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Cochlear implants may provoke new bone formation linked to further hearing loss

<div class="copy"> Cochlear implants are linked to the formation of extra bone in the ear, according to a new study. This new bone could in turn cause increased hearing loss, and further medical complications. Cochlear implants have been used for over 40 years to mitigate some of the effects of hearing loss. They work by implanting a device under the skin to stimulate nerves in a section of the inner ear (the cochlea), which sends information to the brain. An external sound processor sends information to the implant. While cochlear implants can help people recognise speech, they don’t completely replace normal hearing. The implants rarely cause complications when inserted, but some post-mortem studies have found that they can cause inflammation, fibrosis, and the formation of new bone material. But so far, because of the implants’ size and location, it’s been very difficult to spot these effects in vivo (in living people). “Such subtle changes are challenging to visualise in vivo, in particular in the vicinity of a metallic implant causing artifacts on computed tomography images,” says Dr Floris Heutink from the Department of Otorhinolaryngology at Radboud University Medical Centre, in the Netherlands. Heutink, along with some fellow researchers, addressed this by using a new X-ray technique to see the implants better. The researchers took ultra-high spatial resolution CT scans (UHRCT) of 123 people, each of whom had a cochlear implant. Out of the 123 patients, 83 (68%) had new bone formation – mostly at the base of the cochlea in the inner ear. This group was significantly more likely to have long-term residual hearing loss. “As indicated by our study, there is a correlation between new bone formation and long-term residual hearing loss,” says collaborator Dr Berit Verbist, from both the Departments of Radiology at Radboud and Leiden University Medical Centre in the Netherlands. The researchers believe this extra bone can interfere with the electrical current from the cochlear implant, making the device fit less well and reduce its performance. It could also make it harder to use other therapies in future. “Last but not least, new bone formation may complicate reimplantation surgery,” says Verbist. The researchers say that more detection and monitoring of this effect is urgently needed in people with cochlear implants. At the moment, there’s not enough data to decide whether this bone formation needs treatments. Image credits: Getty Images</div> <div id="contributors"> This article was originally published on <a rel="noopener" href="https://cosmosmagazine.com/health/body-and-mind/cochlear-implants-bone-formation-increased-hearing-loss/" target="_blank">cosmosmagazine.com</a> and was written by Ellen Phiddian. </div>

Body

Brain implant helps woman’s severe depression

A woman battling severe depression has had a life-changing experience after she received a personalised brain implant. “It’s like my lens on the world changed,” <a rel="noopener" href="https://www.sciencenews.org/article/brain-implant-severe-depression-activity-stimulation?utm_source=Editors_Picks&utm_medium=email&utm_campaign=editorspicks101021" target="_blank">said Sarah</a>, the research volunteer who received the implant. Though the device was tailored specifically for Sarah’s brain and may not work as a treatment for others, psychiatrist and neural engineer Alik Widge says it is significant because it serves as a way to study how brain activity changes during depression. A team of researchers from the University of California implanted temporary wire electrodes into Sarah’s brain, allowing them to monitor the brain activity that corresponded to her depression symptoms. For Sarah, a fast brain wave called a gamma wave appeared in her amygdala, a part of the brain involved in emotions, that was associated with her symptoms. <img style="width: 500px; height:281.25px;" src="https://oversixtydev.blob.core.windows.net/media/7844766/sarah-brain1.jpg" alt="" data-udi="umb://media/08625f274e4445b3b116fa203d69817b" /> Image: Maurice Ramirez / UCSF The team then worked to uncover a way to interrupt the signal, and identified a potential area to target: the ventral capsule/ventral striatum (VC/VS). When they applied tiny jolts of electrical currents to the area, Sarah’s mood improved. “We could learn the road map of Sarah’s brain in a way that we could really improve her depression symptoms,” Katherine Scangos, an associate professor in psychiatry, said in a news briefing in September. While the researchers were mapping her brain, Sarah would feel joy when the right spot was stimulated. “I laughed out loud,” she said in the briefing. “This was the first time I had spontaneously laughed and smiled where it wasn’t faked or forced in five years.” Since the initial experiment, surgeons implanted a more permanent device into her brain. The device was programmed to detect when the gamma signals in Sarah’s amygdala reached high levels and respond by sending a jolt of electricity to her VC/VS. The stimulation was calibrated so Sarah wouldn’t feel the jolts, but she said they would leave her feeling more energetic. “As time goes on, it’s been this virtuous cycle, a spiral upwards,” she said. “Everything has gotten easier and easier.” The research describing the technology used to make Sarah’s first implant was published in <a rel="noopener" href="https://www.nature.com/articles/s41591-021-01480-w" target="_blank">Nature Medicine</a>, and revealed that the effects Sarah felt occurred over two months. The approach required a lot of sophisticated technology, including imaging and machine learning technology. Helen Mayburg, a neurologist at Icahn School of Medicine at Mount Sinai in New York City, cautioned that its complex nature may make it difficult to turn into a wider treatment. But, the results contain information that is valuable to those looking to understand the effect of depression on the brain and how it can be changed. She said, “What we all want to know is, ‘How does this work?’” Image: Jon Lok / UCSF

Mind

Warning issued for women with breast implants

An urgent warning has been issued by health authorities after a link was found between breast implants and a rare cancer. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has been found in a small number of women who have undergone breast reconstruction surgeries, with the cancer developing between three and 14 years after the procedure. The cancer cells usually grow in the fluid and scar tissue that develops around the implant. Safer Care Victoria issued a public safety notice that urges women who have undergone the procedure to keep an eye out for swelling, caused by fluid around the implant, and any pain, rashes, or lumps. “Please speak to your GP immediately if you notice a chance, as this cancer is highly curable if diagnosed and treated early,” Safer Care Victoria said in a statement. “If you don’t have symptoms, there is no need to remove your implants. Removal of implants, as well as the use of anaesthetics, come with a surgical risk.” According to experts, the risk of developing BIA-ALCL depends on the type of implant used, with the risk estimated to be between one in 1000 and one in 10,000. Though the cause of BIA-ALCL is still unconfirmed, the prevailing theory is that bacterial contamination occurs when the implant is inserted or in the period just after surgery, causing a low-grade bacterial biofilm. According to the theory, the biofilm causes chronic irritation over time that triggers the body’s immune system which causes the number of lymphocyte cells to rapidly increase. The lymphocyte cells can then transform into cancer cells and become ALCL. In Australia, the Therapeutic Goods Administration is aware of 76 cases of BIA-ALCL nationally, while New Zealand’s Medicines and Medical Devices Safety Authority has recorded six cases.

