear on the side of our head has all these little wrinkles in it. And part of that is its way of capturing sound better.

you know, um, the sound waves in the environment and funneling them down into our ear canal and then our eardrum, which then vibrates. And, you know, so the hearing organ is, was designed or created in a way that, or evolved in a way that, um, allowed our brain to hear. So we think there's a natural benefit of using the ear to pick up that sound that really separates us from everybody else on the hearing aid side and the cochlear implant side.

Everybody else uses a microphone either on the outside of the head or they have what's called a subdermal microphone. The other thing about our devices is that because they're fully implanted, obviously you can wear them all day, every day, which you can't do with other technologies. So we have the benefit of these patients really being able to hear around the clock in water because obviously once it's implanted, it's waterproof.

And so a lot of these sort of benefits of having a fully implanted device that you and I take for granted because we're just like, well, we just hear, right? I mean, just I can use an AirPod. I take that for granted. But if you had a hearing aid in your ear, you couldn't put an AirPod on. You couldn't use a certain set of hearing aids, headphones, right?

So there's all sorts of ways that you're limited that you, unless you have hearing loss, you don't really realize it. So I think fully implanted really gives people an opportunity to avoid that. Now, just real quickly, I'll tell you the difference between the two. So a STEAM is for moderate to severe sensory neural hearing loss. And then a CLAIM is a cochlear implant. So it's for severe to profound hearing loss. Profound hearing loss is, you know, what severe to profound hearing loss is what the rest of us sometimes call deaf.

So these are people that are extremely hard of hearing and really have no other options. The Esteem is a nice sort of transition point between hearing aids and cochlear implants for those who want to have more of a natural sound, don't yet want to go to the electric sound of a cochlear implant, but also don't yet need that much therapy. So the Esteem is kind of in this little niche in between hearing aids and cochlear implants. But

I would say, I mean, I spend a lot of my time talking about, you know, why our devices are different from hearing aids, but hearing aids are wonderful technologies. And for those people with mild to moderate hearing loss, they should absolutely look into getting a hearing aid. And that covers the majority of folks out there by far. Like, you know, in the U.S., there's probably 40 or 50 million people that have significant hearing loss.

or hearing loss that's at a high enough level where you would notice it in your day-to-day life. And of that number, you know, 35 million are very well served by hearing aids and not a question. So we're not trying to say we're better than hearing aids or that we're, you know, going to replace hearing aids. What we're trying to say is at a certain point, hearing aids don't do it for you anymore.

And at that point, you need something else. And that's when hearing implants should be considered. And

Could it potentially be used for, I suppose, if you're born deaf? I don't suppose it would help you, right? This kind of implant? Oh, yeah. The cochlear implants, if you're born deaf, well, I should say our devices are for adults because of the implant procedure. But traditional cochlear implants are used for children and they work extremely well for young kids because it's just, you think about your brain, it's just like learning a language at that age.

So you'll find kids as young as six months old will get implanted with some of these cochlear implants. And they do quite well because they've learned, you know, just like kids learn the language that their parents are speaking, they're learning to hear with the cochlear implant. Okay. Is there any plans to develop it for the children and infants or is it more...

I don't know, biological matter, really. You've got to let them develop. So there are plans that we have or some thoughts around how we could work with our product. The tricky part from an engineering standpoint, the tricky part will be

The sensor that we use requires a certain amount of space in what's called the mastoid. So the temporal bone, there's a mastoid cavity in there, and our sensor requires a certain amount of space. So for a baby and then even a toddler where their skull is growing, it's not a great place to have an implanted sensor.

But we have some theories and some thoughts, but I would say that's further down the road. Right now, if a kid was born deaf today, they should definitely consider one of the traditional cochlear implants. Fair enough. That makes complete sense. Again, we've kind of answered this, but I'll ask anyway. Fully implanted hearing solutions eliminate the need for external components, as you mentioned. How does this improve the quality of life for patients compared to conventional hearing devices?

This, I mean, this is really such a big deal to so many of our patients, is the improvement of quality of life in having a fully implanted solution. So the reality is, and I'm not popular in the hearing world when I, the hearing industry when I talk about this, because I'm

Everybody else's company has an external device. So they're all like, you know, don't make it worse. But the reality is not everybody wants something on the side of their head, right? I mean, it's just a reality. We all know people that could use a hearing aid or even a cochlear implant, but they don't want to wear it all the time. And same with eyeglasses, same with other things. You know, you should do certain things for your body, but you don't really necessarily want to.

So our device allows you to, um, to do this in a discreet manner where you can choose to be upfront about it if you'd like, but you don't have to be right. You can, you can address your hearing loss, but you don't have to tell the world about it. And I would, I would put forth that, you know, this is probably 20 to 30% of the people that have hearing loss. I don't have a, this is just a gut sense from talking to everybody that I've talked to over my career. Um,

there's probably 20 to 30% of people who have hearing loss that really don't want to wear an external device. And so we offer that and that should improve their quality of life. Then you'll hear things, one of my favorite things that people really don't think about is pillow talk. So if you have a spouse and you talk at night,

Um, you know, you don't want to, you can't wear a lot of hearing aids or cochlear implants in bed because if you put your hearing aid and you put it up to a pillow and it causes a feedback loop. So you start to hear squealing and a cochlear implant is the traditional ones are attached by a magnet to the side of your head. So if you start rubbing your head on the pillow, it'll fall off.

