Flanked by a stark white lab coat, Dr. Lisa Wenstrup can be seen moving gracefully down the hallways of the University of Cincinnati’s Gardner Neuroscience Institute. The building’s fourth-floor glass windows offer a sweeping view of bustling Clifton life that reflects the diverse group of patients Dr. Wenstrup has been treating in Cincinnati since 2003. She is a doctor of Audiology — the science and study of hearing — with the UC Department of Otolaryngology-Division of Audiology. For the past nine years, she has focused on clinical Audiology with a specialty in cochlear implants.
The News Record: What got you interested in Audiology?
Dr. Lisa Wenstrup: Well I wanted to do something that was involved in the medical field, so the year before I started applying to colleges, I observed a speech pathologist in a rehab facility. I liked that side of medicine, so I decided to study communication sciences and disorders.
I always wanted to do patient care, but I like the work-life balance of Audiology.
TNR: What is the most difficult thing you've had to overcome to get to where you are in your job today?
Wenstrup: Oh gosh, that's a good question. I think the confidence to interact with patients and feel confident in the recommendations that you're making. Also being able to handle difficult patients. The reality is that the people that come to see us have more things going on than just hearing loss.
TNR: You specialize in cochlear implants. I previously thought that those were just hearing aids, but I know they're a lot different. Can you explain what they are?
Wenstrup: Yeah, so cochlear implants are a surgically implanted device. With hearing aids, it's basically a very fancy amplifier. It uses the anatomy that's already in place.
The cochlear implant is called the cochlear implant because it replaces the cochlear function [the transfer of sound waves into nerve functions to be interpreted by the brain]. Our cochlea – the hollow, fluid-filled, snail-shaped canal in the inner ear – is our hearing organ. The cochlear implant uses an electrode array, typically a series of tiny metal rings that electrically stimulate the auditory nerve endings to create sound sensations, to replace the function of the cochlea, so we're kind of changing the way the patient hears. With hearing aids, making it louder sometimes makes sound distorted or doesn't improve the clarity of speech, but the cochlear implant would help with that.
It's a two-part system. There's the surgically implanted part and the processor on the outside.
TNR: When you get cochlear implants and you wake up, or recover from the surgery, can you just immediately hear?
Wenstrup: No. Once patients wake up from surgery, nothing's really changed. And then they come back to see me two weeks later where we activate the processor on the outside.
It can take three to six months for that word understanding and clarity to happen because they have to not only wear the device in their everyday life but do kind of listening practice.
When you sleep, shower, swim or you just don’t want to wear it for whatever reason, it's magnetically connected, so you can just take off the processor.
TNR: If you had to analogize the technology of cochlear implants to something else, what would you say they’re like?
Wenstrup: I mean if you think about it, there aren’t many things that actually replace a sense, right? You can certainly have LASIK surgery but that's not somebody going from being completely blind to having normal vision. It's usually just a corrective surgery, or surgery for some sort of visual impairment. I guess that would be the closest thing, but it's not like a heart transplant or an organ transplant where your body just accepts it and kind of takes over that function.
TNR: Is there a certain group of people that generally get cochlear implants?
Wenstrup: The stereotype with hearing loss is that it's older people. But it's not. I only work with adults here, but children can get them as young as three to six months. Obviously, we know that hearing loss impacts language development and so the earlier you implant children, the more likely they will be able to be streamlined into a classroom.
I would say the majority of my patients are 65 or older but I certainly have people in their late 20s, early 30s, 40s, 50s. I mean, there's really not a specific age.
TNR: Obviously they help you hear, but what other impacts have you seen cochlear implants have on patient’s lives?
Wenstrup: I think the biggest thing is quality of life, which is so rewarding for me. I see patients who are able to hear their grandchildren for the first time. I see patients who are able to go back to work. I see patients who are able to talk on the phone again.
I think hearing loss sometimes goes overlooked, and even though patients try to advocate for themselves and say, look at me, can you speak slowly and clearly, I don't think that always happens. So, giving patients that independence and confidence to function in environments that they avoided or had difficulty with before is great.
TNR: How has the technology of the implants changed over time?
Wenstrup: I think technology has changed for preserving hearing, trying to be as atraumatic as we can to the anatomy. And that's been able to happen by changes in surgical technique. And the manufacturers of implants have come out with slimmer, smaller, more flexible electrode rays.
Everybody has a smartphone. And now, the nice thing is a lot of the processors have an app where you can control things like volume. And some of the technology you can actually stream directly to your processor for talking on the phone, listening to music. The kind of things that all of us do.
TNR: I heard about a canine Audiology program at the University of Cincinnati. Can you tell me anything about that?
Wenstrup: They call it the Fetch Lab. They've developed protocols to be able to test animals, and so they'll test puppies from breeders. They'll test service dogs.
Recently, one of my grad students developed ear protection for military dogs.
It's only one of maybe two or three in the country that actually does animal testing and it's a pretty impressive thing. Anytime we have students come through here they love the experience.
TNR: What do you think is in the future for Audiology technology?
Wenstrup: I think we're going to continue to improve outcomes for patients. With the technology of smartphones and in-the-ear technology, I think a lot of other health tracking will occur, which is pretty cool. You're actually able to get a lot of different feedback; temperature, pulse, things like that.
As far as cochlear implants go, I hope to see totally implantable ones. If you could have a cochlear implant that is completely under the skin, I think patients would be very excited about that. We are a society where cosmetics and aesthetics are very important.