NEW YORK – Dr. George Alexiades is at the cutting edge of the treatment of hearing loss. When age and other factors cause people to lose sensory powers, social and professional life – and thus overall well-being – is endangered, but as technology progresses, doctors’ ability to have dramatic quality of life impact grows.
The field has professional and emotional bottom lines for the empathic physician: “the patients are ecstatic to be able to hear again.”
Assistant Professor of the Department of Otolaryngology and the Director of the Cochlear Implant Center at the Weill Cornell Medical College, Alexiades is the third physician in his family – and his wife, Gari, is an audiologist.
He was born in Queens, joining three older siblings, Michael an orthopedic surgeon, Constantine, whose experience is in the airline industry, and an older sister, Macrene Alexiades-Armenakas , a dermatologist.
Both his parents were born in Northern Greece – his father Gregory in Halkidiki and his mother Sophie in Kilkis with roots in Asia Minor. Gregory became an electrical engineer and provided the math and science example. “My mother’s job was raising four kids,” Alexiades said with reverence.
It was a traditional Greek-American family, with his aunt living above them in a two-family house and his uncle across the street.
Growing up in Jamaica, “sports was my big thing. I played St. Demetrios basketball, but we would always lose to St. Demetrios, Astoria,” he said with a touch of lingering competitiveness. He added, with more community pride, “my father was on the Parish Council would I would always help out.”
Music is also important to him, although it did not inspire his ear specialization. ”I played guitar as a child and just started taking lessons again. “It’s hard,” said the surgeon with obviously superior manual dexterity – “it’s definitely easier to pick it up as a kid.”
“We were all good students” he said, so medicine was always a possibility, and while he did not feel a pull to follow his brother’s footsteps, whom he admired, in retrospect it was a natural thing.
There was also a push from within. “I always thought of myself as an empathetic person, always taking care of my friends when they got hurt.”
He did not spend time at his brother’s office, but he did participate in research activities with his colleagues to see if he liked it, and he volunteered with children with cancer at hospitals during college summer weekends. “The kids are phenomenal, but the hospital is such a sterile environment, so just getting them to enjoy themselves was a great and touching experience.”
He was very excited by the PC revolution, so computer science was medicine’s only professional rival, but after finishing at SUNY Binghamton in three years, he enrolled at NYU’s medical school.
The empathy is the foundation for his strong bedside manner. He acknowledged its importance, “Especially as an ear, nose, and throat physician. Even though we are surgeons, a good portion of our practice is medicine – taking care of patients medically, talking to them…In my subspecialty of ear…With the ones who suffer from dizziness and ringing in the ear – tinitis – handholding is needed to get them through some difficult and trying times.”
He handles all hearing problems, including infections and balance problems, and noted some disorders are caused by diet issues, especially salt intake.
He is also engaged in research, but he is still settling in at Weill Cornell after being at the New York Eye and Ear Infirmary 13 years.
RESTORING HEARING LOSS
When his new position opened up this year he was very excited about becoming director of the Cochlear Implant Center – the cochlea is the organ of hearing and implants are at the forefront of technology.
Originally technology focused on the eyes, but there is no ocular implant yet and “that technology ended up getting ported over to ears…with the first cochlear implant in the late 1970s,” he told TNH.
Nevertheless it is considered a young field. “We are implanting more and more with patients who have more and more residual hearing” rapidly increasing the salience of the question of what is better, a hearing aid or an implant.
Alexiades emphasized, however, that the two experiences differ dramatically. With implants “it’s a totally new way to hear. Hearing aids are amplifiers. Most people’s complaint is that the sound is louder, but they don’t have the clarity.”
He explained that with nerve hearing loss, it’s not the nerve that is damaged, rather, there is a progressive loss of the hair cells that beat to the sound waves in the environment and stimulate the nerve cells.
When enough die off, there is not enough resolution, but with the implants, the nerve cells are stimulated directly.
“That increases clarity, but you are hearing through a processor that converts the sound to electrical signals that stimulate the nerve cells, so it sounds weird – people say it sounds robotic or Mickey Mouse-like in the beginning. The surgery, which takes an hour, is followed by intense therapy, but the new experience becomes more natural as time goes by,” he said.
There is steady progress both in the implants themselves and in the surgery, which is becoming less traumatic and preserves more hair cells.
And while implants work well with speech, music appreciation is limited, although they work better with music that patients know than with new pieces, and rhythmic music is better than melodic.
The device itself costs around $25,000, and including surgery the entire cost is approximately $50,000, but insurance coverage is available.
Alexiades’ patients range from newborns people 100 years old, and children as young as one can receive implants.
He is glad that in the United States there is universal hearing screening that catches most hearing loss from birth.
He says adults without problems should get tested to establish a baseline, and once a problem is identified, doctors like to follow patients every year.