SanSan Hearing Files IPO Prospectus: Focused Innovation in Cochlear Implants Through Strategic Simplification

“Since starting my venture, I have drawn two key insights. First, as long as you persevere, a solution can always be found for every problem. Second, stay committed to simplification—focus deeply on your core professional expertise—and you will build a valuable, high-quality company.”

Eight years ago, Liang Qi, who had worked at West China Hospital of Sichuan University for eight years and then spent another eight years at Cochlear, the world’s largest manufacturer of cochlear implants, founded Ai’er Shidai (Hearing Era). Regarding his initial motivation, Liang stated, “The aim was to create an online education platform, as talent is extremely scarce in the audiology industry.”

Four years ago, Liang Qi brought EarTimes to VCBeat. Liang Qi told VCBeat, “In the niche market of hearing impairment, an internationalization strategy is a key breakthrough.” At that time, EarTimes had been making continuous efforts in five major areas: hearing education, hearing clinics, surgical centers, hearing products, and academic research, gradually developing into an international hearing healthcare platform.

Four years on, the spotlight has shifted from the “Era of Hearing Love.” Liang Qi has returned to VCBeat with SanSan Hearing, a company now fully dedicated to cochlear implant products.33Hearing focuses on innovative technologies in artificial hearing, providing internationally leading auditory implant solutions for individuals with hearing loss through the introduction of globally licensed innovations and independent research and development.

The hearing industry is a relatively niche sector and remains in its early stages of development.

Documents released by the World Health Organization (WHO) show that,More than 60 million people worldwide are affected by severe or profound hearing loss.These patients require hearing implant devices to regain their hearing and reintegrate into mainstream society.However, currently only 5% of individuals have undergone surgery for hearing implant devices. Additionally, there are 360 million people with moderate hearing loss and 1.15 billion people with mild hearing loss, and the hearing impairment in this population can worsen at any time.

"Too many monks, too little gruel" aptly describes the current state of hearing impairment care in China.Among China’s 82.96 million people with disabilities, those with hearing disabilities constitute the largest group, numbering 27.8 million. Each year, there are as many as 900,000 new cases of birth defects, including approximately 35,000 cases of congenital hearing impairment—second only to congenital heart disease. When patients with late-onset or drug-induced deafness are included, the annual number of new cases of hearing impairment reaches 60,000.

Despite the vast number of patients, there are remarkably few specialized physicians available to provide treatment. More than a decade ago, when Liang Qi chose to study audiology abroad, China had only around 20 professionals in the field, most of whom had transitioned from otology.

In response to this reality, Liang Qi’s initial intention was to focus on hearing education. Liang believed that if schools struggled to deliver such education, internet-based learning could break the constraints of time and space, thereby rapidly accumulating talent. However, driven by market demand and development needs, EarCare Era gradually evolved, expanding from hearing education to hearing centers, and from hearing services to the current development of hearing products. Sansan Hearing has spun off from EarCare Era to become an independently operated company pursuing its own growth trajectory.

When VCBeat asked Liang Qi how he had reached his current position, he calmly recounted, “It was actually a fairly natural process. You reach a certain stage and then take another step forward. The same applies to our current venture into hearing health products.”

Of course, Liang Qi also mentioned that many challenges were encountered in this process. “I think the most difficult part was not knowing whether the path we were taking was the right one, because there was no benchmark in the industry to reference, learn from, or strive toward, leaving us uncertain about the correctness of our direction. Throughout this journey, it felt as though there was a peak ahead that we were heading toward, but we had no way of knowing if our route was actually correct.”I simply hold the belief that we should address problems as they arise, progressing step by step.“Her resolute tone also revealed Liang Qi’s firm conviction. Whether right or wrong remains to be seen, but by moving forward and addressing the problems encountered, the answers will eventually become clear.”

Liang Qi’s determination has impressed not only VCBeat but also her team members.The core team of SanSan Hearing now comprises research, otology, and engineering experts with international backgrounds. They have an average of over 15 years of experience in the field of auditory implants, with R&D personnel distributed across the United States, Europe, Australia, and other regions.

“Some leading domestic physicians in the field of cochlear implants consider this initiative highly meaningful and have expressed strong support, with some even stating they would participate pro bono. Therefore, both the R&D personnel and the surgeons in our current team have joined us driven by a shared belief in the significant value of this endeavor,” said Liang Qi with a smile.

“In the future, we aim to establish a dual-engine drive powered by both hearing services and hearing products.”, Liang Qi stated, “We hope to develop our own products that can provide patients with better solutions in terms of price, product quality, and service. Therefore, Sansan Hearing is positioned as a hearing products brand, while Ear Care Era serves as the foundation for hearing services.”

 Cochlear implants are currently the only globally recognized effective solution for severe to profound hearing loss.Cochlear implants are a type of implantable hearing assistance device. Their external speech processor converts sound into electrical signals in a specific coded format, which are transmitted to the cochlea. By stimulating auditory nerve fibers through an electrode system and directly exciting the auditory nerve, they can replace diseased or damaged auditory organs, enabling patients with severe deafness to perceive certain sounds.

