Meet House Institute neurotologist, Dr. Kevin Peng, whose dual commitment to excellent patient care and applicable research helps to advance hearing science and treatments. As we look back to celebrate the 40-year anniversary of the first cochlear implant in children and the 60-year anniversary of the first cochlear implant in adults—both pioneered and developed at House—Dr. Peng looks to the future. We sat down with him between appointments on a busy day at the House Clinic to learn more about future directions for cochlear implants and why they remain more relevant than ever for children who are born deaf as well as those who lose their hearing later in life.
What are your title and responsibilities?
I am an associate at the House Clinic, and I am a surgeon. I see patients in clinic and do surgeries on those who need ear surgeries. In addition, I am a faculty member of the House Institute Foundation and help oversee the research committee as well as do research myself as an investigator. I have been here since I started my fellowship in 2015 and stayed on in 2017 to become an employed associate of the House Clinic.
What keeps you coming into work every day? What do you value most about your work?
The grateful patients. I feel the culture that we have at the Institute is pretty unique. Patients are very grateful by and large to be taken care of by us and we are grateful for their confidence in us. It’s this mutual respect and relationship that keeps me coming in.
What area of research stands out for you in your time at House?
Projects and papers I have been involved with on vestibular schwannomas and neurofibromatosis type 2 stand out the most. I have also published a few papers on cochlear implants including studies on pediatric patients relating to various aspects cochlear implants.
What would you like to see happen or changed in the next 75 years?
I’d like to see our research continue to expand! We have gone through various changes over the past 75 years and are constantly finding new research avenues to explore. For example, right now we are doing less basic science research, but one could argue that our clinical research is a lot stronger. I think it is continuing to evolve and we continue to develop new ways to investigate the questions of the day.
What does House, “elevating hearing science to an art” mean to you?
To me, this mostly focuses on patient care. I think this is one of the things that we excel at. I think we develop a good relationship with our patients, and we also take very good care of them surgically. This is one of the things that really makes us stand out compared to other places and universities.
What effect do you hope telling your story will have on others?
From a patient perspective, I think it is important to seek care for one’s hearing health, whether it be something as simple as experiencing tinnitus or noticing that your hearing may not be as good as it used to be. The public needs to be more aware of this and know help is available!
What is the main benefit of choosing to get a cochlear implant?
I think the main pro is being able to understand conversation better, whether that be in a one-on-one setting or perhaps a group setting where you are out with family members. It helps patients understand spoken language.
Can you share your experience with cochlear implants in children?
In terms of children, we are performing cochlear implants on pediatric patients who have profound hearing loss, meaning they are essentially—what we would call colloquially—deaf. This usually applies to both ears. Very rarely would we put a cochlear implant in one ear if the other ear is working fine. Cochlear implants in these pediatric patients are even more important since research shows, and I think it makes sense to reason, that if someone can engage in spoken conversation, then they are an even more productive member of society than they might otherwise be if they are limited by not hearing as well as others. So, from a public health perspective, that is why we think that cochlear implants can be very valuable and not only support the individual but also society. As an active member of the workforce, I think a lot more doors are opened when a person can communicate with spoken language. That is the reason we do cochlear implants for kids—it’s for kids who otherwise would not have a chance at hearing. Kids will use that same implant until they are an adult except in rare cases where such an implant would have to be replaced. This is something that stays with the child and the child knows this as what their hearing is. Most kids do really well with them!
Can you explain the difference between cochlear implants and other types of implants that are more recent developments? How do you decide which is best?
New technology like the Osia implant is separate from the cochlear implant in the sense that we usually use it on patients who hear well in at least one ear. Occasionally we will use it in patients who don’t hear well in either ear because the bones are misshapen or because the tympanic membrane (the ear drum) has problems. Those are the cases in which the bone-anchored implants, like the Osia implant, would be most useful. That is a distinction from cochlear implants where we are targeting individuals who really have no hearing whatsoever. In one sense, the bone-anchored implant gets the sound into an ear that is capable of hearing a little bit, whereas a cochlear implant is reserved for patients with profound hearing loss, or deafness.
What is the future of cochlear implants?
Better programming, better techniques, and improved technology with cochlear implants will help patients be able to appreciate music better in the future. For now, the sound coming out of the implant, although it may be distinct and clear and allow patients to understand spoken language, still does not sound like what a patient may remember as being normal hearing, and as a result music appreciation is very difficult with cochlear implants. A patient may pick up rhythms and volumes of music, but the actual melodies can be distorted or something that the patient doesn’t remember a piece of music sounding like. I am hopeful that in 30 years’ time, for example, it will be even better than it is now.
To what extent do people adapt to the sound of cochlear implants? To an outsider it can sound mechanical.
Patients are definitely able to adapt to the sound of cochlear implants and their perception of sound changes over time, probably most within the first year after they receive an implant while they feel like they are getting used to it. While perception of sound evolves at first, eventually it will stabilize.
Any other message you would like to share with our readers?
One issue that we are increasingly aware of is that many patients with hearing loss unfortunately do not get all the care that they might need or that might help them hear better. That applies not only to people who need or wear hearing aids but also to patients who might benefit from receiving a cochlear implant. I think that this is a public health and outreach area that we need to develop. We need to increase public awareness about what can be done if one’s hearing aids really aren’t working well. People need to know that there is another solution beyond that. Cochlear implants are now so widely performed that it is a standard of care for patients who have bilateral, profound hearing loss, and insurance covers it.
What do you like to do outside of work? Do you have any other passions or hobbies?
I like playing music! Mostly piano and cello, but I also dabble with other things, like guitar and ukulele. I also like to run, and I bake and cook a lot.