Using cochlear implants, people like Ernst have for more than two decades been able to receive sound through the stimulation of nerves in the inner ear. In recent years, manufacturers and academics have joined to make the devices ever more sophisticated at reproducing the complexities of natural hearing.

"At first, all voices came through like they were computer-generated," said Ernst, who received her implant in May and uses a conventional hearing aid in her other ear. "If I had just my implant, I couldn't tell the difference between a male and a female."

Hearing loss is often age-related, affecting nearly half of people older than 75, so the numbers will increase dramatically as baby boomers hit their Social Security years. The industry has already seen 20 percent growth in recent years. Manufacturers such as Med-El, an Austrian company with U.S. headquarters in Durham, compete by sharpening their customers' ability to enjoy music as well as pick out conversation in crowded and noisy settings.

"Music is a particularly difficult thing to restore with a cochlear implant because so many different things go into it," said Dr. David Kaylie, a Duke hearing specialist and neurologist.

Pitch, rhythm and timbre all contribute to the overall impression music makes, Kaylie said, and to a lesser degree make up the elements of speech. Ernst, who taught music in Long Island schools for 30 years, says her ability to distinguish speech has improved dramatically while working with Justus and others at Duke.

"I could understand what my husband said without looking at him and without reading his lips," she said. "I wouldn't even answer the phone, and now I can. Those two things have been very positive and encouraging."

But Ernst is still working on hearing music.

"I know that will take more time because it is a much more complex sound than speech," she said. Ernst has gotten encouragement from people such as Ruth Miller, a resident of Chapel Hill, N.C., who performed on piano, trumpet and French horn before having profound hearing loss.

"Music has become much more enjoyable for me," said Miller, 65, who has had two cochlear implants for about five years. "And I understand they are coming out with new programming to address that issue."

The Holy Grail, according to Kaylie, is a device under development that combines the properties of a conventional hearing aid with digital enhancements in the same ear. "That's going to be the big thing," he said.

http://www.scrippsnews.com/node/43721