MORGANTOWN, W.Va. – When talking about implants to treat hearing loss or deafness, cochlear implants often come to mind. These implants work by stimulating the cochlear nerve, which relays sounds to the brain. However, for patients with conductive or mixed hearing loss, cochlear implants are not the answer.
Brian Kellermeyer, M.D., WVU Medicine otolaryngologist, was the first in the state to implant a BONEBRIDGE bone conductive implant. The surgery was performed in early May, and the implant was successfully activated at a follow-up appointment this month after giving the patient, Franklin Hinerman, 79 of Moundsville, time to heal from the procedure.
“Bone conduction devices offer a huge opportunity for patients with conductive or mixed hearing loss, especially those with single sided deafness,” Dr. Kellermeyer said.
Conductive hearing loss is caused by problems with the ear canal, ear drum, or middle ear and its tiny bones (the malleus, incus, and stapes). Causes of conductive hearing loss include congenital absence of the ear canal or failure of the ear canal to be open at birth and congenital absence, malformation, or dysfunction of the middle ear structures. It can also be caused by infection, tumors, middle ear fluid from infection or Eustachian tube dysfunction, a foreign body, trauma (such as a skull fracture), and otosclerosis.
Mixed hearing loss is a combination of a sensorineural and conductive hearing loss. It results from problems in both the inner and outer or middle ear.
Single-sided deafness (SSD) is a condition of profound unilateral sensorineural hearing loss with normal hearing in the better hearing ear. SSD is a severe impairment that makes it hard to understand speech and sounds, especially in noisy environments, and causes difficulties in determining the direction of a sound’s location.
“Sound moves from the eardrum to the bones behind the eardrum, which magnify and transfer that sound to the inner ear,” Kellermeyer said. “People who have disruptions in that, either holes, ear infections, or have had ear surgery, may have disrupted that mechanism. This device works really, really well to stimulate the inner ear directly without needing a hearing aid in the ear canal to transfer that sound into the ear.”
Hinerman has struggled with hearing loss since ear infections caused perforations in his ear drums as a child. He underwent surgery in his late 20s to patch the holes, but when the patch in his right ear didn’t hold, his doctor told him a second patch would not be effective.
After years of living with hearing loss, Hinerman’s wife heard about the BONEBRIDGE implant, and they made an appointment with Kellermeyer, who determined he would be a good candidate.
“My surgery was originally delayed about a year because of COVID,” Hinerman said. “At first, they were going to use a different kind of implant, but I would have had to have it removed if I ever needed an MRI. That’s why we went with this implant because you can get an MRI with it.”
Since his device was activated on June 2, Hinerman says he is noticing sounds he’s never heard before, like shingles being installed on his neighbor’s house and the music his wife plays in the background.
“Before, my wife would play music so she could hear it, but I couldn’t. After they turned on my implant, I had to have her turn the music down because it was too loud,” Hinerman said.
“Another thing I never heard before is how much background noise there is in restaurants. I could never hear it before. It was too loud for me, and I had to turn it down as low as I could.”
Because everyone’s hearing and tolerance for sound is different, the implant can be adjusted by doctors to a more comfortable level for the patient that excludes distracting noises like ringing or buzzing but allows the patient to clearly hear speech. Hinerman says he is going to ask to have his baseline volume adjusted at his next appointment.
“I’m grateful to the doctors and nurses who helped me during this process and helped me understand my options. They did a great job,” Hinerman said. “I’d recommend that anyone considering getting a hearing implant do it if they can. There are some things you have to get used to, like not knocking it off when you try to put on a hat or scratch your head, but you have to give it a chance and it’ll be alright.”
For more information on WVU Medicine Otolaryngology, visit WVUMedicine.org/ENT.