Meandering Through A Hearing World

Ongoing Cochlear Implant Research

I cheer when news about hearing loss research pops into my email inbox. This week, I received information about two ongoing efforts with cochlear implants. The first involves clinical trials with a fully implantable cochlear implant, and the second was about the use of artificial intelligence software in tuning cochlear implants.

Research on fully implantable cochlear implants began in 2018. Two companies, Cochlear and Med-EL, have led the research and development in this area. Recently, Envoy Medical (best known for their ESTEEM implantable hearing aid) entered the market by seeking FDA approval for their version of an implantable C.I.

There are 40,000 adults and 25,000 children in the United States with cochlear implants. Currently cochlear implant recipients wear an external processor around the ear, hearing aid style, or as a disc attached to magnet, which has been placed under the skin. This external device sends sound to the inner ear, and via the implantable portion of the C.I., that sound is carried into the hearing centers of the brain. The new implantable devices are smaller and are all of its parts are inserted deep in the inner ear. The internal processor works as a “normal ear” capturing sound. As with a traditional C.I that sound is carried to the hearing centers in the brain.

Recently Dr. Phillipe Lefebvre, Head of the ENT Department at University Hospital of Liege, Belgium, implanted an internal MED-EL C.I. into an adult male with profound hearing loss. The results were astounding, Dr. Lefebvre noted. Fully implantable devices can be activated instantly, thus avoiding the two to four week wait for a surgical wound to heal. 

A similar internal device manufactured by Cochlear has also seen great results. Studies are ongoing at the Royal Victorian Ear and Eye Institute in Australia. Med-El, Cochlear, and Envoy Medical are seeking FDA approval for their devices. There are still the issues of battery changes and whether or not these devices are always left on. However, one can’t help but think that a fully implantable C.I. might soon be available.

If you have a cochlear implant, you probably went through weeks of adjusting your device post surgery. This process can be very unsettling for C.I. users, and at times, discouraging. Audiologist Susan Waltzman, Ph.D., noted the frustration in her C.I. patients at NYU. She decided to try an artificial intelligence program developed by a group in Belgium, which purported to improve the accuracy of tuning a new C.I., thus shortening the time needed for adjustments.

Dr. Waltzman said that tuning an implant is guesswork. Every patient’s audiogram and social needs are different. She went on to say that there is no systematic or scientific way to adjust implants. The A.I program she tested contains a database of adjustments and options made from thousands of C.I. users. An audiologist can search the database and marry the patient’s current audiogram to the closest tuning match, thus creating an opportunity for better hearing in a shortened timeframe. A study of 100 patients concluded that the A.I. program is more accurate and faster in identifying exact settings for C.I. users, particularly in sounds with higher pitchers. This software is awaiting F.D.A approval.

If you suffer from hearing loss, you know the trials and tribulations of trying to hear with the technology that we have. While devices have advanced, it is not always easy to hear in challenging environments or if you have a severe or profound hearing loss. We become hopeful when new products enter our lives to make our meanderings through the hearing world easier.

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Linda Bilodeau

I’ve grappled with hearing loss since 1978. Through it all, I’ve faced periods of denial, acceptance, curiosity, trust and hope. But more often than not, I’ve felt annoyed, angry and frightened. I’ve encountered despair, loneliness and envy. I’ve experienced panic attacks. I’ve met understanding people, kind souls who helped me a great deal and others who thought I had nothing short of an invisible plague. As a way of coming to terms with my hearing loss, I’ve decided to put my feelings about my disability down on paper. My hope is to better understand myself and perhaps you’ll find a little something in my meanderings that will help you, too.

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