August 18, 2025 • 12 mins
This year marks the 40th anniversary of the opening of the world's first public Cochlear Implant Clinic, established at the Royal Victorian Eye and Ear Hospital in 1985. Dr Claire Iseli, chats with Peter Greco about its origins, successes and the difference it is making to people's lives and their families.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
S1 (00:14):
It's a very special year for the Victorian Eye and
Ear Hospital. Celebrating 40 years since they've been around. Let's
chat a bit about it with Doctor Claire. Claire, lovely
to meet you. Thank you for your time.
S2 (00:26):
Thanks for giving me a chance to talk about cochlear implants.
They are my great passion. Always great to have an
excuse to talk about them.
S1 (00:32):
Now, I kind of know of Graham Clark and the
fact that he kind of started it all many, many
years ago.
S2 (00:38):
That's right. So Graham Clark was actually the first in
the world to develop what's called a multi-channel electrode. So cochlear,
our inner ear works like the keys of a piano.
We've got lots of different sounds that are our inner
ear can pick up. And up until the cocktail. Graham
Clark we used to just have an electrode that sat
in there with one point, so it literally could only
(00:58):
make one note, whereas he was the first in the
world to develop lots of different points where we could
simulate our inner ear, and that's what we call a
multi-channel electrode. And that technology is still the basis of
what we use today.
S1 (01:10):
And you're celebrating 40 years this year. How are you
kind of marking the occasion?
S2 (01:15):
So the specific and exciting landmark. You know, the event
is that the Pioneers Clinic running it for public access
to patients. So we're having a big event next Wednesday
where we're inviting Graham Clark to come down and speak
to the team that are now running the cochlear implant
clinic and the patients and recipients. So it's a great
honor to have the great man coming in, and then
(01:36):
we'll sort of have a bit of a party afterwards together.
Be better to the world. But I've also had the
honour of watching him presented with a very prestigious awards internationally.
So this is not just a local thing we're celebrating.
It's actually an international, you know, amazing achievement for the world.
Having multi-channel electrodes.
S1 (01:53):
I don't want to go too much into the long grass,
but of course it's now a very, very successful public
listed company that is worth billions and billions of dollars
and started in Australia. So what a cool thing.
S2 (02:03):
Exactly.
S1 (02:04):
Tell us a bit about, I guess, the kind of
work that you're doing, the kind of difference that makes
the people's lives and the family of people's lives.
S2 (02:11):
It's just such a privilege to be working in this area.
It's a complete joy as a surgeon to do something that,
you know, though I though, I never underestimate surgery as
no one does that for fun. You know, the surgery
is actually very simple. Um, low risk surgery and the
impact on both children and adults is just amazing to
(02:32):
watch and privileged to be a part of. So this
started in adults. You know, we're basically we would replace
someone's natural hearing who had lost it over life. And
it returns them to not just hearing, but also being
able to be employed, being able to communicate with their
friends and family. And, you know, the impacts for someone
on not just their financials, but also their their emotions
(02:55):
and their, you know, cognitive health has just been so
wonderful to see. But now it's also being used in
children who are born without hearing to give them the
opportunity to learn to use oral speech. So a lot
of our children can be both bilingual in sign language
and oral speech, and they can choose to, you know,
go through mainstream schools and use that bilingual language, which
(03:15):
is just also a great privilege to be a part of.
S1 (03:18):
We'll come back to the kids in a second. But
that older age group, if you like. I mean, there's
a lot of evidence to say that, you know, hearing loss.
I don't think it's necessarily a cause of it, but
can be linked to things like memory loss and dementia. So,
you know, such a great preventative thing in a sense,
to be doing or potentially preventative thing to be doing.
S2 (03:34):
Absolutely. So we now know that treating hearing loss can
have a major impact on the trajectory of someone's cognitive
health and their chance of developing dementia. And Melbourne University,
in collaboration with the pioneers, Cochlear Implant Clinic, has actually
also been doing research in this area. And we've seen
patients with early dementia having vessels of their, you know, issues,
(03:57):
not just that it prevents them getting worse, but that,
you know, they actually reverse some of those changes. And
it's not just to do with hearing. It's also to
do with executive planning. So things like going to the
supermarket and being able to do a shopping list actually help.
It's helped a lot by hearing better. And specifically, the
cochlear implants seem to have a big impact on that.
So it's been really exciting to see.
S1 (04:19):
Yeah. That's amazing. What about in terms of the you
played it down a bit. I think Clare saying it's
not a tricky surgery or a complicated surgery, but I'm
sure it's much more than than you're making it out
to be. But tell us a bit about how it
kind of works without sort of going too gory.