Body

Breakthrough treatment for glaucoma sufferers

An eye implant that's smaller than a grain of sand has the potential to revolutionise the treatment of glaucoma, which is a leading cause of blindness. The implant measures just 0.2mm by 1mm and is a tiny polyester plug that gradually releases bimatoprost. This is a drug that's already found in eye drops that are often prescribed to patients to treat glaucoma. With more than seven in ten patients failing to use the drops properly, this highly reduces the benefit of the drug and others suffer from side-effects of the eye drops. It is hoped that the implant will improve treatment as well as slow down the progression of the disease. Glaucoma is most common in people in their 70s and 80s and is often caused by fluid building up in the front part of the eye. This increases pressure in the eye and squeezes the optic nerve, killing some of the fibres needed to transmit information to the brain and leads to a loss of vision. The implant's benefits last for around eight months, with a patient only being able to be fitted for one. It is hoped in the future that they are able to have replacements when needed. "Anything that makes it easier for people to manage glaucoma is a good thing," says Daniel Hardiman-McCartney, clinical adviser for the College of Optometrists. "Implants are a possible option, but recent research suggests that a pressure-lowering laser treatment called selective laser trabeculoplasty may be even more helpful."

Caring

Why women are more likely to have dodgy hip implants or other medical devices

The past year has seen <a href="https://www.abc.net.au/news/2018-11-26/implant-files-shine-light-on-medical-device-industry/10521480">wide concern</a> about the safety of medical implants. Some of the worst scandals have involved devices for women, such as textured <a href="https://www.smh.com.au/business/companies/directly-linked-to-patient-harm-worldwide-recall-of-textured-breast-implants-20190725-p52ai9.html">breast implants</a> with links to cancer, and transvaginal mesh implants, which were the subject of a <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/MeshImplants/Report">senate inquiry</a>. But women are harmed not only by “women’s devices” such as breast implants and vaginal mesh. Women are also more likely to be harmed by apparently gender-neutral devices, like <a href="https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1653996">joint replacements</a> and <a href="https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010869">heart implants</a>. In recently published <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/hypa.12483">research</a>, I explored the reasons for this. I found gender biases at all stages of design and use of medical implants. Proposed changes to how devices are regulated, such as introducing <a href="https://www.abc.net.au/news/2018-03-27/pelvic-mesh-implants-tracking-medical-devices/9588070">a national register of all implants</a>, will make it quicker to identify dodgy devices. But this will not address gender bias in how devices are designed and used. <h2>Bias starts with design, then lab testing</h2> Biological and social factors <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3013263/">can affect</a> how women present when injured or ill, and how well treatments work. Often, device designers <a href="https://www.tandfonline.com/doi/full/10.1080/17483107.2018.1467973">do not take these differences into account</a>. The lab tests used to make sure implants are safe often ignore the possibility women could have <a href="https://www.sciencedirect.com/science/article/pii/S0013935106001745">different reactions to materials</a>, or their activities could <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/jor.23374">place different loads on implants</a>. <h2>Bias continues with clinical trials</h2> Some medical device companies <a href="https://www.theguardian.com/science/2011/may/16/medical-devices-lack-clinical-data">have exploited regulatory loopholes</a> to get devices to market in the UK without clinical trials. Even when trials take place, women <a href="https://link.springer.com/article/10.1007/s11999-015-4457-9">are not always included</a>. Or researchers <a href="https://link.springer.com/article/10.1007/s11999-015-4457-9">do not analyse the data for gender differences</a>. Regulators such as the Food and Drug Administration (FDA) in the United States and Australia’s Therapeutic Goods Administration (TGA) <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2645146">often approve devices</a> without data split by gender on how well devices perform or how safe they are. <h2>Then there’s the doctor-patient relationship</h2> The gender of the doctor and patient can make a difference to what women learn about their implant. The <a href="https://www.smh.com.au/national/hidden-curriculum-surgeons-women-gender-equity-20180508-p4ze0w.html">very low numbers of women in surgery</a> mean female patients often see male surgeons. And there is <a href="https://www.sciencedirect.com/science/article/pii/S073839910900264X">some evidence</a> male doctors tend to treat female patients in a more paternalistic and less patient-centred way. Then there’s the issue of whether surgeons raise important safety issues with their female patients. For example, some surgeons <a href="https://journals.lww.com/clinorthop/Fulltext/2004/11000/Surgeons_Rarely_Discuss_Sexual_Activity_with.37.aspx">feel uncomfortable</a> discussing whether it’s safe to have sex after a hip implant, especially with female patients. This is important as some sexual positions <a href="https://www.arthroplastyjournal.org/article/S0883-5403(13)00561-5/fulltext">are