An opera singer who hid her worsening deafness for more than 30 years has described the double cochlear implants she received as “life-changing” – a procedure that a major new NHS trial aims to offer to thousands of adults across the country.
Janine Roebuck, 72, from London, spent decades concealing her deteriorating hearing while performing as a mezzo-soprano at venues including the Royal Opera House. She now says the implants have “broken a generational curse” and transformed every aspect of daily life.
Ms Roebuck suffers from sensorineural hearing loss, an inherited condition that accounts for about 70 per cent of all genetic hearing loss cases. Her father, grandfather and several of her father’s siblings all struggled with the same condition. For years she coped by hiding the problem, but the fatigue of constant concentration became debilitating.
In 2019, under current NHS guidelines, she received one cochlear implant. But she decided to pay for a second implant for her other ear at the same time. The difference, she says, is profound. “Having two implants is light years away from just one,” she explained. “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. With bilateral implants, I no longer consider myself to be deaf.”
She described the moment her implants were switched on as a revelation. “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 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 implants have also given her a new sense of safety. “If anything goes wrong with one of the implants, I’m not suddenly plunged into a world of total silence,” she said. She added that struggling to hear can be extremely isolating, causing anxiety or depression, but the implants have “reconnected me to the world and, most importantly, to people”.
Why the NHS trial matters
Ms Roebuck’s experience sits at the heart of a major new study called the LUCIA trial, funded by the National Institute for Health and Care Research (NIHR) and led by Addenbrooke’s Hospital and the University of Cambridge. The trial involves more than 250 adults across 14 hospitals. Participants must have become deaf later in life and cannot already have an implant. They will be randomly given either one (unilateral) or two (bilateral) implants, then monitored for 12 months to compare hearing, wellbeing, quality of life and – crucially – the cost-effectiveness of the double procedure for the NHS.
Current guidelines from the National Institute for Health and Care Excellence (Nice) mean the vast majority of deaf adults are only eligible for a single cochlear implant. This policy is based on earlier analyses suggesting two implants are not cost-effective and that evidence of benefit in adults was lacking. However, children routinely receive bilateral implants, which provide three-dimensional hearing and better social engagement.
The LUCIA trial aims to close that gap. Researchers and charities hope the results will persuade Nice to revise its guidance, opening the door for thousands more adults to receive two implants on the NHS. Preliminary research already suggests bilateral implants may be cost-effective, and the trial will formally evaluate that question. The cost of a single implant, including surgery and rehabilitation, is estimated at between £20,000 and £30,000.
Matthew Smith, an ear, nose and throat surgeon at Addenbrooke’s Hospital and co-lead of the trial, said: “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.”
Professor Debi Vickers, a speech and hearing scientist at the University of Cambridge and co-lead, 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.”
Expert reaction and wider context
Professor Anthony Gordon, programme director for the NIHR health technology assessment programme, which funded the trial, said: “This study offers real hope to people with severe hearing loss and the chance of a significant improvement in their quality of life.”
Ralph Holme, director of research at the RNID, said Ms Roebuck’s story was “wonderful” and underscored the transformative potential of cochlear implants. “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 is a major public health issue in the UK, affecting an estimated 18 million adults – roughly one in three. The problem becomes markedly more common with age: more than half of those aged 55 and above, and around 80 per cent of those over 70, experience some degree of hearing loss. Untreated hearing loss is linked to loneliness, social isolation, an increased risk of cognitive decline and dementia, and costs the UK economy an estimated £30 billion a year in lost productivity.
Despite an estimated 6.7 million people who could benefit from hearing aids, only about 2 million use them. Many delay seeking help. Genetic factors account for a substantial proportion of hearing loss: around 70 per cent of all genetic hearing loss is non-syndromic, and about 1-2 children per thousand are born with permanent hearing loss in the UK, with genetic causes in about half of those cases.
Separately, the music industry’s responsibility for protecting hearing has been highlighted by a successful lawsuit against the Royal Opera House, where a violist won compensation for hearing damage caused by excessive noise during a performance, a case that recognised “acoustic shock” as a compensatable condition.
Ms Roebuck’s message is simple: “Communication is surely the longing of every human heart. The implants are life-changing. They reconnect you to the world and, most importantly, to people.”
