High-tech children’s hearing aids that could help you, too
VALERIE JAMES’S hearing had been deteriorating since her teens, and by the time she reached her early 70s she expected it only to get worse. ‘Five years ago, I could only really communicate using a notebook I carried in my handbag,’ says Valerie, 74, a retired office administrator, from Wimbledon.
‘People were starting to ignore me because they were tired of me asking them to repeat everything, and there were many times I drove home from a meal out with friends in tears, because I was unable to follow conversations.’
But last year, her hearing — and life — were transformed by a cochlear implant. These devices are usually fitted in children and younger adults but, as Valerie found, older people may benefit, too.
Valerie, a grandmother, was first affected by hearing problems in her youth when, as a keen swimmer and diver, she suffered frequent ear infections.
At 18, she developed mastoiditis, a bacterial infection affecting the mastoid, the honeycomb-like bone behind the ear inside the skull which maintains the air space in the middle ear. The bone was removed, but the infection had permanently damaged her hearing.
In her late 40s, Valerie began wearing an NHS analogue hearing aid — which amplifies electronic signals — in her right ear, and a few years later in her left, too.
When she was 57, she began using newly available digital hearing aids (which use a tiny computer to process sound). These were helpful, but then her hearing declined further. Her balance was affected, too, and she constantly feared she would trip on pavements.
By 2013, Valerie was told her hearing had become so poor in both ears that hearing aids could no longer help.
HEARING loss affects around 10 million people in Britain, and it is thought that 14.5 million (20 per cent of the population) will be affected by 2031.
There are two main types. Conductive hearing loss is when sound can’t pass freely into the inner ear, often because of a blockage (such as a build-up of wax) or abnormal bone growth in the middle ear. Surgery can usually correct this.
The other is called sensorineural hearing loss. This is caused by damage to tiny hair cells inside the cochlea, the spiral-shaped structure in the inner ear, or to the auditory nerve, which takes information from the cochlea to the brain. This is the type of hearing loss that may be helped with a cochlear implant.
Indeed, Valerie was told it was the only option that might help.
First successfully trialled in Australia in the early Eighties, these devices help people who are profoundly deaf or severely hard of hearing.
Profound deafness is when someone can only hear a sound at about 90 decibels — slightly louder than a hairdryer (people with normal hearing can hear as low as 20 decibels).
Cochlear implants bypass the damaged parts of the ear, and electrically stimulate the hearing nerve. This sends a signal to the brain which is interpreted as a sound, although patients describe this as more ‘synthetic’ than that heard by the human ear, with speech lacking tone or inflection.
During surgery to fit the device, a receiver and magnet are put under the skin behind the ear — a series of electrodes are then placed in the cochlea.
On the outside, just above the ear, is a speech processor and transmitter coil (removed when showering). The microphone part picks up sound and converts it into digital signals, which are sent to the transmitter coil. This sends a signal to the receiver stimulator where it’s converted into electrical signals.
These go on to the electrodes that stimulate the hearing nerve, sending signals to the brain. Children are typically given one in each ear, because they need their hearing to be as good as possible as they learn communication skills, whereas adults are usually fitted with just one.
There are about 11,000 cochlear implant users in Britain, 6,000 of them children. About 650 adults have an implant fitted each year, but most are under 65.
But in Australia, germany and the U.S., more of the over 70s are given cochlear implants than here. One issue may be that current guidelines for eligibility are seen as stricter than elsewhere: an NHS cochlear implant is only an option for adults with severe or profound deafness if they have tried hearing aids for three months without success. The Ear Foundation, a UK cochlear implants support charity, is calling for more elderly people to have access to them.
Last month, the charity published a report claiming that if more patients over 65 were given implants, it would reduce risks of life-threatening falls and cut cases of depression and dementia (a number of studies have found a link between dementia and hearing loss).
‘Hearing is one of the most acute un-met needs in terms of health of older people today, as people face a greater risk from health problems and the social isolation of deafness,’ says Sue Archbold, chief executive of The Ear Foundation.
‘Many older adults who have hearing aids that are no longer effective are unaware they could be considered for an implant.’
Although it costs £25,000 to fit an implant, compared with £400 for two hearing aids, the charity claims tackling hearing problems earlier would free up money for the new technology.
The issue was also highlighted earlier this year in an action plan on hearing loss, produced by NHS England and the Department of Health, which stressed that older people need early access to new technology.
Matthew Trotter, an ear, nose and throat consultant at the Spire Parkway Hospital in Solihull in the West Midlands, agrees that ‘if someone is at the limits of conventional hearing aids, implants are a very good option’.
‘Age is no barrier,’ he adds. ‘Someone in their 70s may have 20 or more years ahead of them. Being able to hear makes a big difference to their quality of life.’ However, Mr Trotter warns that implants ‘aren’t for everyone’.
‘If the patient isn’t fit enough for surgery or they don’t want to undergo the assessment before and rehabilitation afterwards, an implant isn’t right for them.’
THE risks include infection, and damage to the facial nerve and facial paralysis, he says. The device may also malfunction.
Valerie had the surgery last October at St george’s Hospital in Tooting, South-West London. ‘I was scared that if anything went wrong, my hearing would be even worse, but I wanted to have a one-to-one conversation with people again.’
During a three-hour operation, the cochlear implant was fitted into her left ear, where her hearing was slightly better. ‘ For the first ten days I suffered very bad giddiness, which was awful,’ she says.
She had to wait four weeks before the implant was switched on to let the wound heal and ensure no infection. This meant ‘a month of total silence’, as the hearing in her other ear was too poor for an aid.
When the implant was switched on, it was ‘an overwhelming experience’, she recalls.
‘At first, the sound of voices was so different. Everyone sounded like Donald Duck until the implant was adjusted.’
But a year on, Valerie has a new lease of life. ‘I can talk to people and go out without feeling I’m being ignored.’
She can also now hear the music at her ballroom dancing classes — before she’d dance from memory.
‘Now my balance is better, I feel more confident and steadier on my feet. Even at my age, having a cochlear implant has improved my life.’