If your hearing hasn't improved after using a hearing aid for at least 6 months, you may be a candidate for cochlear implant surgery. In this segment, Peter Weber, MD, MBA, board-certified neuro-otologist, discusses Cochlear Implants now offered at BMC and what drew him to work at Boston Medical Center.

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Peter Weber

Peter Weber, MD, MBA

Peter Weber, MD, MBA is a board-certified neuro-otologist, recently joining BMC from the New York Eye and Ear Infirmary, where he served as Professor and Head of Otology/Neurotology/ Skull Base Surgery and Director of the Ear Institute. Upon Dr. Weber’s arrival, BMC’s Cochlear Implant Program was established, providing high quality, team-centered hearing care to both adults and children. Dr. Weber has performed over 2000 cochlear implant surgeries to date, and specializes in working with patients to preserve their pre-existing hearing, after the cochlear implant is in place.

Learn more about Peter Weber, MD


Melanie Cole (Host): If a person has severe hearing loss, a cochlear implant may help. My guest today is Dr. Peter Weber. He's board-certified ENT physician who specializes in just the ear and recently joined Boston Medical Center. Welcome to the show, Dr. Weber. Tell us a little bit about yourself and what drew you to Boston Medical Center?

Dr. Peter Weber, MD, MBA (Guest): Well, good morning Melanie. It’s great to talk to you. I was really drawn to Boston Medical Center for the opportunity to start a new program that offers all the advantages for hearing loss for our patients. Cochlear implants is something that’s been near and dear to my heart. I've started many programs across the country. I've taught how to do the surgery throughout the world, and Boston Medical Center had still not had a program in cochlear implant surgery or other implantable devices for hearing loss, and so this gives me the opportunity to bring this technology to Boston Medical Center, and all the patients that it serves so that they too can have the opportunity to hear again.

Melanie: So, tell us a little bit about a cochlear implant and the difference between that and a hearing aid because I think people are not quite sure of the difference.

Dr. Weber: Sure, a hearing aid is basically nothing more than an amplifier that you put on your ear. So, it's a mechanical device. Everybody knows it. Everybody can see it, and all it basically does is make the sound louder whereas a cochlear implant is a device that’s actually implanted surgically. So, it's a very small surgery in the sense that it's about 45 minutes. You go home the same day, but we implant the device under the skin that then also has a small little electrode wire that goes into the inner ear. What happens when you lose your hearing is that the nerve endings actually die, and what we're able to do is bypass those nerve endings and stimulate the nerve directly so that now you can actually hear again. You still have to wear a device on the outside of the ear that looks like a small hearing aid, but this now brings hearing to people that no longer could hear before or have a hearing loss where the hearing aid just is not giving you enough benefit, and it transforms people’s lives.

Melanie: So, what are some of the most common causes? Are these mainly like children that were born deaf or is this something that can occur from a trauma or another situation?

Dr. Weber: Sure, there's many different reasons for having hearing loss. It can start from birth, meaning that you were born not being able to hear well. It can be from trauma. It could be from an infection. It could be that you’re preprogrammed to lose your hearing early in life. It can be from noise exposure. It can be from a viral infection or just the fact that we get older, and so we treat patients all the way from six months of age. I think the oldest patient that I've implanted was 92. So, it is technology that can help anybody for just about any cause of hearing loss.

Melanie: So, is there a first line of defense, Dr. Weber? Do you try a hearing aid first, and if that doesn’t work in a certain period of time then you look to cochlear implant?

Dr. Weber: Absolutely. You know, in most people we are going try hearing aid first. Always if you can treat somebody without surgery -- that’s always the best -- but the cochlear implant is really designed for those patients who really receive little benefit from a hearing aid.

Melanie: So, tell us some important facts to understand when considering a cochlear implant. Do they restore the hearing back to normal? What is it like for the patient, doctor?

Dr. Weber: So, it's interesting. When you talk to adults who have had speech and language so they know what sounds are supposed to sound like, they will tell you that initially, it has more of a mechanical sound to it. So, it’ll sound a little bit like Donald Duck. However, as you continue to use this over a few months to longer, the brain actually is able to start to make sense out of those signals, and it starts to sound like normal hearing again for patients. Now, the actual hearing level can come pretty close to normal for most patients. Not everybody is going to perform perfectly. Some patients are going to perform better than others, but people will do significantly better than what they could have done before.

