An unknown virus had triggered sudden and permanent sensorineural hearing loss that was so severe that not even the most sophisticated hearing aid could rescue him from a world of silence. But then he was offered a cochlear implant operation, one of about 500 people a year who have the life-changing surgery, and he can now hear again.
"As far as I am concerned, it was a miracle. I am not trying to over-egg the matter but, quite simply, without it I am stone deaf; I hear zero. I was becoming a loner, cut off from the world and it was very depressing. The sad thing is that many other deaf people don’t know about the operation or cannot get it because of lack of funding," he says.

The life-changing implant — in effect, a bionic ear — could benefit thousands of severely or completely deaf people in Britain, both adults and children, but fewer than 600 operations are carried out each year, well below the rates of many other European countries. This week, Deaf Awareness Week, only a dozen operations are likely to have been carried out. Demand is so great that one of three centres in London which operates on children has just closed its waiting lists as demand outstrips resources. Another, Great Ormond Street Hospital, has just “tightened” the criteria for who should have the operation, so great is the demand.

"Our paediatric programme has had to be closed," says Wanda Aleksy, the cochlear co-ordinator at the Royal National Throat, Nose and Ear Hospital, Central London. "Our waiting times were becoming increasingly unacceptable clinically. Children should not be waiting 18 months to two years; that is unacceptable. Closure is for a temporary period while we clear the backlog and we have a year’s worth of patients. The adult’s programme is not affected, but adults are waiting quite a long time."

Cochlear implants have revolutionised the way deafness can be treated. With normal hearing, sound enters the ear and is converted inside the cochlea (inner ear) into electrical signals, which are then sent to the brain where they are converted into what we hear as sound. In the profoundly deaf, the mechanism in the cochlea is absent or lost and, as a result, no signals get through to the brain.

In the cochlear-implant operation, an electronics package is implanted under the skin behind the ear which picks up signals from a sound processor. Electrodes implanted in the cochlea respond to the signals from the electronics package. Different electrodes stimulate the nerve fibres inside the cochlea, causing electrical impulses to be fired off to the brain which are perceived as sound.

Professor Gerard O’Donoghue, professor of otolaryngology at Queen’s Medical Centre, Nottingham, and one of the leading cochlea specialists in the UK, says that supply is not meeting the needs for the implant operation. “It is not a Gucci service; it is a vital service. Yet, per capita, we implant substantially fewer than Germany or Belgium and other European neighbours. To have people on long waiting lists, and to have hospitals closed, is outrageous,” he says.

"Many people are not accessing the services because they are unaware of it,” he adds, “while many others have to wait to have the money approved."

Cochlear, the biggest provider of the implants, says that about 570 operations a year are carried out in the UK. "If you look at Europe, the UK is the one country that is stable and flat with no growth, while the others are growing considerably. The adult population that could benefit is huge, but there is no money, and that is the biggest issue," says Amanda Whiffin, the Cochlear manager for the UK and Ireland. The full cost of the procedure, including the £15,000 implant, is £30,000.

For children born deaf, or who become deaf as a result of meningitis or for other reasons, there is a need to have the operation done as soon as possible. For most children that means having the operation before they are six or seven; a vital window of opportunity when the implant stands the greatest chance of succeeding. And although the costs of the implant and surgery are high, the long-term rewards are enormous — not just in quality of life. Giving hearing to someone who is deaf means that they are more likely to become economically independent.

Work by Professor Bruce Gantz, a professor of otolaryngology at Iowa University, shows just how effective the implants can be. "Results are much better than we expected. We have kids now whose language development is close to normal. If you look at reading levels of children who are profoundly deaf and use sign language, only 20 per cent achieve fourth-grade reading levels. In children who have implants, 58 per cent exceed fourth grade levels," he says.

Professor O’Donoghue says that everything should be done to meet demand: "Children’s interests have to be paramount. We live in a society where communication skills are increasingly important. This operation offers deaf children access to those skills and we should remove all the obstacles we can."

From Times Online