Path-breaking Ear Implant Technology Shows New Way to Treating Partial Deafness or Sloping Hearing Loss

January 27 2016,  14.02 PM IST || Pocket Press Release

•First Adult Patient in South Asia to Receive Nucleus Hybrid Cochlear Implant completes rehabilitation and is delighted to Hear His Daughter’s Voice

•Sloping hearing loss is different from flat hearing loss and needs different technological mechanism to treat it

New Delhi, 27th Jan 2016: Vikram, 35, was born with moderately severe deafness and lived a major part of his life depending on hearing aids to communicate. However, when his hearing aids started to fail him a few years back, he realized his hearing was getting progressively worse, and he could no longer hear sounds of higher pitch or frequencies anymore even while wearing his devices.

Sloping sensorineural hearing loss, as it is called, is a condition when the patient experiences difficulty in hearing different frequencies of sounds. So while such patients can hear background noises (of low frequency), they are not able to hear speech clearly. Sound amplification options for such patients are fairly limited. Neither do these patients meet the criteria of cochlear implants, nor do they find help with hearing aids.

Nucleus Hybrid Cochlear Implant system is the first FDA-approved solution that can help restore high-frequency hearing and at the same time enhance low-frequency hearing, with one Hybrid Hearing device. This is the technology that came to the rescue of Vikram as he struggled to cope with his progressively increasing hearing loss and landed at SpHear Speech & Hearing Clinic. Vikram became the first adult patient in South Asia to have received a Nucleus Hybrid Cochlear implant.

Vikram was first diagnosed with a moderately severe sensorineural hearing loss as a toddler. Although awareness regarding hearing loss and its relation to speech development was very sparse in India at the time, Vikram’s parents, being educated professionals, understood the importance of early intervention. He was fitted with bilateral hearing aids and enrolled in a hearing and speech therapy programme.

Vikram continued to use his hearing aids and with the help of intensive therapy continued to develop language and speech. However, with passage of time, his hearing progressively worsened. He began to lose more hearing in higher frequencies (high pitches) of sound and despite moving to more powerful hearing aids, he realised that the benefit he was getting from them was less and less. A time came when he could only hear background noises and was unable to understand what people were saying. Frustrated, he stopped using hearing aids completely for as long as five years and had to rely on lip reading. During this distressing period in life, his wife gave birth to their second child, and Vikram was unable to hear her cry. This broke his spirit. Depressed and dejected, he withdrew from the family, society as well as work.

Fortunately for him, a new technology was being unveiled during this time to help patients like Vikram. The family’s quest for solutions led them to SpHear Speech and Hearing Clinic where they met leading experts in the field – Ms Neevita Narayan, Senior Audiologist & Founder, SpHear Clinic; and Dr Ameet Kishore, Senior ENT Consultant, Indraprastha Apollo Hospital and Sphear Speech & Hearing Clinic – who helped completely, change Vikram’s life. The detailed hearing and speech tests conducted at SpHear Clinic revealed that Vikram had a sloping type hearing loss.

“There are different kinds and degrees of hearing impairment and there is no one-device-fits-all solution for these different cases. Poor understanding or discrimination of speech in the presence of some hearing is quite characteristic of someone with a sloping hearing loss. The speech understanding tests showed that although Vikram was not 100% deaf and could hear some sounds, he found it extremely difficult to understand words clearly. This meant that his hearing ability varied according to frequencies of sounds.

Such patients have better low frequency hearing, which allows them to hear sound, especially background noise, but the lack of hearing in the higher frequencies makes it very difficult and sometimes impossible for the listener to understand speech.  We had to find a way to allow Vikram to hear the higher pitches of sound, without disturbing what he is already hearing through his hearing aids in the lower pitches,” says Ms Neevita Narayan, Senior Audiologist and Founder, SpHear Speech & Hearing Clinic.

Standard cochlear implants are ideally suited to help someone with a severe to profound hearing loss across all frequencies, and who does not get benefit with hearing aids. As Vikram’s situation was unique, the experts wanted him to hear low tones through hearing aids and use cochlear implant technology to help him hear the high tones. This is where the Hybrid Cochlear Implant fitted the bill perfectly.

“Hearing aids provide acoustic hearing and Cochlear Implants provide electrical hearing. The Hybrid device is a combination of a hearing aid and a specially designed cochlear implant. This is called Electro-Acoustic Hearing. The surgeon uses a specially designed delicate array of the hybrid cochlear implant and inserts it very carefully and precisely in the inner ear (cochlea) in such a way that it does not disturb the patient’s residual hearing.  A few weeks after the operation, the audiologist connects the hybrid processor (combination of hearing aid and cochlear speech processor) and programs it in such a way that the patient can hear acoustically from the hearing aid and electrically from the cochlear implant using the same processor,” explains Dr Ameet Kishore, Senior Consultant Surgeon, ENT & Cochlear Implants at Indraprastha Apollo Hospital & SpHear Speech & Hearing Clinic.

Vikram underwent a Nucleus hybrid cochlear implant operation in both his ears simultaneously. It is a very specialized procedure as special electrode array has to be inserted into the inner ear without damaging the delicate and fine neural structures of the inner ear. Vikram recovered very well from the procedure and was discharged the next day.

Six weeks after the operation, Ms Narayan activated Vikram’s Nucleus N6 hybrid processor and programmed the hearing aid component to help him hear the low frequencies of sound, and the cochlear component for high frequencies. The return of his ability to hear speech brought a renewed vigour to Vikram’s life and he attended SpHear regularly for six months for auditory training and regular programming (mapping) of his processor. Regular hearing tests confirmed that Vikram’s residual hearing had been preserved and through his hybrid implant, his hearing had improved considerably as did his speech understanding.

“Vikram has had regular hearing tests at SpHear Clinics for the last one year and these confirm complete preservation of his residual hearing till date,” says Ms Narayan.

After several years, he had again begun to converse with people and could manage his business successfully, but the most precious gift was hearing his daughter’s voice. “For the first time I could hear the sound of my younger daughter,” says an emotional Vikram.

“Vikram is the first such adult patient in South Asia to have received a Nucleus Hybrid Cochlear implant in both his ears. The excellent results obtained in Vikram’s case can be considered to be the first step towards application of a new method for the treatment of patients with partial deafness who are not getting desired benefit with hearing aids,” says Dr Kishore.