tiny satellite dish behind my ear to help me hear

Every year, around 10,000 Britons go deaf in one ear as a result of nerve damage. Conventional hearing aids, which amplify sound, cannot help. Christopher Burn, 61, a parking enforcement officer from Gateshead, underwent a new procedure, as he tells Thea Jordan.

THE PATIENT

My job requires good hearing because I often work alongside heavy traffic and need to be able to hear vehicles coming.

I also spend a lot of my time dealing with the public - especially when handing out tickets.

I had perfect hearing until one morning at work two years ago, when it just went in my left ear.

I heard a high pitched buzzing noise and then suddenly couldn't hear anything.

My GP said I'd had a bacterial infection without knowing it; I could have had it for weeks and not realised the damage it was doing.

The infection had permanently damaged the auditory nerve, which transmits messages from the ear to the brain.

Being able to hear only on one side made me confused and disorientated - I couldn't pinpoint where sounds were coming from, which is a particular danger in my job.

I also had problems walking properly (I was amazed to learn that the auditory nerve also sends information to the brain about balance).

When I walked to the social club down the road, my wife had to guide me because I couldn't walk in a straight line. Everyone assumed I must have been drinking.

I asked to see a specialist. The first ear nose and throat (ENT) consultant I saw confirmed I had suffered profound hearing loss, but said there was nothing he could do.

A conventional hearing aid, which amplifies sound, would not work for me because there was no sound to amplify - the nerve was damaged beyond repair and my left ear was totally deaf.

My GP then sent me to see Ian Johnson, a consultant ENT surgeon at the Freeman Hospital in Newcastle.

He said he could restore my hearing using a special digital processor screwed directly into my skull behind my left ear.

This would pick up sounds on my left side and transmit them through the top of my skull into my right inner ear so I could hear them.

My brain would be able to tell which sounds were coming from the left and which were coming from the right because of the sound delay.

I had the surgery to implant the screw six weeks later (the sound processor would be fitted after this wound had healed).

I was apprehensive about having a screw drilled into my head, but decided it would be worth it to hear again. I woke up an hour after the operation with a small dressing behind my ear; this covered the screw, which sat a few millimetres above the skin. There was no pain.

I left hospital the same day and was soon back at work. Two months later, when the screw (which is about the size of a shirt stud) had bonded tightly with the bone, I went back to see Mr Johnson, who clipped the sound processor on to the screw; it's a bit like a tiny satellite dish at the side of my head.

The sound was amazing. It took a few months for me to adjust to the time delay of the sound from my left side reaching my right ear, but soon I was able to pinpoint where every sound was coming from; my hearing was back to normal.

Every day I have to clean the sound processor with a soft brush, to prevent any infection around the screw hole. I also have to clip off the processor when I have a shower or go swimming; it's electronic and will short circuit if it gets wet.

For comfort, I also take it out at night.

Having the hearing aid has changed my life - when my ten grandchildren come to see me, I can hear them all shouting at the same time.

THE SURGEON

Ian Johnson is a consultant ENT surgeon at the Freeman Hospital in Newcastle.

He says... One-sided hearing loss is quite common and can happen for a variety of reasons, including an infection or a skull fracture.

Either way, the nerve is damaged and sound signals can no longer travel to the brain.

The condition is very difficult to treat as unlike normal hearing loss, where sounds are quieter, no sound can be heard at all.

The way to get around this is by 'capturing' sounds from the left side using a special digital sound processor and feeding them into the right ear, which still works.

Luckily, these bone-anchored hearing aids, as we call them, work really well for people such as Christopher.

The operation has been performed in the UK for the past three years on more than 1,000 people.

The hearing aid works by transmitting sound waves from one side of the skull to the other, so sound from the deaf side can travel through the skull and reach the inner ear on the side which is still working.

This extra distance causes a tiny sound delay; this is actually a good thing as it allows the patient's brain to work out where the sound is coming from.

First we insert the screw, then, at a later date, fit the sound processor. I started by making an incision in the area behind Christopher's ear and peeled back a small area of skin.

Below, I scraped away a circle of fat and muscle to expose the skull bone. Using a very precise drill, I made a hole about four millimetres deep, not so deep that I broke through the other side.

Drill has a special guard to ensure that the surgeon cannot go any further and accidentally damage the brain beneath.

It is also kept cool by a continuous stream of cold water, which is suctioned away from the wound site. If it got too hot, it would kill the bone cells in the skull and cause tissue damage.

I then enlarged the hole with another special drill. Finally, I inserted the titanium screw until it was secure and tight. Titanium has a unique feature - it bonds with the bone so the device actually fuses with the skull over time.

Exactly the same thing happens when you have a dental implant made with a titanium screw.

The screw sits inside the scraped-out area and is stitched neatly into place. The procedure takes about 25 minutes and we finish by placing a small dressing over the wound.

Christopher made a great recovery and was able to go home the same day. Two months later, once the bone and screw had fused, we fitted the processor and his hearing was completely restored.

The processor contains a battery that needs to be replaced every ten days. It is just like a watch battery and it clips into the back of the processor.

It does take a few months for patients to get used to the time delay in their hearing; the brain has to relearn how to interpret signals and which side they are coming from.

Although there is a slight risk of infection where the stud protrudes from the skin, most people are really happy with this procedure because it restores near-perfect hearing.
Hair grows over the hearing aid, so it's very hard to spot.

The only problem can be that patients forget to remove it when showering - a new processor costs around £2,000, so this can be a very expensive mistake.

• The operation is widely available throughout the UK. It costs the NHS £3,000 and up to £6,000 privately, including a year's aftercare.

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