New Methods of Imaging the Inner Ear Help Improve Diagnosis of Deafness

Hearing-loss is the most common
sensory deficit across the globe. By 2025, 900 million people will
be affected by hearing-loss. It’s also being associated
with increased social isolation and depression and that leads to huge costs
personally and for society at large. The problem that we have to overcome is we cannot see inside the inner-ear and so for the vast majority of people,
we don’t know why they’re going deaf. The Bertarelli Program for Translational Neuroscience
and Neuroengineering has enabled us to actually
tackle this difficult problem. How is your hearing now? My hearing-aid in my right ear
is turned all the way up and I can barely hear you. And, if I don’t have
my hearing-aids in, I can’t hear myself talk, even with the hearing-aids in,
I can’t hear myself breathe, and you’re in isolation. You had a brain MRI scan,
and everything looked okay. -Yes.
-So this is a big enigma. I’ve been totally
healthy my whole life, this just blows me out of the water. So it’s very frustrating. Patients like Sally
are really frustrated by not knowing what
is causing their hearing loss. They keep asking, “Why? Why?” “How can that be?
We are in the 21st century!” “Technology is exploding, and you still can’t tell me
what’s wrong with my ear?” “Well how can you then help me?” And they’re right. The incredible vision
of the Bertarelli Foundation allowed people with complementary
expertise to come together and talk about big and important
problems in neuroscience and see if by joining forces
and thinking out of the box, we may be able to solve them. Dimitri Psaltis, he is an optical
engineer and has been studying how to view things through turbid media. And I realised that if he
really knows how to see through difficult encasing bone, then we could look
inside the inner ear. Well that was actually
Tina coming to me, at the event organized to get the
Harvard and the EPFL people together. And she said well,
we have this problem, that we can not see
inside the cochlear. Cochlear is a very very small organ. It converts the sound
into electrical signals. And she said, “well, we’d like to
be able to see what the problem is.” A majority of hearing-loss
originates from the inner-ear. And the inner-ear is one of the few
organs in the body you cannot biopsy. The hairs cells that are located
inside the cochlear here basically are directly
connected to the brain. We have encasing bone around, so it’s really difficult
for the tools to access. So the first thing is,
‘how do I get there?’ The first stage of funding was, to find out whether there
is a way to see the cells. We looked at cochlears that
have been extracted, from mice. And the major finding then, was that you could see under
normal microscope….florescence. Which means that in a human
we could do the same thing. And when we saw, that
we could see individual cells, we thought – wow –
let’s keep working on it. The next step was
to do this in humans. And for that you have
to enter the ear canal through the middle-ear
and then get to the cochlear, and, now we have to design
an instrument, then look inside. This setup that you see here is a prototype version of what
we call a confocal microscope. So it is, in a sense,
a regular microscope, except that it allows you
to see things in three dimensions. And then through that you can see about half of the first
turn of the cochlear, which is the part of the
cochlear that is responsible for high pitched noise, which is the
part that gets damaged the most. Of course, seeing these cells for
the first time has been exhilarating. The next step is to make a version
that Tina can use in humans. And so, we need to have something
that is engineered to be hand-held. What that would mean
is that we could actually tell what’s wrong
in a patient’s inner ear. We can then design and customize
therapies for a given patient. It affects me socially, it’s got to be frustrating for
whoever I’m speaking with too. My husband says,
“I miss talking to you.” We are incredibly grateful
to the Bertarelli Program for allowing us to tackle what
seemed as an impossible task. If we’re successful, you know, we can
help make people hear. You know right now,
my world seems like that with each day it gets
smaller and smaller. I hope it’s within my lifespan, you know, that they’re going
to come up with some answers and some equipment that… …will bring you back to… …life.

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