Implants sounding better
May 2, 2000
By Anita Manning, USA TODAY
A generation ago, restoring hearing in people who were profoundly deaf seemed
unrealistic, if not impossible . Today, a growing fraction of the half-million Americans
who suffer severe hearing loss are using cochlear implants, a sophisticated and
controversial technology that many think is nothing short of a miracle.
A cochlear implant is more than a fancy hearing aid.
It is "one of the 20th century's most consequential developments in
communication," John Niparko, director of otology-neurotology at Johns Hopkins
Hospital in Baltimore, writes in the book Cochlear Implants: Principles &
Cochlear implants pick up sound through a tiny microphone attached near the ear. The
implants send the sounds through a processor and back to a transmitter that delivers the
sounds through electrodes, which stimulate the auditory nerve.
Scientists are working on producing smaller units that process signals faster, enhanced
processing to improve the perception of speech and music, and fully implantable devices,
which are expected in three to five years. First marketed in 1972, the implants are used
by about 32,000 people worldwide, and the demand for them is growing by 25% per year,
The most common hearing loss (85%) is caused by damage to tiny cochlear hair cells in the
inner ear, called sensorineural hearing loss or "nerve deafness." The damage can
be genetic or caused by a disease (such as meningitis or measles), injury, aging or a
reaction to drugs, including some antibiotics and anti-cancer medications.
The devices cost $30,000 to $50,000 and are prescribed only to people whose hearing loss
is severe and who do not benefit from hearing aids. Unlike hearing aids, implants are
covered, at least in part, by most insurance companies.
Their use in children has been controversial, and their success somewhat spotty.
Generally, Niparko says, the younger the child is when implanted, the easier it is for him
or her to learn to understand sounds and to speak.
Research shows that exposure to speech early in life is crucial to language development.
If the brain has no knowledge of sound, it can't immediately interpret sound information
"We have to work with Mother Nature in providing this at the optimal time,"
Niparko says. "Three (years of age) is not too old, but 5 may be. Three may not be as
good as 18 months, and 18 months may not be as good as 12 months."
That doesn't mean children who are older are never successful with implants. "We do
tell parents an implant experience can be wonderful, but it is a hell of a lot of
work," he says. "Getting a child of 3, 4, 5 on schedule with language
development is difficult."
But for babies 18 months old and younger, Niparko says, an implant is "a simple
developmental experience." When a child is born deaf and doesn't get an implant for
years, there is a language gap, he says. "It's easier to backfill that gap if a child
For adults who lose their hearing, implants can be what David Rutledge, 53, of Lincoln,
Neb., calls "truly a miracle of modern science."
Rutledge, an elementary school principal, lost the hearing in one ear 10 years ago as a
result of a never-identified flulike illness. His other ear was affected, but he got by.
Then, in October, after another bout of flu, he lost all ability to hear.
In February, he got a cochlear implant, but he had to wait until he had completely healed
from the surgery before his doctor turned it on.
In the interim, "I was totally and completely deaf," he says. "It was like
living in a silent cave." He took a leave of absence from work. Unable to read lips
and not knowing sign language, he and his family were reduced to passing written notes.
When the implant was turned on, what he first heard "was a pinball game of
sound," he says, speaking by phone two weeks after the big event. "Imagine
standing in a casino where everybody is winning. That's what it sounded like for the first
10 seconds. I could see my doctor's lips moving, but there was no relation between that
and the pinball sound.
"But in 10 seconds my brain was able to take those sounds and make them into sound I
could understand. It still had that pinball quality around the edges of the words, but
within two minutes I could converse with everyone in the room and banter with them. Now,
it's still not perfect, but it's becoming increasingly perfect."
Hearing trouble to hit 40 million people by 2020
|Some statistics you should see:
Of the 3,500 people who received cochlear implants in the USA in 1999, 1,800 were under
More than 28 million Americans are deaf or hard of hearing. Population projections predict
the number will reach 40 million by 2020.
Two companies are licensed to sell cochlear implants in this nation - Advanced Bionics
Corp. of Sylmar, Calif., with the Clarion device (www.cochlearimplant.com),
and Cochlear Ltd. of Englewood, Colo., with the Nucleus (www.cochlear.com).
Severe-to-profound hearing loss occurs in five to 30 babies per 10,000 born.
More than a third of people 65 and older report a hearing loss.