SU program breaks ground with cochlear implant surgery research

From: The Daily Orange - Syracuse,NY,USA - Apr 14, 2004

By Christine Snow

Syracuse University students may be able to give a second chance to those who thought they would never hear again.

The Institute for Sensory Research, a department-level center in the L.C. Smith College of Engineering and Computer Science, is developing a research program to help give completely deaf people an opportunity to gain hearing. The research is focused on cochlear implants, which are placed inside a deaf person's head in an attempt to rehabilitate hearing.

The ISR was founded by Jozef Zwislocki in 1958. Since its inception, the institute has developed a Sensory Communication program, the first of its kind in the world. Within the institute, graduate students have worked on various research projects of hearing, vision and touch.

"It brings together engineers and other scientists," said Dr. Robert Smith, a professor of bioengineering and neuroscience.

Smith and several graduate students studying engineering and audiology head up the research program. The program attempts to build a bridge between engineering and other sciences to try to restore hearing in those believed to be permanently deaf, Smith said.

During the normal hearing process, sound comes in through the exterior of the ear and goes through the ear canal into the ear drum. The sound continues through a small shell cochlear, where fluid in tiny hair cells bend electrical impulses to a hearing nerve. The nerve then carries a signal to the brain, allowing people to hear.

People who are completely deaf, though, lack these electrical impulses. The cochlear implantation consists of a transmitter that is surgically placed along the hair cells next to the brain. There is a magnetic receiver on the exterior of the head that helps transmit sounds. The implants serve as a way for the implanted cochlear to deliver sound through the head piece to the cochlear hairs in the brain.

People who decide to get implants must undergo a two-to-three-hour operation under anesthesia, during which the implant is placed in the person's head and then turned on. After three to four weeks of recovery, they can become part of a small group of subjects in the ISR's research program.

"The big moment is to turn on the implant," Smith said. "It's like being present at someone's birth. It's exciting to watch."

There is no guarantee that the person who receives cochlear implants will be able to hear after the surgery, because of the relatively small amount of nerve channels within the implants. A person who can hear normally has 30,000 nerve channels, while the implants only have 22 channels.

"No one thought we could do this with so few channels," Smith said.

As advanced as the implants have become in helping the deaf to hear, the ISR has a long way to go before figuring out how to establish currents that allow a deaf person to fully hear sound. Currently, implanted patients are only able to hear speech and quiet, but sounds such as music are difficult to hear, Smith said.

"As much as it is a miracle in speech and quiet, the implants do not work in noisy places," Smith said. "The implants can't do that."

Students working in the research program want to find a way to help the deaf community.

Nicole Sanpetrino, one of the program's research assistants and a doctoral student in audiology, decided to take part in the research to figure out what people perceive and sense in their ears.

"Audiologists are at the front line of research," Sanpetrino said. "I have studied normal hearing and I wanted to regain senses that (deaf people) had or never had and return that back to them."

Ben Milczarski, a research assistant and a graduate student in bioengineering, decided that working on human research such as cochlear implants was the most appropriate kind of work for him.

"I wanted to pursue something more human-oriented," Milczarski said. "I did my undergraduate here at SU working on the vision of horseshoe crabs. I wondered, what relevance did that have to humans?"

The research originated 30 years ago in France, Smith said. Since then, there have been several sample groups throughout the country, including three test subjects at SU.

The implants help people who are so deaf that they are unable to use hearing aids and have become one of the most advanced medical studies in the world. These implanted individuals have either never had hearing or have lost hearing at some point in their lives, Smith said.

"(The people who get implants) are the real pioneers," Smith said. "They spend hours working on sound and we can't promise to help them."

However, the cochlear implant research has stirred controversy in the deaf community.

"Their major objection is that (the implants) are not going to work right," Smith said. "They see it as too complicated a system, but there are many brave subjects who have tried them."

"The deaf community is a whole culture, and they see (implants) as genocide," Sanpentrino said. "They feel that is destroying their own culture."

The National Institute of Health, the primary funding program for the ISR's research, has found over a million deaf people in the United States, Smith said. There has been an increasing number of people who are a part of the deaf community, making this research much more necessary, Sanpetrino said.

Local physicians, including Dr. Sam Woods of University Hospital, currently perform the surgery, Smith said. Through working with surgeons and the ISR, deaf people may be able to take part in this program.

"The research has pushed a field that probably wasn't ready yet," Smith said. "It's a revolution."

© 2004 The Daily Orange