Hearing loss affects millions worldwide, but could a cure be within reach? Researchers at Stanford’s SICHL are making significant strides in regenerative medicine and innovative therapies to address one of the most common sensory impairments. Dr. Tina Stankovic, Chair of Otolaryngology at Stanford University, discusses the latest advancements in hearing loss research and the collaborative approach SICHL is taking to accelerate discoveries. She highlighted the complexity of the cochlea—a tiny yet intricate organ embedded deep in the skull—making traditional treatments challenging. However, with new technologies and multidisciplinary expertise, researchers are making strides toward solutions that could one day restore hearing.
Dr. Stankovic emphasized SICHL’s collaborative research model, bringing together experts from diverse fields, including physics, genetics, engineering, and neuroscience. She shared insights into key breakthroughs, such as high-resolution imaging probes designed to study the human inner ear, new regenerative responses discovered in human cochlear tissue, and efforts to modify certain antibiotics to reduce their toxic effects on hearing. Additionally, she highlighted the advocacy work of musician Paul Simon, whose support has raised awareness and funding for hearing research.
Looking ahead, Dr. Stankovic underscored the importance of prevention and public education in hearing health. While SICHL continues to push the boundaries of treatment, she encourages individuals to take proactive steps, such as protecting their hearing, managing underlying health conditions, and supporting research initiatives. With hearing loss remaining one of the most prevalent yet often overlooked disabilities, continued innovation and collaboration are key to unlocking future therapies.
Welcome to This Week in Hearing.
I’m Shari Eberts,
co author of Hear & Beyond
Live Skillfully with
Hearing Loss.
And this week Our guest is Dr.
Tina Stankovic,
the department Chair of
Otolaryngology Head and Neck
Surgery at Stanford University.
In this role,
she also runs Stanford’s
Initiative to Cure Hearing Loss,
or SICHL for short.
Tina has a very impressive
career as an academic and
also in research.
She was trained as an ear and
skull based surgeon at Harvard
and as an auditory
neuroscientist at MIT.
And she was also recently
elected to the prestigious
National Academy of Medicine for
her scientific contributions
into the field of hearing loss.
So thank you Tina for being here
to talk about the incredible
work of SICHL and all that
you’re doing to move the field
of hearing research forward.
So thank you,
thank you for having me.
Really appreciate having the
opportunity to chat with you.
Absolutely.
So before we dive into
the discussion,
I would love to learn a little
bit more about you and how you
got interested in studying
hearing and how that sort of led
your career path to your current
role at Stanford.
Thank you for that opportunity.
Like so many of us,
I’ve been inspired by remarkable
people I’ve had the privilege of
learning from over the years.
My love of music drove me into
the field of hearing.
I played the piano semi
seriously before school and
before high school,
and since then have remained
a dedicated listener.
And of course to appreciate
music,
we must be able to hear it.
As an undergraduate at MIT,
double majoring in physics
and molecular biology,
I looked for a project that
would allow me to combine these
two disparate majors with my
passion for music and my budding
interest in medicine.
So I chose to work in a cochlear
implant lab at Massachusetts Eye
and Ear and was fascinated,
realizing that some people can
do remarkably well in terms of
their ability to understand
speech and others don’t.
So that led me to pursue my PhD
studies in how the brain
controls the function
of the ear.
And then during medical studies
which I pursued at Harvard
in parallel with my PhD,
I maintained that interest in
hearing and actually studied
for my thesis
fluid and ion balance
in the inner ear.
And I was inspired by the
kidney. And you could say, well,
how similar are these
two organs?
Because they are so different
in terms of scale. However,
they do share many similarities
because they both regulate
fluids and
ions very tightly,
and they develop around the
same time during embryonic
development.
And they are similarly
susceptible to certain
medications that can be
Toxic to both organs.
So then it was natural for
me to pursue residency
in otolaryngology,
head neck surgery during which
I did a formal postdoctoral
fellowship studying how
supporting cells in,
in the inner ear promotes
survival of both the hearing
nerve and the sensory
cells in that organ.
