Dr Mondy Hammad, the director of the cochlear implant programme at the hospital, said these patients could gain up to 80 per cent of normal hearing through the operation, which combines the acoustic hearing made possible with a hearing aid with the electric hearing provided by the implanted electrode.

“This type of a procedure used to be available in the past three decades only to patients with total deafness because they had nothing to lose,” said Dr Hammad, who is also an assistant professor of ear, nose and throat medicine.

Regular cochlear implant surgery often destroys any residual hearing when the inner ear is opened and an electrode is inserted. The process damages hearing sensory cells.

With the new procedure, “we are able to preserve a patient’s residual hearing”, Dr Hammad said.

People with normal hearing have some 20,000 sound-receptive sensory cells in their inner ear. Patients with mild, moderate or severe deafness have only from 2,000 to 3,000.

In the past, these patients would typically use a hearing aid to boost what limited auditory capacity they had. For them, cochlear implant surgery was regarded as a blunt instrument that posed too much risk to their residual hearing.

“The human ear is a miracle in itself,” Dr Hammad said. “Even with just a few thousand cells providing residual hearing, a patient can benefit.”

Dr Hammad, an Egyptian, is one of only three doctors in the country and no more than 15 in the region who are skilled in the delicate procedure.

Since the start of the cochlear implant programme at Al Mafraq Hospital two years ago, he has performed the soft surgery successfully for three patients with residual hearing. The programme won the hospital the Arab Health Award for excellence in surgery services in January.

“This type of a treatment is a breakthrough because it means that, theoretically, there should no longer be any deafness in society,” Dr Hammad said.

Many children with hearing loss go undiagnosed for years. By the time their condition is recognised, it frequently is too late to head off difficulty in speaking clearly.

“The first six years of a child’s life are crucial because that is when a language is learnt and speech is acquired,” Dr Hammad said.

Children who learn to speak in “deaf voice” typically have difficulty pronouncing hard consonants because the child cannot properly hear them and, hence, reproduce them.

“The newborn screening programmes currently being implemented in the UAE will mean that we will always be able to follow up on children with partial deafness and perform this surgery in time.”

The new procedure suits only a few patients: those who have some residual hearing and who have learnt language are preferred.

Because he performs the special surgery infrequently, Dr Hammad ensures that he retains his skill by practising during the regular implant surgeries.

“It requires no more than 20 extra minutes of my time for me to be careful to preserve the cochlear structure during surgery when I am drilling … even for patients with total deafness,” he said.

Dr Hammad hopes that future technologies will emerge and his caution will be rewarded.

Implants, Dr Hammad said, are better than hearing aids in three ways: “It improves sound discrimination … in a patient; it enables a patient to hear and differentiate what is heard when in a noisy environment; and it allows a patient to localise sound.”

Because the implant provides electrical impulses directly into the auditory nerves, it can mean an 80 per cent improvement in a patient’s ability to hear when combined with a hearing aid. That allows a patient to listen to music, talk on the phone, and not have to rely on lip-reading.

Ultimately, he said, the measure of success is in “how much more of life the patient can enjoy and participate in”.

‘My problem won’t hold me back’

AL AIN // Nada Sayed always found it embarrassing to have to stare at people’s mouths when they spoke to her.

Until last year, however, lip-reading was the only way for Nada, now 17, to understand what anyone said.

Following her soft surgery cochlear implant in July last year, Nada can now not only hear, she can also use the telephone.

“I used to only be able to watch English movies on TV because they are subtitled so I can read the Arabic,” said Nada, who was diagnosed with moderate deafness when three.

By the time she had the operation, Nada’s deafness had progressed to the profound level − one step from total deafness − with every indication that it would worsen.

“I would even avoid being with friends who are talkative or speak too quickly because I knew I would not understand them and get left behind,” she said.

The operation changed her life. “I want to go to medical school and I want to be the best student always. I know I can be; my hearing problem won’t hold me back any more,” she said.

As her hearing deteriorated, her mother, Dr Huda Mahmoud, a gynaecologist at Al Ain Hospital,

began looking for a solution.“Nada was getting more and more depressed at the thought of losing what hearing she had, and could not communicate, or understand her teachers in school,” Dr Mahmoud said. “So we began considering the cochlear implant, especially when we understood it would preserve what hearing she had.”

Dr Mahmoud had believed the surgery would be too risky. However, Dr Monday Hammad, the director of the cochlear implant programme at Al Mafraq Hospital, said Nada was an ideal candidate.

In the weeks and months after the so-called “soft surgery”, Nada and her mother began to notice marked improvement.

“Nada can now understand 90 per cent of what she hears, compared to 20 per cent before the surgery,” Dr Mahmoud said.

Nada’s residual hearing was completely preserved, and she can still use her regular hearing aid when needed. She can also tell from which direction sound is coming.

http://www.thenational.ae/apps/pbcs.dll/article?AID=/20100413/NATIONAL/704129915/1010