Cochlear implants improve quality of life for those with significant hearing loss

This story first appeared in Healthy You - November 2024, The Gazette’s quarterly health publication.

When Tim Downs Mullen of Center Point experienced sudden profound hearing loss in one ear recently, he had reason to think it might just be temporary.

About 20 years earlier, he’d had sudden hearing loss in his other ear, and steroid treatments had brought back about 50 percent of his hearing in that ear.

But this time — and in this ear — Downs Mullen’s hearing did not return.

“At that point, I had profound hearing loss in both ears,” he said. He failed listening comprehension tests. “I could hear noises, but I couldn’t make out simple words.”

The experience was “traumatic” for Downs Mullen, who was unable to talk to friends and loved ones

Luckily, Downs Mullen lives near some of the world’s leading experts in treating problems related to ears and hearing: specialists at the Department of Otolaryngology at University of Iowa Health Care. He was quickly connected with Dr. Marlan Hansen, professor and chair of the Department of Otolaryngology – Head and Neck Surgery, who knew how important it was for Downs Mullen to be treated.

“Hearing loss is connected to social isolation, and even dementia,” Hansen said. Because the brain must work extra hard to try to decipher words, it can be exhausting for adults with hearing loss to be with people. So they become isolated, which can lead to mental illness and sometimes dementia.

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Many adults who experience hearing loss can mitigate these health impacts by using hearing aids. Hearing aids amplify sound, which works well for those with mild to severe hearing loss. For someone with profound hearing loss, like Downs Mullen, amplifying sound won’t be effective since the ear does not process sound well anymore.

In cases like Downs Mullen’s, Hanson recommends a cochlear implant, a device that allows sounds to bypass the damaged part of the inner ear. Instead, it sends electric impulses directly to hearing nerves, which can then be decoded by the brain.

The cochlear implant has two parts. One part is surgically implanted under the skin, next to the skull. Thin wires emerging from this piece go into the inner ear near the hearing nerve. The second part is often worn behind the ear, but it can also be clipped to clothing or hair. This part contains a microphone which picks up sounds, converts them into electric impulses, and conveys them to the implanted piece inside the ear. From there, the hearing nerve picks up the impulses and conveys them to the brain, which interprets them as sound.

At UIHC, specialists have been doing these delicate cochlear implant surgeries for more than 40 years. After founding one of the country’s first cochlear implant programs in 1980, it currently performs more than 200 surgeries per year. And the faculty works on the cutting edge of research into the procedure and technology.

“Over the last 35 years, we’ve brought in $75 million in research grants,” Hanson said. One research group is investigating how the implant affects the cochlea — the tiny, spiral-shaped cavity in the inner ear that is the hub of human hearing. Another group of researchers is studying the way the brain processes sound. Other doctors and researchers are examining changes in the lives of adult patients who’ve gotten implants.

When Downs Mullen got his implant, he agreed to be part of a research study; his implant contained medications that would slowly be absorbed, preventing scarring and any kind of problems that might come from having a small device implanted in the ear.

Indeed, Downs Mullen had good results with his surgery. There were no complications, and eventually, his hearing was restored so that his comprehension of words was up around 80 percent, an amazing improvement.

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Still, it took a while for Downs Mullen to get there. At first when the doctor turned on the device, he was “very frustrated” — every sound, from footsteps to the wind rushing by, seemed strange, and it was hard to pick out voices amid the noise.

It took him about six months to get used to the new device and all the new sounds it brought to his hearing.

“I was tired at the end of each day,” Downs Mullen said. “My brain was doing a lot of remapping and relearning for a long time.”

Now Downs Mullens can hear and understand conversation, even on the phone, though he often uses his phone’s transcribing app just to make sure he gets the gist. Voices still sound somewhat robotic, but he can understand them, and he’s beginning to be able to tell different people’s voices apart.

Hansen hopes that more adults with hearing loss will consider getting cochlear implants to improve their quality of life.

“Anyone who struggles with their ability to understand words — or has moderate to profound hearing loss — could be a candidate for this implant,” Hansen said. People who have a fair amount of natural hearing but who have lost the ability to hear higher pitches and distinguish between words can benefit. With an implant, their hearing can be hybrid, using both acoustical sounds and electrical impulses.

Sadly, according to Hansen, only about 8-10 percent of people who could benefit from a cochlear implant get them.

“We need more awareness of this technology and the ability to use it,” he said.

Downs Mullen agrees. “I couldn’t hear at all without it. For adults with profound hearing loss, I would recommend it.”