A new implant could help the many people who struggle with standard hearing aids.  Peter Kay, 70, a business consultant from Bramhall in Greater Manchester, had one fitted, as he tells CAROL DAVIS. THE PATIENT
Peter Kay, 70, from Bramhall in Greater Manchester
Peter Kay, 70, from Bramhall in Greater Manchester
My first indication that I had a hearing problem was nearly 20 years ago when my wife, Olwyn, and I were on a summer holiday in Switzerland.  I couldn't hear the crickets or the fact that I'd left our car indicators on - Olwyn had to tell me. Back home, my GP referred me for hearing tests at Wythenshawe Hospital, in Manchester - the audiologist confirmed I had age-related hearing loss, caused by the tiny hair cells in my inner ear dying off.  These cells help transmit nerve signals to the brain. It happens to everyone, but can be worse in some families - my father had it severely in his 70s. I didn't need hearing aids straight away.  But six months later, a test showed my hearing had worsened to the point where I needed one for my right ear and, six months after that, I had one fitted in my other ear as well. The hearing aids helped, but the plastic inserts felt strange, and the sound was distorted. And after five years, I began to suffer from severe infections caused by the hearing aids - they stopped oxygen getting into my ear, which meant bugs could flourish. I also developed eczema in my ear, and had to have skin and debris syringed out regularly.  Every few months I was having steroid and antibiotic drops to get rid of the infection - changing hearing aids didn't help. And because I couldn't tolerate the hearing aids when my ears were infected, my hearing was still bad - Olwyn didn't like me going out alone, as I couldn't hear the cars.  So, four years ago I was referred to Manchester Royal Infirmary where I saw Kevin Green, a consultant ear, nose and throat surgeon. He told me about a new implant called Vibrant Soundbridge that would boost the sound signals reaching my brain - this would involve having an operation to fit a special vibrating device, about the size of a grain of rice, to the tiny hearing bones in the middle ear.
These bones move in response to sound and the vibrations are then transmitted to the hair cells - the extra stimulation from the implant would send stronger vibrations to my inner ear, to help my damaged hair cells function at their best without a hearing aid. I should also stop getting ear infections, too.  A few weeks later, once the blood from the surgery had cleared, I would be fitted with external processors, held behind each ear with magnets, to pick up the sound.
The new implant, Vibrant Soundbridge, boosts the sound signals reaching the brain
The new implant, Vibrant Soundbridge, boosts the sound signals reaching the brain
In August 2010, I had the three-hour operation to have the implant put in both ears. When I woke up I couldn't hear anything at all.  This was very disconcerting, but I knew it was temporary - caused by the build-up of blood. Once I had the external processors fitted I could suddenly hear normal conversations again, which was great.  Within four to five weeks I was able to listen to the TV at its normal volume - my hearing is almost as good as it was in my 30s. My eczema and skin infections have also gone. THE SURGEON Kevin Green is consultant ENT surgeon at Manchester Royal Infirmary More than 600,000 Britons have severe hearing loss. The most common is age-related, which affects everyone by their 60s or 70s. When we hear, soundwaves move through the ear canal and make the eardrum vibrate. The vibrations are passed via three tiny bones in the middle ear, to the inner ear. This contains a structure called the cochlea, which has thousands of tiny hair cells that convert the vibrations into nerve impulses which are carried to the brain. As we age, these hair cells become damaged and die.
Peter, 70, pictured with wife Olwyn on their wedding in '67, says hearing is 'as good as it was in his 30s'
Peter, 70, pictured with wife Olwyn on their wedding in '67, says hearing is 'as good as it was in his 30s'
For most people, small digital hearing aids - which work by amplifying sounds - will be effective. But some people suffer from repeated ear infections because the hearing aids block the ear canal.  One alternative is a bone-anchored hearing aid, where a sound processor is attached to a screw in the skull. But some people don't like the idea of this.  Also, this procedure works best for those with conductive hearing loss, when sound cannot pass freely to the inner ear, perhaps due to a blockage or a problem with the hearing bones. Until a decade ago there wasn't much more we could do for people with sensorineural hearing loss - caused by damage to the hair cells. This is where Vibrant Soundbridge comes in. It was developed in the U.S. around 20 years ago, but has only become widely used in the UK in recent years.  As with a conventional hearing aid, the implant boosts hearing across all frequencies, including the high frequencies that people tend to lose first - women's voices and speech. It also uses sophisticated technology to cut down on background noise. Many people do well with hearing aids and don't need surgery, but this could help thousands of Britons with moderate to severe hearing loss who don't get on with hearing aids, including people with damage to their middle ear or inner ear. The operation takes 60 to 90 minutes under general anaesthetic. First, I make a 6-7cm incision behind the ear and drill a 3-4mm wide tunnel through the mastoid bone behind the ear to reach the middle ear. I then clip a vibrating device to the central bone in the middle ear. The vibrating device - called a transducer - is 2.3mm by 1.8mm and is like a tiny generator which vibrates. It has a wire wrapped around it - this wire runs to the other part of the implant which works like a radio receiver. I tuck this 'receiver' under the muscle and tissue close to the skull behind the ear, closing the incision with dissolvable stitches. This will transmit signals to the transducer.
 The Vibrant Soundbridge boosts hearing across all frequencies, including the high frequencies that people tend to lose first - women's voices and speech
Once the blood from surgery has cleared, usually after two or three weeks, we use a magnet to attach an external audio processor to the skin, on the other side of the implant.  This picks up sounds, which are transmitted to the receiver and onto the transducer, making it vibrate. The operation carries small risks including loss of hearing - potentially permanent - if we damage the delicate middle ear bones. There is also the risk of bruising the nerve supplying taste sensation - though this should ease after a few weeks - and damaging the facial nerve which runs through the mastoid bone, leading to temporary or permanent facial paralysis. But I'm delighted to see this operation worked well for Peter. It has transformed his life. ANY DRAWBACKS? As well as the risk of hearing loss and bruising to nerves, touching the hearing bones could lead to tinnitus, says Mike Pringle, consultant ENT surgeon at Portsmouth Hospitals NHS Trust. He says: 'Previously, patients with Soundbridge could not have an magnetic resonance imaging (MRI) scan because it was thought the magnetic charge would displace or demagnetise the implant. 'But recent experience has shown the risk is small. Overall, this is a great device which has stood the test of time for reliability and effectiveness.' The operation costs £12,000-£15,000 privately and £8,000-£10,000 to the NHS - it is available in 15 NHS and private centres.