During my clinical fellowship in
neurotology and skull
based surgery,
I became really fascinated by
vestibular schwannomas,
which are these intracranial
tumors that typically
cause hearing loss,
and was really moved by the
suffering these caused because
currently there are no drugs
that can eliminate these tumors.
After completing my
long training,
I joined faculty at Harvard
as a surgeon scientist,
focusing on ear and skull based
surgery and opening my lab
focused on hearing restoration.
A dozen years later,
I came to Stanford,
which is now my new home.
I’m inspired by the vibrant
culture we have here and our
core values of kindness,
creativity,
innovation and collaboration.
I love that. You are a
well educated woman.
That’s very impressive.
Thank you for sharing those
details with us.
I appreciate that.
So research into a cure
for hearing loss,
I feel like that’s been ongoing
for many years,
but sometimes it feels like
progress can be a little bit
slower maybe than compared
to other fields.
Do you agree with that?
And why is hearing loss such
a tough nut to crack?
You are correct, of course.
Research progress is
never fast enough.
1 and 1/2 billion people
have hearing loss.
Half a billion of them
are disabled by it.
And the cost of unaddressed
hearing loss is the staggering
nearly trillion dollars
annually.
And as you say,
the hearing loss has been a
difficult nut to crack,
both literally and figuratively.
Literally.
This is a tiny and fragile organ
embedded in the hardest bone in
the body, deep within the skull.
So how tiny is it?
If you look at a penny,
you’ll notice that Lincoln
is on a penny.
And the human organ of hearing,
called the cochlea in cross
section is the size of Lincoln’s
upper face on a penny and the
total fluid volume within it
is just three raindrops.
But because of these challenges,
we have been at the forefront of
technology development
and adoption.
In that respect, we are really,
truly standing on the shoulders
of the giants. For example,
it was two ear surgeons who were
the first to introduce a
microscope into the
operating room.
This propelled all of surgery,
from neurosurgery to
microvascular reconstruction.
Moreover,
hearing researchers developed
the cochlear implant,
which is the most successful
neural prosthesis.
With more people wearing this
device than all others.
Neural prosthesis combined and
the modern multi channel
cochlear implant was enabled by
the work of a physicist and a
Nobel laureate, von Bekesy,
who described the place
frequency map in the cochlea.
And what I mean by that is
that it’s a coiled organ.
So now if you uncoil it,
then every place along the
length of the cochlea
corresponds to a different
frequency,
which means that it’s
a tuned system,
just like the strings on guitar.
So Stanford played a seminal
role here with an ear surgeon,
Blair Simmons,
collaborating with an electrical
engineer, Bob White,
to contribute to the first multi
channel cochlear implant.
And they chose a winning
strategy,
which is a digital signal
processing.
Today we are addressing
the new frontiers,
and they include cellular
imaging of the inner ear,
regenerative therapies that are
based on stem cells and small
molecules, and gene therapies,
as well as alternative modes of
stimulating the auditory system,
including magnetic and
optical stimulation.
We are focused in developing
medical therapies for hearing
loss because currently there are
no drugs that are FDA approved
for hearing loss,
despite the enormity
of the problem.
Thank you for that.
It is a tough nut to crack,
but it’s great to see that there
are so many avenues that are
being explored currently.
One of my favorite things about
SICHL is the collaborative
research approach that
you guys use.
And maybe you can talk a little
bit about if this is different
from the way scientific research
is typically done,
and then what impact that
philosophy is having on the work
that you all are doing.
So, like many human activities,
research is an elaborate dance.
It involves students,
postdoctoral fellows,
junior colleagues,
and senior faculty.
And each of these groups is a
constituency with slightly
different needs and
expectations.
So the role of an institution is
to help research groups function
as orchestras of varying sizes,
from a chamber group
to a big band.
And I really love how it’s done
at the Stanford Initiative
to Cure Hearing Loss.
We have a constantly varying
stream of people with diverse
backgrounds and interests,
and they are held together by a
common belief that together we
can make a difference in the
lives of the current and
future patients.
Wonderful.
I understand the researchers
work on projects together
many times.
Do you think that contributes to
the success of the projects or
why is that such an important
part of the philosophy?
Oh, absolutely.
We strongly believe in synergy,
which means that two people
working together is more
than addition.
So it’s more than adding
component parts. And of course,
when you add even more people,
then we can really solve
challenging problems that have
remained unsolved for so many
years and decades and
literally centuries.
And because these are
challenging problems,
they require a multidisciplinary
approach to solve them.
And we have experts in a variety
of different fields that
literally range from math and
physics and basic biology to
structural biology and
engineering and genetics
and molecular biology,
regenerative biology and
clinicians. And at Stanford,
we have all three components of
research, basic research,
which if you think of a tree,
these would be the roots of the
tree that are feeding the trunk,
and that’s translational
research that then leads
to branches,
which is clinical research.
These branches then bear fruits.
There are multiple feedback
loops at every level where
clinical insights may inform
what is being done at the bench.
And in return,
basic science discoveries can
lead to major breakthroughs in
how we treat patients
with hearing loss.
So it is a tree that
we think of.
And as you know the redwood tree
is in the Stanford University
logo with multiple feedback
loops to allow us to collaborate
in the most productive
and most fun way.
I love that. All right,
so let’s get to the
fun stuff then.
Maybe you can give our listeners
some hints or some exciting
advancements that you all are
working on in hearing science
and you know,
maybe a couple of the most
promising projects.
Absolutely.
So let me first start with
the imaging probe.
Because the human inner
ear is so tiny.
We cannot get clear images of
it on MRI and CT scans.
Therefore,
we cannot tell any person
exactly what is wrong
in their inner ear.
We are changing that by
developing a tiny micro
endoscope whose diameter is
equivalent to a bundle of
just 10 human hairs.
And it can provide 100 fold
better resolution than what’s
available today.
So,
after more than 10
years of work,
we are eager to move into
clinical testing of this device.
And the impact could be
revolutionary because it would
enable us to establish precise
diagnoses for various causes of
hearing loss and thereby
guide personalized,
very tailored therapies.
A second example is that our
investigators have developed a
pipeline for access to the human
inner ear tissue that’s still
living and that is obtained
from organ donors,
as well as from patients
undergoing ear surgery.
This is remarkable because
currently the primary source of
information regarding the
cellular origins of human
hearing loss comes from studying
autopsy specimens.
These specimens are obtained
when individuals who pass away
from completely unrelated causes
generously donate their ears
for research purposes.
Now,
when organs are harvested
for transplantation,
our teams have the opportunity
to collect human inner
ear tissue,
allowing us to study at both the
cellular and the molecular
level.
And this has major implications
for future development of
regenerative therapies.
I’ll just give you two examples
within this category.
One is that our investigators
have defined the first molecular
atlas of the normal and diseased
sensory organs within
the human inner ear.
This atlas now serves as a
roadmap to accelerate the
development of regenerative and
restorative therapies for
human hearing loss.
Also,
studying this living human inner
ear tissue has allowed our
investigators to observe the
evidence of regenerative
responses within the diseased
human inner ear.
Although the process
is incomplete,
this is really significant
because previously we thought
that only lower species,
such as birds and reptiles,
were capable of spontaneous
regeneration.
The next step is to determine
how to sustain this regenerative
process in humans and bring
it to a full blown effect.
Of course,
our strategy will be informed by
what our investigators and
others across the world have
learned from studying
birds and reptiles.
And then I’ll give you a third
example of our researchers
making antibiotics non toxic.
So it turns out that many
widely used medications,
such as certain antibiotics,
have the potential to cause
permanent hearing loss.
And our researchers are
developing innovative methods
to enhance safety of these
antibiotics by altering their
chemical structure.
So these are just a few
examples. There are many more.
And I could talk them,
but talk about them for
hours and days.
I’m sure you could.
That is very exciting.
Thank you for sharing those
snippets with us. And people,
I’m sure,
can learn more about the
projects on your website
as well.
Yes, absolutely.
So I have noticed,
and I’m sure you have as well,
that it can be hard to get
mainstream news coverage
about hearing loss.
