Breakthrough: A Re-sounding Remedy


ALLYSON SISLER
DINWIDDIE: I never thought in a million
years I would ever end up deaf– completely deaf. June 4 of 2004, I got in
a motor vehicle accident that ultimately ended up causing
a progression of my hearing loss over the course
of about six months. I’ll never forget this day
because it was a Saturday. I had a little dog. She went to the door
like someone was there. I couldn’t hear her bark at all. And at that point I realized,
there’s no more hearing left. This is it. I’m a pediatric audiologist
here at Vanderbilt. Being an audiologist, it’ll
send me from the schools to the clinic back to OR. During cochlear
implant surgery, my job is to check the integrity
of that cochlear implant before the surgeon
implants the device. When I was young, my hearing was
tested for the very first time. And we walked away
with hearing aids. I had hearing loss growing
up, but the car accident made it so much worse. I remember my father
saying to me, Ally, promise me that you will never,
ever let your hearing loss get in the way of anything
you want to do. In 2003, I started my first
year of graduate school with my hearing aids. But between my first
and second year, I got in the car accident,
and there was no more sound. That’s when I realized I
want to try to find a way to keep on keeping on. I want to be an audiologist,
and there’s got to be a way. RENE GIFFORD: Ally had
basically almost no sound detection whatsoever. We’re talking about the most
severe types of hearing loss. My name’s Rene Gifford. I run a large research program. I teach in the graduate
school program here. I also direct a large
portion of the clinic. I see patients. I was actually raised
by my grandparents. My grandfather incurred
very severe hearing loss during World War II, and
so you had to speak loudly. You had to speak clearly. You had to get his attention. It absolutely shaped
sort of my desire and my interest that would come
into play many years later. Like Tim said, you
want to look straight until the noise is played. SPEAKER 1: Ready bearing
go to white five now. RENE GIFFORD: Helping
people who have hearing loss is pretty complex. We’ve got the outer
ear, of course, that everybody is familiar with. You’ve got the ear canal. At the very edge
of the ear canal is the tympanic membrane– or
as we call it, the ear drum. Connected to the
tympanic membrane are the three smallest
bones in the body. The very smallest
bone in the body is then connected
into the inner ear. The inner ear is the cochlea. Within this cochlea,
it’s three small chambers that are filled with
highly conductive fluids. And then you have a
number of hair cells and their vibration creates
this electrochemical reaction through the auditory
nerve and then ultimately up to the brain. SPEAKER 2: When I
was 25, I started losing my hearing for no
reason at all, pretty much. RENE GIFFORD: The
most common type of hearing loss that we see
is the deficit of the cochlea. It’s a deficit of
those hair cells that are dysfunctional or
are completely destroyed. ALLYSON SISLER-DINWIDDIE:
As hearing loss gets worse, you lose the ability to
piece things together. There’s just not
enough information. A cochlear implant
definitely has the ability to provide sound. A very different kind of sound. It’s an electronic
device, but it’s in the brain where all of
the magic really happens. RENE GIFFORD: Cochlear
implants bypass the outer and the
middle ear entirely. The actual implant itself
is placed beneath the skin. And then the electrode
array enters the cochlea or through the middle ear. Each of those individual
tiny electrodes are actually stimulating
auditory nerve fibers from within the cochlea itself. That device receives input from
the external processor that’s worn on the outside of the ear. This is connected
through a magnet. ALLYSON SISLER-DINWIDDIE: When
I got my first cochlear implant, I went from nothing
to a world that’s so far beyond what my hearing
aids were able to provide. And I had no idea how
much I missed growing up. No idea. RENE GIFFORD: Cochlear implants
are a miraculous technology, but when you stimulate an
electrode, even though you’re wanting to stimulate just a
narrow population of cells, what happens is it spreads. SPEAKER 3: It’s got kind
of a background noise I hear when I’m talking. RENE GIFFORD: We know
that’s one of the biggest culprits for why our
patients struggle for communication and noise. Why they struggle
with music perception. SPEAKER 2: So a piano would
sound a little different or like a violin
would sound different. RENE GIFFORD: If you think of
electrical spread of activity causing a smearing of
the incoming frequencies and pitches, more could
potentially be less. Now with a cochlear implant,
you can see the electrode array as you’re inserting it,
but beyond the first turn of the cochlea, you’re
basically blind. The engineering group was
looking at 3D reconstruction of the internal ear. And we just kind
of said, we know the distance between each
one of those electrodes in those neuron targets that
we’re trying to stimulate. Now let’s selectively deactivate
some of those electrodes. SPEAKER 4: What we have
suggested is turning off 6, 9, and 10. RENE GIFFORD: Fewer number of
electrodes, but the right ones. It was sort of like
one of those literally “aha” moments that you get a
handful of times in a career. We’ll take everybody’s
individual anatomy and function and really develop
a cochlear implant program that can maximize
their hearing capabilities. ALLYSON SISLER-DINWIDDIE:
I had heard this research was going on. I was here on staff. But as a patient, to hear that
we’re going to turn stuff off. Even though I know–
even though I knew it was going to be for the best. I was very nervous. RENE GIFFORD: Ally was the
first or second participant. ALLYSON SISLER-DINWIDDIE:
I kept thinking we are all here to make this
experience better for everyone else. If we don’t do this,
we’ll never know. RENE GIFFORD: With her,
I recall it was just two electrodes we deactivated. I turned off those two
electrodes and she said, it’s like you took a
pillow off my head. ALLYSON SISLER-DINWIDDIE:
That program ended up being so far
beyond my other program that I had before. RENE GIFFORD: I am
very much a skeptic. You know, I just– unless I
see data, I don’t believe it. So she came into the lab. At her baseline, she was getting
about 38% word recognition. And we just ran that test again. She was at 88% overnight by
just turning off two electrodes. We were just so excited. ALLYSON SISLER-DINWIDDIE:
So it’s been four years. The number of patients that have
been able to take part in this, it has gone on and on. And so they’re not
going to stop here. RENE GIFFORD: So you ready? Morgan Yeah. RENE GIFFORD: Yeah? OK. Activation can be a very
emotional experience. This is something
they’ve been waiting for. They’ve had surgery
and now they want to know how well
it’s going to work. So I’m going to have you
just turn around and talk to your parents and
just kind of see what their voices sound like and
kind of get used to the sound. Morgan Hi. SPEAKER 6: Hi, Morgan. Morgan You sound the same. SPEAKER 6: I sound the same? You remember my voice? SPEAKER 7: Can you hear me? [INAUDIBLE]? Pretty cool. SPEAKER 6: Is it better? Morgan It’s a good thing. RENE GIFFORD: I love it. I mean, that’s the moment. One of the goals
is to try to get this technology into the
hands of people who need it. The Mama Lere Hearing
School at Vanderbilt– we’ve enrolled about 30 children. And the children actually
show even greater outcomes than the adults. SPEAKER 8: Boom. Boom. SPEAKER 9: Beautiful, Laura. RENE GIFFORD: And we’re really
hopeful that, in the future, we’ll really develop
a cochlear implant program that can maximize
their hearing capabilities. ALLYSON SISLER-DINWIDDIE: Yeah! The patients that I have the
opportunity to see every day help me just as much as I am
hopefully able to help them. RENE GIFFORD: What a role
model for these little patients of ours who see that
gosh, look, Dr. Ally’s got implants just like I do. And I can grow up and I
can help other people too. I mean, we couldn’t
ask for a better job. ALLYSON SISLER DINWIDDIE:
Everybody’s got challenges. Everybody’s got things
that they want to overcome. It’s just all about
your perspective. SPEAKER 10: Bye, Miss Ally.

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