IN THIS EDITION: Rachel’s story

The hearing zone

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June 2010News and advice from the world leader in hearing implants

Rachel was born with microtia and atresia. Microtia is an incomplete or underdeveloped external ear, while atresia is the absence of the ear canal. Atresia and microtia often occur together, usually with poorer hearing in the ear with microtia.

If your child has no ear canal, there is at least a moderate degree of deafness in that ear – so a Cochlear™ Baha® is a great hearing solution.

Rachel’s mother, Shabina says, “I was very sad when Rachel was born without being able to hear the world around her, but the condition never stopped us from helping Rachel live life like other children her age.”

Professor Philip Newall, Rachel’s audiologist and a Professorial Fellow at the Renwick Centre at the Royal Institute for Deaf and Blind Children in Sydney, donates his time to improve services for hearing impaired children in the Pacific Islands. He works in Samoa and Fiji and first examined Rachel at a Fijian Hearing Aid Clinic and fitted her with a bone conduction hearing aid – standard on-the-spot management for her condition.

As Rachel grew, the band became too small and tight creating a hollow dent behind her ear and the skin became red, swollen and irritated. Despite the discomfort, Rachel kept wearing the aid every day so that she could hear friends, teachers, TV programs and her family.

Fortunately, Shabina had started working at the Carabez Alliance with Bronwyn and Virginia Carabez, aiding children with hearing aids in Fiji. She told

Bronwyn and Virginia about the challenges Rachel was facing with the bone conduction hearing aid and they suggested a Baha system. Along with relieving the discomfort of her old hearing aid, they advised that a Baha would be more discreet (no headband) and deliver clearer hearing.

Professor William Gibson, Rachel’s ENT surgeon, director of the Sydney Cochlear Implant Centre and head of the Ear, Nose and Throat Unit at the University of Sydney and Professor Newall explored Rachel’s options and agreed that a Baha system was the best solution.

The Baha system consists of three parts: a titanium implant, an external abutment, and a sound processor. The implant is placed behind the ear during a straightforward surgical procedure and over time the implant naturally joins with the bone in a process known as osseointegration. The same process has been successfully used in dental implants for over 30 years. When connected to the external processor, sound is passed directly to the inner ear or the cochlea.

Professor Gibson kindly donated his time and surgical expertise so that, at age 13, Rachel became the first-ever recipient of a Cochlear-donated Baha in Fiji.

After surgery, Rachel declared “It was so quick! I had surgery in the morning and was home in the afternoon!” And then later when the Baha was activated the sound was crystal clear compared to my bone conduction aid. I can hear whispers – even in a noisy room.”

Now, she wants everyone with conductive hearing loss to, “hear the world through Baha.”

Shabina is also very pleased with the outcome of Rachel’s surgery. She wants to reassure every parent that they are making a wise decision for their child’s future.

Rachel has had her Baha for over a few months now and finds it more comfortable and discreet than the bone conduction hearing aid. She also loves the improved hearing clarity. As she says, “It has allowed me to take part in every conversation, even if YOU WHISPER, I HEAR.”

For more information on the Cochlear Baha, visit www.cochlear.com

It’s big news for Baha® recipient Rachel Kumar. Even though she never let her hearing impairment stop her enjoying life to the full, she’s thrilled to be part of everything that’s going on around her.

You whisper, I hear

Cochlear Nucleus Implant DesignThe Cochlear Nucleus solution has been developed into an internationally award-winning design by Cochlear’s research teams, in collaboration with world-renowned scientists. The design includes several features for maximising the hearing zone, including:

1. The electrode array length fits the hearing zone precisely, in order to maximise hearing while minimising the risk of damage to the cochlea and any loss of residual low frequency hearing in the top portion of the cochlea.

2. An array of 22 electrodes, all in the cochlea’s hearing zone, to give your audiologist more flexibility when programming the implant to meet your individual hearing needs.

3. A unique self-curling array that hugs the natural shape of the cochlea, providing more precisely focused stimulation and higher quality sound.

4. Softip is the industry’s only soft tip electrode array designed to protect the delicate walls of the cochlea during surgery, in order to help preserve any residual hearing.

Cochlear has reconnected over 200,000 Cochlear recipients worldwide over the last 25 years, and we continue to pioneer advances that will deliver even better hearing outcomes for our recipients. So you can be confident that Cochlear will help you Hear now. And always.

For more information, please read the performance and reliability fact sheet on www.cochlear.com.

Many people worry about how a new cochlear implant might affect their already limited hearing. In fact, a recent cochlear recipient survey shows that one of the most significant concerns for adult recipients in choosing a cochlear implant is the potential loss

of any remaining hearing. It is therefore important to understand how hearing works and how the design of your cochlear implant minimises additional damage to the inner ear or the cochlea and therefore minimises any remaining low frequency hearing loss.

The Hearing ZoneResearch shows that in normal hearing the entire cochlea responds to sounds, while only a specific area of it responds to the electrical impulses from an implant. We call this area ‘the hearing zone’. What’s more, the sound heard as a result of the implant’s impulses is lower in pitch than the same sound heard by normal hearing. That means the electrode array doesn’t need to be inserted deeply to achieve the same results.