So these things, you know, you and I take for granted because we don't, we don't have to think about that, but we have patients that say, I just love the fact that I can talk to my wife at night, you know, and not have to scream at her while we're sitting in bed. Right. Because I can actually talk, have a normal conversation. Right.

There's other stories like hunters who can go, you know, we have a patient who's a hunter who now can walk around in the field and feels like he has much better sense of what's around him because the wind doesn't bother him by hitting the microphone in the external hearing aid.

um there's just a lot of i there's uh we have a hockey player who loves the fact that he can wear his hockey helmet without having to worry about it disrupting his um external so it's just it really lets you be how you want to be um without having to be tethered to your hearing loss and i think that's just what people want at the end of the day that's fantastic and you you've been married a long time it's kind of a good excuse yeah it is it is interesting that uh

We have the ability to hear, our patients have the ability to hear all day, every day. And I will come across patients who say, I turned it off that night because I don't want to hear my spouse snore. Or I don't want to hear the kids in the other room. I want my wife to get up when the kids are screaming. So it is kind of funny to see the marriage dynamics there. Indeed. My wife's listening. I didn't say that. Yeah.

It's pretty silly question, but could it, if you've got perfectly normal hearing, could a device like this be used to kind of give you super human hearing or enhance your hearing at all? Or is that a silly question? It's not. I get asked that question a lot. So it's not a silly question. The answer is no, unfortunately, but.

But I do get asked that question quite a bit. So you need a certain level of hearing loss to really make it worthwhile going under the procedure. And there are risks with surgery. So you definitely should have a significant amount of hearing loss before you proceed with these. But maybe in the future, you never know. But right now, no, the answer is no supernatural hearing, unfortunately. Shame. Does it leave any scars after the surgery? Or is it all kind of the keyhole surgery through the ear or?

I don't know how you access. Yeah, they do what they, so they do do an incision behind the ear. Well, so they'll go behind your ear, they'll make an incision and they kind of pull, this is going to sound a little graphic, but they pull back your ear to access the temporal bone so they can drill it out. Now for the surgeons who, you know, have done this for a while, you will see maybe a little tiny scar sort of in line with your hair.

It's really impressive how small the scar is. And then as long as you do a good job and listen to your instructions, you know, you don't disturb it, you don't mess with it. Some patients will actually, you know, they kind of mess, they push with it. Same thing for pacemakers, by the way, in deep brain stimulation. Like there's people that like to fidget with their medical devices. Do not do that because what will happen is then it could cause the wound to break down and you can have issues. So as long as you leave it alone,

And you have a good surgeon and you follow their instructions. It's a very minimal scar that you wouldn't notice. Fair enough. I presume it's not affected by, I don't know, talk about pacemakers, things like security scanners and things. It doesn't set them off or anything like that. So there can, it depends on the security system. We have had patients go through, you know, like at the airport, they usually have to say,

I have a medical device, same with a knee implant too. So it's not, you know, it's not anything different from other medical devices, but you know, if you do that scanner thing at the airport, they, it will show up that you have something in your head, um,

But, and then, yeah, pacemaker. So there's EMC testing that we have to do part of our standards to make sure that our device doesn't interfere with other things and other things don't interfere with our device. There are some things that can certain frequencies, but it's exceptionally rare. So we have had some people that'll say, you know, I got too close to the security system at

Walmart or something and I got a little buzz in my ear for a second but I just walked away from it well fair enough same with their mobile phones cell phones yeah no reported it no reported issues for us and there's no testing to suggest there's any issues with with mobile phones oh fantastic um so uh what do you see are some of the most significant barriers uh for the broader adoption of fully implanted hearing devices is it the cost awareness regulation or something else

Definitely cost and awareness. In the U.S., for example, we do not have insurance coverage for our first device, the Esteem. Part of that reasoning, which I think is poor reasoning, is that Medicare and Medicaid or our government payer in the U.S. has said that it's a hearing aid and that hearing aids are not covered, therefore your device is not covered. So we actually got a bill introduced, two bills introduced to us

correct this and we're working on that to have that corrected because they are expensive. I mean, obviously if you're getting a surgery, it's an expensive undertaking up front. People should not have to pay out of pocket for that. So cost is a, is an issue. Lack of insurance is an issue. Um, our cochlear implant, the one that the acclaimed, the fully implanted cochlear implant will be covered by insurance because cochlear implants are, are already covered by insurance. Awareness is, um,

is an issue and it's hard to compete. I said earlier, I alluded to us being an underdog. It's hard for us to compete in an industry that's really been dominated by a few number of players, manufacturers who have very close relationships with audiologists in the field. So, you know, if you go to your local audiologist right now and you say, what are my options?

