Digital Device Gives Hope to Nerve-Deafness Patients

For the first time in years, Gordon M. Silesky can hear a voice clearly without having to turn his head in the direction that he thinks the sound is coming from.

The Baltimore businessman now can distinguish a voice in a crowd where previously, at a large gathering, all he heard was noise.

For several weeks now, Silesky, 62, has been wearing in his left ear a prototype of a tiny, custom-made, digital hearing device that makes up for a 50% to 60% hearing loss.

Silesky’s hearing loss is due to nerve, or inner ear, deafness. This problem affects 15 million to 20 million Americans.

The flesh-colored, hard-to-detect hearing aid that he uses requires delicate surgery so that it can sit deeply in the ear canal near the eardrum.

The removable device, which can easily be reinserted by the user, is designed to restore normal loudness and a more natural tone at all sound levels. Patients and doctors contend that use of the device results in “crystal-clear” hearing.

“I don’t know how I ever got along without this,” Silesky said recently, explaining that the narrow, inch-long, battery-run instrument has freed him from his “greatest fear”--growing older with increasing deafness and without a remedy.

“Both my mother and my grandfather had that problem,” said Silesky, the president and part-owner of a Baltimore printing firm. “They had hearing aids that they never wore. They were tucked away in bureau drawers because they couldn’t help them.”

Silesky said he was desperate for relief when he called Dr. Lewis Newberg, ear surgeon at Harbor Medical Center.

“I had read about his previous surgeries and I thought that he might be able to help me, too,” he said.

According to Newberg, Silesky also was brave. “It takes guts and a certain kind of motivation to be willing to be a doctor’s first patient for a new procedure,” said the surgeon. “But we learn from people like him. That’s what medicine is all about.”

Silesky wanted “the best,” providing it could do the job. The hearing aid, which Newberg describes as “the ultimate technology,” costs $950. Including the device, the tuning, surgery and other hospital fees, the cost adds up to $9,500.

So far, only about 200 patients--mostly in California and in other parts of the West Coast--have been fitted for the prototype device developed by AT&T; Bell Laboratories and Dr. Rodney Perkins, a clinical professor of otology at Stanford University in Palo Alto.

The Resound Personal Communicator is unique because it has a compressor, “which reduces the useful and comfortable range of speech to fit into the reduced range of speech of a patient,” said Dr. Kathryn Copmann, who heads the audiology clinic at Loyola College and works closely with Newberg.

The compression is done, Copmann said, “without losing any sounds, with protection against over-amplification of intense sounds and an increase in the relative gain from weak sounds.”

Part of the problem with other hearing aids is that “the vowels, which are the low tones, have a tendency to boom, and the consonants, which are the high tones, will be louder but not clearer,” Newberg said. “Words like ‘life, light, lift’ will all sound the same.”

Silesky’s wearing of the device culminates a long process that began last June with the new surgical procedure to widen the external and internal parts of the ear canal. This normally takes about three hours and is done under local anesthesia on an outpatient basis.

According to Perkins, the surgical procedure should be performed by otolaryngologists trained in the fundamentals of reconstructive ear surgery. Newberg and several members of his staff went to California in the summer of 1988 to learn the ear canal-widening technique.

When Silesky’s surgery healed, a plastic mold impression was taken of the broadened ear canal and sent to the Resound Corp. in California, where the custom-fitted hearing aid was made for Silesky.

Within a month or so, all the prototypes--including the one worn by Silesky--will be replaced by a refined, standardized manufacturer’s model, Newberg said.

It will be programmed for both quiet and noisy environments and can be changed electronically at a moment’s notice by a small “remote clicker” in one’s pocket--similar to a TV remote control.

The device is not only programmed to meet one’s immediate hearing requirements but can also be reprogrammed to accommodate any changes in hearing.