Jefferson University Hospitals

Hearing Implant Helps 21-Year-Old Jefferson Patient with Single-Sided Deafness To Hear Again

10/24/11

Reading resident Kayla Alshouse is about to have her birthday wish come true and she can’t wait.  Alshouse, who just turned 21 this past Saturday, Oct. 22, has hoped for this wish for the past 13 birthdays.

“Each birthday since I was eight-years-old, I blew out the candles wishing to get my hearing back in my right ear,” she says.  “For years, my family and I were told there was nothing that could be done.”

That was until two months ago, when Alshouse and her parents met Dr. Thomas Willcox, otolaryngologist and medical director of the Jefferson Balance and Hearing Center at Thomas Jefferson University Hospital.

On Tuesday, Oct. 25, Alshouse will have a Bone Anchored Hearing Aid (BAHA) implant turned on.  The device’s FDA approval for unilateral sensorineural hearing loss is relatively new.  While the more well-known cochlear implant helps those with total deafness, there haven’t been many options for patients with unilateral, or single-sided deafness until now.

“BAHA is a surgically implanted system that allows sound to be conducted through the bone rather than through the middle ear – a process known as direct bone conduction,” says Dr. Willcox.  “It’s used to help people with chronic ear infections, congenital ear malformations and single sided deafness who cannot benefit from conventional hearing aids.”

Here’s how the BAHA works:  The system consists of three parts – a titanium implant, an external abutment, and a sound processor. The titanium implant is surgically placed behind the ear during a short surgical procedure, leaving the ear canal open.  It is worn under the hair and is not perceptible to others. Over time, it naturally integrates with the skull bone.  For hearing, the sound processor transmits vibrations through the external abutment to the titanium implant. These sounds transmit from the hearing impaired side to the normal ear and ultimately results in a sensation of hearing from a deaf ear.

Until recently, the best available approach for providing help to those with single sided hearing loss has been the CROS (contralateral routing of offside signal) hearing aid, says Dr. Willcox.  This technique utilizes hearing aid microphones worn in both ears and routed sound from the deaf ear to the hearing ear.  Common complaints included an unattractive cosmetic appearance, discomfort of the headband, and the use of a hearing aid mold in the good ear.

Alshouse was never prescribed the CROS system.  She is not sure what caused her hearing loss, and whether it was sudden or gradual.  “I just remember coming in from recess at school and a friend was calling me nearby.  She was on my right side and I couldn’t hear her.  My parents took me to numerous specialists, but none of them knew why I had hearing loss, nor what could be done to help me hear again.  Some said it could be allergies, others said wax.  I knew it was something I couldn’t do anything about so I learned to live with it.”

Unilateral deafness can result from viral infections, trauma, acoustic neuromas and other ear tumors and ear surgery.

“One ear does not provide adequate hearing in many situations,” explains Dr. Willcox. “Patients with severe hearing loss on one side, but normal hearing in the other ear have difficulty understanding speech in background noise (such as group conversations and in restaurants), as well as determining which direction sound comes from.”

Alshouse compensated by walking on the right side of whoever she was with so she could hear them with her left ear.  She would also sit closer to the teacher in the classroom.  Over time, it became second nature to her.

Still, she never stopped wishing.  “This past summer, I started thinking about how much I wanted to hear again.  I kept seeing information about cochlear implants but knew it wasn’t for me, because it helps those with total deafness.  But it still spurred my interest.  I made an appointment at Jefferson to explore my options.”

Alshouse was glad she did.  After extensive testing, Dr. Willcox suggested Kayla receive the BAHA implant.  With it being a two-part process, Dr. Willcox performed a simulation and learned that the device would be was successful for Alshouse.  He then surgically embedded the titanium implant on Sept. 8.

Even those few minutes of hearing in the right ear were thrilling for Alshouse.  “It was great, absolutely amazing to hear out of my right ear,” she says.  “All of a sudden, I heard someone coming down the hall, her heels clicking against the floor.  It felt like a miracle.”

Because the skull must heal with the implant in it, a few weeks must pass before the processor can be put on.  The system will be permanent and complete.  Alshouse will only have to take off the processor to shower, sleep or swim.  The implant does run on batteries, and they need to be replaced every four to seven years, but doing that is a simple outpatient procedure.  What’s more, by having a hearing system that bypassed her middle ear, Alshouse prevented further hearing damage to her right ear.

On Tuesday, Oct. 25, Alshouse will have the processor turned on.  For patients with single sided hearing loss, it's the medical breakthrough many have waited years to see.

“I can’t wait,” she says.  “It's going to change my life drastically.”

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