Last month’s One in Five introduced readers to the remarkable story of Auditory Brainstem Implant (ABI) recipient Hannah McPierzie and the work of her surgeon, Dr Jafri Kuthubutheen. While that story explored one of today’s most specialised hearing technologies, Dr Kuthubutheen believes the next decade could bring advances that transform hearing healthcare even more broadly. 

Yet despite that progress, he believes hearing loss itself still does not receive the attention it deserves. 

For Dr Kuthubutheen, innovation is only part of the future. Increasing awareness of hearing loss, expanding treatment options and helping people have informed conversations with their healthcare teams are equally important. 

Speaking with One in Five, he identified three developments already moving from research towards clinical reality that could reshape hearing healthcare in the years ahead. 

Combining implants with targeted drug therapies 

For decades, hearing implants have focused on replacing or bypassing damaged parts of the hearing system. The next frontier, Dr Kuthubutheen says, is making those devices work even better by combining them with specialised medicines. 

“There is a lot of work that’s happening in this field where we can augment, enhance or optimise the function of implants with very specialised drugs and pharmacotherapy,” he explains. 

Rather than viewing surgery and medicine as separate treatments, researchers are increasingly exploring how the two can work together. 

“The combining of the two together is a field where a lot of work is happening,” he says. “I think we may see some new advances soon.” 

If successful, these approaches could improve how implant recipients experience sound by helping optimise the performance of the implanted device itself. 

Invisible hearing through fully implantable cochlear implants 

Today’s cochlear implants rely on both an internal implant and an external sound processor worn behind the ear. 

That may not always be the case. 

Dr Kuthubutheen says researchers have already begun clinical trials of fully implantable cochlear implants, where the microphone, processor and receiver are all implanted beneath the skin. 

“There is work that’s been done now to essentially do without the external piece,” he says. 

For recipients, the implications extend well beyond appearance. 

“They can have invisible hearing, essentially, and hearing that’s there all the time.” 

While today’s users generally remove the external processor for charging, a fully implanted system has the potential to provide continuous hearing without external hardware. 

“There have already been some patients who have undergone this in clinical trials,” Dr Kuthubutheen says. “I think that’ll be a huge advancement in the field.” 

Gene therapy moves from possibility to reality 

Perhaps the most exciting area, according to Dr Kuthubutheen, is the rapid progress being made in gene therapy for some inherited forms of hearing loss. 

“You may have heard there has been some very exciting progress in gene therapy for treating hearing loss,” he says. 

Recent developments in the United States have demonstrated that replacing a faulty gene can restore hearing for people with a very specific genetic form of hearing loss. 

Dr Kuthubutheen points to research involving people with mutations in the OTOF (otoferlin) gene as an example of how quickly the field is advancing. 

“This is essentially a way of giving patients hearing by replacing the gene that is responsible for the hearing loss,” he explains. 

He describes the early results as “quite astonishing and truly groundbreaking.” 

While not every type of hearing loss is genetic, Dr Kuthubutheen believes the progress being made today is only the beginning. 

“The more we discover over time, I’m confident that we will find more targets for gene therapy, and I think this will become more widespread.” 

For some future patients, this could mean treating the underlying cause of hearing loss rather than relying solely on hearing devices. 

Looking ahead 

The technologies Dr Kuthubutheen describes are at different stages of development. Some are already being tested in people, while others remain the focus of ongoing research. Together, however, they point towards a future where engineering, medicine and genetics increasingly work hand in hand. 

For Dr Kuthubutheen, the greatest opportunity lies not only in developing new treatments, but in ensuring more people understand hearing loss, know what options are available and feel empowered to seek advice. 

“Work like this is really important in bringing everyone’s awareness about the importance of hearing loss and the impact that hearing loss has on people’s everyday lives.” 

As research continues to advance, hearing healthcare is moving into a new era. One where treatment is becoming increasingly personalised, technology continues to evolve, and people living with hearing loss may have more options than ever before.