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

<div class="copy"> <p>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.</p> <p>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.</p> <p>While cochlear implants can help people recognise speech, they don’t completely replace normal hearing.</p> <p>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).</p> <p>“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.</p> <p>Heutink, along with some fellow researchers, addressed this by using a new X-ray technique to see the implants better.</p> <p>The researchers took ultra-high spatial resolution CT scans (UHRCT) of 123 people, each of whom had a cochlear implant.</p> <p>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.</p> <p>“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.</p> <p>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.</p> <p>“Last but not least, new bone formation may complicate reimplantation surgery,” says Verbist.</p> <p>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.</p> <em>Image credits: Getty Images</em></div> <div id="contributors"> <p><em>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. </em></p> </div>

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Could cochlear implants improve your cognitive function?

<p>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.</p> <p><strong>What is a cochlear implant?</strong></p> <p>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.</p> <p>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.</p> <p>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.</p> <p><strong>Who needs them?</strong></p> <p>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.</p> <p>People over the age of 65 years are three times more likely to have hearing loss than younger adults. 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.</p> <p><strong>Implantation</strong></p> <p>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.</p> <p><strong>Cochlear implant or hearing aid?</strong></p> <p>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.</p> <p><strong>Costs</strong></p> <p>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 private health fund cover the costs of the implant and hospital expenses and holders of Gold Veteran Affairs cards are usually fully covered.</p> <p>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.</p> <p><strong>Benefits</strong></p> <p>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.</p> <p>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.</p> <p>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.</p> <p><strong>Who to see</strong></p> <p>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.</p> <p>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.</p> <p><em>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></em></p>

Technology

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Thanks to cochlear implants I can now hear my grandchildren

<p>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.</p> <p>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. </p> <p>"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." </p> <p>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." </p> <p>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?'." </p> <p>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.” </p> <p>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.</p> <p>"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."</p> <p><strong>Related links:</strong></p> <p><a href="http://www.oversixty.co.nz/health/hearing/2016/07/common-causes-for-earaches/"><em><strong><span style="text-decoration: underline;">5 of the most common causes or earaches</span></strong></em></a></p> <p><a href="http://www.oversixty.co.nz/health/hearing/2016/06/the-dangers-of-single-sided-deafness/"><em><strong><span style="text-decoration: underline;">The dangers of single sided deafness</span></strong></em></a></p> <p> </p> <p><a href="http://www.oversixty.co.nz/health/hearing/2016/06/funny-jokes-about-hearing/"><span style="text-decoration: underline;"><em><strong>In pictures: 11 funny jokes about hearing</strong></em></span></a></p> <p> </p>

Hearing

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I was deaf for most of my life

<p><strong><em>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.</em></strong></p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p>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!”</p> <p>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.</p> <p>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.</p> <p>Cherish your hearing, it is so very precious.</p> <p><em><strong>If you have a story to share please get in touch at <span style="text-decoration: underline;"><a href="mailto:melody@oversixty.com.au" target="_blank">melody@oversixty.com.au</a></span>.</strong></em></p> <p><strong>Related links:</strong></p> <p><a href="/health/hearing/2016/06/understanding-long-term-hearing-damage/"><strong><em><span style="text-decoration: underline;">Understanding long-term hearing damage</span></em></strong></a></p> <p><a href="/health/hearing/2016/05/different-kinds-of-hearing-aids/"><strong><em><span style="text-decoration: underline;">The different kinds of hearing aids explained</span></em></strong></a></p> <p><a href="/health/hearing/2016/04/importance-of-hearing-tests/"><strong><em><span style="text-decoration: underline;">Study highlights importance of hearing tests</span></em></strong></a></p>

Hearing

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“Bionic” ears allow little girl hear

<p>A new world of sound opened up for the Invercargill 2-year-old when her "bionic ears" were turned on.</p> <p>Madeline, who is profoundly deaf, was the Southern Cochlear Implant Programme's first bilateral implant recipient from Southland.</p> <p>The implants, known as bionic ears, provide partial hearing to the deaf.</p> <p>As noise slowly began infiltrating her life, the toddler discarded her toys and a puzzled expression crossed her face.</p> <p>She pointed at her ear.</p> <p>"Can she hear it?"  6-year-old brother Thomas asked.</p> <p>"Yes she can," pediatric audiologist Naomi Gibson replied.</p> <p>Madeline's mother covered her mouth in shock while her father wiped away tears.</p> <p>"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.</p> <p>The parents "knew something was wrong" early in their daughter's life, and an audiologist confirmed she had severe hearing loss.</p> <p>Last year, Madeline lost all forms of sound and was diagnosed profoundly deaf.</p> <p>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.</p> <p>"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.</p> <p>The toddler is also developmentally delayed and suffers from poor vision. Several cysts were recently found in her head.</p> <p>Despite her misfortune, Madeline has battled on in silence.</p> <p>She adapted her own version of sign language and "always has a smile on her face".</p> <p>"She's just such a happy wee girl and a real battler," Collard said.</p> <p>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.</p> <p>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.</p> <p>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.</p> <p><em>Written by Olivia Carville. First appeared on <a href="http://Stuff.co.nz" target="_blank"><strong><span style="text-decoration: underline;">Stuff.co.nz.</span></strong></a></em></p> <p><strong>Related links:</strong></p> <p><a href="/health/hearing/2016/03/deaf-girl-can-hear-under-water/"><em><strong><span style="text-decoration: underline;">Deaf girl can hear under water</span></strong></em></a></p> <p><a href="/health/hearing/2016/04/fundraiser-for-little-boy-with-one-ear/"><em><strong><span style="text-decoration: underline;">1-year-old boy’s family raising money to help his hearing</span></strong></em></a></p> <p><a href="/health/hearing/2016/04/importance-of-hearing-tests/"><em><strong><span style="text-decoration: underline;">Study highlights importance of hearing tests</span></strong></em></a></p>

Hearing

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Deaf woman gets cochlear implants as she’s going blind

<p>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.</p> <p>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”.</p> <p>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.</p> <p>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.</p> <p>“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”.</p> <p>Watch what happens in the video in moment her implants are turned on.</p> <p><em>Video credit: Tremayne Crossley</em></p> <p><strong>Related links:</strong></p> <p><span style="text-decoration: underline;"><strong><em><a href="http://www.oversixty.co.nz/health/hearing/2016/01/common-myths-about-tinnitus/">5 common myths about tinnitus</a></em></strong></span></p> <p><span style="text-decoration: underline;"><strong><em><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></em></strong></span></p> <p><span style="text-decoration: underline;"><strong><em><a href="http://www.oversixty.co.nz/health/hearing/2016/01/questions-to-ask-an-audiologist/">Questions everyone should ask an audiologist</a></em></strong></span></p> <p> </p>

Hearing

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Hearing aids vs cochlear implants

<p>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.</p> <p><span style="text-decoration: underline;"><strong>Hearing aids</strong></span><strong> –</strong> 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.</p> <p>There are several types of hearing aids:</p> <ul> <li><strong>Behind the ear (BTE) –</strong> 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><strong>Mini BTE –</strong> Much like the BTE version, but smaller, these have increased comfort and reduced feedback, as well as being a more subtle option.</li> <li><strong>In the ear (ITE) –</strong> These are contained entirely in the outer part of the ear and, larger than their counterparts, are easier to handle.</li> <li><strong>In the canal (ITC) or completely in the canal (CIC) aids –</strong> These are much like ITE aids, but much smaller, making them a good option for those cosmetically inclined.</li> </ul> <p>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.</p> <p><span style="text-decoration: underline;"><strong>Cochlear implants </strong></span><strong>–</strong> 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.</p> <p>There are two main components of cochlear implants:</p> <ul> <li><strong>Internal –</strong> 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><strong>External –</strong> 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> <p>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.</p>

Hearing