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The April 12 edition of The ASHA Leader includes an excellent report of the American Association of the Advancement of Science (AAAS) session on the status of cochlear hair cell regeneration. Studies in both avian and cold-blooded vertebrates are described with the research challenges which lie ahead clearly identified.
I write to take exception to the statement by Steven Green of the University of Iowa that "currently the most effective treatment for sensorineural hearing loss caused by the loss of hair cells is the use of cochlear implants." The most effective treatment of sensorineural hearing loss (SNHL) is the directed used of high-quality digital amplification incorporating wide dynamic range compression, directional microphones, and other modern technology. Amplification should be preceded and followed by systematic, organized programs of audiologic rehabilitation administered by trained and qualified audiologists.
Cochlear implants are a revolutionary breakthrough in the rehabilitation of a subset of persons with SNHL who derive no significant benefit from the best current amplification devices available. To suggest that they represent "the most effective treatment" ignores the millions of persons with use or could benefit from the technological progress that characterizes current forms of fully digital instrumentation.
Maurice Miller
New York, NY
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