Since its founding, AB has been guided by a passion for improving hearing through innovation in medical technology. To this day, this passion drives us to look beyond cochlear implant devices, and invest in scientific research, to foster better understanding of the human ear, and to help usher in a time when hearing loss can be repaired as easily as a scraped knee.
Patrick Boyle, AB’s Senior Director, External Cooperation is one of our scientists actively working with researchers in academia towards this end. We caught up with him to learn a little more about some of his interesting current work.
The kind of work the team is doing right now has never been done before. Can you tell us a little about it?
PB: Yes. I’m very excited about the work we’re doing together with The University of Nottingham, Guy’s and St Thomas’ Hospitals and Rinri Therapeutics (a spin-out from the University of Sheffield). For the first time ever, we’re able to observe and record the inner workings of the cochlea, our hearing organ, frequently enough to learn how it behaves and changes on a daily basis.
The cochlea is a tiny, intricate structure the size of an eraser on the end of a pencil. It is encased deep in the densest bone in the human body, so it’s been very hard to access and learn about. But with the information we’re now able to capture about the cochlea and the structures inside, the possibilities are limitless.
How has this been made possible?
PB: Well, this takes us back to the beginning of AB, when we were designing our first cochlear implants in 1991. Unlike what had been done before, we wanted to a create a system with an electrical pathway that goes both ways. In other words, we wanted to not only send a signal into the cochlea, we also wanted to be able to get information back, information that would let us know that the system is working.
This is the beginning of the technology that, today, allows hearing care professionals to perform impedance tests, which check the integrity of the electrodes every time a cochlear implant recipient goes in for a check-up. But we only perform such tests in CI patients maybe once every six months. We have no idea how the cochlea is doing in between.
In 2019, AB developed the AIM system, the world’s first commercially available cochlear monitoring and objective measurement system, for use during and after CI surgery. It’s a tool that uses the CI electrodes to measure the tiny electrophysiological impulses generated by the cochlea in response to sound.
Clinically, the AIM system provides valuable information to the surgeon performing CI implantation, and also to the audiologists working with the patient afterwards. But for our research purposes, it is also the perfect tool to monitor a person’s cochlear status easily and frequently.
How’s the study going so far?
We started the study in October, 2020. It involves participants who are adult CI recipients, who use the AIM tablet to measure their electrode impedances twice a day, every day, as well as electrophysiological measures once a week. Participants are also asked to log their general health status during the same time period. We started with study participants who have had an implant for longer than a year because we expected that at that point post-implantation, there wouldn’t be much variation in the day-to-day measurement results. But we were surprised to find that while this is true for some participants, others have had results that fluctuate widely.
That just shows us that there is so much that we don’t know about the workings of our inner ear. What’s causing these fluctuations? What are the interactions between different body states such as hormonal and stress level changes and cochlear health? Discovering these unexpected fluctuations is the first step that will lead us to learn more.
In the next phase of the study, we will be following the same procedure, but with participants who have just been implanted. So we expect to see eye-opening results from that study group as well.
What kind of research and real world applications do you think the results of your study will lead to?
PB: I think the opportunities are limitless! With the AIM system, we can collect so much information about the cochlea—the excitability of the auditory nerve, the status of the hair cells and basilar membrane, the effects of abnormalities, etc.
And that knowledge can help us develop a deeper understanding of how we hear, why we don’t hear, and how we can hear again. This can help with the development of therapeutic treatments to reverse hearing loss, and even regenerative cell therapies to treat deafness, such as those being developed by Rinri Therapeutics. I think it is this prospect which makes this study extraordinary, and particularly exciting.
More immediately, the results of this study can also help us to fine-tune our instruments and devices. For our cochlear implants, it can help us optimize how our electrodes stimulate the auditory nerve and deliver a better sound. Even for the AIM system, the very tool we’re using to conduct this research, the results we get can help us determine what other measurements and tests we need to develop.
Sounds like you’ll be exploring this avenue of research for a while. What are the next steps you’re looking forward to?
PB: Besides what kind of discoveries we might make with the results of the study, I’m first looking forward to an upgrade in our methodology and instrumentation. With AB’s recent launch of Marvel CI and its unprecedented wireless connectivity capabilities, we anticipate that in the near future, essentially all Advanced Bionics implant recipients will be able to make these measurements in the comforts of their own homes. Then they can simply send the data remotely to our clinical and research partners. I’m confident that when we can do that, we’ll be able to collect even more valuable data.
This is the kind of thing that really makes me proud to be a part of AB. Our company’s mission isn’t only centered on commercial success, but also on discovery. AB realizes that only though science and research can we create innovations that bring real world benefit. And this is how we put our patients first in everything we do.
Study participant using the AIM system to check his cochlear function
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