S2 (04:33):
Sure. So basically we put a little, uh, this, uh,
multi-channel electrode that Graham Clark developed. We placed that inside
the inner ear, and then we place a processing body
just under the skin, under the skull, and then we
close up the skin. So it's we're on the outside.
There's nothing visible whatsoever. But then someone would wear an
externally worn processor, so like a conventional hearing aid, but
(04:57):
it attaches via a magnet to that internal divide. And
it doesn't just pick up sound, it tunes sound, adjusts sounds,
and delivers it directly to the nerve endings inside the cochlea.
So it means that we can give someone kind of
adjusted sound. So it comes through much clearer. I don't
know if you've ever known someone with advanced hearing loss,
they'll often say, it's not just that I can't hear you,
(05:19):
it's that I can't hear clearly. Even though the sound
comes through, it's not clear enough to be understood. And
that's what a cochlear implant is really unique. In doing that,
it can provide clearer sound, not just louder sound.
S1 (05:32):
How long does the surgery take? Like one one surgery.
S2 (05:35):
So we are really unique in Melbourne. We have a
single service that serves all of Victoria and some of Tasmania.
There are many other hubs throughout Australia doing similar work,
but we are the oldest running single public service in
the world. We have a group of surgeons who are
highly trained, you know, subspecialty trained. Most of us have
done international training, specifically in cochlear. So for our surgeons,
(05:58):
who usually makes about two hours, something like that, someone
might at most patients will stay one night in hospital
and then do all normal activity within a week of
surgery around the world. You know, people aren't quite as
experienced with this surgery. It might take longer, but because
we've been quite careful to only have surgeons highly trained
in this, doing it on Australian patients, but they should
(06:20):
expect an operation that only takes two hours.
S1 (06:22):
It's extraordinary. What about for young kids and how young
can the kind of youngest recipient be?
S2 (06:28):
So our goal is to connect children with hearing before
their 12 months of age. And we know that makes
a really big difference in the children who are born
without any hearing at all, that it's a little bit
like a seedling you've got to plant. You know, once
you plant that seedling, you've got to water it straight away.
Otherwise it's not going to get nice and strong. So
we do have a unique window where we've got implant
(06:50):
them early. So we definitely know from Victoria. And again
we were you know doing a lot of research in
this area to show that timing does make a big difference. Um,
most of our recipients, the little children, would receive it
somewhere between 6 and 9 months. It's probably three months,
but we just try and balance the risks of the
surgery with the benefit of getting them connected with dad.
So usually that kind of sweet spot of safety plus
(07:12):
good outcomes is between 6 and 9 months.
S1 (07:14):
And that can sometimes be, you know, sometimes that kind
of gets, um, data for the want of a better
term as the child gets older.
S2 (07:20):
But actually the internal device does not need to be changed.
The internal device can live with that child or that
adult for the rest of their life. But the external device,
which carries a lot of the kind of technology can
be upgraded very simply by taking the one off the
outside and putting a new one on, which is like
changing the magnets on your fridge. You know, it's very
simple technique, but actually, we've also had a really exciting
(07:42):
advancement in cochlear implants this year, which is that the
cochlear brand have brought out a device that can also
be upgraded, so the internal device can now be upgraded
as well as the external device without removing the internal device.
So it's a little bit like your smartphone that you
can load on, um, a new upgraded technology without taking
(08:02):
it out. So that's actually the first implant in the
world to do that. So it is quite a big
step forward.
S1 (08:10):
Claire, without maybe giving too much away or obviously, you know,
prevent or maintaining people confidentiality. Well, what about some of
the sort of, uh, stories that you can tell of
people that have received an implant and the, the, their reaction,
for example.
S2 (08:26):
I just, you know, it's such a privilege working this way.
So I can't say that enough, you know, the joy
of getting to know people, understanding what their lives are
and how I can help them improve their function, is
means that I really do get a chance to get
to know them, to be able to ask what's right
for them. Obviously, the little children who come in, you know,
(08:46):
telling me all about their favorite thing or telling me
about what their new school is just so fun to watch.
Given that that child would not have used the same
language as I'm most comfortable using, which is oral language.
I had that recipient. Um, you know, they not receive
the cochlear implant, but probably some of my favorite patients
are the older patients. You know, I had 93 year
(09:07):
old who was was single and and keen to, you know,
meet a new person. And he felt his hearing was
really getting in the way of that. Um, after, you know,
careful assessment. He considered a cochlear implant recipient, and he
went through the surgery very smoothly. And, uh, six months
after receiving his implant, he told me he had three
hot dates to go to. I felt, um, I'd spread
(09:29):
a little bit of love in the world.