safer</a> than others. <h2>Let’s look at one example, a hip implant</h2> The DePuy ASR (articular surface replacement) hip implant caused serious complications for <a href="https://www.bmj.com/content/342/bmj.d2905">patients around the world</a>, <a href="https://www.mdpi.com/2079-4983/6/3/486/htm">including Australia</a>, such as inflammation, painful growths, dislocations and metal toxicity. Despite <a href="https://www.abc.net.au/news/2016-03-31/class-action-over-defective-hip-replacements-settles-for-%24250m/7288350">media coverage</a>, few were aware this hip implant was <a href="https://link.springer.com/article/10.1007/s11999-015-4227-8">more than twice as likely</a> to fail in women. In the case of hip implants, the same models are available for women and men, implying these devices are gender neutral. Most models come in a range of sizes, with some having <a href="https://www.sciencedirect.com/science/article/pii/S1098301518361606">better outcomes for women</a>. But women are not small men, and there are gender differences in basic activities involving the hip, <a href="https://link.springer.com/article/10.1007/s12147-016-9151-z">such as walking</a>. When <a href="https://journals.sagepub.com/doi/10.1177/0954411913483639">women stand up from sitting</a> or <a href="https://www.sciencedirect.com/science/article/pii/S0883540313005615">have sex</a>, the fragile edges of their hip sockets tend to bear greater loads than men’s. This “edge loading” increases the risk hip implants will wear down and release dangerous metal particles. These differences would not matter if lab tests showed equal safety of hip implants for men and women. However, evidence is not collected on this. In fact, international standards for lab tests that measure rates of wear in hip implants ignore gender differences, and only test <a href="https://journals.sagepub.com/doi/10.1177/0954411913483639">normal walking</a> rather than more stressful activities, such as running or having sex. The FDA, TGA and other regulators often approve new hip implants based on their similarity to already approved models. This <a href="https://www.nejm.org/doi/full/10.1056/NEJMp1211581">happened</a> with the ASR hip implant. Regulators did not need new data, let alone evidence the hip was equally safe for women and men. <h2>It’s a concern internationally</h2> Internationally, there is increasing concern about the regulation and safety of medical implants. An international group of journalists released a <a href="https://www.icij.org/investigations/implant-files/">damning report</a> late last year. The <a href="https://www.fda.gov/medical-devices/device-approvals-denials-and-clearances/510k-clearances">FDA’s 510(k) process</a>, which approves new devices based on their similarity to existing ones, allows approval of some high-risk implants <a href="http://bleedingedgedoc.com/the-fdas-overhaul-of-the-510k-process/">without additional evidence</a>. The situation is no better <a href="https://www.bmj.com/content/342/bmj.d2973.extract">in Europe</a>, where commercial agencies do the approvals. This system has been criticised for approving devices <a href="https://medtech.pharmaintelligence.informa.com/MT095225/EU-must-tackle-clinical-trials-shortfalls-as-current-lack-of-evidence-is-quotappallingquot">without good data</a> and for <a href="https://www.bmj.com/content/342/bmj.d2973.extract">lacking transparency</a> when it comes to implant recalls. The FDA has taken some steps to address gender bias, <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/evaluation-sex-specific-data-medical-device-clinical-studies-guidance-industry-and-food-and-drug">issuing guidance</a> for companies to provide data on their devices in women and men. However, this is not binding. A study of devices approved after its introduction found <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2645146">only 17%</a> included data analysis by sex. <h2>How could we improve things?</h2> In Australia, scandals with implants have led to <a href="https://theconversation.com/the-tgas-proposed-breast-implant-ban-exposes-a-litany-of-failures-and-fails-to-protect-women-120281">calls for bans</a> and <a href="https://www.abc.net.au/news/2018-03-27/pelvic-mesh-implants-tracking-medical-devices/9588070">registries</a>. These are good ideas, but will not prompt new devices to be designed with women in mind, nor improve patient communication. Surgeons need to raise topics important for their patients to know about surgery, however uncomfortable it makes them feel. Current efforts to improve the <a href="https://www.surgeons.org/about-racs/about-respect">culture of surgery</a>, and to attract trainees <a href="https://ama.com.au/sites/default/files/documents/RACS_diversity_and_inclusion_plan.pdf">who better reflect</a> the communities they serve may help. But there is a long way to go. Regulators like the TGA and FDA can influence device design by requiring data on the safety and performance of all new (and modified) devices in both women and men. The FDA experience <a href="https://medicine.yale.edu/news/article.aspx?id=15444">shows</a> these requirements must be binding if they are to work.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/121363/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> Written by Katrina Hutchison, Postdoctoral research fellow, Macquarie University. Republished with permission of <a rel="noopener" href="https://theconversation.com/why-women-are-more-likely-to-have-dodgy-hip-implants-or-other-medical-devices-121363" target="_blank">The Conversation</a>.

Body

Could cochlear implants improve your cognitive function?

