For two baby boys born deaf because of a genetic mutation, the moment sound entered their lives came together.
Identical twins underwent cochlear implant surgery on the same day, with ENT surgeon Dr Rithvik Reddy placing four implants during an eight-hour operation that made Australian medical history.
The complexity of operating on both babies in a single day attracted medical attention, but Reddy says the part that mattered most was what happened afterwards.
“I feel like a bit of an imposter, to be honest,” he says, describing the operation as “just doing one thing twice”.
For the family, the outcome was far more personal. “The most important part was that both twins got to hear mum’s voice on the same day, at the same time.”
The twins’ experience also draws attention to a condition that affects families well beyond the operating theatre. Around one in every thousand children born in Australia has permanent hearing loss, with hospital screening identifying most cases early.
A cochlear implant is used when the normal mechanism that carries sound to the brain is not working effectively. In a healthy ear, sound travels through the ear canal and causes the eardrum and tiny bones of the middle ear to vibrate. Those vibrations reach hair cells within the cochlea, which convert them into electrical signals sent to the brain.
When those hair cells are damaged or absent, a cochlear implant bypasses them and directly stimulates the hearing nerve.
“Hearing aids in children are incredibly difficult to manage,” Reddy says, particularly when a child’s level of hearing loss means conventional amplification is not enough.
Hearing problems in young children are not always present at birth. Some develop later, including fluid behind the eardrum, commonly known as glue ear.
The signs can be subtle. A toddler may be slower to develop speech and language, appear slightly unsteady when walking or repeatedly ask “what?” during conversation.
Reddy’s advice to parents is to take those changes seriously and seek an assessment if something appears wrong.
The consequences of hearing loss also extend well into adulthood, where Reddy sees patients who have lived with deteriorating hearing for years before seeking help.
Part of the problem, he says, is the perception that continues to surround hearing aids despite the routine acceptance of other devices used to correct sensory loss.
“You’re wearing glasses, I’m wearing contact lenses. There’s no stigma surrounding that,” he says. “That all of a sudden you have to wear a hearing aid and everyone thinks that you’ve got a disability. I think that’s quite sad.”
Reddy also points to the connection between untreated hearing loss and dementia risk, describing hearing loss as an important modifiable risk factor. He says mild hearing loss can double the risk, moderate hearing loss can triple it and severe hearing loss can increase it fivefold.
“If you treat the hearing loss, that risk reverses,” he says.
The effect of restoring hearing can also be seen in more immediate ways.
Reddy recalls treating an older man who had become quiet as his hearing deteriorated. Family members had become accustomed to speaking around him or answering on his behalf.
For many patients, hearing problems are less obvious. Tinnitus, experienced as ringing, buzzing or humming without an external source, is among the conditions Reddy regularly encounters
After receiving a cochlear implant, the patient returned wanting the procedure performed on his other ear.
“He actually used the phrase, ‘I don’t feel like a pot plant anymore’,” Reddy says.
For many patients, hearing problems are less obvious. Tinnitus, experienced as ringing, buzzing or humming without an external source, is among the conditions Reddy regularly encounters.
“Tinnitus is incredibly common,” he says. “It’s one of the most frustrating presentations that I see, because often there isn’t a cause, and there isn’t a terrific treatment.”
He describes the experience by comparing it with a candle burning in a dark room. When the surroundings are completely quiet, the sound can become difficult to ignore. Introducing gentle background noise, such as a fan, soft rain sounds or a low radio, can make it less dominant.
Across childhood hearing loss, tinnitus and age-related deterioration, a common issue is how easily changes in hearing can alter someone’s involvement in everyday life.
It may begin with a toddler falling behind in speech, an adult struggling to follow conversation or an older relative steadily increasing the television volume. Reddy’s advice is to recognise those changes early rather than accept them as something that must simply be lived with.
For the twin boys, that intervention came at the beginning of life.
Their operation was technically unusual, with two babies, four implants and eight hours of surgery on the same day. But the measure of its success was much simpler: two brothers able to hear their mother’s voice together.
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