S1 (09:30):
Oh, that is amazing, isn't it? Well, good luck to him. And, uh,
good luck to his dates. Well, he certainly got something
to talk about, hasn't he?
S2 (09:37):
That's true. And I.
S1 (09:38):
Guess.
S2 (09:38):
If he can hear what? He can be a good
listener as well as a good talker.
S1 (09:42):
Now, what about a sneak peek into the future? Claire,
can you sort of take us down that path, I guess.
It's almost limited by a person's imagination.
S2 (09:51):
Absolutely. So I think there's a few exciting things. You know,
we're really privileged in Melbourne. Part of why this service
started at the Ioneer is the strong collaboration between Melbourne
University and the Ioneer. So there's a lot of exciting
research being done on new technologies, new treatments. Um, you know,
certainly we're we're finding that we can get better and
(10:11):
better outcomes for the clarity of sound. And so we
can offer people implants even, who have quite a lot
of natural healing hearing still there. And we're getting better
at better detecting that inner ear hearing. And that means
we can start to offer implants to people, you know,
before they're losing too much hearing, rather than having to
wait until they're very, you know, affected by their hearing loss.
(10:32):
It's the other exciting thing is, you know, genetic treatments.
So we can use the cochlear implants actually to deliver
genetic material to the cochlea and that, you know, those
kinds of trials are in in process right now. And
Melbourne is recruiting for those, though they are, you know,
sent a bill for Australia in the world where, you know,
we might be delivering a gene that a child is
(10:53):
missing or we might actually be delivering, you know, neural, uh, structure,
you know, neural health factors that get us the regrow
nerves that we didn't have before. So, you know, I
still think there's a lot of, uh, opportunities for this
to get better and better over time.
S1 (11:07):
Well, that sounds most exciting because there's so much talk
about gene therapy and all sorts of health conditions, isn't there?
S2 (11:13):
Absolutely.
S1 (11:14):
Claire, we're out of time. I could chat to you for, uh.
I'll probably chat to you for days. It's such a
fascinating topic. Thank you. Thank you for being so modest.
And thank you for giving us a little snapshot into
40 years. And, uh, it'd be great if we could
chat in the future with that. That's just wonderful. And
congratulations to all those that have been involved and enjoy Wednesday.
S2 (11:31):
Thank you so much.
S1 (11:33):
It's, uh, doctor Clay there from the Victorian Eye and
Ear hospital celebrating 40 years. And what an incredible insight
into some of the work that goes on.
It's a very special year for the Victorian Eye and
Ear Hospital. Celebrating 40 years since they've been around. Let's
chat a bit about it with Doctor Claire. Claire, lovely
to meet you. Thank you for your time.
S2 (00:26):
Thanks for giving me a chance to talk about cochlear implants.
They are my great passion. Always great to have an
excuse to talk about them.
S1 (00:32):
Now, I kind of know of Graham Clark and the
fact that he kind of started it all many, many
years ago.
S2 (00:38):
That's right. So Graham Clark was actually the first in
the world to develop what's called a multi-channel electrode. So cochlear,
our inner ear works like the keys of a piano.
We've got lots of different sounds that are our inner
ear can pick up. And up until the cocktail. Graham
Clark we used to just have an electrode that sat
in there with one point, so it literally could only
(00:58):
make one note, whereas he was the first in the
world to develop lots of different points where we could
simulate our inner ear, and that's what we call a
multi-channel electrode. And that technology is still the basis of
what we use today.
S1 (01:10):
And you're celebrating 40 years this year. How are you
kind of marking the occasion?
S2 (01:15):
So the specific and exciting landmark. You know, the event
is that the Pioneers Clinic running it for public access
to patients. So we're having a big event next Wednesday
where we're inviting Graham Clark to come down and speak
to the team that are now running the cochlear implant
clinic and the patients and recipients. So it's a great
honor to have the great man coming in, and then
(01:36):
we'll sort of have a bit of a party afterwards together.
Be better to the world. But I've also had the
honour of watching him presented with a very prestigious awards internationally.
So this is not just a local thing we're celebrating.
It's actually an international, you know, amazing achievement for the world.
Having multi-channel electrodes.
S1 (01:53):
I don't want to go too much into the long grass,
but of course it's now a very, very successful public
listed company that is worth billions and billions of dollars
and started in Australia. So what a cool thing.
S2 (02:03):
Exactly.
S1 (02:04):
Tell us a bit about, I guess, the kind of
work that you're doing, the kind of difference that makes
the people's lives and the family of people's lives.
S2 (02:11):
It's just such a privilege to be working in this area.
