Cochlear implant surgery restores lost hearing
For Utah sculptor, robotic-assisted approach offers greater precision — and peace of mind
By the end of 2023, Marcia Robinson-Rouse needed two hands to count all that she had lost as her health declined from Meniere’s disease, an inner ear condition that usually affects one ear, causing vertigo and hearing loss.
First, Robinson-Rouse lost her balance to spells of vertigo that started in 2006. Then she began to lose her hearing, first noticing her right ear felt “plugged” and then realizing it hardly worked at all. She lost her sense of safety when her vertigo progressed to “drop attacks,” causing her to collapse suddenly to the floor.
Robinson-Rouse quit a job she enjoyed as a retail buyer, and a hobby she adored, sculpting, for fear she would injure herself with the power tools used to create her art.
She lost hope when the hearing aids she began using in 2015 became useless by 2020.
Finally, she lost her home, moving with her husband away from the high altitudes of Colorado’s Rocky Mountain region — and away from family — to southwestern Utah on the advice of a doctor who had little else to offer her. The shift in barometric pressure eased Robinson-Rouse’s vertigo, but her hearing continued to decline.
Robinson-Rouse was growing so accustomed to loss that when she learned about a robotic-assisted cochlear implant surgery available at University of Iowa Health Care, she had low expectations.
“I went in [to UI Health Care] thinking, ‘This is a nice trip,’” she says. “I didn’t expect to qualify.”
Decades of cochlear implant expertise at Iowa
Robinson-Rouse met with Bruce Gantz, MD, professor in the Department of Otolaryngology and investigator with the Iowa Cochlear Implant Clinical Research Center. Gantz and the team at Iowa have been performing National Institutes of Health-funded research on cochlear implants for more than four decades.
After hearing tests, Gantz delivered good news: Because of the profound deafness in her right ear, her diagnosis of Meniere’s disease, and her health history, Robinson-Rouse was an ideal candidate for surgery.
In cochlear implant surgery, doctors implant a receiver under the skin and a small electrode array into the cochlea with an external transmitter, microphone, and speech processor behind the ear. The device delivers sound directly to the auditory nerve — avoiding the damaged part of the ear — which makes it a viable option for people like Robinson-Rouse whose hearing is not improved by hearing aids.
Performing the surgery requires the steadiest of hands. The cochlea, known for its snail shell-like coil, is the approximate size of a green pea and sits deep within the inner ear. Injuring the inner ear’s fragile lining can cause inflammation that damages any residual hearing, says Gantz, who has been performing cochlear implant surgeries at UI Health Care since the 1980s.
Robotic-assisted cochlear implant technology developed by Iowa team
The cochlear implant landscape changed in 2021, when the U.S. Food and Drug Administration cleared a small robotic tool, the iotaSOFT® Insertion System, that precisely inserts the electrode array into the cochlea as slow as 0.1 millimeters per second. The tool was developed at Iowa by Marlan Hansen, MD, professor and chair of the Department of Otolaryngology, and former resident physician Chris Kaufmann, MD, MS, at their spin-off company, iotaMotion.
“Robotic assistance is really an advantage,” says Gantz, who also performs robotic-assisted surgeries and has had patients come from Florida, Texas, and California for the procedure. “I think in the next 10 years, most people will have a robotic insertion of their devices.”
Currently, UI Health Care is the only medical center in Iowa to offer cochlear implant surgery with this advanced technology.
Robinson-Rouse says the use of robotic assistance made her more comfortable with the surgery.
“There is little room for human error,” she says. “It gave me total ease and peace of mind about the surgery.”
Robinson-Rouse had her surgery at UI Health Care in March 2024, then flew home to Utah a few days later. She returned to UI Health Care after a few weeks’ recovery to have her sound processor activated. Then the real work began.
Because a cochlear implant transmits sound directly to the cochlea, the sound it creates isn’t the same as what is normally heard through the ear. For three months post-surgery, Robinson-Rouse spent 90 minutes a day, punctuated by much-needed naps, using an iPhone app that taught her how to understand this new sound.
“It was exhausting,” she says.
Yet by her three-month follow-up appointment with her audiologist in Utah, Robinson-Rouse was hearing as well as a patient one year out from cochlear implant surgery. Today, she’s fully acclimated to her cochlear implant.
“The hearing is not perfect, but it's so much better than it used to be,” she says. “I can function in society.”
An artist’s appreciation
Today, Robinson-Rouse is back in her sculptor’s studio. In fact, she was so thankful to UI Health Care that she donated a special piece to the health system in October. “Having A Bad Ear Day” is a limited-edition bronze rabbit, who sits on his hind legs at about two feet tall, with one ear up and the other flopping down over his face.
Robinson-Rouse is grateful for the robotic-assisted cochlear implant procedure available at Iowa.
“The robotic-assisted surgery has given me my life back, and I’m so grateful,” she says. “I’m quite sure other recipients feel the same way.”
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