95% of the time, they're only going to tell you about the hearing aids that they're selling at their facility. They're not going to go and tell you about all the other things that people are working on. So if you're a patient or you have a loved one who needs a hearing device, what I say and really encourage people to do is you need to do your research online. I mean,

The internet's here. We all have access to it. One of the benefits should be being able to be an advocate for yourself for things like this. So go online, learn about your options so that you can go to an audiologist and say, I want to learn about all of these things. And if that audiologist says, oh no, I don't know about that, or oh no, I can't do that, then find somebody who can. I mean, what most people don't realize about the hearing aid industry is

The connections between the hearing aid manufacturers and some of these retail professionals is incredibly intertwined to like a level that would make a lot of people uncomfortable. So I really think you need to be an advocate for yourself. Fair enough. Let's hope this raises some awareness for you. Okay. Do you foresee a future where traditional external, pardon me, hearing aids become obsolete or would they always have a role in the hearing health space?

I think external hearing aids will only get better. And I think they will always have a place. Really in that mild to moderate category, they do quite well. And there are some hearing aids that are very, very discreet. And because at that level, you have an opportunity to be, you don't need that much power. You can have a very discreet hearing aid if you'd like.

So I think external hearing aids will always be there. And then implants, I do believe implants will be a bigger deal for people in that severe to profound as we go. Because right now you see a lot of people in the severe range get hearing aids that, quite frankly, I think they should have implants. So I think you're going to see more of that. Now,

The other wildcard here is, you know, things like gene therapy, pharmaceuticals. If somebody comes up with a wonder drug for hearing loss, then, you know, maybe everything goes away. But from what I'm aware of,

There's nothing on the horizon related to gene therapy or pharmaceuticals that's really going to have an impact across the board. Yeah. I keep making the analogy to glasses, but yeah, it's kind of the same thing. I myself am short-sighted. I'm wearing contact lenses right now, but I don't want to take the plunge with laser surgery. So yeah, I'm always going to need some external device, aren't I? So same with Priscian.

Yeah, absolutely. It makes sense. You have to do something, right? So you have to find what you're comfortable with because not doing something is not reasonable, in my opinion. Yeah, absolutely. Okay, then. With AI revolutionizing healthcare, do you see the potential for AI-driven enhancements in hearing technology, such as real-time noise filtering, automatic tuning, or personalized sound processing?

Yes. I think you're already starting to see AI or at least the discussion of AI start to come into hearing aids. So there are some companies out there, again, we're not a hearing aid company. So I'm sort of speaking on the outside about this. I don't know. We don't have any AI in our devices right now. It's a little harder to go down that path with fully implanted devices because it's moving so quickly. But yeah,

I, the hearing aid companies that I'm aware of that are working on it do have things like you walk into a room and the device will sort of recognize where you are, the environment you are, and will automatically sort of tune the device to your environment.

There can also be some voice recognition benefits to that, noise canceling, like you mentioned. There are some ways of, I don't know if that's really AI or if that's machine learning. I'm not smart enough to know the difference, but yeah, those things are in the works for sure. Okay, fair enough. Last question then. If you could change one thing about how society perceives and addresses hearing loss, what would it be?

And how do you think we can move forward and move toward that change? I think it would be highly beneficial if more people were aware of how hearing loss impacts your overall health. Because then I think more people would address it earlier on. Here in the United States, for example, if you go to your primary care physician to get your annual physical checkup,

you almost never talk about your hearing loss. You don't get a hearing test unless it's incredibly obvious that you have hearing loss.

But what would be very helpful is just like your cholesterol or your blood pressure, if you're getting an annual test or every couple of years gets a test, so you can monitor how your hearing loss is progressing. Because I think if people started to really understand how hearing loss ties to other things, they would probably address it earlier. Or they would do a better job of protecting what hearing they do have. So I think if I could change one thing, it would be

increasing awareness just about how hearing loss is tied to so many other things. Absolutely. Yeah. You got me tempted to go and get mine tested to be a core out of you. Um, speaking of, uh, AirPods, uh, the AirPod two, if you have the, you know, AirPod two and you get a, a recent iPhone or you update it, they have a very nice hearing test, uh, within the iPhone. And, um, I, I took mine on my iPhone, uh,

I think it was in the ballpark. It's not perfect, probably, but it's in the ballpark. Definitely something you could do independently. Yeah, closest I've come is those YouTube videos. It goes from a high frequency to a really low one where you stop hearing it, whether it's normal or not. But yeah, I guess it does the same thing. Brilliant. That's everything I was going to ask you. Is there anything else you'd like to add you think is important, Brent?

before we go? No, again, if people are interested in our products, Envoy Medical, E-N-V-O-Y medical.com. Again, if you're interested in following our company on sort of the public stock side of it, C-O-C-H is our ticker. But yeah, please drop us a line, follow us on social media and, you know, see where we go in the future. Thank you. Well, with that then, Brent, thank you very much for your time. That was very, very interesting.

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