UAMS Audiologist Receives Second Cochlear Implant
Oct. 16, 2012 | Audiologist Samuel R. Atcherson, Ph.D., has a more personal view of hearing loss than some in his profession since he began losing his own hearing at age 3.
UAMS audiologist Samuel Atcherson (right) visits with John Dornhoffer, the surgeon who recently installed Atcherson's second cochlear implant.
Atcherson has used a hearing aid in his left ear, a cochlear implant in his right ear and his lip-reading ability to perceive sounds and communicate. But with profound hearing loss, he still had problems carrying on a conversation in a noisy room or in a situation with a lot of background noise.
Atcherson is an assistant professor of audiology in the Department of Audiology and Speech Pathology, which is hosted jointly by the UAMS College of Health Professions and the College of Professional Studies at the University of Arkansas at Little Rock.
Now, after 12 years with one of the surgically implanted electronic devices that transmit sound impulses directly to the brain, Atcherson received an implant in his left ear in August. The devices were activated in concert recently, an experience he described as "interesting."
"I was content with the first implant for nearly 12 years and felt I had a reasonably good quality of life. I had just enough residual hearing in the non-implanted ear and was still getting considerable benefit from it with a hearing aid while wearing it together with my first cochlear implant," Atcherson said.
"Lately, I began to feel that maybe I wasn't getting as much benefit as before and began to think that perhaps with two cochlear implants I might get a little more benefit,” he said. "The goal isn't 'perfect' hearing, which I know I will never achieve with two cochlear implants. But every little bit of improvement can help as I begin to encounter more and more complex listening situations that my life and career have demanded of me."
Atcherson joins a small but growing number of patients who are choosing to have bilateral implants - an implant in each cochlea. He is continuing to go through the process of "tuning" the implants as his brain is being trained to discern sounds from the two implants.
The surgeon who performed Atcherson's second implant procedure, John Dornhoffer, M.D., professor and director of the Division of Otology and Neurotology in the College of Medicine, compared the tuning process to learning a new language.
"When they are turned on, you have to train your ear to hear — like learning a foreign language," said Dornhoffer, who is world-renowned for pioneering ear surgery advances. "At first you hear nothing but after a few months it starts to click and you can do it without thinking — the patient is learning to hear sounds all over again."
Dornhoffer said most born with significant hearing loss will have bilateral implants while still in infancy. Bilateral implants in older patients is increasing with growing research that shows benefits to having the dual implants, he said.
"The perception of sound changes for bilateral implants versus unilateral, with benefits especially for discerning background noise, directional sound and better understanding in a noisy environment," he said.
The implants help patients whose hearing loss is due to damage to or loss of the hair cells within ear that act as sensory receptors and transmit sounds through the auditory nerve to the brain. While the hair cells are damaged, the nerve remains, so the implant includes electrodes that tap into the nerve and replace some of the function of the hair cells.
The quality of sound from the implants is different from natural hearing, but it offers many patients the ability to hear and understand speech and environmental sounds.
Atcherson said his experience with his first implant got off to a rocky start. He had trouble telling the difference between a male voice and a female voice. He continued to have trouble understanding conversations, so he threw himself into situations that challenged the device and his hearing.
"Two months after the implant I began to feel a sense of normalcy with hearing," he said. "By six months, I was using the phone, which was my ultimate goal."
He called the decision to get the second implant not an "if" but a "when."
After healing from the surgery to install the second implant, the new implant was activated. For the first few weeks, he didn't use the original implant, giving his auditory system a chance to sync up with the new implant.
"It's a common practice, kind of like wearing a patch over a stronger eye to give a lazy eye a chance to strengthen," he said. "It was a bit of an adjustment."
Atcherson has adjusted to his hearing loss since an early age when he was diagnosed with large vestibular aqueduct syndrome, an abnormality in temporal bone growth in the ear that resulted in progressive hearing loss throughout his childhood.
He had a hearing aid by age 4. He learned speech before his hearing loss reached profound levels. He also learned sign language in middle school to communicate with peers.
Dornhoffer said Atcherson's personal experience uniquely positioned him to appreciate the ability to hear and communicate.
"He understands hearing loss better than anyone I know — which offers him an advantage in his field because he has that experience," Dornhoffer said.
Atcherson said though he knew at an early age he wanted to work in health care. However he feared his hearing loss would keep him from working directly with patients. An audiologist he went to for hearing aids encouraged him to consider a career in audiology instead of laboratory sciences.
While his hearing loss didn’t drive him to enter audiology, he considers it a motivator. “I think it gave me a sense of purpose,” he said. “I can be objective when talking to a patient, but also can share a personal side.”
Since joining the UAMS faculty in 2008, Atcherson has earned kudos for his teaching with a Chancellor’s Faculty Teaching Award for 2010-2011.
Also in 2011, he received the College of Health Related Professions’ Excellence in Teaching and Excellence in Scholarship awards. It was the first time in the college’s history that one person received both awards in the same year.
He sees teaching as another way he can help patients with hearing loss. “I may not be able to help everyone, but I can help train 20 to 25 students each year who will go on to see patients,” he said.
UAMS Audiology Clinic