- Billy Coughlin has had his hearing restored thanks to implant
- The 22-year-old aspiring actor has been deaf in one ear since 17
- The new bone anchored magnetic implant is inserted beneath skin
- An electronic sound processor can then be be attached when needed
Sound of music: Actor Billy 22, can now hear 'the smallest noises' after implant
A revolutionary magnetic implant has restored the hearing of a young actor who went deaf in one ear at the age of 17 – and gives new hope to the thousands of Britons who cannot benefit from traditional hearing aids.
Aspiring TV and theatre star Billy Coughlin, 22, from Hall Green, Birmingham, had the groundbreaking procedure at Heartlands Hospital, Birmingham, in March and says: ‘I can now hear the smallest noises, like footsteps.
‘It sounds silly but these are things I’ve not been able to hear for five or six years. I finally feel I’m my normal self again.’
The new device is the bone anchored hearing aid (BAHA) Attract, and it replaces the older version of the BAHA.
While the traditional implant uses a metal screw that is embedded in the patient’s head and channels vibrations to the inner ear, the Attract involves a small magnetic disc being inserted beneath the skin behind the ear.
This allows an electronic sound processor – the size of the bluetooth hands-free mobile phone earpiece – to be attached or removed as needed.
When the receiver is not worn, the implant is completely invisible.
Billy lost most of the hearing in his left ear after developing an infection of the inner ear bones called mastoiditis. He has full hearing in his right ear.
After struggling with his hearing, he was referred to surgeon Matthew Trotter at the hospital’s ENT clinic earlier this year.
Billy trialled the device using a headband to attach it behind the ear. Then, a month after surgery to implant the magnetic disc, a sound receiver was fitted, giving him full hearing again.
Mr Trotter explains: ‘How we treat hearing loss depends on the physical cause of the problem.
‘BAHAs are suitable for patients who have problems with the outer and middle parts of the ear, usually due to infections or previous surgery. In these people, using a normal hearing aid in the ear canal won’t help because the transmitted sounds won’t reach the inner ear.
‘It’s important to note these are not cochlear implants, which are for yet another group of patients – those with hearing loss due to problem in the inner ear.
‘BAHAs basically involve a titanium alloy peg being screwed into the skull behind the ear, so part of it pokes through the skin. In a similar way to a dental implant, the surrounding bone integrates with the screw, making it very secure and not removable.
‘The screw transmits sounds picked up by the receiver directly into the inner ear, bypassing the outer parts. But patients are left with a metal screw sticking out of the head behind the ear, which is visible when the receiver is removed – to swim, for instance.
‘This alone puts many off, but it also takes a lot of care and special cleaning on a daily basis to avoid infection.
‘The great thing about this new implant is there is no screw poking out. The receiver attaches to a small magnet under the skin so when it’s removed, the head looks completely normal.’
The implant is attached during a 40-minute procedure under general anaesthetic. The surgeon cuts a 2in semi-circular flap behind the ear and the implant is drilled about half an inch into the bone beneath. The magnet is attached to the screw and the flap is the stitched back into place. Mr Trotter adds: ‘The skin heals in a fortnight, and the bone knits with the screw within a month. At this point it is stable, and we give the patient their receiver.’
Approximately 1,500 patients with hearing loss who will potentially benefit from a bone-anchored hearing aid are diagnosed each year in the UK. Up to half of these could benefit from the Attract device.
Mr Trotter hopes the Attract will be adopted throughout the NHS.
He says: ‘Not every case is suitable due to the subtle differences in the causes of hearing loss, but it’s worth discussing the option of the Attract with your consultant should you be referred for a BAHA.’
Billy, who has had roles in Doctors on BBC1 and ITVs Peak Practice, had been offered an old-style BAHA but turned it down as he felt a visible screw would affect his chances of success at auditions.
He says: ‘After the operation there was a bit of pain but I only needed a couple of paracetamol.
‘The moment they switched it on was a shock. Being able to hear everything perfectly was distracting at first. But now when I take it off, it’s as if someone has stuck cotton wool in my ear. Having it on feels normal.’
What is the difference between a Cochlear Implant and a Bone Anchored Implant?
A Bone Anchored Implant (BAHA) is appropriate for someone where traditional hearing aids are not efficient because of draining ears or chronic infections, blockage or damage in the outer or middle ear or loss of all hearing in one ear such as following an acoustic tumor removal. Candidates have either a conductive hearing loss or a single sided deafness. The bone anchored implant uses a titanium device placed in the skull behind the ear and a sound processor that attaches to the implant. The sound processor will collect sounds from the environment sending vibration into the implant which in turn vibrates the bone. This bone vibration bypasses the outer and middle ear and stimulates the inner ear. The hair cells inside the inner ear convert the sound to electrical impulses that travel to the brain allowing the recipient to hear naturally. A BAHA can be surgically placed on a child starting around 5-years of age. However, even infants can successfully use a Bone Anchored Implant by using a soft-band to hold the processor in place. For adults, there is no upper age limit to receiving and using a Bone Anchored Implant. Recipients report being happy to be free of hearing aid earmolds and that they are understanding speech in noise better than they were able to with their hearing aids.
A Cochlear Implant candidate differs from a Bone Anchored Implant in that they have a greater degree of hearing loss. They have a severe to profound sensorineural hearing loss (often called “nerve deafness”) in both ears where traditional amplification is no longer beneficial. Often times candidates report that wearing a more powerful aid or increasing the volume of their hearing aid is like turning up the volume on a bad speaker. It can make sound louder but more distorted. A sensorineural hearing loss can be caused by illness, head trauma, malformation of the inner ear, exposure to loud noise, general aging or other unknown causes. The Cochlear Implant is a two part system where the internal device is surgically placed under the skin and the sound processor sits on the outside of the ear capturing sounds from the environment. The processor translates the captured sound into digital information sends it to the internal implant which in turn converts the digital information into an electrical signal that stimulates the auditory nerve bypassing the damaged portion of the inner ear. The electrical signals are sent to the brain and are perceived as sound. Cochlear Implants can be placed on children as young as 12-months of age and there is no upper age limit for cochlear implant use. Cochlear Implant recipients report that they are able to relax and not work so hard to communicate with friends and family any more and are excited to share stories of all the “new” sounds they forgot were in their world.
VORP = Vibrating Ossicular Prosthesis