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A thumb-sized sound processor worn behind the ear and held in place by a small, magnetized titanium implant inserted under the skin is now being offered at NewYork-Presbyterian/Columbia University Medical Center to people with single-sided sensorineural hearing loss and for those with conductive hearing loss who cannot wear conventional hearing aids.

"The Sophono Alpha 2 abutment-free, bone-anchored hearing system is for patients who cannot wear conventional hearing aids because of chronic ear infections or external auditory canal atresia, a condition where the ear canal is not fully formed or functional," said Dr. Anil K. Lalwani, an otolaryngologist at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Other devices for these patients tether in place by drilling a hole in the skull and installing a screw (abutment) that pokes through the skin on the side of the head. Patients then have to wait three months before the device can be used and often suffer from chronic skin infection around the abutment. "The Sophono Alpha device, which is abutment-free, is cosmetically more appealing as no apparatus comes through the skin. As a result, there is no issue of constant wound care, as the hearing aid is secured in place by magnets," said Dr. Lalwani, who is also professor and vice chair for research in the Department of Otolaryngology — Head and Neck Surgery at Columbia University College of Physicians and Surgeons, and director of the Division of Otology, Neurotology and Skull Base Surgery and of the Cochlear Implant Center, Columbia University Medical Center.

Additionally, the Sophono can be used within two to four weeks after surgery, instead of the three months that is required with other devices.

The Sophono addresses a common problem for those with impaired hearing — distinguishing speech from background noise. "This is a huge issue even for people who have hearing loss in one ear. They have problems following a conversation in social settings, such as at restaurants or at parties, or in other noisy environments," said Dr. Lalwani. Like fine-tuning a radio station to eliminate background static, the Sophono Alpha System enhances the auditory system's ability to hear by improving the ratio of recognized speech to noise.

Hearing Device Bypasses Ear Canal Blockage

In people with normal hearing, sound waves, or vibrations, travel from the outer ear into the middle ear and eardrum, then make their way through three tiny bones into the cochlea, a snail-like coiled tube in the inner ear. Once inside the cochlea, the vibrations are picked up by thousands of specialized hair cells that convert them to an electrical signal. This signal is then sent to the brain by the auditory nerve and translated into hearing.

"The system functions much like a 'work around' in people with conductive hearing loss, which occurs when there is a blockage between the outer and inner ear," said Dr. Lalwani. The external sound processor picks up the sound waves and amplifies them by activating the titanium implant, which vibrates the skull and sends a signal directly to the cochlea and then to the brain.

In environments with background distractions, technology embedded in the sound processor automatically detects and reduces unwanted noise from behind and amplifies speech in front, resulting in clearer communication.

In one-sided sensorineural hearing loss caused by nerve damage in the cochlea, the external sound processor picks up a sound wave — on either side of the head — triggering the titanium implant to vibrate the skull and transmit the sound to the ear with hearing. "This new system eliminates the need for those who are deaf in one ear to constantly turn their head toward the hearing side, which improves hearing and reduces frustration," said Dr. Lalwani.

Hearing Device Implanted in Outpatient Procedure

People who are candidates for the Sophono Alpha System undergo an outpatient procedure to insert the titanium implant under the skin. Once the incision is healed, in roughly four weeks, an audiologist activates the external sound processor, which enables instant hearing.

In April 2013, the Sophono Alpha received clearance by the U.S. Food and Drug Administration (FDA) for use with magnetic resonance imaging (MRI). The Sophono Alpha also has passed ASTM International tests for MRI use.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, nonsectarian hospital, with 2,409 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including 12,758 deliveries and 215,946 visits to its emergency departments. NewYork-Presbyterian's 6,144 affiliated physicians and 20,154 staff provide state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/The Allen Hospital and NewYork-Presbyterian Hospital/Westchester Division. One of the most comprehensive health care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area and is consistently ranked among the best academic medical institutions in the nation, according to U.S.News & World Report. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast.