New world of sound
Cochlear implants impact the lives of hundreds of PHHP patients
By Rebecca Burton
Leigh Boan, a histotechnologist at the Malcom Randall Veterans Affairs Medical Center, remembers the first day she switched from traditional hearing aids to cochlear implants. Although she was nervous about the surgery, the technology held promise to open up a new world of sounds.
The day before her 18th birthday, Boan underwent surgery at UF Health to have the device implanted behind her ear.
Cochlear implants work differently than traditional hearing aids — which simply amplify acoustic sounds — by converting the acoustic sound to an electronic signal that creates impulses to stimulate the damaged ear.
Forty-two stitches and six weeks of healing time later, Boan was “turned on” for the first time, meaning her device was ready to be tested by audiologists in the College of Public Health and Health Professions’ UF Health Speech & Audiology Center. At first, Boan described the sounds she heard as robotic, a series of beeps and pings. But, after a couple of adjustments, Boan said she heard a strange sound while she was at her parents’ house in Georgia.
“It was pretty unbelievable. I kept saying ‘What’s this?’ and ‘What’s that sound? What’s that sound?’” Boan said. “I heard rain on the roof and asked what the noise was. I had never heard it before.”
Boan also said music had a new meaning. Before, she could understand bits of the beats and rhythm, but now she could understand the lyrics. Since her implant has a slot for an auxiliary cord, she can connect it to her iPhone to call people or listen to music.
“It’s like a surround sound in your head,” Boan said.
Boan moved with her husband, Paul, and 4-year-old son, Hudson, who are both deaf, from Georgia to Gainesville three years ago. Because of her experience at UF Health, Boan wanted her son to get the care she received, and she started the process of getting Hudson qualified for cochlear implants after he was diagnosed at age 1.
He has had them for more than a year now and the preschooler who previously never spoke is now the most outgoing patient his audiologist, Melissa Hall, Au.D., has seen. He attends speech therapy weekly, and the visible device he wears on his ear is the only clue that he has hearing impairment.
Boan said Hudson had trouble at first, and would constantly rip off the outer portion of the device and he even buried one in the sand. But, after working with the UF audiologists, he started to get used to the sounds.
“Now he’s asks ‘Where’s my ear?’” Boan joked.
The implants can be placed in children as young as 12 months old, as approved by the FDA, but in extenuating circumstances they may be implanted at a younger age, said PHHP audiologist Rhiannon Pitkin, Au.D. She said the quicker the hearing loss is treated, the better off the child is developmentally, socially and academically.
“Now, with newborn hearing screening we’re able to identify hearing loss at a younger age and provide management and intervention a lot earlier to help them maintain a level of progress that’s on par with their peers,” Pitkin said. “That way they don’t fall behind and they have the same amount of opportunities available to them that other people do.”
Boan’s husband Paul was previously against cochlear implants, because he used to think being deaf was part of who he was and didn’t want to change it. But after seeing the improvements in his son and wife he has decided to start the process to obtain his “new ears” as well.
Audiologists and speech-language pathologists in the college’s department of speech, language, and hearing sciences have treated hundreds of patients like the Boan family since UF was part of the clinical trials for multi-channel cochlear implants in 1984. The multi-channel implant provides a much more detailed representation of incoming sound over the previous single-channel device that was first implanted in a patient in 1972, said Alice Holmes, Ph.D., a professor of audiology and a member of the 1984 clinical trial team.
“The amazing thing about cochlear implants is that the brain can take limited information and learn to use it,” Holmes said. “Over the years implants have improved so dramatically, but even in those early cases the implant was a miracle to people. Our first patient was a schoolteacher who was able to go back to teaching after the implant, and she actually was named the teacher of the year in her county.”
Holmes said one of the biggest recent advances in cochlear implants is the development of implantation surgery techniques that preserve patients’ existing hearing. Even in people with severe hearing loss some residual hearing remains, usually in the lower frequencies, she said. These patients may be candidates for electrical acoustic stimulation, which combines the use of hearing aids to amplify sound at the lower frequencies, with cochlear implants to help patients hear sound in the middle and high frequencies.
“This may open up a whole portion of our population who previously received little benefit from hearing aids and were not good candidates for cochlear implants,” Holmes said.
But just as cochlear implants can be viewed as life-improving technology, the devices have also drawn controversy. To some in the deaf community, deafness is a cultural identity, not a disability that needs to be treated.
The National Association of the Deaf encourages parents of children who are deaf to research all options before making a decision about implantation, and to seek out opportunities to interact with adults who are deaf and with other parents of children who are deaf.
According to the organization’s position statement on cochlear implants, “Throughout the developmental years, the deaf child — implanted or not, mainstreamed or not — should receive education in deaf studies, including deaf heritage, history of deafness and deaf people, particularly stories and accounts of deaf people who have succeeded in many areas of life.”
Holmes, who remembers walking through a line of protesters to attend a cochlear implant meeting in 2002, believes the opposition to cochlear implants has lessened as our understanding of who receives the greatest benefit from implants — such as young children and adults who previously had normal hearing — has increased.
“There’s still some controversy, without a doubt, and you have extremists on both ends: people who say every child should be implanted and people who say nobody should get implants, but there’s middle ground there,” Holmes said. “Implantation is a personal choice that individuals and families need to make.”