An opera singer who concealed her deafness for more than three decades has described life-changing surgery that could become standard practice for thousands of NHS patients. Janine Roebuck, 72, from London, received bilateral cochlear implants to restore her hearing, a procedure now being tested across the country to determine whether it could revolutionize the lives of many more people.
Current NHS Guidelines
Under current National Institute for Health and Care Excellence (Nice) guidelines, the vast majority of deaf adults qualify for only one cochlear implant. This is based on analysis suggesting that providing two implants is not financially viable for the NHS and that there is insufficient evidence in this field. To address this, the National Institute for Health and Care Research (NIHR), which is government-funded, is supporting a new study examining bilateral implants for adults, led by Addenbrooke's Hospital and the University of Cambridge.
Janine's Story
Ms Roebuck has the hereditary condition sensorineural hearing loss, which accounts for approximately 70 per cent of all genetic hearing loss cases. The condition has affected multiple generations of her family. In 2019, she received cochlear implant surgery on the NHS for one ear, in accordance with guidelines, but chose to privately fund the procedure for her other ear at the same time. For over thirty years, she hid her worsening hearing loss while working as a mezzo-soprano, performing in operas, operettas, and musicals, including at the Royal Opera House in London. She has since retired from performing.
She described undergoing the procedure as "the best thing I've ever done in my life," explaining: "Having two implants is light years away from just one. Sound quality is so much better, sounds are fuller, clearer, louder and more natural. It's much easier to tell where sounds are coming from, especially in busy spaces." She added: "If you're out in public, it can be hard to follow who is speaking, making joining in with conversations almost impossible. As a result, you have debilitating concentration fatigue at the end of every day."
She explained how the operation has transformed her life: "With bilateral implants, I no longer consider myself to be deaf. They have been utterly life-changing and, for me, have broken a generational curse. Struggling to hear can be extremely isolating and many people experience anxiety or depression as a result. The implants are life-changing. They reconnect you to the world and, most importantly, people." She added: "Communication is surely the longing of every human heart. I also feel safer and more secure having the two implants. I am more aware of and connected to what's happening in the world around me. And, if anything goes wrong with one of the implants, I'm not suddenly plunged into a world of total silence."
She told the Press Association that her father had the same condition and "dealt with it graciously and bravely." Her grandfather and his brothers and sisters also struggled. She said having the implants switched on gave her joy, and over the next six months she discovered new sounds. She told PA: "The one that actually made me weep was, I was in the kitchen and I could hear this noise, and it wasn't the tap, it wasn't the cooker, it wasn't the oven, and I'm thinking, 'oh my god, what is it?' And the door into the garden was open, and it was pouring with rain, and it was the sound of rain on the leaves. I didn't even know that was a sound."
The Upcoming Trial
The trial will take place across 14 hospitals and involve more than 250 adults. Participants will be fitted with either one (unilateral) or two (bilateral) implants to enable comparison of outcomes. Eligibility requires candidates to have experienced hearing loss in adulthood and not currently have an implant. Matthew Smith, an ear, nose and throat (ENT) surgeon at Addenbrooke's Hospital, alongside Professor Debi Vickers, a speech and hearing scientist at the University of Cambridge, are leading the research.
Mr Smith explained: "We know from giving bilateral implants to children that it can have a transformative effect on their quality of life and interactions with other people. Through this study, we can offer the same opportunity to adults who have become deaf, and understand the potential added value of bilateral cochlear implants, not just in terms of hearing, but also how they enrich quality of life."
Prof Vickers explained: "Children routinely receive bilateral cochlear implants. These can provide three-dimensional hearing, enabling them to hear more naturally than unilateral, with improved access to sound and better engagement with society." She added: "Adults tell us, and I agree, that they should be given the same hearing opportunities as children. In turn, these will result in reduced social isolation, enriched communication, improved mental health, and better overall quality of life."
Professor Anthony Gordon, programme director for the NIHR health technology assessment programme, which funded the trial, commented: "This study offers real hope to people with severe hearing loss and the chance of a significant improvement in their quality of life." Following the trial's completion, it will be submitted to Nice for review.
Expert Reaction
Ralph Holme, director of research at the RNID, said: "It's wonderful to hear just how life-changing this experience has been for Janine, and the impact it's had on her quality of life. Cochlear implants can be truly transformative for people with hearing loss, helping them reconnect with the world around them, and with friends, family and colleagues." He added: "The added benefits bilateral implants could bring are particularly exciting, and this study will play a vital role in building the evidence needed so that many more people can benefit, just as Janine has. Hearing loss and tinnitus affect 18 million people in the UK, and trials like this offer genuine hope for a future in which effective treatments are available to everyone who wants them."
