P.E.I. woman makes a sound decision

Charlottetown resident’s bilateral bone conduction implant surgery first of its kind in North America

Mary MacKay comment@theguardian.pe.ca
Published on March 15, 2014

Last October, Shannon Micallef of Charlottetown became the first person in North American to have a bilateral Bonebridge bone conduction hearing system surgically implanted to replace her traditional hearing aids. GUARDIAN PHOTO BY MARY MACKAY


At first, it was hearing the jingling of her car keys in the ignition.

Then it was being able to decipher the words of a song playing in the background during a restaurant meal.

It was also catching the gist of her kids’ conspiring whispers in the backseat.

But one of the most moving moments last fall for Shannon Micallef after she became the first person in North America to receive a front bilateral Bonebridge bone conduction hearing system implant in both ears came in the form of a feeling more so than a sound.

“There is nothing in my ears, which is the best part. I’m still not used to having the wind in my ears,” says this Charlottetown woman, who was able to break free from conventional hearing aids after more than three decades of use.

“It’s a very strange feeling for me because for 35 years I have never had the wind blow through my ears. Every now and then it catches me (by surprise).”

Micallef was born with bilateral congenital conductive hearing loss, which was discovered when she was a toddler.

“At about 18 months, my parents thought something was not right because I’d go up to the television to put my ear up (to the speaker),” she says.

“The bones were misshapen and not connected. So basically the sound goes in and stops right there and doesn’t continue on the way it’s supposed to,” Micallef says.

From that point, she wore conventional large-sized behind-the-ear hearing aids with a mold that sits in each ear.

“Basically that gave me volume and gave me the ability to use a telephone, go to school, whatever,” Micallef says.

“If I took everything out, I couldn’t hear anything. If you were to yell at me I’d be able to hear it, but not enough to function at work or anywhere without them. I had to have them in order to live a normal life.”

In the spring of 2013, Micallef was referred to Dr. David Morris, ear surgeon at the Queen Elizabeth II Health Sciences Centre in Halifax, to address some ongoing problems relating to her syndrome, which is called klippel-feil.

Because of the syndrome, Micallef was prone to middle ear infections, the consequence of which was some perforation and scarring of her eardrums.

Morris performed surgery on her left ear in an attempt to combat these issues and while doing so looked at the chain of ear bones to see if there was anything he could do to improve the conduction of sound through the middle ear.

“It was my impression having looked at the bones that that wasn’t possible and would certainly risk damaging her middle ear, which throughout all of this was definitely well maintained . . . . That was a key thing for her. It was almost like she had this untapped potential,” he says.

The post-op visit included the good news that the perforated ear drum and issues related to that were fixed, but the bad news was that Morris wasn’t able improve her hearing.

“That was difficult news to give her, and she was very upset by that. We had some tears, and I could definitely relate to that,” he remembers.

“But the good thing was I had a plan B, and that was that I’ve done quite a lot of work with traditional bone conduction implants and that I’d just been to a surgical course in Berlin where I’d been introduced to this new transcutaneous (Bonebridge) bone conduction implant.”

Because of the excellent condition of Micallef’s middle ear, her longstanding issues with her traditional hearing aids and the fact that she was maxed out on the ability to increase volume, he thought she would be an ideal candidate to receive the Bonebridge devices.

Unlike other bone-anchored hearing devices that poke through the skin, the Bonebridge implant is transcutaneous, so it is inserted into a small pocket under the skin.

The external audio processor is held in place discretely under the hair through magnetic attraction to the implant.

The next step was to seek special dispensation from the Prince Edward Island government to have two $5,000 state of the art bone conduction devices, instead of one, which is the norm.

“With Shannon, of course, this was a bilateral problem, so she is quite unusual in that this problem is on both sides,” says Morris, who has done seven implants on six patients in the last six months.

For Micallef, it was all or nothing.

“I had told Dr. Morris that I am not doing one. . . . Sound is a feeling as well as a noise and I was not going to be half of a person. So it was either going to be both or we weren’t doing it.”

After receiving the go-ahead from the P.E.I. government, on Oct. 23 she became the first patient in North America to receive a bilateral bone conduction implant system.

A few weeks later she returned to Halifax to have Morris activate the devices.

“When he turned it on there was a desktop and the fan was running, and I said, ‘Geeze, that’s loud!’ I know what it sounds like, but it was so loud,” Micallef remembers.

“There’s no volume control on it. That’s the one thing that I’ve lost is volume control. However, in place of volume control I gained clarity (so I can now hear) lots of little sounds that I never noticed before in the background . . . .”

“It’s just pretty cool. You’ve got these things in your head and you feel bionic almost.”