THE success of the first tolal middle ear implant performed here could mean the end of silence for sufferers of advanced hearing loss.

Until recently, a per on whose condition was omewhere between moderate hearing loss and total deafness had little choice but to use a conventional external hearing aid.

The middle ear implant is a hearing device comprising a microphone, sound processor and rechargeable battery - which is placed completely under the scalp above the ear.

The device, about the size of a 50 cent coin, is connected to a transducer that is in contact with the middle ear. It stimulates the middle ear directly and enable the patient to perceive and recognise sound.

Associate Professor Lynne Lim, a senior consultant with the Ear, Nose, Throat - Head and Neck Surgery Department at the National University Hospital (NUH), said the sound quality is more natural compared with that of the conventional hearing aid, which often sends feedback.

"The implant amplifies sound by directly vibrating the middle ear bones. It can also be used in case where there is no ear canal, or abnormal ear bones that failed to be corrected by surgery," she said.

"People without ear canals, abnormal middle ear bones from birth, age-related hearing loss or hearing loss from infections or trauma can be helped."

She performed Singapore's first total middle ear implant last year but had to wait 12 months before it could be declared a success.

Most scientific reports worldwide also report implant results at one year - to ensure that the device not only works but works well for the recipient.

The 2 1/2 hour total middle ear implant was the second such operation in the Asia-Pacific. The first was performed in Hong Kong in April last year.

The recipient here was in her early 20s when she was first diagnosed with middle ear hearing loss, Australian Marie Johnson, now 51, was forced to wear hearing aids in both ears.

"I tried the aids because it improved my hearing but found them very uncomfortable with annoying side effects, For example, when someone hugged me closely, the aid emitted a squealing noise which could be embarrassing," Mrs Johnson told The Straits Times.

A search online at the start of last year brought her to the website of a company specialising in hearing aids in Singapore, and later to NUH.

"The surgery was not available in Australia and I didn't want to wait year for it be available. So I travelled to Singapore to speak to the people and it didn't take me long to make up my mind to go ahead," she said.

Following the surgery, the implant was tuned by a trained audiologist here. It took Mrs Johnson about two months to get ed to the new device.

According to the Society for Audiology Professionals (SAP), there are about 360,000 people ill Singapore with hearing loss requiring hearing aids.

And the problem is not just affecting the older generation. Last year, doctors here saw an increasing number of people in their 20s and 30s complaining of hearing problems due to the excessive use of mobile music devices played at maxImum volume.

Middle ear implants are costly, ranging from $12,000 to $30,000.

"Singaporeans tend to think less about quality of life work and social options. But with a more sophiscated, educated, and rapidly greying population which needs to and may want to work longer, this 'attitude is fast changing," Prof Lirn said.

Since the implant lasts for life, she said that "makes it cost -effective without question".

She has since performed one other total middle ear implant, and a third has been scheduled within the next few weeks.

As for Mrs Johnson, she feels very fortunate to have been "switched on" now for over a year.