Known as a bone-anchored hearing aid, or BAHA, the not-quite-matchbox-sized sound processor transmits sound energy via the skull from his almost-deaf right side to his "good" left ear.

'I'M ECSTATIC'

Having a box stuck on his head a finger's breadth or so behind his upper ear may earn him more than a few second glances, but the results are worth it, says Pepperell, vice-chair of TD asset management in Toronto.

"I'm ecstatic," he says, laughing. "The result couldn't be better."

Pepperell, 59, first noticed diminished hearing in his right ear about 10 years ago, a loss that gradually grew more pronounced.

He was diagnosed with an acoustic neuroma, a relatively rare, benign tumour affecting the cranial nerve responsible for inner ear functioning; it eventually destroyed 90% of hearing in that ear. (He chose not to have the tumour removed because of the likelihood of losing what little hearing he had left and the risk of facial nerve damage.)

Having one-sided hearing was playing havoc with his business and social life.

"But more importantly, I was noticing that I was having a lot of trouble hearing in certain situations where I was trying to get company information for investment purposes," says Pepperell, who manages investments, buying and selling stocks from around the world.

"In my business, I do interviews and I'm at conferences where an executive of a company will be talking about his company and it's material if I miss the word 'Not,' " he says with a chuckle.

"That's critical."

So, when he heard about the bone-anchored hearing aid, he decided to go for it -- even though he'd be walking around with a plastic gizmo on his scalp.

During a 45-minute, general-anesthetic surgery last October, doctors at Sunnybrook and Women's College Health Sciences Centre in Toronto drilled into Pepperell's skull and implanted a three- to four-millimetre-long titanium screw, capped with a snap-on connector that would eventually hold the box-like receiver on the outside of his head.

IDEAL CANDIDATES

Dr. Julian Nedzelski, the neural otologist at Sunnybrook who performed Pepperell's surgery, says patients with one-sided hearing loss due to an acoustic neuroma are not the most common recipients of bone-anchored hearing aids.

"The ideal candidate for the BAHA is someone who has a bilateral conductive hearing loss," Nedzelski explains.

"A conductive hearing loss is where the sound can't get into the inner ear because either the external ear channel is blocked or they don't have any bones of hearing."

The BAHA works by picking up sound energy in the titanium screw anchored on the same side as the affected ear, which causes skull bones to vibrate, he says.

"And you can then hear in the inner ear because you've bypassed the ear channel, the ear drum and the bones of hearing."

In Pepperell's case, sound vibrations go "across the skull to the other side," Nedzelski says.

While the surgery is usually covered by the province, the $4,500 cost of the hearing aid must be borne by the patient.

By Sheryl Ubelacker
http://ottsun.canoe.ca/News/National/2006/01/28/1415285-sun.html