A Sacramento doctor is making history by performing a cochlear implant procedure that allowed his patient to remain awake.
For Patty Peasley, the experience offered a new approach to treating her moderate to severe hearing loss, while also allowing her to avoid the lingering effects of general anesthesia.
"I've realized for quite some time that I was missing an important part of my life," Peasley said.
She decided to pursue a cochlear implant, a medical device that bypasses damaged portions of the inner ear and directly stimulates the auditory nerve, allowing the brain to interpret sound.
Traditionally, cochlear implant surgery is performed under general anesthesia. But Peasley also lives with Type 1 diabetes and wanted to avoid the potential fogginess and drowsiness that can accompany anesthesia.
"I'm on an insulin pump, and it helps me not to be foggy with the anesthetic, so I just wanted to be more comfortable with that," she said.
That led her to Dr. Varun Varadarajan, a Sacramento ear, nose and throat neurotologist who performed what he says is the first cochlear implant surgery in the Sacramento region with the patient awake.
Rather than being put completely under, Peasley was given local anesthesia to numb the area around her ear.
On the day of the surgery, Varadarajan asked Peasley what music she wanted to hear.
"She chose classical piano, so I chose Chopin," he said.
As surgeons worked behind her ear, Peasley listened to the music and remained conscious throughout the procedure.
"At another point when you will feel pressure, and yeah, I did," Peasley said.
She could also hear some of the sounds coming from the operating room.
"There was some drilling going on, and the nurse talked me through that just beautifully," she said.
Peasley said the experience wasn't frightening.
"That was not an issue for me. It was like going to the dentist," she said.
The procedure involves making an incision behind the ear and drilling into the mastoid bone to reach the inner ear. Surgeons then thread an electrode array into the cochlea.
The cochlear implant bypasses damaged portions of the inner ear and directly stimulates the auditory nerve, allowing the brain to process sound.
Cochlear implants have become significantly less invasive over the years. What once could require four to six hours of surgery and days of hospitalization can now often be performed as an outpatient procedure.
"Now they're in and out of the same morning, and a couple of weeks later they're already hearing," Varadarajan said.
The National Institutes of Health estimates that more than 1 million people in the United States could benefit from a cochlear implant, but only about 10% have one.
Varadarajan says the awake-surgery approach won't replace traditional anesthesia for most patients. But for some people, including those who may benefit from avoiding general anesthesia, it can provide another option.
For Peasley, the procedure has already changed how she views her future.
"Don't wait, don't wait. See your audiologist. They have many options to offer you," she said. "It really is changing my life, and I'm looking forward to the journey of hearing better."
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