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In the past, cochlear implants were employed in people with severe hearing loss, improving their ability to hear the conversations around them. But now, research shows that these devices offer benefits to patients with mild or moderate hearing loss – a group that UNC researchers and doctors are soliciting to receive cochlear implants as part of ongoing clinical trials.

From Endeavors magazine:

A semicircle of stereo speakers surrounds George Schneider, who sits with his hands folded in his lap in the middle of a small, soundproof room.

A woman’s voice emits from one of the speakers: “I just need a little air.” Schneider repeats the phrase. “Take a wild guess.” Schneider repeats that phrase too.

Gradually, more voices join in from the various speakers, talking over the woman. “The engagement was not official.” Schneider, in his 60s, squints his eyes as he tries to concentrate. “Something artificial?” He’s less sure. By now, the room sounds like a crowded party layered with dozens of voices.

Schneider, who has a hearing aid in one ear and a cochlear implant in the other, is participating in a UNC clinical trial exploring indications for cochlear implants. Unlike hearing aids, which amplify sound, an implant helps restore speech perception. A patient needing one may be able to hear one-on-one conversations, but struggle to follow conversation among background noise.

“I don’t think that most people who have good hearing recognize what impact not having it has,” says Kevin Brown, MD, medical director of the Children’s Cochlear Implant Center at UNC. “It becomes very isolating and really affects quality of life.”

Previously, cochlear implants were predominately used for people with poor hearing in both ears, as outlined by the Food and Drug Administration and many insurance companies. If a patient had a lesser degree of hearing loss or single-sided deafness, there weren’t many options.

“Patients were told if they had one normal hearing ear that was good enough,” says Margaret Dillon, MD, director of the UNC cochlear implant clinical research program. “Now we know that hearing in one ear is not good enough. There are options that can restore that hearing.”

Evidence points out a correlation between hearing loss and increased social isolation, depression, and fatigue, Brown notes. Most recently, it has also been associated with accelerated cognitive decline, like dementia. Among children, hearing issues can lead to difficulty in learning and behavior problems.

Researchers at the UNC Adult Cochlear Implant Program and the Children’s Cochlear Implant Center explore these expanded indications. Around 70 patients have participated in a total of six clinical trials thus far, completing a variety of auditory tests every few months for one year after implant activation. Among participants, researchers have seen significant improvements in speech perception, ability to localize sound, and better quality of life reports.

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