26 PULSE SPRING 2003 EAR PHOTO: ROBERT DISCALFANI/STONE/GETTY IMAGES; PHOTO ILLUSTRATION: SHEILA JOHNSTON SHERER
ON THE CUTTING EDGE OF COCHLEAR IMPLANT TECHNOLOGY BY MARYANN B. BRINLEY Jed A. Kwartler, MD, NJMS ’83, likens cochlear implant surgery to “installing <strong>the</strong> light switch that allows someone to turn on a light.” Kwartler is a clinical associate pr<strong>of</strong>essor in otolaryngology at <strong>New</strong> <strong>Jersey</strong> <strong>Medical</strong> <strong>School</strong> (NJMS) and a University Hospital (UH) staff surgeon. “It’s a small thing to be able to do. But, for a deaf patient, it means all <strong>the</strong> world. To take someone from <strong>the</strong> isolation <strong>of</strong> non-hearing to hearing…well, that is very satisfying.” Close your eyes, he suggests. Keep <strong>the</strong>m closed. “We can continue talking and you are still connected to <strong>the</strong> world.” Now, put your fingers in your ears. Don’t take <strong>the</strong>m out. Try to have a conversation. “Being deaf can cut you <strong>of</strong>f from <strong>the</strong> world,” Kwartler says. “Even when Helen Keller was once asked if she had a choice <strong>of</strong> being blind or deaf, she chose blindness.” Sometimes, his patients are as close to home as <strong>the</strong> Alumni Office on B Level in <strong>the</strong> <strong>Medical</strong> Science Building where coordinator Dianne Mink had anguished over her diminishing ability to hear for years. No one knew exactly why this was happening (an auto-immune factor? <strong>the</strong> residue <strong>of</strong> childhood ear infections? a genetic connection? hereditary link? hormones? stress?)—and <strong>the</strong>y still don’t. Gradually, she went from one hearing aid to two and <strong>the</strong>n suddenly, not even <strong>the</strong> newest, most sophisticated device helped. That was last year. “Nothing!” she says, “No improvement. I’d be panicked. Your whole way <strong>of</strong> life changes. People think you are normal because you look normal but you are out <strong>of</strong> touch. That isolation is <strong>the</strong> worst. To be honest, I wanted this cochlear implant so badly that I was just fine, not nervous at all, on that morn- PHOTO COURTESY OF COCHLEAR LIMITED ing <strong>of</strong> surgery in June,” she says. Her three grown daughters “were bananas!” she laughs, “and wondering why I would do this to myself. Yet, <strong>the</strong> situation had become so stressful and even in terms <strong>of</strong> connecting to <strong>the</strong>m, I just feel this is a miracle I needed.” Like a complicated melody in a symphony <strong>of</strong> sounds, a cochlear implant is a complex medical solution with a rich, rocky history and success doesn’t begin or end with <strong>the</strong> surgery. The brain itself may have to rewire <strong>the</strong> lost or missing neural circuitry which interprets sound waves, not to mention all <strong>the</strong> high-tech auditory computer mapping required for noise to be understood. “Surgeons get too much credit,” Kwartler says. For a patient like Mink, a master student in her own aural recovery, teamwork and timing are certainly factors which promised <strong>the</strong> best <strong>of</strong> what this cutting edge technology can bring. Consider this: Mink even owes her current ability to hear that ice maker in <strong>the</strong> freezer section <strong>of</strong> her refrigerator, <strong>the</strong> directional turn signals clicking in her car, and her daughters’ voices on <strong>the</strong> telephone, to a host <strong>of</strong> medical scientists dating all <strong>the</strong> way back to Allessandro Volta, <strong>the</strong> Italian physicist in <strong>the</strong> 1880s who invented <strong>the</strong> electro-magnetic battery, among o<strong>the</strong>r things. “Volta,” Kwartler explains, “took his electrodes, stuck <strong>the</strong>m in his own ears and created a low level electrical charge. He described <strong>the</strong> sound as something like gurgling porridge. Obviously, <strong>the</strong> technology languished a little,” he jokes, before emerging in <strong>the</strong> 1950s in Europe and Australia. According to <strong>the</strong> Food and Drug Administration (FDA), approximately 70,000 people worldwide now have cochlear implants and this technology is evolving rapidly. Like <strong>the</strong> dot NEW JERSEY MEDICAL SCHOOL 27
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