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Improving cochlear implantation surgery to preserve residual hearing

Nauman Hafeez is a PhD student in Dr Xinli Du’s laboratory at Brunel University, London. His project will end in September 2020.

A cochlear implant restores hearing by converting sound into electrical signals that are transferred via electrical contacts implanted in the inner ear to the hearing nerve. The hearing nerve then carries these signals to the brain to be perceived as sounds. Cochlear implantation involves the insertion of an electrode array into the cochlea (inner ear) by a manual micro-surgical process.

There are two issues with this approach – it can induce trauma which leads to the loss of any remaining hearing a person might have, and there is a limit to how precisely and accurately the electrode can be placed within the cochlea. Currently, only 5% of eligible people opt for cochlear implantation. This low uptake is, in part, a direct result of people’s concerns that the benefits of cochlear implants don’t outweigh the risk of losing their remaining hearing during the implantation procedure. 

To preserve residual hearing, the physical trauma that is induced during implantation needs to be kept to a minimum. Reducing surgical trauma should make individual outcomes more predictable, residual hearing should be preserved and the performance of the implant itself should be greater.

Project aims

The aim of Nauman’s project is to develop new micro-technology to allow a cochlear implant electrode to be inserted automatically into the inner ear with a high level of precision and minimal trauma. He will investigate how changes in the electrical properties of the implant as it interacts with surrounding tissue and the shape of the cochlea itself during implantation can be used to control the insertion process to avoid damage to the cochlea.

He will also investigate technology that could be able to ‘pull’ the implant into the cochlea. His goal is to integrate the sensing and insertion technologies to automate the placement of cochlear implants in the cochlea. This will allow implants to be placed in the cochlea with high precision that is beyond the capability of surgeons. 

Project benefit

This research could lead to technology that reduces the amount of damage caused to the cochlea when a cochlear implant is fitted. This would lead to more predictable outcomes for people undergoing implantation while at the same time better preserving their residual hearing. This in turn could lead to eligibility criteria for cochlear implantation being relaxed, and an increased number of people with hearing loss gaining access to cochlear implants.