The World Health Organisation estimates that 278 million people worldwide suffer from moderate to severe hearing loss (2005 figures). Due largely to population growth and increasing life expectancy, the number of people with hearing loss can be expected to increase.
In addition to preventive measures, it is very important to promote research in the field of hearing and to improve conditions for those who suffer from hearing loss through the continuous advance of clinical and therapeutic strategies, thereby increasing their quality of life. A particularly sensitive area in the treatment of hearing loss is cochlear implantation, as it involves active implants and requires invasive surgery.
Research in the field of cochlear implants (CI) began in the 1950s. The first implant with electrical stimulation was used in Paris in 1957. The first micro-electronic multichannel CI was implanted 20 years later. The first major breakthroughs in this field were achieved in the 1970s and today’s technologies are based on this research.
Over the years, several research centres have emerged worldwide. In the 1990s and especially since the start of the new millennium, significant new clinical and therapeutic solutions have been discovered. Today, using cochlear implants to treat hearing loss is standard practice and offered in clinics around the world. Because the hearing of patients with CIs is almost as good as that of people without hearing loss, established hearing tests are sometimes insufficient for studying patients with the implants.
While the technical development of the components of a CI system is ongoing, issues such as surgical technique, how to ensure implantation is as minimally invasive as possible in order to enable optimal use of a patient’s residual hearing, and complete cochlear stimulation have become increasingly important in the last few years. There have also been technical advances: for example, combined electro-acoustic systems (which combine a conventional hearing aid with a CI) have become standard clinical practice for patients with partial hearing loss.
The first steps
The exchange of information and new ideas typically occurs through the medical literature and personal contacts, e.g. at medical congresses and conferences. In HEARRING’s case, renowned specialists from CI clinics in Antwerp, Warsaw, Vienna and Würzburg met over a period of some years, soon discovering that they agreed on many topics above and beyond surgical technique and rehabilitation. The open exchange of information and ideas as well as mutual learning played an important role.
However, the specialists involved in this occasional exchange soon found it to be insufficient, and it became clear that a structured form of collaboration was needed for a more intense and regular flow of information. In keeping with Aristotle’s assertion that the whole is greater than the sum of its parts, a network was established with the objective of providing each patient with the best possible hearing implant solution.
The first official meeting took place in Vienna in 2008, where the decision was made to establish HEARRING as a network of specialists in the field of hearing implants. The name arose from the concept itself and the understanding that all members are coequal.
Over the following months, other clinics around the world joined the network. The second meeting was held in May 2009 in Warsaw, where the basis for cooperation was developed. The common objective of the HEARRING members is to improve the quality of treatment and of pre- and post-operative care and surgical techniques in the field of hearing implants and to share this knowledge through high-quality education and training. By these means HEARRING seeks to achieve its primary objective: the provision of optimal support and care to patients with hearing loss. Comprehensiveness is the key word — extensive support, research and care using the most modern hearing implants available; cochlear implants, electro-acoustic implants and middle ear implants.
The main areas of cooperation have been defined as follows:
- The international exchange of knowledge and international cooperation among HEARRING members;
- The provision of top notch medical care, surgery, (re)habilitation and long-term patient care worldwide;
- The highest level of information and counsel for patients;
- The most up-to-date multicentric research;
- The setting of the highest standards;
- Excellent training;
- An optimal infrastructure and professional organisation.
The HEARRING members are committed to the highest quality standards in order to provide all patients with the best hearing implant solution for their hearing disability. These standards were first defined for adult patients and cover the entire treatment pathway. All factors that play a role in the provision of optimal care to patients have been taken into account. The standards begin with “infrastructure requirements”, “criteria for candidacy”, “key professionals before, during and after treatment” and “information and counsel”. They also cover “surgery” and “cochlear implants”, and extend to “post-operative care”, “rehabilitation” and “audit”. The standards are evaluated at regular intervals to incorporate the most up-to-date knowledge in the field. Further steps are currently being taken to define the quality criteria for the areas of “implantation in children”, “middle ear implants” and “electro-acoustic stimulation”.
Opportunities & benefits
Given the constant development of new technologies and materials in the hearing implant field as well as the steady growth of knowledge through scientific advances, the joint research efforts of the HEARRING members are extremely important for meeting the challenges of the future. Patients are not the only beneficiaries of the network. It also opens new opportunities for its members. The exchange allows members to be more up-to-date than ever before in terms of new knowledge, to improve their skills through the mutual support and alternative views of other members, and last but not least, to gain knowledge more quickly through multicenter studies and standardised protocols. Ultimately, these benefits of the members also benefit patients.