Liang Qi introduced that China’s cochlear implant industry is still in its early stages of development, with a relatively small market size but significant growth potential. Data shows thatFrom 2013 to 2017, the market size of China’s cochlear implant industry (including products, surgeries, rehabilitation, and services) grew from RMB 2.2 billion to RMB 5.5 billion, representing a compound annual growth rate (CAGR) of 25.7%. Over the next five years, the market continued to expand at a CAGR of 11.2%, reaching RMB 9.66 billion in 2022.

However, from the perspective of the international market, the three major global brands—Australia’s Cochlear, the United States’ Advanced Bionics, and Austria’s MED-EL—collectively hold a 95% market share. Their product technologies are similar and increasingly convergent.

In the Chinese market, three major brands account for 90% of sales revenue and 80% of surgical implantations; two domestic brands, Shanghai ReSound and Hangzhou Nurotron, have obtained registration certificates from the National Medical Products Administration (NMPA).However, due to the lag in product research and development, there is still a significant gap compared to international standards.

Liang Qi told VCBeat that the technical barriers to cochlear implants are high. “As a bionic organ, it involves not only engineering craftsmanship but also neuroscience, medicine, and many interdisciplinary fields of electronic engineering, making R&D particularly challenging.”

“Furthermore, due to the relatively niche nature of the hearing healthcare industry, it is difficult to attract talent into this field. Yet, high-complexity R&D demands an exceptionally large and highly skilled workforce. This contradiction constitutes one of the key challenges in cochlear implant development.” Liang Qi could not help but lament when discussing the talent landscape in the cochlear implant industry: “This is also why conducting R&D in China remains a considerable challenge; recruiting outstanding young R&D personnel and engineers is truly difficult.”

Despite numerous difficulties, Liang Qi also sees hope and a turning point, “Now may be a favorable time. The vigorous development of brain-computer interfaces (BCIs) in the United States in recent years has drawn the attention of many forward-looking researchers. Compared with the past two to three decades, there are now greater opportunities in this field, including promising developments in talent acquisition and other areas.”

In the Chinese market, to promote the healthy and rapid development of the industry, the national and local governments have introduced multiple favorable policies. Provinces and municipalities such as Jilin, Liaoning, Henan, Shanghai, Zhejiang, Hunan, Anhui, and Guangdong have included cochlear implants in their medical insurance reimbursement coverage, thereby fostering the healthy and rapid growth of the cochlear implant industry. These policies have reduced the high costs associated with cochlear implant surgery, making the procedure more affordable for more families, boosting consumer willingness, and expanding the overall market size of the industry.

In addition, from a regulatory perspective, the state has also strengthened supervision and management of the cochlear implant industry by establishing stringent standards to guide its development.

SanSan Hearing is continuously driving innovation in cochlear implants through advanced technologies. Currently, SanSan Hearing has three product pipelines, including one licensed from a well-known European brand and two independently developed pipelines.

Liang Qi told VCBeat that one of the company’s self-developed product pipelines embodies a novel concept from Sansan Hearing. “In addition to the implanted internal component, cochlear implants also include an external speech processor. While the internal implant is not replaceable, the external speech processor typically requires upgrading every three to five years, which entails considerable costs.Our independently developed and designed fully implantable product consists solely of an internal component, with no external parts. Much like a Tesla vehicle, once the device is purchased, it only requires charging. After implantation, there are no ongoing maintenance costs, thereby reducing the financial burden on patients.”

In addition,San San Hearing's products also offer advantages such as compact size, high precision, water and dust resistance, and moldability.The compact size enables a more minimally invasive implantation procedure; high precision, along with water and dust resistance, extends the service life of cochlear implants while reducing costs and financial burden.

Its plasticity further enables minimally invasive upgrades of the implants in Sansan’s auditory products.“Currently, both domestic and international products do not update the implant itself; instead, they rely primarily on upgrading the external processor in later stages, which results in higher costs. The product’s flexibility enables minimally invasive upgrades, thereby reducing the financial burden on patients and enhancing their experience,” introduced Liang Qi.

As Liang Qi told VCBeat, “We firmly believe in subtraction—focusing deeply on our core professional expertise—and are confident that this approach will enable us to build a valuable and successful company.”“Sansan Hearing will focus on cochlear implants and excel in this field.”

Liang Qi told VCBeat,SANSAN Hearing Plan aims to complete the clinical trials for its first product next year, obtain a Class III medical device registration certificate within two to three years, and achieve market launch and sales. For its second product line, the prototype will be completed within two years, along with the registration of relevant intellectual property rights, laying the foundation for developing competitive next-generation products in the future.

As Liang Qi noted, “In the niche market of hearing impairment, an internationalization strategy is a key breakthrough point.”Sansan Hearing has also established internationalization goals. “Our positioning is rooted in China and oriented toward the global market. Therefore, from the composition of our core team to the layout of our partner institutions, we have incorporated professionals from Europe and the United States into our core team. Our current partners include enterprises from regions such as Europe and the United States. Furthermore, we have collaborated for several years with top-three-ranked surgeons in Europe, and multiple research and clinical projects are currently underway.”