Bridgewater girl hears 'more': Four-year-old learning to use her new cochlear implant

September 23rd, 1999

WORCESTER, Mass.— Victoria Mahtesian was a year and a half old when she was brought to the United States in June, 1996, by her adoptive parents, Ken and Valerie Mahtesian of Bridgewater. Although Victoria seemed unresponsive to sounds, her parents assumed it was a temporary result of her early life in a Romanian orphanage and decided to give her a bit of time to adjust to her new life. By the end of that summer, however, tests conducted at a Boston hospital confirmed that Victoria had profound bilateral hearing loss. Doctors told the Mahtesians and their older daughter, Kassandra, to learn sign language, and the family reluctantly accepted it as their only option.

Sometime later, however, the Mahtesians saw a television program on cochlear implants and began aggressively pursuing the option for their daughter. They learned as much as they could about the cochlear implant, a tiny electronic device placed in the inner ear that is designed to provide useful hearing and improved communication ability to individuals who are significantly hard of hearing. Undaunted by their doctors’ attempts to dissuade them— Victoria, they were told, was too developmentally delayed to benefit from the implants—they searched the Internet for more information and eventually were connected to the newly formed Cochlear Implant Program at UMass Memorial Medical Center in Worcester. There, they met Cliff Megerian, MD, who focused more on Victoria’s potential than on her limitations.

"He focused on the other developmental progress she had made since coming home with us," Ken Mahtesian said, "He put us at ease and was able to explain the implant itself and what it might do for Victoria, if she was a viable candidate for the device."

Cliff A. Megerian, MD, Associate Professor of Otolaryngology at UMass Medical School and Director of Otology & Neurotology and Medical Director of UMass Memorial’s Cochlear Implant Program, said, "Victoria is such a bright little girl who, we felt, was an excellent candidate for the surgery. She’s done so well."

After undergoing numerous tests, Victoria received her cochlear implant in June. In early August, after the surgical site had healed the device was turned on.

"Dr. Megerian had told us not to expect much at first, since introducing sound to a deaf child can be overwhelming," Ken said. "But when they turned it on, Victoria smiled and laughed and signed ‘more, more’. We couldn’t believe it."

By combining computer technology, electronic circuitry and sound processing strategies, cochlear implants transmit electrical signals directly to the auditory nerve, which the brain can interpret as sound. They differ from hearing aids, which simply amplify sound for people with hearing difficulties. An estimated 2 million Americans are profoundly deaf, unable to participate in normal verbal conversation or hear smoke alarms or use the telephone. Approved by the FDA in 1996, the implant restores hearing by bypassing damaged parts of the auditory system and sending electrical signals directly to the auditory nerve. As with normal hearing, the auditory nerve carries these signals to the brain where they are interpreted as meaningful sound. Manufactured by companies such as the Cochlear Corporation of Framingham, MA, which produces the Nucleus implant and Advanced Bionics Corporation of California which markets the Clarion implant, the device consists of both surgically implanted and externally worn components. The external components include a speech processor (usually worn on the belt like a pager or in a harness for young children), a headpiece (worn just behind the ear) and a thin cable that connects the two units. The internal parts include the cochlear receiver/stimulator (ICS) and 16 tiny wires called an electrode array.

Sound waves enter the system through a microphone located in the headpiece. The sound is sent to the speech processor via a thin cable, which connects the headpiece to the speech processor. The processor, a powerful mini computer, converts the sound into a special signal and, once processed, the signal is sent back up the cable to the headpiece where it is transmitted through the skin via radio waves to the implant. The implant receives the signal and delivers it to the electrode array positioned within the cochlea where it stimulates nerve endings and causes electrical impulses to be delivered to the brain where they are interpreted as sound.

"The cochlear implant has proven to be the treatment of choice for many patients," Dr. Megerian said, "who either were born with profound hearing loss, or had deterioration of hearing to the point where normal hearing aids were not helpful anymore."

Victoria is currently undergoing speech therapy and will continue to have "tune ups" to adjust the device and learn to interpret the sounds she hears.

The impact the implant has had on Victoria’s life has been great. It has improved her communication skills to the point that her parents have decided to move her from a school for the deaf to a mainstream school. "She’s doing great," said her dad. "She can hear us now, and she is gaining in verbal skills. When we go for the tune ups, she keeps signing ‘more, more, more.’ She just can’t get enough."

Additional information available 

Cochlear Corporation (www.cochlear.com), Advanced Bionics Corporation (www.cochlearimplants.com, www.advancedbionics.com)