It's a complete joy as a surgeon to do something that,
you know, though I though, I never underestimate surgery as
no one does that for fun. You know, the surgery
is actually very simple. Um, low risk surgery and the
impact on both children and adults is just amazing to
(02:32):
watch and privileged to be a part of. So this
started in adults. You know, we're basically we would replace
someone's natural hearing who had lost it over life. And
it returns them to not just hearing, but also being
able to be employed, being able to communicate with their
friends and family. And, you know, the impacts for someone
on not just their financials, but also their their emotions
(02:55):
and their, you know, cognitive health has just been so
wonderful to see. But now it's also being used in
children who are born without hearing to give them the
opportunity to learn to use oral speech. So a lot
of our children can be both bilingual in sign language
and oral speech, and they can choose to, you know,
go through mainstream schools and use that bilingual language, which
(03:15):
is just also a great privilege to be a part of.
S1 (03:18):
We'll come back to the kids in a second. But
that older age group, if you like. I mean, there's
a lot of evidence to say that, you know, hearing loss.
I don't think it's necessarily a cause of it, but
can be linked to things like memory loss and dementia. So,
you know, such a great preventative thing in a sense,
to be doing or potentially preventative thing to be doing.
S2 (03:34):
Absolutely. So we now know that treating hearing loss can
have a major impact on the trajectory of someone's cognitive
health and their chance of developing dementia. And Melbourne University,
in collaboration with the pioneers, Cochlear Implant Clinic, has actually
also been doing research in this area. And we've seen
patients with early dementia having vessels of their, you know, issues,
(03:57):
not just that it prevents them getting worse, but that,
you know, they actually reverse some of those changes. And
it's not just to do with hearing. It's also to
do with executive planning. So things like going to the
supermarket and being able to do a shopping list actually help.
It's helped a lot by hearing better. And specifically, the
cochlear implants seem to have a big impact on that.
So it's been really exciting to see.
S1 (04:19):
Yeah. That's amazing. What about in terms of the you
played it down a bit. I think Clare saying it's
not a tricky surgery or a complicated surgery, but I'm
sure it's much more than than you're making it out
to be. But tell us a bit about how it
kind of works without sort of going too gory.
S2 (04:33):
Sure. So basically we put a little, uh, this, uh,
multi-channel electrode that Graham Clark developed. We placed that inside
the inner ear, and then we place a processing body
just under the skin, under the skull, and then we
close up the skin. So it's we're on the outside.
There's nothing visible whatsoever. But then someone would wear an
externally worn processor, so like a conventional hearing aid, but
(04:57):
it attaches via a magnet to that internal divide. And
it doesn't just pick up sound, it tunes sound, adjusts sounds,
and delivers it directly to the nerve endings inside the cochlea.
So it means that we can give someone kind of
adjusted sound. So it comes through much clearer. I don't
know if you've ever known someone with advanced hearing loss,
they'll often say, it's not just that I can't hear you,
(05:19):
it's that I can't hear clearly. Even though the sound
comes through, it's not clear enough to be understood. And
that's what a cochlear implant is really unique. In doing that,
it can provide clearer sound, not just louder sound.
S1 (05:32):
How long does the surgery take? Like one one surgery.
S2 (05:35):
So we are really unique in Melbourne. We have a
single service that serves all of Victoria and some of Tasmania.
There are many other hubs throughout Australia doing similar work,
but we are the oldest running single public service in
the world. We have a group of surgeons who are
highly trained, you know, subspecialty trained. Most of us have
done international training, specifically in cochlear. So for our surgeons,
(05:58):
who usually makes about two hours, something like that, someone
might at most patients will stay one night in hospital
and then do all normal activity within a week of
surgery around the world. You know, people aren't quite as
experienced with this surgery. It might take longer, but because
we've been quite careful to only have surgeons highly trained
in this, doing it on Australian patients, but they should
(06:20):
expect an operation that only takes two hours.
S1 (06:22):
It's extraordinary. What about for young kids and how young
can the kind of youngest recipient be?
S2 (06:28):
So our goal is to connect children with hearing before
their 12 months of age. And we know that makes
a really big difference in the children who are born
without any hearing at all, that it's a little bit
like a seedling you've got to plant. You know, once
you plant that seedling, you've got to water it straight away.
Otherwise it's not going to get nice and strong. So
we do have a unique window where we've got implant
(06:50):
them early. So we definitely know from Victoria. And again
we were you know doing a lot of research in
this area to show that timing does make a big difference. Um,
most of our recipients, the little children, would receive it
somewhere between 6 and 9 months. It's probably three months,
but we just try and balance the risks of the
surgery with the benefit of getting them connected with dad.
