MUSC performs state's first Sophono implant procedure

by Ashley Barker
Public Relations

A new option to restore the ability to hear for patients who have deafness in one ear is now available at MUSC.

Paul R. Lambert, M.D., chair and professor, Department of Otolaryngology, Head and Neck Surgery, performed the state's first Sophono Alpha 2 implant on a patient Jan. 2. The Sophono procedure rehabilitated hearing through Rick McComsey's right ear to his left ear, something he hadn't had for nearly 10 years because of an advanced inner-ear disease.

Dr. Paul Lambert attaches the Sophono device to the right side of Rick McComsey's head.

"During my childhood, I often had ear aches," McComsey said. "Back in October of 2003, I had an ear ache. I just thought, I'll take some antibiotics and get rid of it. But it didn't go away."

When McComsey went to his doctor in Phoenix, he was diagnosed with Meniere's disease, a condition caused by too much fluid in the inner ear. As the disease progressed, McComsey began losing hearing in one ear.

"The hearing loss just got worse and worse," McComsey said. "My doctor told me a traditional hearing aid wouldn't work. I thought this was something that I'd just have to live with."

McComsey, 43, explained that prior to the Sophono procedure he could hear a sound through his good left ear, but he wouldn't know what direction it was coming from.

"I would literally be looking around trying to find it," he said. "It was especially annoying while driving, because if I heard an ambulance I didn't know if it was beside me, behind me, in front of me or underneath if I was on a bypass."

It also caused problems with people trying to get his attention.

"Suddenly you hear someone talking to you and you have to look around to see where it's coming from. People think you're ignoring them, but you're not," McComsey said. "My wife had to be my second pair of ears."

After moving to the North Charleston area in 2007, McComsey decided to research alternatives to being deaf in one ear for the remainder of his life. He came across the Bone Anchored Hearing Aid system, which involves placing a titanium post through the skin and into the bone of the skull. The system restores hearing, but a transcutaneous post is left protruding through the skin to attach to a hearing aid. The post can become infected and most patients don't find it cosmetically appealing.

McComsey was willing to deal with the post and its potential risks in order to have his hearing back. But before the procedure was done, the FDA cleared the Sophono implant.

"The Sophono device is a different system in that there is no transcutaneous post. It's all implanted beneath the skin," Lambert said. "A hearing aid instrument attaches magnetically to the skin. It picks up sound, digitally amplifies that sound, and transfers it into vibrations, which are then passed through the skin into a titanium encased magnet attached to the skull. Then the signal is transferred to the opposite ear through bone conduction."

Dr. Paul Lambert

Thirty days after the 40-minute outpatient Sophono surgery is complete, the patient returns to be fitted with the external part of the device, which restores hearing. With the BAHA system, a patient must wait three to six months after the surgery for the post to integrate into the bone before hearing is restored.

The internal portion of the device is about the length of a paperclip, according to Lambert. The external portion, which is about half the size of a person's little finger, is held in place magnetically.

"There have been tremendous advances in magnet technology," Lambert said. "We use them in our cochlear implants, which we do often here. As that technology improved, it has been transferred to hearing aid type devices, like the Sophono."

The ideal patient for the Sophono device would be someone who is totally deaf in one ear. If the patient is deaf in both ears, he or she would be a candidate for a cochlear implant.

It would also be applicable to an individual who had a conductive hearing loss, which is when the nerve is normal but it simply cannot conduct the sound into the inner ear, for example if someone was born with no ear drum or ear canal. In that case it would be used to transfer the sound into the nerve of that ear.

McComsey is the first patient to have a Sophono implant in South Carolina, according to Lambert, even though the technology has been in the United States for more than four months.

"We like to think that MUSC is at the leading edge of all technologies. This is one technology that simply corroborates our standing as an innovative center," Lambert said. "Fortunately there are not a lot of patients out there with total deafness in one ear. Traditional hearing aids can help the vast majority of patients. I would project maybe 20 to 30 patients a year at MUSC that may be able to benefit from this technology."

McComsey began benefiting from the Sophono implant the same day it was fitted.

"The first night that I had it, my wife and I were going to church. I was walking in the parking lot, and I heard someone call my name behind me. I turned around and said 'hello' to him. That would never have happened before this. I would have just kept walking," he said.

The external part of the Sophono is not waterproof, but McComsey doesn't mind taking the magnet portion off.
"Living with it is really nice. I can reach up, take it right off and not have to worry about it. If my head itches, I just take it off, scratch then put it back on," he said. "It's phenomenal."

Friday, March 8, 2013