From silence to sound

HSC Winnipeg celebrates 100th cochlear implant

Mathew Spears (centre)
Mathew Spears eyes the camera while his dad, Ian, and mom, Erin, chat with Dr. Darren Leitao.
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How a cochlear implant works

About cochlear implants

Winnipeg Health Region
Wave, November / December 2014

Like any other curious and active two-year-old, Mathew Spears is busy learning to communicate. Watch him sing along with his mother, Erin, or listen to his father, Ian, read a book, and you can see this toddler drinking in the sounds, tones and words of language.

Mathew wears what looks like hearing aids on both of his ears. In fact, the devices are the tip of the technology that allows him to hear after he suddenly became deaf six months ago.

"Mathew was very ill in March of 2014, and he ended up in hospital for three weeks with what we learned was meningitis," says Erin. "We didn't realize at first that Mathew had lost his hearing. The hearing tests were performed automatically on him because hearing loss is a side effect of meningitis. After it was discovered he was deaf, he rapidly became part of the program to have cochlear implants done."

The surgery to install cochlear implants in Mathew's ears took place in April, 2014, and the process of activating them happened in May. Since then, Mathew has learned to wear his devices all day, only taking them off when he's asleep. "Before he lost his hearing, he could say about 10 words," says Erin. "With his devices on, he can hear us just fine, and he's learning new words every day."

Mathew and his parents took part in an event earlier this month celebrating the 100th cochlear implant surgery done in Manitoba since the program was launched three years ago. In that time, 16 young children have received implants, along with 78 adults.

Cochlear implants are electronic devices surgically implanted into a patient who has suffered severe hearing loss. Along with the surgery, each patient is treated by an audiologist who programs the device.

Timing of the surgery is critical in the case of young children, says Dr. Darren Leitao, Co-director and surgeon with the Surgical Hearing Implant Program at Health Sciences Centre Winnipeg.

"Their brains are undergoing a critical period, where they're hungry for input from all their senses. If a child cannot hear, their brain will wire itself for the other senses, like sight and touch," says Leitao. "After the age of five, it is much harder for a child who is deaf to be able to process sound, and a cochlear implant will not work for them. That's why we treat severe deafness in young children as an emergency."

The implant program is able to perform 35 surgeries a year. According to Justyn Pisa, Co-ordinator of the Surgical Hearing Implant Program, there are around 50 adults on the waiting list for surgery.

"We're clearing out the backlog, so patients are waiting 20 months, and we hope to get that down to 12 in the future," he says.

Richard Piotrowki says his grandchildren like to take him in to school for show and tell, since he underwent the surgery in January, 2014. "They say, ‘My grandpa is a robot,'" he says. "But seriously, this is a gift. I had some hearing loss, and one day, I went to bed and woke up completely deaf. Without my ability to hear, I was getting isolated and depressed. Before I retired, I was a civil engineer, and I love learning about new technology and science. I was very interested in these implants."

After having a cochlear implant installed on the left side of his head, Piotrowski says he fully expected to hear all voices coming through squeaky, like Minnie or Mickey Mouse. So he was pleasantly surprised to hear everyone speaking the way he remembered before he lost his hearing. "I can't hear high-pitched tones, like the melody line when someone is singing," he says. "Other than that, there's no difference. I feel like I'm fully back, a part of life again."

HSC's Surgical Hearing Implant Program works in partnership with the Central Speech and Hearing Clinic in Winnipeg, which provides the pre-operative evaluation of each patient and post-operative rehabilitation of their hearing. The clinic was established in 1989 and is dedicated to helping hard-of-hearing and deaf children and adults integrate into a hearing world.

Prior to the opening of the surgical program at HSC, adult patients would have to travel to places like St. John's, Newfoundland, and children would have to travel to Toronto, Ontario, in order to have cochlear implants done, says Leitao.
Dr. Jordan Hochman, Co-director and surgeon with the program, says that while a cochlear implant is not a cure for hearing loss, it is a prosthetic substitute that uses technology to bring hearing to those who have lost the sense. "The implants work by bypassing damaged portions of the ear and stimulating the auditory nerve directly."

Historically, inserting a cochlear implant into a person with residual low-level hearing would have destroyed their auditory nerve, says Hochman. "New techniques and devices permit the preservation of the low frequencies with synergistic electrical hearing," he says.

In conjunction with the clinical work, Hochman heads a robotics laboratory that is pioneering temporal bone surgical simulations.

"We're leaders in virtual surgery," says Hochman. "We can employ patient-specific imaging, and generate simulations that allow a surgeon to better appreciate the relationship between disease and structures of interest before that patient ever enters the operating room," he says, adding that it is a great pleasure as well as humbling for him to assist patients on their journey from silence to sound.

Watching young Mathew Spears play with his mother, the two of them pretending to sing to each other over a microphone borrowed from one of the reporters at the event, Piotrowki summed up the difference the surgery makes in the life of those who have lost their hearing.

"You really don't know what you have until you lose it. I felt like an invalid, useless, dependent on everybody. Dr. Hochman gave me hope," says Piotrowski, adding that having his hearing back is a miracle.

Susie Strachan is a communications advisor with the Winnipeg Health Region.


About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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