Cochlear implants could be associated with improved speech perception and cognitive function in adults with profound hearing loss who are 65 years or older. Here is a comprehensive break-down of the associated options. What is a cochlear implant? It is a small electronic hearing device that provides a sense of sound to profoundly deaf patients by electronically stimulating the hearing nerve and bypassing damaged parts of the inner ear. It has both internal and external parts. The complex technology essentially emulates the function of an ear to receive, process and transmit sound waves. The external part of a cochlear implant is placed just above the ear and involves a microphone and sound processor, which selects and arranges sound. While the transmitter converts the signals from the processor and converts them into electric impulses. The impulses are sent to the internal part of the implant, which is put in place surgically under general anaesthesia. This internal part involves a receiver and magnet under the skin behind the ear and a series of electrodes placed in the cochlear. The electrodes collect the impulses and send them to different regions of the auditory nerve. A cochlear implant for someone who is considered deaf is a useful representation of sound in the environment and helps them to understand speech. It bypasses the damaged portions of the ear and directly stimulates the auditory nerve. Although it takes some time to learn or relearn, hearing by a cochlear implant allows the user to recognise warning signals, understand environmental noises and even have conversations. Who needs them? Cochlear implants are useful for children or adults who are deaf or severely hard-of-hearing. Many children who are deaf at birth receive cochlear implants from 12 months of age. However, adults who lose hearing later in life also frequently use the devices. These individuals are then able to associate the provided signals with sounds they remember, negating the need to learn lip-reading or sign language. According to the Australian Communication Exchange, three in every four Australians over 70 are affected by hearing loss. This is largely due to the damage we expose our ears to on a day-to-day basis. Loud or excessive noise damages the hair cells in the cochlear, which unfortunately don’t regrow. As well as gradual hearing loss, many people may also have incidents that cause them to suddenly lose their hearing, meaning they will also require the assistance of these devices. Implantation Use of a cochlear implant requires both a surgical procedure and significant therapy. Cochlear implantations are almost always safe, however, as with all surgical procedures there is always a small risk. Cochlear implants are quite costly, and the learning process is quite lengthy, however, the benefits are considered to be usually worthwhile. Cochlear implant or hearing aid? Hearing aids simply amplify sounds and can be easily fitted on the external part of the ear, requiring no surgical procedure. There are a variety of hearing aids available, which generally consist of a microphone, amplifier, miniature loudspeaker and battery. Hearing aids pick up and amplify surrounding sounds and help to make speech more intelligible. People with profound hearing loss or residual low frequency hearing will likely receive no benefit from hearing aids and will be considered for a cochlear implant. Costs Cochlear implants are an expensive piece of technology, possible adding up to around $40,000. Depending on your state Department of Health, funding is usually provided for a limited number of cochlear implants per year. Most Australian private health fund cover the costs of the implant and hospital expenses and holders of Gold Veteran Affairs cards are usually fully covered. As well as financial costs, time costs must also be taken in to consideration. The assessment period usually takes three months, and then there is usually a few week’s wait for surgery. After surgery, the MAP (the programming for the cochlear implant) will need to be adjusted to the needs of its user. Benefits Several studies have shown benefits. One that adult cochlear implant patients allow a more marked improvement physically, psychologically and socially than hearing aid patients. This means that cochlear implants can bring as much benefit to those with profound hearing loss as hearing aids bring to those with less severe hearing loss. Another found that cochlear implants vastly improve the quality of life of deaf patients over 50. Cochlear implants are found to be a cost-effective solution in this age group, due to their increase in health and emotional-related quality of life. Increases in speech perception scores showed a strong correlation with magnitude of health utility gains. More recent research which was published online by JAMA Otolaryngology - Head and Neck Surgery. This research indicates that cochlear implantation is positively associated with improved cognitive function and speech perception in adults 65 years and older with profound hearing loss. Hearing impairment correlates strongly with cognitive decline, and in cases where hearing aids are not sufficient, cochlear implantation is seen to be highly beneficial for older patients. This study also showed that cochlear implants not only improve speech perception – in both quiet and noise – however, they can also improve quality of life and show less incidence of depression. More than 80% of the 94 patients in the study with impaired cognitive function improved their brain function scores one year after implantation. Who to see If you have suddenly or gradually become profoundly hard-of-hearing, it is important to seek professional medical advice immediately. Help is available and seeking advice early could increase your quality of life. Options are to either visit an otolaryngologist, a doctor specialising in the diagnosis of ear, nose and throat diseases; an audiologist, who has specialised training in identifying and measuring the type and degree of hearing loss and recommends option; or a hearing aid specialist, who conducts and evaluate basic tests and offers counselling. Because cochlear implantation is for more serious hearing loss, you will need to see a specialist and then be referred to receive surgical treatment. Written by Greta Mayr. Republished with permission of <a href="https://www.wyza.com.au/articles/health/could-cochlear-implants-could-improve-your-cognitive-function.aspx">Wyza.com.au.</a>

Technology

Thanks to cochlear implants I can now hear my grandchildren

The birth of a grandchild is one of the sweetest experiences of growing older. But for Lynne Haynes, the arrival of her latest grandson was especially poignant – because she could hear him cry. The 64-year-old Mackay, Queensland resident doesn't know when or how she lost her hearing – it could have been the scarlet fever and glandular fever she suffered as a child, a car accident she had as a teenager or the loud music she enjoyed. What she does know is that by the time her second child Jessica was born in 1979, there were concerning signs. "If Jess woke during the night I didn't always hear her," she says. "It was about two years after Jess' birth that I decided to do something about my hearing loss," Lynne says. "It was then that I received my first set of hearing aids and boy was I amazed at the difference. I went back to work, life seemed to be great, communication became a lot easier," she recalls. "But over the years, as the children grew up, the hearing started to slip again. Conversations became tumbled, I would miss key words. I was frustrated and confused." The greatest heartbreak was losing the communication with her children. "I lost so much conversation with them," the now 64-year-old Lynne recalls. "Eventually, probably through frustration, they would say 'It doesn't matter' and go off and play, but for me and for them that moment was lost. Or to see the embarrassment on their faces when in front of their friends I would make a silly comment because I misunderstood what had been said." Everything changed in 2015 when Lynne and her husband Ted moved from Melbourne to Mackay. "I needed a hearing test to see if my hearing aids needed to be adjusted. It was the audiologist at Clarity Hearing Solutions, Michael Polkinghorne, a brilliant young man, who asked the question 'Have you ever considered a Cochlear Implant?'." Thanks to that checkup and conversation Lynne's world changed in 2015 when she received her Nucleus 6 Cochlear Implant. “I've had my challenges,” she says. “Like any journey the road isn't always smooth. The love and support of family on the journey has been incredible.” Since then she has gone from strength to strength. She says her Cochlear Implant gave her back her life. "I've gone back to work, working in a remote community as an aged care coordinator," Lynne says. "My confidence is back up where it used to be. Conversations around the family dining table are something I now actively join in. Also, we have a new grandson and I don't intend to miss any of his conversations like I did with the others. "The first step in any journey into the unknown is the hardest. Look at it as an adventure into a world of hearing. Move out from the shadows and into the sunshine. Hold on tight for a wonderful road to hearing. The road may be a little bumpy, but the destination is so worth it." Related links: <a href="http://www.oversixty.co.nz/health/hearing/2016/07/common-causes-for-earaches/">5 of the most common causes or earaches</a> <a href="http://www.oversixty.co.nz/health/hearing/2016/06/the-dangers-of-single-sided-deafness/">The dangers of single sided deafness</a> <a href="http://www.oversixty.co.nz/health/hearing/2016/06/funny-jokes-about-hearing/">In pictures: 11 funny jokes about hearing</a>

