Functional Center Preparing for First Auditory Brainstem Implant

Doctor poses for photo

Ravi Samy, MD, Director of the Adult Cochlear Implant Program. Photo by Cindy Starr/Mayfield Clinic

If a siren sounded but you were deaf, might you still be able to hear it?

That is a challenge being addressed by Ravi N. Samy, MD, FACS, Director of the Adult Cochlear Implant Program at UCNI’s Functional Neuroscience Center, a center devoted to people who have diseases and disorders related to hearing, swallowing, voice, taste, and smell.

Dr. Samy (pronounced SAH-mee) is working with an investigational device that will enable people who have lost hearing in both ears to still be able to process certain types of noise. The device bypasses structures within the ear and works by stimulating the brainstem, which sends a message to the brain that a noise has been “heard.”

During the normal hearing process, Dr. Samy explains, “Sound waves pass through the ear canal and cause the ear drum to vibrate. Three little ear bones (ossicles) in the middle ear then vibrate, and fluid is moved in the snailshell-shaped cochlea. This sets off hair cell movement and subsequent electrical discharges through the cochlear nerve, which are transferred to the cochlear nucleus and the brainstem to the higher centers of the brain.”

For more than 20 years, UC’s collaborative functional team has been providing cochlear implants to patients who have become deaf for reasons related to genetic defects, infection, medication, age and noise. Candidates for cochlear implants have suffered damage to the hair cells in the cochlea but have a healthy cochlear nerve.

For the very small number of patients whose cochlear nerves are damaged, however, something else is needed. The most promising solution available is a device called an auditory brainstem implant. “This implant bypasses the cochlea and the cochlear nerve and is placed right next to the cochlear nucleus of the brainstem,” Dr. Samy explains. “We can stimulate that region, and then our patients have some sense of hearing. It won’t be the level provided by cochlear implants; it won’t be normal hearing. But our hope is that with day-to-day advancements and lip-reading skills, we can give patients an improved quality of life.” The Functional Neuroscience Center was recently designated one of a select number of national Auditory Brainstem Centers by Cochlear Corporation, and Dr. Samy will be heading up this important new clinical option. He and his team expect to perform their first auditory brainstem implant this spring at University Hospital.

It is no surprise that Cincinnati has been selected as a national auditory brainstem implant center. Cincinnati’s multi-site team, which includes UCNI, Cincinnati Children’s Hospital Medical Center and the Veterans Administration Medical Center, is a national leader in cochlear implantation. Dr. Samy, meanwhile, studied auditory brainstem implants while he was a fellow at the University of Iowa.

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