Interview with Geoff Ball

HH/Beck: Hi Geoff, it is a pleasure to speak with you again.

Ball: Hi Doug, thanks for contacting me.

AO/Beck: Before we get too far into your personal experiences, thoughts and observations on Middle Ear Implants, please tell me about your position with Symphonix?

Ball: Sure, I am the founder, a vice-president and the Chief Technology Officer of Symphonix, and as you know, I wear two Symphonix Soundbridge^' units.

HH/Beck: Geoff, please tell me a little about your education?

Ball: I have a master's degree in systems management from the University of Southern California and I've worked as a biomedical engineer for many years. In particular, I worked with Dr. Richard Goode at Stanford University from 1986 to 1994 directing the biomedical lab there.

HH/Beck: Very good. Geoff, if you don't mind, can you please tell me about your hearing loss and your history as it relates to hearing aids and amplification?

Ball: I've pretty much had hearing loss my whole life. As a child, I was a pretty sick kid. I was diagnosed with severe hearing impairment following an ototoxic reaction to medicine. In fact, I've worn hearing aids for some 30 years now and I've benefited greatly from audiologists and hearing aids. I have a 'cookie bite' audiogram, about a 75 dB loss in both ears. I believe I know what hearing aids can do, but I wanted something else. I didn't want to wear hearing aids for the rest of my life. You know, a lot of the work on middle ear implants (MEI) was done in the 1930s, and the progress was very slow, mostly due to power needs of the electronic systems. Anyway, the one thing that was common across all of the research studies for many decades was that the patients reported the sound of the various MEIs was very clear and it was a much more natural sound than the hearing aids they were compared to. So, after reading and studying the literature, and after considering all of my own personal amplification options, I decided I wanted to do everything I could to help make these products available. Better sound and non-occluded ears were the attributes I was looking for.

HH/Beck: After wearing hearing aids for many decades, what was it like when your Symphonix Soundbridge was initially turned on?

Ball: The first thing I thought was'There are a lot of TV cameras here!' But the second thing was -- Yes, the sound was better, the sound was clearer , and the sound was more realistic. I got my first Symphonix Soundbridge in 1996 at the House Ear Institute and the second unit was implanted in 2000.

HH/Beck: What was it that convinced you to have a second MEI?

Ball: Well, after only having the first implant for a few days, I thought the sound was so great, that I wanted more of it. In retrospect, adding the second unit was not at all a 'one plus one equals two' sort of experience. It was more like 'one plus one equals four.' As good as the first one was, adding the second unit was infinitely better.

HH/Beck: Can you tell me the most significant differences for you personally, regarding hearing aids versus MEIs?

Ball: Yes. The differences are enormous. First of all, I have to say that newer, digital hearing aid circuits are fantastic. The technology and the results are very good. Nonetheless, getting an even better sound, and getting the plastic earmold out of my ear canal was an enormous relief. Occlusion was a big issue for me, and I love hearing without my ears being plugged up! For those of us with significant hearing loss, the occlusion issue is bigger than you can imagine. I have to tell you that it took about a month for me to get used to the feeling of having my ear canals open for the first time- while hearing people speaking - it was amazing!

HH/Beck: Tell me about wearing the Symphonix Soundbridge hardware?

Ball: The Audio Processor' (AP) is about the size of three quarters stacked up and it's held in place by a magnet. All of the guts of the signal processor and the battery are in the Audio Processor. There are no restrictions on showering or swimming because the unit is held in place by magnets across the skin, so there are no wires or electronics that pierce the skin.

HH/Beck: What about the technology of the AP?

Ball: The new APs use digital signal processing with a sophisticated PC programmable system with multiple frequency bands for gain and compression. This is an important point because the electronics are highly reliable, accurate and are very flexible. Again, the technology is very impressive. It's important to realize that even my early implant is now operating on a digital system, because we've upgraded the external AP, and our externals are backwardly compatible with all our implants. So in essence, my old implant and my new implant are both using digital systems.

HH/Beck: Can you tell me about the magnetic contact point? Are you able to let hair grow across the magnet site? I can recall a few of my previous cochlear implant patients and for some of them, they had to keep the hair between the magnets shaved or the magnet wouldn't have enough strength to hold on.

Ball: Yes, a lot of people ask about that. I let my hair grow over the contact point and it has been no problem at all. I don't know for sure but I cannot recall anyone with the Symphonix Soundbridge who has had to keep the contact point shaved.

HH/Beck: Geoff, as we're conversing here, you are using a telephone. How are you doing that? What is the connection between the MEI and the telephone?

Ball: Great question. One of my pet peeves on this planet is T-Coils. I have tried many T-coils, and some are better than others. So I use a speaker phone with my MEIs, and other times, like right now, I hold the phone up to the AP (Audio Processor) and do pretty well.

HH/Beck: Yes, you're doing great. You've obviously been hearing my questions and responding appropriately. So you're using the microphone of the AP placed against the telephone's speaker?

Ball: Yes, that's exactly what I'm doing at the moment. Again, phones in general are lacking with hearing aids, I do much better on the phone with the Soundbridge.

HH/Beck: Who do you think are the ideal candidates for the device?

Ball: I think the primary candidates may be the baby-boomers with a variety of losses from mild to sever to moderate-to-severe, who have tried traditional hearing aids but find themselves wanting more. In other words, I think it's really important for the candidates to try regular hearing aids and give that the best effort they can. Then, if they find themselves experiencing issues with feedback, occlusion, sound quality or just wanting better hearing, they really ought to consider the Soundbridge. I think it's important for them to work with traditional units first because that helps clarify their motivation and their knowledge of what amplification can do for them, and what the issues are before seeking a middle ear implant. We want candidates who are seeking better hearing and who are motivated to try new and exciting technology, and we want them to know what they are doing before they agree to a middle ear implant!

HH/Beck: What's the new upcoming technology going to be like?

Ball: The new stuff is even more amazing and very exciting. Of course it's in the development stages and I cannot say anything with certainty. Nonetheless, I think the next big step will be totally implantable hearing devices and looking into my crystal ball, I think that could be ready in the next few years. Of course clinical trials, FDA approval and technological advances can all dramatically change the timeline.

HH/Beck: Geoff, who pays for the Symphonix Soundbridge implant at this time?

Ball: There is some limited coverage for the Soundbridge through insurance companies. I think that'll change quickly as more and more patients benefit from it and request coverage.

HH/Beck: Geoff, how many candidates do you think there are for this technology in the USA?

Ball: Of course no one really knows, but I would guess there are easily a million candidates for this technology in the USA.

HH/Beck: Geoff, how do candidates and family members learn more about the topic?

Ball: They can send me email directly, or they can visit the website. The website address is below and my email address is geoffb@symphonix.com

HH/Beck: Geoff, it's been a pleasure speaking with you. Thanks for your time today.

Ball: Thank you Doug. Let's do this again and I'll keep you updated.

FOR MORE INFORMATIONON ON MIDDLE EAR IMPLANTS and SYMPHONIX, CLICK HERE.

Editors Note: This interview first appeared on Audiology Online (4-17-2001). The interview was revised and updated by Dr. Beck and Mr. Ball in February, 2002 for Healthy Hearing.