Hearing

I was deaf for most of my life

Shirley Ackehurst, 74, became deaf as a young girl then returned to the world of sound after having a cochlear implant at the age of 44. She rejoices in being able to hear her family again and one of her favourite sounds, rain drumming on the roof. As I walk in my garden I can hear the quiet clucking of the yellow-tailed black cockatoos as they feed on the hakea nuts. I remember a time when I couldn't hear them at all or any other sound. I had lived in a silent and isolated world after losing half of my hearing when I had the mumps at 11 years of age and the rest had slowly dwindled away until at the age of 36, I was profoundly deaf in both ears. Even with a hearing aid I could no longer hear the voices of my husband and children and our social life became very limited. This illness was to change my life forever. I had once been a happy and confident child growing up on a wheat and sheep farm near Elmore, in central Victoria. I loved the sounds on our farm but most of all I loved to hear the rain drumming on our iron roof at night while feeling safe and cosy tucked up in bed. However, deafness sapped my confidence and I became a shy and lonely teenager, struggling to keep up with my friends in social situations and keeping up at school only by lip reading. For as long as I could remember I wanted to be a nurse when I left school and was devastated when told I was too deaf to cope with nursing and the wonderful Nursing Bursary I had won was cancelled. I felt I lived in my own isolated world apart from everyone else and this made me very miserable and depressed. After Graham and I married we lived in Geelong where two of our daughters were born then later on we moved to Adelaide where our third daughter was born. As a very deaf mum my life was difficult and I was exhausted by evening from the energy required to lip read constantly and having to check on the children all the time because I couldn't hear them. Then at the age of 44 a miracle happened, I had a cochlear implant in my right ear. It is almost impossible to describe my great joy in being able to hear my husband and children again and later on, my adorable grandchildren. And once again I could hear my favourite sound, the rain drumming on the roof. My cochlear implant has given me back my life, it has given me self-confidence and self-worth, it has returned me to the hearing world and it has given me once again, the ease of communication, especially with my loved ones. I know I am very fortunate and I feel a deep sense of gratitude every day for this wonderful invention. It saddens me that many older people do not realise they may be eligible for a cochlear implant, thinking that it is only available for small children. I have friends who were in their 80's when they received their implants and it has made such a difference to their lives. I have heard them say, “Oh! I wish I'd had this implant years ago!” Sometimes hearing impairment can creep up on us so slowly we don't realise how many sounds we cannot hear any more. We struggle to understand when using the phone or in noisy situations and at family gatherings and frequently need to ask others to repeat themselves. We strain to hear in social situations and come home tired out and lacking in confidence and we feel isolated and sometimes embarrassed. Often our loved ones plead with us to have our hearing checked because a hearing loss impacts on all the family too. In recent years the cochlear implant and hearing aids have improved immensely so help is out there, we just need to take the first step and have a hearing check. Above all, we need to protect our hearing at all times by using hearing protection when operating noisy machinery and avoiding prolonged loud noise. Cherish your hearing, it is so very precious. If you have a story to share please get in touch at <a href="mailto:melody@oversixty.com.au" target="_blank">melody@oversixty.com.au</a>. Related links: <a href="/health/hearing/2016/06/understanding-long-term-hearing-damage/">Understanding long-term hearing damage</a> <a href="/health/hearing/2016/05/different-kinds-of-hearing-aids/">The different kinds of hearing aids explained</a> <a href="/health/hearing/2016/04/importance-of-hearing-tests/">Study highlights importance of hearing tests</a>

Hearing

“Bionic” ears allow little girl hear

A new world of sound opened up for the Invercargill 2-year-old when her "bionic ears" were turned on. Madeline, who is profoundly deaf, was the Southern Cochlear Implant Programme's first bilateral implant recipient from Southland. The implants, known as bionic ears, provide partial hearing to the deaf. As noise slowly began infiltrating her life, the toddler discarded her toys and a puzzled expression crossed her face. She pointed at her ear. "Can she hear it?" 6-year-old brother Thomas asked. "Yes she can," pediatric audiologist Naomi Gibson replied. Madeline's mother covered her mouth in shock while her father wiped away tears. "She has a new world in front of her and it starts today. From now on everything is going to be different," mother Vicky Collard said. The parents "knew something was wrong" early in their daughter's life, and an audiologist confirmed she had severe hearing loss. Last year, Madeline lost all forms of sound and was diagnosed profoundly deaf. Collard recalled the shock she had felt during one audio test when her daughter had continued to "happily play" while a fire alarm was blaring and every other person in the room was assigned earmuffs. "It was quite a shock to find out she wasn't just a little girl with hearing loss, but she was actually deaf," she said. The toddler is also developmentally delayed and suffers from poor vision. Several cysts were recently found in her head. Despite her misfortune, Madeline has battled on in silence. She adapted her own version of sign language and "always has a smile on her face". "She's just such a happy wee girl and a real battler," Collard said. Madeline's hearing impairment has resulted in her family of six learning sign language. Her elder brothers, 4 and 6, both sign "Good morning Maddie" every day. The Invercargill family drove up to Christchurch's cochlear implant programme, based at St George's Hospital, for Madeline's implants to be switched on, and her grandparents travelled from England to witness the moment. Watch the special moment for yourself in the video above. What do you think is the first sound she heard? Let us know what you think in the comments below. Written by Olivia Carville. First appeared on <a href="http://Stuff.co.nz" target="_blank">Stuff.co.nz.</a> Related links: <a href="/health/hearing/2016/03/deaf-girl-can-hear-under-water/">Deaf girl can hear under water</a> <a href="/health/hearing/2016/04/fundraiser-for-little-boy-with-one-ear/">1-year-old boy’s family raising money to help his hearing</a> <a href="/health/hearing/2016/04/importance-of-hearing-tests/">Study highlights importance of hearing tests</a>

