A cochlear implant is an implanted electronic hearing device that electrically stimulates the nerves inside the inner ear allowing a profoundly deaf person the ability to hear sounds.

Marlan Hansen, MD, an otolaryngologist specializing in ear surgery with University of Iowa Children's Hospital, says patients with severe to profound hearing loss that do not receive significant benefit from hearing aids are candidates to receive a cochlear implant.

"Most implants are placed in young infants-1 to 2 year olds-who are born deaf or in patients who had hearing at one point and develop severe hearing loss later. Recent advances in implant technology and surgical techniques pioneered at UI Hospitals and Clinics allow patients with a fair amount of residual hearing to benefit from the implant," says Hansen.

"It is hard to overstate the tremendous benefit that cochlear implants offer children. It allows children who would otherwise be deaf and have to attend special schools away from home and not be able to communicate with the vast majority of people in society to attend mainstream schools, to develop speech and language skills similar to normal hearing children, and to perform much better academically, especially with regard to reading skills," he says. "In the long-term these children attend college or trade schools and are employed in regular jobs. It is one of the true miracles of modern medicine."

Friday night, July 27, the Cedar Rapids' Kernel's baseball team will honor Eric Lehmkuhl, 12, who was born with a hearing deficit and eventually lost all ability to hear when he was six-years-old. Eric, and honor student, received a cochlear implant in February 2002. He will be a seventh grader at Roosevelt Middle School in Cedar Rapids.

Eric and his family describe him as a "huge" baseball fan and hopes to play catch with some of the Kernels. Eric's doctor and other members of the UI neurosciences team will accompany Eric as Kernels' staffers introduce him to the fans at the ballpark and as he circles the bases to celebrate his remarkable success story.

Hansen says that since the inner ear reaches adult size well before birth and doesn't grow after birth, the implant typically lasts a life time and does not require replacement. With advances in technology, the external components may require upgrading from time to time. In extremely rare cases, the internal components of the implant may fail, requiring the device to be changed.

In patients with severe hearing loss, their inner ears are unable to convert sound waves into electrical impulses. The external components of the cochlear implant device pick up the sound waves and convert them into electrical signals. This information is then relayed to a series of small electrodes placed in the inner ear that activate the hearing nerve, bypassing the non-functional parts of the ear.

Successful implant teams are composed of a variety of hearing experts including:

• Audiologists who test hearing and determine whether the patient is a candidate
• Surgical team, including an ear surgeon, nurses, anesthesiologists. place the device

After surgery is when the real work begins of learning to use the device says Hansen. "This requires frequents adjustments of the device at first and so there are a group of audiologists that specialize in programming the implant to best fit the patient. For children, education and speech and language specialists assist to ensure the patient is making good progress. However the most important component for any successful implant team-the MVPs-if you will, are the patient and their family. It requires a devoted family and patient for the child to achieve the best results.

"The UI Hospitals and Clinics Otolaryngology Department was involved in some of the initial cochlear implant surgeries in the early 1980's," Hansen says. "In fact, the first multichannel implant in the United States was performed by Bruce Gantz, MD, professor and head of the department, in 1985. We have patients, including children, who have now been using their implants for over 20 years so we have been able to see the tremendous benefit it has provided these children as they mature into adults.

"Our department has been one of the foremost leaders in cochlear implant research. Led by Gantz, the department has received over 25 years of continuous funding from the National Institutes of Health to support the cochlear implant research program and hearing loss in general.

"Our programs focus on areas such as developing new technologies, music appreciation, child development, genetics of hearing loss, and even regeneration of the hearing nerve. It is exciting to participate and watch the advances in this technology and to see the appreciation of the patients for the restoration of their hearing," Hansen says.