So usually that kind of sweet spot of safety plus
(07:12):
good outcomes is between 6 and 9 months.
S1 (07:14):
And that can sometimes be, you know, sometimes that kind
of gets, um, data for the want of a better
term as the child gets older.
S2 (07:20):
But actually the internal device does not need to be changed.
The internal device can live with that child or that
adult for the rest of their life. But the external device,
which carries a lot of the kind of technology can
be upgraded very simply by taking the one off the
outside and putting a new one on, which is like
changing the magnets on your fridge. You know, it's very
simple technique, but actually, we've also had a really exciting
(07:42):
advancement in cochlear implants this year, which is that the
cochlear brand have brought out a device that can also
be upgraded, so the internal device can now be upgraded
as well as the external device without removing the internal device.
So it's a little bit like your smartphone that you
can load on, um, a new upgraded technology without taking
(08:02):
it out. So that's actually the first implant in the
world to do that. So it is quite a big
step forward.
S1 (08:10):
Claire, without maybe giving too much away or obviously, you know,
prevent or maintaining people confidentiality. Well, what about some of
the sort of, uh, stories that you can tell of
people that have received an implant and the, the, their reaction,
for example.
S2 (08:26):
I just, you know, it's such a privilege working this way.
So I can't say that enough, you know, the joy
of getting to know people, understanding what their lives are
and how I can help them improve their function, is
means that I really do get a chance to get
to know them, to be able to ask what's right
for them. Obviously, the little children who come in, you know,
(08:46):
telling me all about their favorite thing or telling me
about what their new school is just so fun to watch.
Given that that child would not have used the same
language as I'm most comfortable using, which is oral language.
I had that recipient. Um, you know, they not receive
the cochlear implant, but probably some of my favorite patients
are the older patients. You know, I had 93 year
(09:07):
old who was was single and and keen to, you know,
meet a new person. And he felt his hearing was
really getting in the way of that. Um, after, you know,
careful assessment. He considered a cochlear implant recipient, and he
went through the surgery very smoothly. And, uh, six months
after receiving his implant, he told me he had three
hot dates to go to. I felt, um, I'd spread
(09:29):
a little bit of love in the world.
S1 (09:30):
Oh, that is amazing, isn't it? Well, good luck to him. And, uh,
good luck to his dates. Well, he certainly got something
to talk about, hasn't he?
S2 (09:37):
That's true. And I.
S1 (09:38):
Guess.
S2 (09:38):
If he can hear what? He can be a good
listener as well as a good talker.
S1 (09:42):
Now, what about a sneak peek into the future? Claire,
can you sort of take us down that path, I guess.
It's almost limited by a person's imagination.
S2 (09:51):
Absolutely. So I think there's a few exciting things. You know,
we're really privileged in Melbourne. Part of why this service
started at the Ioneer is the strong collaboration between Melbourne
University and the Ioneer. So there's a lot of exciting
research being done on new technologies, new treatments. Um, you know,
certainly we're we're finding that we can get better and
(10:11):
better outcomes for the clarity of sound. And so we
can offer people implants even, who have quite a lot
of natural healing hearing still there. And we're getting better
at better detecting that inner ear hearing. And that means
we can start to offer implants to people, you know,
before they're losing too much hearing, rather than having to
wait until they're very, you know, affected by their hearing loss.
(10:32):
It's the other exciting thing is, you know, genetic treatments.
So we can use the cochlear implants actually to deliver
genetic material to the cochlea and that, you know, those
kinds of trials are in in process right now. And
Melbourne is recruiting for those, though they are, you know,
sent a bill for Australia in the world where, you know,
we might be delivering a gene that a child is
(10:53):
missing or we might actually be delivering, you know, neural, uh, structure,
you know, neural health factors that get us the regrow
nerves that we didn't have before. So, you know, I
still think there's a lot of, uh, opportunities for this
to get better and better over time.
S1 (11:07):
Well, that sounds most exciting because there's so much talk
about gene therapy and all sorts of health conditions, isn't there?
S2 (11:13):
Absolutely.
S1 (11:14):
Claire, we're out of time. I could chat to you for, uh.
I'll probably chat to you for days. It's such a
fascinating topic. Thank you. Thank you for being so modest.
And thank you for giving us a little snapshot into
40 years. And, uh, it'd be great if we could
chat in the future with that. That's just wonderful. And
congratulations to all those that have been involved and enjoy Wednesday.
S2 (11:31):
Thank you so much.
S1 (11:33):
It's, uh, doctor Clay there from the Victorian Eye and
Ear hospital celebrating 40 years. And what an incredible insight
into some of the work that goes on.
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