Hearing

After years of deafness, 74-year-old Shirley Ackehurst celebrates 30th hearing anniversary

Shirley Ackehurst is 74. A mother and grandmother who loves working in her garden. She's also a medical pioneer whose story is one of perseverance, loss, heartbreak and triumph that she relays with such poignancy, humour and courage it is impossible not to be moved and inspired by her. Thirty years ago, on 15 April 1986, Shirley (then 44) became South Australia’s first Cochlear implant recipient. She was very much a pioneer, at a time when Professor Graeme Clark’s invention was still a bit of a mystery. But her story began three decades earlier, in 1956, when she contracted mumps at the age of 11. Shirley didn't know it immediately, but her world had changed forever. "I didn't realise I had lost my hearing at first," she recalls. "When I went back to school, everyone seemed to be mumbling and I couldn't understand them. I thought something had happened to everyone else. Not for one minute did I think something had happened to me." It was the adaptability of childhood that allowed her deafness to remain undetected for several years. "Although I didn't realise it, I started to lip read straight away and really no-one noticed that I couldn't hear very well," Shirley says. "I still passed my tests and kept up with my school work." As a country kid from Corop West in Victoria, Shirley attended a boarding school for two years. It was when she returned home that her parents began to notice that she didn't answer them if she wasn't looking at them. "They decided to take me to a hearing specialist and I believe we were all shocked when he told us I was very deaf and I had only been coping by lip reading," she recalls. Then came the blow. For as long as Shirley could remember she had wanted to be a nurse. "I was due to have a medical exam after I won a Nursing Bursary. When the doctor tested my hearing, of course he found out how deaf I was and my treasured bursary was cancelled. I was shattered." Shirley was now very shy, self-conscious and began to feel isolated, lonely and miserable. "Social outings were fraught because I couldn't lip read in poor light in the evening," she says. "I started to hide my deafness and pretended I could hear, which led to all kinds of misunderstandings and even more embarrassment." Shirley received her first hearing aid at 15. "It was large and heavy, like a metal cigarette box," she recalls. "I wouldn't wear it, partly because it didn't help at all and partly because I felt too ashamed to wear it. After I was married I tried out a more modern aid and it still did not help me to hear much better. I eventually gave up on it as my hearing gradually got worse." Then came the 1980s and Shirley read about Professor Graeme Clark's early work with Cochlear Implants. "I was unable to hear my daughters' and husband's voices by now, so this information about the implant gave me hope." So when a cochlear implant clinic opened at Flinders Medical Centre in 1985, Shirley couldn't wait to get a referral to implant surgeon. "I saw Dr Beaumont in late 1985 and received my implant April 15, 1986." That first sound processor was a heavy metal container, a little larger than a packet of cigarettes that Shirley wore on a belt. A far cry from the small, light, unobtrusive Cochlear implants she wears behind her ear today. But it gave her the gift of sound. "It wasn't until I arrived home and I heard my footsteps on our polished wooden floors and that I felt very excited," she recalls. "The sound anchored me back into the hearing world. My hearing came in slowly and I remember on the third morning after switch-on I was buttering the toast for breakfast and I could hear the crackling sound that makes. Small everyday sounds filled me with so much excitement. The environmental sounds were the ones I loved most in those early days, rain on the roof, the birdcalls, the click of my little dog's toenails on the polished wooden floor." As South Australia's first Cochlear implant recipient, Shirley was asked to do a lot of public speaking about her experience. "I would run a mile from this before my implant," she says. "In fact, I'd never made a speech in my life before. I wrote a book, Broken Silence and I went on an author's tour of Adelaide, Melbourne and Sydney with numerous radio, newspaper and TV interviews including the Ray Martin Show. I volunteered for committees and helped to start up a support group, the Cochlear Implant Club and Advisory Association, South Australia. With my friend Rhonda Smith (another implant recipient), we spoke to people before their implants, visited them in hospital and supported them in the early weeks after their implant. I also helped to raise funds for Better Hearing Australia.” Shirley says her life would have been very different during the past 30 years if she did not have her Cochlear Implant. "I would have been isolated and lonely," she says. "I would have avoided social situations. I would have existed in my own silent world." <img width="500" height="250" src="https://oversixtydev.blob.core.windows.net/media/23917/shirley-and-grandson-02_500x250.jpg" alt="Shirley And Grandson 02"/> She says the greatest gift her implant has given her is the ease of communication with family and friends as well as the sounds of nature. "One of my greatest joys is to have my breakfast outside every morning and listen to the birds," Shirley says. “It has given me the joy of hearing the birds, rain on the roof, wind in the trees and music. It has given me confidence and self-worth. It has anchored me back in the real world. It has made my life warm and happy.” But for Shirley the most beautiful sounds of all are those of her grandchildren's voices. "My youngest grandson, Harrison, who is three years old, inspects my processor every time I see him and tests it out by saying different words in my ear. He is quite fascinated with it." For more information on cochlear implants, visit the hearing experts <a href="http://www.cochlear.com/wps/wcm/connect/au/home" target="_blank">Cochlear</a>. Related links: <a href="/health/hearing/2016/05/quotes-about-hearing-for-first-time/">Quotes about hearing for first time</a> <a href="/health/hearing/2016/05/man-proposes-to-girlfriend-with-cochlear-implants/">Man proposes to girlfriend with cochlear implants</a> <a href="/health/hearing/2016/05/take-the-first-steps-towards-better-hearing/">Take the first steps towards better hearing</a>

