Surgical Implants Help Solve Annoyances of Hearing Aids
The Wall Street Journal
There is hope for people who hate their hearing aids.
Although today's hearing aids do a good job achieving their main purpose -- helping people hear -- they can make users feel like they are talking in a tunnel. Hearing aids can squeal, whistle and create echoes during phone conversations. They pick up so much background noise that it is difficult for users to distinguish between the person to whom they are speaking and the person chattering at the next table.
But new devices that are surgically implanted in the middle ear solve many of these problems. Though the implants don't offer any marked improvement in speech comprehension compared with hearing aids, users say their own voice sounds normal and background noise is more easily filtered.
An estimated 28 million people in the U.S. have hearing loss, but 80% don't use hearing aids for a variety of reasons, including expense, embarrassment and frustration. Although age-related hearing loss is common, the problem also can be triggered in young people by loud noises or illness. Those who suffer some of the worst consequences include Baby Boomers who need to hear well to function at the office, but don't want to wear bulky hearing aids.
The Food and Drug Administration has approved only two middle-ear implants to date: the Vibrant Soundbridge from Symphonix of San Jose and the Direct System from Soundtec of Oklahoma City. The technology is so new that there are little long-term data on how long the implants hold up or whether they cause any unusual wear and tear on the middle-ear bones. In the U.S. about 400 patients have Soundtec implants. The Symphonix device is used by 250 patients in the U.S. and about 1,000 world-wide.
So far, the biggest downside seems to be cost. The implants run between $5,000 and $15,000, including the implantation surgery, while a top-of-the-line digital hearing aid costs about $3,000. All of that comes out of a user's pocket because implants and hearing aides generally aren't covered by insurance.
The expense was entirely worth it for Cheryl Konowitz of Terra Haute, Ind. She spent $15,000 last summer for the Vibrant Soundbridge implant and liked it so much that she and her husband forked over another $15,000 in January to have one placed in her other ear.
Mrs. Konowitz, 48, quit her job as an intensive-care nurse because she couldn't put a stethoscope to her ear or take orders over the phone while wearing hearing aids. Even a simple hug triggered feedback. With the implants, those problems vanished. "It's opened up a whole new dimension in my life," she says. "Hearing aids drove me crazy. You want to rip them out."
But the implants aren't for everyone. Some users complain of a feeling of heaviness in the ear and have them removed. Other, less-common complications include further hearing loss, pain and altered taste.
Users also say retail antitheft devices and home electronics can trigger strange sensations. Mrs. Konowitz felt like she had a tuning fork in her head while walking into a record store. Mindy Lummus, a 30-year-old from Oklahoma who is enthusiastic about her Soundtec implant, nonetheless says she "feels" the device when she stands close to televisions, microwaves or computers.
Still, doctors say the majority of people who get the middle-ear implants prefer them to hearing aids. "There have been some who did not like it at all," says Thomas Balkany, professor and chairman of otolaryngology at the University of Miami. "But for most patients, it's a major advantage."
The two implants, although different, operate on the same principle. A hearing aid amplifies the sound that comes into the ear and pushes it against the ear drum. The implants also amplify sound, but they start the process farther inside the ear, directly at the middle-ear bones. Because the device vibrates the middle-ear bones directly, it more closely mimics the natural hearing process. And because the ear canal isn't plugged, the sound isn't distorted.
To insert the Symphonix device, patients usually are placed under general anesthesia, and doctors drill a small hole behind the ear. Later, a processor the size of a quarter is placed behind the ear; a magnet keeps it in place.
Surgery to insert the Soundtec device is less extensive, resulting in a lower price tag (around $5,000). The patient is awake as the device is inserted through the ear canal. Doctors lift the eardrum and place the device in the middle ear. The current version uses a processor that hooks around the back of the ear, although a newer version sits inside the ear canal.
a 73-year-old retired rear admiral, says his hearing improved markedly
the processor was put in place. "My voice was
my own voice and all the sounds were natural," he says. "I'll
never forget it."
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