|A Friday Story|
With little fanfare and a great deal of success, for over two decades specialists in the Hadassah's Department of Otolaryngology/Head and Neck Surgery – which all of us refer to as ENT – have been changing people's lives. Nearly 500 people have benefited from their expertise in cochlear implantation. Some are babies who were born deaf; others, adults whose hearing deteriorated as they grew older.
A cochlear implant is a small, complex electronic device. Its external portion sits behind the ear to pick up and filter sound; the internal portion is surgically placed under the skin behind the ear to send impulses through electrodes to the auditory nerve and then to the brain stem and the brain. "It is the only manmade device that is connected to the central nervous system, and its impact has been enormous," says Prof. Josef Elidan, Head of the Department.
"Hadassah's first cochlear implant patient was an adult who had lost his hearing," recalls Prof. Elidan, who performed the operation. "I had just come back from the United States where I had been trained in the procedure. In an operation that took several hours, I implanted a device that had one channel and one electrode. Today, it takes considerably less time and the implant has 22 electrodes." And today, because people hear with both ears and lose hearing in both ears, bilateral implants are the norm, rather than the exception.
The surgery is only part of the process, however. "Without rehabilitation the implant is less effective," says Miriam Adler, Coordinator of Hadassah's Cochlear Implant Program. "We hear with our ears and our brains," says Haya Levi, Director of the Department's Speech and Learning Center, "but the brain is the star of the show." A month after the internal implant, the external part is connected. Then the Center's staff begins to train people to speak or to retrieve speech.
"The implant provides sound – a great deal of sound," Ms. Levi says. "People who experience progressive hearing loss remember how speech sounds. Our job is to teach them how to distinguish among the sounds and how to filter them, how to identify words and sometimes, how to how speak on the phone. Basically we help them reconnect with the world that disappeared with their hearing. It takes about six months for people to begin feeling comfortable with the equipment. "
Children who are born deaf have no auditory memory – their condition is usually caused by a genetic malfunction or illness. After receiving the implants, deaf children have to be taught how to speak as well as how to hear. "The process is exciting and challenging – and the results can be amazing, " Ms. Adler says. "Success has given the hard of hearing and those born deaf the possibility of integrating into society. Almost all of the children are mainstreamed in the school system. When they speak, it's hard to believe they are deaf. Their language sounds extremely natural."
Ms. Levi and Ms. Adler described a 14-year-old boy who received an implant when he was three and-a-half – and the speech he made to a gathering of professionals, patients and their families. "I didn't hear and I didn't speak," he told the audience, clearly enunciating his words. "Now I am part of group and interact easily with my friends. Thank you for the miracle."
And there is the 17-year-old who was one of the first children to receive an implant after meningitis left him deaf when he was less than a year old, Ms. Levi continued. He has a newer implant model now and is a drummer with a band.
There is no age barrier to implants, Prof. Elidan says, although the U.S. Food and Drug Administration does not allow the procedure for children under the age of one. "Almost everyone is a candidate. One of my patients was 85. Even when there are technical problems like damage to the nerve fibers and very little residual hearing, we have special techniques that can overcome the problems."
The Speech and Hearing Center patients are almost equally split between Hebrew speakers and Arabic speakers, mostly Israelis, but some from nearby areas. Because intermarriage between family members is common among certain populations in Israel, genetic mutations are passed from generation to generation and a high proportion of their children have hearing difficulties or are completely deaf. Fortunately for them, the Center's 23-person staff includes Hebrew and Arabic speaking audiologists and speech pathologists to help them overcome the hurdle.
"This technology completely revolutionizes peoples' lives. It returns people to the land of the living," Ms. Adler says. "I come to work every day with the feeling that we are doing something good," Ms. Levi says simply.
Anyone who has a deaf friend or relative and everyone who has personally experienced hearing loss knows how disoriented life becomes, how difficult communication becomes. Cochlear implants, like so many other new and innovative techniques, are miracles of modern medicine, but more than that, they are an unspoken part of the Hadassah mission – to heal and to help, with expertise and understanding.
In the Department Otolaryngology – and throughout the entire Medical Center – our staff is passionate about their professions, dedicated to connecting people with the world they know and helping them return to their lives and their loved ones – doing something good.
ShlomoDate: 4/8/2011 12:00:00 AM
Prof. Shlomo Mor-Yosef