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Pushing the Envelope with Surgery to Restore Hearing: Notes from a Leading Otolaryngology Program

For the 500 million people worldwide who suffer from hearing loss, sounds and the ability to receive them are incredibly precious resources. Many of these individuals make subtle adjustments to optimize their hearing including turning to the side with stronger hearing (if there is some differentiation), reading lips and where accessible, using any of a variety of existing hearing aids. The causes of hearing loss are quite varied, including age-related changes, infection and trauma, abnormalities in the structure of the auditory canal or middle ear bones, and inner ear pathology affecting the sensorineural components of the hearing apparatus. For those who are lucky enough to have pathology that is mechanically correctable, surgery presents an option for improving hearing. However, these operations can be quite risky with errors resulting in further hearing loss or in the worst cases, deafness.

Dr. John Oghalai and the otolaryngology team at Keck Medicine of USC have developed significant expertise in performing delicate operations to treat hearing loss. Some of these operations involve reconstruction of the ear drum, the tiny middle ear bones and/or the external auditory canal. Oghalai, a graduate of the neurotology/otolaryngology program at the University of California, San Francisco and the Chair of the USC Caruso Department of Otolaryngology acknowledges the complexity of these operations saying, “[Surgery for aural atresia] is one of the most delicate surgeries we do. In fact, it is so delicate that many ear specialists won't even attempt it.” However, he is confident in the expertise possessed by his team and is proud of their ability to rise to the challenge posed by these complex cases. He remarks, “[We] like to be able to restore normal hearing [and] have been gratified by the results of our patients.”

One such patient — Jake, a high school principal in El Paso, Texas — was born with congenital aural atresia and has struggled with hearing issues since childhood. Patients with this condition do not have a functioning ear canal, have a damaged ear drum and/or have improperly formed middle ear bones. After multiple hearing aid trials and two prior surgeries — each with meaningful, but temporary improvements in hearing — Jake met Dr. Oghalai who performed a series of tests to fully characterize the pathology in his ear. When testing demonstrated improved hearing with skull vibration testing, Dr. Oghalai and his colleagues knew that there was an opportunity to improve Jake's hearing with surgery. “I knew his inner ear was functioning fine and we just had to get sound to that inner ear” says Oghalai.

Shortly after the initial meeting, Dr. Oghalai performed an operation to reconstruct Jake's ear machinery which included creating a new ear canal and lining it with a skin graft from Jake's thigh, fashioning a new ear drum and implanting artificial bones to replace the malformed middle ear structures. All of this was connected to the cochlea using a titanium prosthesis. The operation was a success and has allowed Jake to fully enjoy his favorite musicians, while also empowering him in his job. He no longer has to frequently ask others to repeat things or strategize about where to sit during meetings to optimize his hearing. Like many other USC patients, Jake feels incredibly grateful for the treatment he received. He says, “Getting my hearing back gives me more drive to keep pushing forward and see what lies ahead. I have Dr. Oghalai and Keck Medicine to thank for that.”


USC Caruso Department of Otolaryngology – Head and Neck Surgery I Keck Medicine of USC

At USC Otolaryngology Department of Otolaryngology – Head and Neck Surgery, we strive to cure diseases of the ear, nose, throat, head, and neck by pursuing new scientific discoveries, by translating this knowledge into novel and effective clinical treatments, by offering our patients a culturally sensitive experience while they receive high-level, compassionate care, and by educating our trainees to continue these philosophies into the future.

Research is central to our mission because we are not just here to provide the standard-of-care; we are here to advance it. Every faculty member recognizes how research helps us improve the care provided to our patients. To learn more or refer a patient to an otolaryngologist at Keck Medicine of USC, please visit or call (800) USC-CARE or (800) 872-2273.