Hearing

Deaf woman gets cochlear implants as she’s going blind

Jo Milne, 40, from Gateshead, defied the odds when she underwent an eight-hour, high-risk operation to experience hearing for the first time… because it was the only way she could hold onto some sense of “normal” communication. She was born profoundly deaf and had a happy, early childhood. She wore a phonic ear box-an old style hearing aid strapped to her chest- that helped her get a sense of her environment. She describes her deafness as “like being under water and trying to listen to the world”. Despite the cruelty of both teachers and children at her school, Jo accepted deafness as part of her identity. However, she struggled with the news that at just 16, she was going blind as well. At 29 she was diagnosed with Usher syndrome, a genetic condition that affects hearing and vision, sometimes gradually leading to complete blindness. As her sight deteriorated, an overwhelming and deafening fear took hold of her. Jo says it was when she stopped to take in a view of rolling green hills in her home town that she thought to herself ‘I can still see’, and decided to take the risk associated with Cochlear implants. “The month after surgery was the most petrifying. With the implants not yet activated, and because I wasn’t able to wear my hearing aids, I was immersed in complete, terrifying silence”. Watch what happens in the video in moment her implants are turned on. Video credit: Tremayne Crossley Related links: <a href="http://www.oversixty.co.nz/health/hearing/2016/01/common-myths-about-tinnitus/">5 common myths about tinnitus</a> <a href="http://www.oversixty.co.nz/health/hearing/2016/01/childhood-illnesses-linked-to-hearing-loss-later-in-life/">Childhood illnesses linked to hearing loss later in life</a> <a href="http://www.oversixty.co.nz/health/hearing/2016/01/questions-to-ask-an-audiologist/">Questions everyone should ask an audiologist</a>

Hearing

Hearing aids vs cochlear implants

When it comes to hearing loss, modern technology has given us many options, two of which are the traditional hearing aid and the cochlear implant. You may have wondered, “What is the difference between the two, and which is better?” We can explain.Hearing aids – Hearing aids use the hair cells within the inner ear to amplify sound. Because they rely on the integrity of the cells to work, hearing aids are often not effective for anyone who has severe or profound hearing loss.There are several types of hearing aids:<ul><li>Behind the ear (BTE) – These are a small plastic case which resides behind the ear, as the name would suggest. This is connected to a mould by clear tubing. The most accommodating of the bunch, these are a good option for children as they can be replaced as the child grows.</li><li>Mini BTE – Much like the BTE version, but smaller, these have increased comfort and reduced feedback, as well as being a more subtle option.</li><li>In the ear (ITE) – These are contained entirely in the outer part of the ear and, larger than their counterparts, are easier to handle.</li><li>In the canal (ITC) or completely in the canal (CIC) aids – These are much like ITE aids, but much smaller, making them a good option for those cosmetically inclined.</li></ul>There are also two other variants of hearing aids: analog and digital. Analog aids amplify all sound but are programmable, while digital aids, more complex, convert sound waves into digitized signal, creating an exact duplication of said sound. Because of the greater benefits, most hearing aids today are digital.Cochlear implants – Cochlear implants essentially replace damaged hair cells, stimulating the ear’s auditory nerve directly. The implants create a “spark” that, picked up by the auditory nerve, are then interpreted by the brain.There are two main components of cochlear implants:<ul><li>Internal – Internally, cochlear implants contain a decoder and a magnet, which picks up information from the external component. In order to implant the internal piece, the surgeon drills into the skull to create a cavity for the decoder while the rest sits on the skull. </li><li>External – The external component contains a microphone and cords, as well as a transmitting coil and speech processor. Sound is picked up by the microphone and interpreted by the speech processor. A signal is then sent to the internal component in real time. Both the internal and external pieces must be worn in order for cochlear implants to work.</li></ul>The choice between a hearing aid and cochlear implant ultimately falls according to the state of your ears and your individual needs. Your doctor can help recommend which of the options is best for you.

Hearing

Hearing aids vs cochlear implants

Hearing

Surgery allows toddler hears her parent’s voices for the first time

An American toddler was able to hear her parents’ voices for the first time after receiving cochlear implants. Laken Westbook was born deaf. After a variety of complications such as insurance coverage refusal and fluid in the ear, the one-year-old underwent a life-altering surgery that allowed her to finally hear the voices of her happy parents. “We’ve been through so much and just like any parent that’s been through the same thing, you know it’s that day leading up to it, you know that’s like the climax of the story,” Gary Westbrook, Laken’s father, Gary told WFMYNEWS2. Following the insurance complication, Laken’s father, decided to pay out of his own pocket to grant his daughter the possibility of hearing. This included a staggering $US20, 000 down-payment. Luckily, the family received generous donations to help them cover the costs. “I don’t know that we would have ever done it ourselves. To see how that worked, it was amazing,” Gary said. “There’s no way words can show our gratitude.” Following the surgery, the proud parents were ecstatic to see their child make eye contact and listen to the sound of their voices. “She’s never done that before,” Laken’s mother, Stacy, said. Laken is now working with teachers to aid in the development of her new-found hearing. Photo source: myfoxatlanta Related links: <a href="/health/hearing/2015/07/how-hearing-is-tested/">What happens when your hearing is tested</a> <a href="/health/hearing/2015/05/young-people-at-risk-of-hearing-loss/">Tell your grandkids! 1.1 billion people, especially young people, at risk of hearing loss, according to World Health Organisation</a> <a href="/health/hearing/2015/05/hearing-loss-pill/">Could a pill to treat hearing loss be on the way?</a>