Melanie: And what about the implant itself? How long does that last? Is it something that might have to be replaced? Does it have batteries like hearing aids that have to be replaced? Tell us about the implant.

Dr. Weber: So, the part that’s actually implanted under the skin is designed to last about 70 years. It’s a very robust device unlike other implantable devices. The chance that it breaks is quite low, but if it does, we just replace it. So, that is a plus in its factor, but really it's designed to stay. The guts are on the outside -- meaning that the part that gets upgraded – the part that processes the sound is the part that fits behind the ear. Now, that’s the part that does need batteries. Changing it sort of like a hearing aid, every few days or a rechargeable battery. But, there as technology improves, we can make stuff better in the sound processing capabilities. I've been doing this for 25 years. When we first started out, we were happy if somebody just heard a sound. With the advances in the processors, now, people are able to talk on the telephone. They can have a conversation with somebody who’s in another room. We have technology where it can hook up to somebody’s cell phone, to the TV, to a little microphone that either a teacher could wear or your significant other could wear if you're in a noisy restaurant so that you're able to hear and go out and have fun again.

Melanie: Wow. That’s amazing. So, tell us a little bit about Boston Medical Center’s Cochlear Implant Program and your team and what people can expect. Is this for adults and children? Tell us about the program.

Dr. Weber: So, the program is a multi-specialty team depending really on your needs and also the age of the patient. So, for children, there’s myself. We have Stephanie, my audiologist, who is fantastic. Though, we will evaluate most patients and then determine if those patients need to see one of our special services meaning social work, to make sure that children are going to be integrated into the school system. Speech pathology to make sure that they're going to get speech and language therapy that they need in order to succeed. Psychiatry sometimes is important for both adults and also for parents. It’s not always easy trying to figure out how to communicate with a child who cannot hear. It can be frustrating. Adults who go to get cochlear implants sometimes do have some depressions, and if we feel it's necessary, that team member is incorporated. So, we have a very good team associated, depending on the level of care that a particular patient needs.

Melanie: And do you feel that this can somehow reduce some of the stigma that surrounds hearing loss because if somebody is blind -- people don’t yell at them, why can’t you see, but when people have hearing loss, it's – people get very frustrated and they say well, I’m speaking slowly or loudly, why aren’t you understanding what I'm saying? Do you see this stigma, and do you see this as a way to help reduce some of that?

Dr. Weber: Yes, I do, and you see it all the time. Patients, you know, it's an unseen disability. Everybody looks normal, you know, they don’t assume that you have an issue and when you keep asking somebody to repeat themselves, either the person asking who cannot hear gets frustrated, or the other person gets very frustrated, and you can see the levels of communication then deteriorate. Because of this, it's one of the many facets where it can affect job performance, school performance, and people try to hide it. We have a capability now of being able to integrate people back into society so that that doesn’t happen.

Melanie: So, wrap it up for us, Dr. Weber with your best advice about cochlear implants procedure and this new program at Boston Medical Center.

Dr. Weber: So, I would say that anybody who is frustrated with the level of hearing that they have and frustrated that they cannot get the hearing that they want with the hearing aid, they should come and have us evaluate them. Because nowadays, we’ve advanced the technology so far, that we’re actually able to now implant patients that we can preserve hearing that you might have. So, we're at the point where low-frequency hearing can be almost normal and yet we can still implant you because your high frequencies are so poor, you're not getting what you need with current technology such as hearing aids. So, don’t think you have to be deaf in order to qualify for this type of technology.

Melanie: And please just briefly in the last few minutes touch on your other specialty services.

Dr. Weber: Sure. So, my whole subspecialty is the ear. So, I go for anything to do with the ear itself. So, whether it's hearing loss, whether it's infections, whether it's tumors, whether it's cholesteatoma, whether it's perforations in the ear drum. Anything that has to do from the ear all the way to the nerve going into the brain -- that’s everything that I encompass. So, ear surgery, brain surgery of the ear, the facial nerve, those are all the things that I take care of.

Melanie: Thank you so much for being with us today, Dr. Weber. This is Boston Med Talks with Boston Medical Center. For more information, you can go to bmc.org. That's bmc.org. This is Melanie Cole. Thanks so much for listening.