The Sound of Celebration: 30 Years of Cochlear Implants at UH

From a toddler finally hearing her parents’ voices and the sounds that shape a childhood to a fireman able to safely catch the auditory cues on his job, University Hospitals has brought the gift of hearing to people of all ages for three decades and counting. The UH Cochlear Implant Program is celebrating 30 years of broadening the world for children and adults who have significant hearing loss.

Youngstown firefighter Tommy Gibbs can hear blaring sirens, but the more subtle sounds of a tenuous search and rescue operation were challenging before his cochlear implant. Riding shotgun in a ladder truck racing to the scene of a blaze, the deafness in his left ear hampered his ability to communicate with his crew.

“As a captain, we do a lot of search and rescue, and I am the one who goes in first,” said Gibbs, who used a hearing aid but experienced four years of aggressive hearing loss in one ear before receiving the latest technology in cochlear implants. “We are always blind going in, and you have to use all your senses. If I can’t fully hear what’s going on around me, I’m both blind and deaf.”

Mallory Abazia was born with severe hearing loss, and her parents realized when she was a toddler that she wasn’t responding to the clank of pots and pans or the clapping of hands. In Mallory’s early years, a cochlear implant helped her begin to interpret sounds such as speech, offering a way to connect with the world around her. A device was implanted into Mallory’s cochlea, the hearing organ. Utilized in conjunction with an external sound processor, which picked up the sounds around her, the implant helped translate those sounds into something meaningful for her brain.

Mallory’s surgery was performed by James Arnold, MD, who started the program in 1995 under the guidance of pioneer ENT surgeon David Proops, MD, visiting from Queen Elizabeth Hospital in England. Dr. Proops was in the operating room on the first day of surgeries to observe and provide support to ensure the foundation of UH’s fledgling program.

She was followed for many years by audiologist Gail Murray, PhD, who recalls those early years as a “special time,” adding, “I’m really proud of what we were able to accomplish for these patients.”

Implants were FDA-approved and performed at UH Rainbow Babies & Children’s Hospital in children as young as 2 years old and now can be done as early as 6 months of age.

A Leader in Cochlear Implants

“We were one of the earliest children's hospitals in the Midwest and really the country to realize that cochlear implants in an infant would be able to provide meaningful language abilities later in life,” said UH Chief Executive Officer Cliff A. Megerian, MD, FACS, an otolaryngologist and neurotologist who previously served as Medical Director of the Cochlear Implantation Program. “That was a big leap of faith, but it was a leap based upon the science that was emerging.”

Dr. Megerian was instrumental in building the renowned program that is now led by Alejandro Rivas, MD. The multidisciplinary team includes surgeons, nurses, audiologists, speech and language therapists, social workers, psychologists, geneticists and a clinical nurse navigator who guides patients through the process.

UH’s program stands out for its breadth of top-notch surgeons recruited from leading hospitals, and the depth of research and clinical trials, said Dr. Megerian. Now the Jane and Henry Meyer Chief Executive Officer Distinguished Chair, Dr. Megerian has also held the Richard and Patricia Pogue endowed Chair in Auditory Surgery and Hearing Sciences. Tremendous donor support has helped bolster the program, he added.

“We are one of the national leaders in cochlear implant clinical trials, where implant manufacturing companies are trusting the doctors here to be leading clinical trials on new device development,” Dr. Megerian said. “We have a very sophisticated, multidisciplinary program, where each case is reviewed to make sure it's the right thing to do. That is what sets us apart and results in a huge volume of patients, both children and adults, choosing UH.”

How Cochlear Implants Work

A cochlear implant helps individuals with moderate to severe hearing loss perceive sound. Unlike hearing aids, which amplify sound, these implants circumvent damage in the inner ear to directly stimulate the auditory nerve.

The implant is surgically placed within the cochlea along with a component placed beneath the skin behind the ear. The sound processor sits externally on or behind the ear, capturing sound and converting it into digital signals. These digital signals are transmitted to the internal implant, which sends electrical impulses through an electrode array inserted into the cochlea. These impulses directly stimulate the auditory nerve, allowing the brain to interpret them as sound.

As technology evolves, it becomes medically necessary to update processors to ensure patients continue receiving the most effective and reliable care. Abazia is on the sixth-generation sound processor in her right ear and the third generation for her left. Both are the most current sound processors available for their respective implants. Gibbs, the firefighter, was recently implanted with the cutting-edge Cochlear™ Nucleus^® Nexa^® System, the most advanced cochlear implant technology available. The surgery performed by Sarah Mowry, MD, took just over an hour.

“When you have a severe hearing loss like he did, a cochlear implant is the only thing I can do that will give you back hearing in the ear that has lost it,” said Dr. Mowry. “The brain receives the information differently than natural hearing and has to integrate the information. Clarity is not guaranteed immediately, but the brain ultimately adapts to this degraded signal and helps the patient hear.

“Tommy will be able to grow with the technology and our reprogramming capabilities.”

Witnessing the world open up for an individual of any age who receives a cochlear implant is “pretty awesome,” Dr. Mowry said.

New Dimension of Sound

In three decades of working with cochlear implant patients, the team has seen these small but complex devices transform the world for so many children and adults. Dr. Murray has seen children learn to play instruments, even perform with the Ohio State University marching band. Dr. Megerian still receives a note of thanks annually on the anniversary of a patient he implanted two decades ago. He’s even been invited to a graduation party for a high school student accepted to a stellar college, when hearing improved his ability to communicate in the classroom.

“The technology, particularly the current technology, is really a miracle,” said Dr. Murray, who followed the patients closely during and after activation, which usually takes place a few weeks after surgery.

Abazia turned her firsthand experience into a career and now, as an engagement manager with Cochlear America, works with patients to answer questions and provide insight into the life-changing surgery they are contemplating.

“I was one of the first patients to receive a cochlear implant here,” Abazia said. “My parents were very fortunate to have access to give me a lifetime of hearing at this incredible system here in Cleveland. Within the last 30 years, UH has become a center of excellence for cochlear implants.”