Hearing

80-year-old man regains sight with first-ever bionic eye implant

A British man has had his eyesight restored thanks to an innovative bionic eye implant. <img width="306" height="454" src="https://oversixtydev.blob.core.windows.net/media/7581/2aba2ef900000578-3169864-image-a-2_1437502854290.jpg" alt="2ABA2EF900000578-3169864-image -a -2_1437502854290" style="float: right;"/> Ray Flynn of Audenshaw, Manchester, whose eye impairment is caused by age-related macular degeneration (AMD), is now the first person ever to receive an artificial retina. AMD is the number cause of eye problems throughout the UK, which means that thousands of citizens, English and otherwise can eventually see improvement through this seemingly space-age technology. The procedure took place last month, and the 80-year-old patient is now able to make out shapes even with his eyes closed. Now, the treatment, which runs for about £80,000 and works by transferring video images captured by special glasses into electrical impulses, has allowed Flynn to read the newspaper for the first time in many years. From here, surgeons plan to implant the device into more patients to prove its broad effectiveness amongst a variety of patients. <img width="500" height="364" src="https://oversixtydev.blob.core.windows.net/media/7582/2abba97a00000578-3169864-image-m-16_1437523031305_500x364.jpg" alt="2ABBA97A00000578-3169864-image -m -16_1437523031305" style="display: block; margin-left: auto; margin-right: auto;"/> Related links: <a href="/news/news/2015/07/pet-terminal-jfk-airport/">JFK airport to unveil first-ever animal-only terminal</a> <a href="/news/news/2015/07/old-moses-painting-revealed/">143-year-old painting revealed for the first time in 70 years</a> <a href="/news/news/2015/07/telstra-dial-a-doctor/">Telstra unveil dial-a-doctor service</a>

News

Cochlear implants shown to reverse cognitive decline

A new study has found that cochlear implants in older people not only help with hearing loss but may also help thinking and memory.Researcher Isabelle Mosnier, of Assistance Publique-Hopitaux de Paris, examined the effect of cochlear implants on people with profound hearing loss aged 65 to 85. The study, published in the journal JAMA Otolaryngology-Head & Neck Surgery, is the first to measure the effect of cochlear implants on memory and mental flexibility in elderly patients.The study found after being fitted with cochlear implants and with hearing and speech therapy, there was marked improvements in three areas: speech perception, quality of life (depression) and cognitive performance.The findings of the study have global relevance.“Our study demonstrated that hearing rehabilitation using cochlear implants in the elderly is associated with improvements in impaired cognitive function,” Mosnier wrote. “Given the projection of an increase to more than 100 million people with dementia worldwide by 2050, any study that suggests a way to offset that decline, even temporarily, has enormous public-health significance.”Related links: <a href="/health/hearing/2015/01/facts-about-cochlear-implants/" target="_blank">What you need to know about cochlear implants</a><a href="/health/hearing/2015/01/why-look-after-hearing/" target="_blank">5 reasons to cherish your sense of hearing</a><a href="/health/hearing/2014/11/signs-of-hearing-loss-to-keep-an-ear-on/" target="_blank">Signs of hearing loss to keep an ear on</a>

News

What you need to know about cochlear implants

Considering a cochlear implant but not sure what it’s all about? Here are the answers to some commonly asked questions.What is a cochlear implant?A cochlear implant is a surgically implanted medical device that replaces the function of the damaged inner ear. Unlike a hearing aid which makes sounds louder, a cochlear implant provides stimulation directly to the auditory nerve. However, like a hearing aid, an implant does not mean your hearing will be “restored” but it will allow you to perceive and hear sounds.How do they work?One of the main causes of hearing loss is due to damage to the hair cells in their inner ear (the cochlea). A cochlear implant does the work of the damaged cochlear: it captures the sound from outside environment, processes it and then transmits small electrical currents to the auditory nerve. The nerve then sends a signal, which is interpreted as sound, to the brain.The cochlear implant is made up of both internal and external parts. The internal part is put in place surgically while the external part is worn behind the ear, similar to a hearing aid.Who can they help?Cochlear implants are designed to help those who have moderate to profound sensorineural hearing loss, and who found little or no benefit from hearing aids.What are the cons?It’s important to remember that while a cochlear implant attempts to mimic natural hearing, the result is not the same as normal hearing. However, many adults with cochlear implants say that they hear better with a cochlear implant than with a hearing aid. Results of cochlear implants can vary though depending on the severity and length of hearing loss as well as the condition of the cochlea.

Hearing

Have you heard about eye implants?

Thanks to researchers in California glasses could soon be a thing of the past. Researchers have developed an eye implant that could see reading glasses for over 1.3 million Australians made obsolete.Long sight due to age is extremely common. After 40, the eye’s natural lens begins to stiffen, making it harder for muscles to tug it into the round shape needed to focus on nearby objects. Our minimum focusing distance gradually creeps up from the “normal” eight inches, until we have trouble reading. Many people struggle on for years, straining their eyes in the process, before finally relenting and buying reading glasses. Some opt for laser treatment, which helps by changing the shape of the eye, but as the lens continues to stiffen the effect lasts only a few years.The revolutionary implant, the Raindrop, is a corneal inlay that has been distributed to a select few opthalmologists in Australia and New Zealand. It is a very small two-millimetre wide restorative disc that is placed in the eye – enhancing corneal function and focus.Astonishingly, the procedure takes just 10 minutes – which will seem a godsend to those whom suffer from long sightedness. Primarily this implant is used to combat presbyopia, an eye condition very common in people over the age of 40 that hinders their ability to focus on nearby objects.The Raindrop could see the end of much longer and more expensive treatments such as laser eye surgery, however it could still leave patients requiring glasses in dim lighting conditions.With distribution is still in early days, there is very limited access to the Raindrop worldwide. While prices are likely to alter as it becomes more available, it currently costs between $3500 and $4000.

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