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Via Internet, NY doc helps deaf Ugandan man hear -- Newsday.com
Through the power of Internet technology, medical experts in New York have switched on an inner-ear device, allowing a man in Uganda to hear for the first time in two years.
Activating the device from halfway around the world is a first, and highlights a trailblazing way in which the growing realm of telemedicine - conducting medical procedures from remote locations - can enhance the lives of people in struggling nations.
David Nuwagaba, 23, of Kampala, Uganda, had to drop out of college after becoming deaf from the toxic effects of tuberculosis medication. But when Dr. J. Thomas Roland, co-director of NYU Medical Center's cochlear implant center, learned of his plight, he knew he could help.
A cochlear implant is a tiny electronic device that is surgically placed in the inner ear, allowing the patient to receive and process sound. It is sometimes referred to as a bionic ear. But ever since the technology emerged in the 1980s, most of the devices have been implanted in rich, developed nations where patients can afford them. The device is far more complicated than a hearing aid - and dramatically more expensive.
The American Academy of Otolaryngology estimates the cost of patient evaluation, surgery, the device and rehabilitation to run $40,000. Among the more than 100,000 cochlear implant surgeries performed worldwide, none has been in Uganda.
Roland, who frequently volunteers in the country, found that the surgical suite at Makerere University's Mulago Hospital in Kampala could support his efforts to help the young man hear. He performed the complex implant surgery for free.
But Dr. William Shapiro, chief of audiology at NYU Medical Center, underscored that a cochlear implant is a device of numerous complexities that go well beyond the intricate surgery. Once in the ear, the implant has to be turned on - and that's where the Internet came into play.
Electronically crossing time zones and cultures, Shapiro conducted the programming to activate Nuwagaba's device around 10 a.m. on Feb. 27. Eight time zones away in Kampala, Nuwagaba knew the operation was a success because he could respond to questions Shapiro posed by cell phone.
"That's what's so fascinating about telemedicine," Shapiro said, "when you can reach people in faraway places to provide technology that they normally wouldn't have."
Nuwagaba received the operation without charge, and the device was donated by its manufacturer. Shapiro said all signs so far point to a very successful outcome. "He was a great candidate," Shapiro said. "He had a very short length of deafness. We really had a sense that this kid would do really well."
"What the cochlear implant does is bypass the damaged hair cells [in the inner ear] and stimulates the auditory nerve, directly allowing a deaf patient to perceive sound," Shapiro said. He added that the implant itself "is composed of an internal and external portion."
"The surgeon implants the internal device that is composed of an electrode array that's threaded into the cochlea," Shapiro said, referring to the spiral-shaped structure in the middle ear that contains vital hair cells, which are responsible for sensing sound. Within the device itself are 22 electrodes.
Each electrode has to be activated, which is the job Shapiro performed remotely from NYU Medical Center. "I had to obtain a threshold on each of those electrodes," Shapiro said.
The device performs the work of the eardrum and hair cells of the inner ear.
"We are able to implant patients we never would have implanted 15 years ago," Shapiro said, "and now the Internet is making the world a lot smaller. And that's really very exciting to me, it really is."
Through the power of Internet technology, medical experts in New York have switched on an inner-ear device, allowing a man in Uganda to hear for the first time in two years.
Activating the device from halfway around the world is a first, and highlights a trailblazing way in which the growing realm of telemedicine - conducting medical procedures from remote locations - can enhance the lives of people in struggling nations.
David Nuwagaba, 23, of Kampala, Uganda, had to drop out of college after becoming deaf from the toxic effects of tuberculosis medication. But when Dr. J. Thomas Roland, co-director of NYU Medical Center's cochlear implant center, learned of his plight, he knew he could help.
A cochlear implant is a tiny electronic device that is surgically placed in the inner ear, allowing the patient to receive and process sound. It is sometimes referred to as a bionic ear. But ever since the technology emerged in the 1980s, most of the devices have been implanted in rich, developed nations where patients can afford them. The device is far more complicated than a hearing aid - and dramatically more expensive.
The American Academy of Otolaryngology estimates the cost of patient evaluation, surgery, the device and rehabilitation to run $40,000. Among the more than 100,000 cochlear implant surgeries performed worldwide, none has been in Uganda.
Roland, who frequently volunteers in the country, found that the surgical suite at Makerere University's Mulago Hospital in Kampala could support his efforts to help the young man hear. He performed the complex implant surgery for free.
But Dr. William Shapiro, chief of audiology at NYU Medical Center, underscored that a cochlear implant is a device of numerous complexities that go well beyond the intricate surgery. Once in the ear, the implant has to be turned on - and that's where the Internet came into play.
Electronically crossing time zones and cultures, Shapiro conducted the programming to activate Nuwagaba's device around 10 a.m. on Feb. 27. Eight time zones away in Kampala, Nuwagaba knew the operation was a success because he could respond to questions Shapiro posed by cell phone.
"That's what's so fascinating about telemedicine," Shapiro said, "when you can reach people in faraway places to provide technology that they normally wouldn't have."
Nuwagaba received the operation without charge, and the device was donated by its manufacturer. Shapiro said all signs so far point to a very successful outcome. "He was a great candidate," Shapiro said. "He had a very short length of deafness. We really had a sense that this kid would do really well."
"What the cochlear implant does is bypass the damaged hair cells [in the inner ear] and stimulates the auditory nerve, directly allowing a deaf patient to perceive sound," Shapiro said. He added that the implant itself "is composed of an internal and external portion."
"The surgeon implants the internal device that is composed of an electrode array that's threaded into the cochlea," Shapiro said, referring to the spiral-shaped structure in the middle ear that contains vital hair cells, which are responsible for sensing sound. Within the device itself are 22 electrodes.
Each electrode has to be activated, which is the job Shapiro performed remotely from NYU Medical Center. "I had to obtain a threshold on each of those electrodes," Shapiro said.
The device performs the work of the eardrum and hair cells of the inner ear.
"We are able to implant patients we never would have implanted 15 years ago," Shapiro said, "and now the Internet is making the world a lot smaller. And that's really very exciting to me, it really is."