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Pioneering implants for deaf people

TWO deaf women in the US have become the first people to undergo the risky procedure of having implants in their brainstems.

The devices are designed to restore hearing by directly stimulating nerves. Some deaf people have been given implants that sit just outside the brainstem, but these do not work very well.

Feeding auditory signals directly into the brainstem should work better, but because the brainstem carries signals from the entire body to the brain, any damage caused by an implant could be disastrous.

The procedure is far more risky than, say, placing implants in the cortex to try to restore some vision. "If you damage the cortex it's not that big a deal. But at the brainstem level every neuron you damage could damage function," says Bob Shannon of the House Ear Institute in Los Angeles, the surgeon who pioneered the procedure. "We took 15 years to convince ourselves that this could be done safely."

Most deafness is caused by problems with the sound-detecting hair cells in the cochlea in the ear. Cochlear implants bypass the hair cells and stimulate the auditory nerve directly. But they cannot help people with a damaged cochlea or auditory nerve.

This often happens as a result of type II neurofibromatosis (NF2), a rare disease that causes benign tumours in the inner ear.

At the moment, the only way to restore hearing to people with NF2 is to stimulate the brainstem using a non-penetrating device called an auditory brainstem implant.

ABIs enable the person to hear, but usually not well enough to understand speech because the implant cannot separately stimulate different groups of nerves corresponding to distinct frequency ranges, or "channels".

Cochlear implants do not have this problem because nerves corresponding to audible frequencies are spread along the length of the cochlea.

By stimulating different points on the cochlea it is possible to activate eight or more channels- e
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Contact: Claire Bowles
claire.bowles@rbi.co.uk
44-207-331-2751
New Scientist
7-Jan-2004


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