In fact, research has shown that as the cochlear spirals and becomes smaller several different electrodes may stimulate the same nerve cells at different points along the cochlea, causing a confused sound pitches. As a result, deep insertion techniques have been found to frequently produce worse hearing outcomes.

The implant design is critical for a successful hearing outcome, which is why Cochlear Nucleus implants focus on the hearing zone which does not extend deeply into the cochlea.

Understanding your Cochlear implant design

Electrode array

Cochlear implant

Be in the zone: the hearing zone

Helpful Hints:1. Store batteries in the fridge to help them last longer.2. Always take a spare battery and cord out with you, in case one stops working.

3. Make a point of taking your lapel microphone with you too – it can filter out a lot of background

noise for clearer reception. You’ll find it wonderful for parties, movies, restaurants and any meeting

with three or more people. 4. Save yourself from those irritating popping noises caused by static build-up. Clothes made from

wool or silk usually generate static, so either avoid them or try a static guard spray. 5. Using Closed Captioning while you watch TV can help you with your long term speech habilitation

by improving your speech understanding. Hearing the dialogue and reading Closed Captioning will

help you to recognise different sounds, as well as the tonal differences between male and female

voices. It can also help you learn the sounds of letters and vowels, for clearer speech.6. If you’re attending a large meeting, seminar or lecture, try to sit in the middle of the venue. If

you’re at the front, the presenter will be too loud while people at the back will be too far away

for you to hear their questions or comments. The middle of the room should give you a much

better balance. However, you should allow for the location of the speaker and, if the speaker

is using a microphone and sound system.

Cochlear implant inserted inside the cochlea (blue spiral)

Human cochlea

Electrode array inside the cochlear

Area of the cochlear receptive to electrical stimulation.

Hearing nerve

HEARING ZONE

SoftipThe industry’s only Softip electrode array is designed to protect the delicate walls of the cochlear during surgery, which may lead to preservation of residual hearing.

Thin self-curling arrayThis significant design feature places the electrodes closer to the hearing nerve fibres and is engineered to provide more focussed stimulation and greater power efficiency, while applying less pressure to the delicate cochlear structures.

22 electrodesThese provide accurate stimulation of the hearing nerves, important for high quality sound.

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References: 1. Arndt P, Staller. S, Arcaroli J, Hines A, Ebinger K. “Within Subject Comparison of Advanced Coding Strategies in the Nucleus 24 Cochlear Implant.” Cochlear Corporation, 1999.2. Murphy J, O’Donoghue G., Bilateral Cochlear Implantation: An Evidence-Based Medicine Evaluation, Laryngoscope, 2007.

Nucleus is a registered trademark of Cochlear limited. Baha is a registered trademark of Cochlear Bone Anchored Solutions AB. Freedom, Cochlear and the elliptical logo are trademarks of Cochlear Limited. © Cochlear Limited 2010.

As a Cochlear recipient, you know the enormous difference an implantable hearing solution has made to your life. Now your life-changing story could inspire other adults and children all around the world.Imagine – you could be the person who inspires someone else to discover the joys of hearing now and always. Here are some common questions to get you started:

• What concerns did you have about getting an implant (if any)?

• What resources did you use to help you make the decision (audiologist, education program, online research, speaking to another recipient)?

• What was life like before, and then with, your cochlear or Baha implant?

• How did you feel before and after you got your cochlear or Baha implant?

• What finally convinced you to get the implant?

• After switch on, what was the first thing you heard and what was the experience like?

• If you are a bilateral recipient, how does hearing with two ears compare to one?

• What is the most memorable experience from your journey?

• What is your favorite sound?

• What advice do you have for others considering an implantable hearing solution?

So please, share your experiences at cochlear.com/community today.

Change someone’s life Improving Your HearingHow Cochlear Accessories can help every dayCochlear’s accessories are all about connecting with the world around you. Whether you want to hear the teacher, dance to music or take in a movie with friends, accessories are often the key to really enjoying – and improving – your ability to hear.

• TV/Hi-Fi CableConnect your system directly to mains-powered equipment like your TV, home stereo, personal computer or gaming console. It’s the ideal way to enjoy programs without bothering others. Simply use your volume and sensitivity controls in the usual way, to set the sound and environmental noise levels to suit your hearing.

• Personal audio cableWhy should you miss out on all the exciting personal audio products that are around today? Our personal audio cable lets you connect an iPod®, Walkman®, MP3 player, portable radio or other battery-operated product to your Cochlear or Baha system, then use your volume and sensitivity controls to personalise your audio experience.

• Lapel Microphone Wearing this discrete, external microphone on your lapel lets you enjoy better noise filtering and clearer reception in noisy or difficult settings. This microphone is separate to your system’s in-built microphone and, when it’s connected, you only hear through the lapel microphone. You can easily move it closer to the person or sound you want to hear; and you can adjust the volume and sensitivity in the normal way.

• TelecoilsHear more clearly on the telephone, and enjoy better sound quality in buildings equipped with a loop facility – such as cinemas, lecture theatres, train stations, etc.

To find out more about accessories for your system, contact your clinic or Cochlear.