Cochlear implants have restored basic hearing to some 220,000 deaf people, yet a microphone and related electronics must be worn outside the head, raising reliability issues, preventing patients from swimming and creating social stigma. Now, a University of Utah engineer and colleagues in Ohio have developed a tiny prototype microphone that can be implanted in the middle ear to avoid such problems. The proof-of-concept device has been successfully tested in the ear canals of four cadavers, the researchers report in a study just published online in the Institute of Electrical and Electronics Engineers journal Transactions on Biomedical Engineering. The prototype - about the size of an eraser on a pencil - must be reduced in size and improved in its ability to detect quieter, low-pitched sounds, so tests in people are about three years away, says the study\'s senior author, Darrin J. Young, an associate professor of electrical and computer engineering at the University of Utah and USTAR, the Utah Science Technology and Research initiative. The study showed incoming sound is transmitted most efficiently to the microphone if surgeons first remove the incus or anvil - one of three, small, middle-ear bones. U.S. Food and Drug Administration approval would be needed for an implant requiring such surgery. The current prototype of the packaged, middle-ear microphone measures 2.5-by-6.2 millimeters (roughly one-tenth by one-quarter inch) and weighs 25 milligrams, or less than a thousandth of an ounce. Young wants to reduce the package to 2-by-2 millimeters. Young, who moved the Utah in 2009, conducted the study with Mark Zurcher and Wen Ko, who are his former electrical engineering colleagues at Case Western Reserve University in Cleveland, and with ear-nose-throat physicians Maroun Semaan and Cliff Megerian of University Hospitals Case Medical Center. Problems with External Parts on Cochlear Implants The National Institutes of Health says almost 220,000 people worldwide with profound deafness or severe hearing impairment have received cochlear implants, about one-third of them in the United States, where two-fifths of the recipients are children. In conventional cochlear implant, there are three main parts that are worn externally on the head behind the ear: a microphone to pick up sound, a speech processor and a radio transmitter coil. Implanted under the skin behind the ear are a receiver and stimulator to convert the sound signals into electric impulses, which then go through a cable to between four and 16 electrodes that wind through the cochlea of the inner ear and stimulate auditory nerves so the patient can hear. \"It\'s a disadvantage having all these things attached to the outside\" of the head, Young says. \"Imagine a child wearing a microphone behind the ear. It causes problems for a lot of activities. Swimming is the main issue. And it\'s not convenient to wear these things if they have to wear a helmet.\"