But SICHL’s really been in
the news a lot lately,
and we have a legendary musician
Paul Simon to thank for that.
So can you talk a little bit
about how Paul got interested in
SICHL’s work and what impact
his support is having
on that work?
Absolutely.
Paul has been very public about
having come to Stanford
as a patient,
and that’s how he learned
about our research.
His impact has been tremendous.
He performed benefit concerts
for us here in California
and in New York.
He spoke about the Stanford
Initiative to Cure Hearing Loss
when he appeared on Stephen
Colbert’s show.
And he brought his friends from
CBS News to visit our labs and
to film the segments that
were aired in November.
Through his advocacy
and ambassadorship,
our network of friends and
donors has expanded greatly.
Last year was a whirlwind of
publicity and new opportunities
for the Stanford Initiative to
Cure Hearing Loss
because of Paul,
and his impact still continues.
Most importantly,
I think we have drawn attention
of many people to hearing loss,
which is an invisible and
stigmatizing disability.
Well,
I love seeing him and others
talk so openly about
their hearing loss.
Part of it is just the
expression of how it’s
challenging for them,
and so it helps people better
understand that there are a lot
of challenges people with
hearing loss face.
Even if it is invisible,
it’s always there in
the background.
And I love his positive attitude
about it as well. Right.
That he’s still out there
finding a way to perform his
music and to use his celebrity
and his reputation to help
move the field forward.
So it’s really wonderful to see
that incredible partnership
you have with him.
Yes.
We really feel lucky and blessed
to have him on board.
Absolutely. Absolutely.
So this podcast is often watched
by consumers in addition to
hearing care professionals.
And so I was wondering if you
had any advice for consumers who
might be worried about their
hearing and what can they expect
down the road from.
SICHLs work
At this point,
hearing protection is key.
This implies using ear
protection if you are attending
loud music events or loud
sporting events,
or using power tools
if you develop tinnitus
after a loud event.
And even if it goes away
the damage that has occurred
has already happened and may
manifest itself years
and decades later.
So this really highlights the
importance of protecting
our hearing.
And there are Other important
ways to protect it such as
eating a healthy diet or having
a healthy lifestyle that
includes regular exercise,
avoiding medications that can be
damaging to the inner ears,
such as certain antibiotics,
certain blood pressure
lowering medications,
certain
chemotherapeutic agents.
It’s also important to control
the underlying health issues
that are strongly linked to the
increased risk of hearing loss,
such as high blood pressure
or diabetes.
And avoiding smoking is
really important.
And we have learned about the
importance of these preventative
measures from large scale
epidemiologic studies that have
involved hundreds of thousands
of people,
followed over years and decades.
Oh, that is very good advice.
Thank you for sharing that.
I know that I always try and
wear big headphones whenever
I go to a concert,
but are earplugs enough or how
can we be sure that we’re doing
the right type of protection?
Earplugs can be enough depending
on the intensity of sound and
how much attenuation
they provide.
So we really have to be
quantitative about it.
And you can very easily get
a field for how loud your
environment is by using an app
on your phone. It’s free,
it’s called dB app for decibel.
And you should check how much
attenuation the earplugs that
you get in any pharmacy over
the counter provide.
So how much attenuation
do they provide?
Is it 15 or 20 or 30 decibels?
And I’ll just give you a rough
rule of thumb to use when
considering how much attenuation
you need.
So it’s generally agreed that
sounds of 80 decibel for
eight hours are safe.
But then for every three decibel
increase in sound intensity,
you have to half the
safe exposure. So,
so that means 83 decibels
is okay for four hours,
86 decibels for two hours,
89 decibels for one hour,
92 decibels for half
an hour and so on.
And to give you a flavor for
what that means in real life,
many music concerts are well
above 100 decibel.
And in fact it’s not uncommon
that they are as loud
as 110 decibels.
And some sporting events
are ridiculously loud.
And in fact the US is in the
Guinness Book of World Records
for having achieved the highest
noise levels at a football
stadium.
That’s not a good thing.
Which was in Kansas and it was
more than 140 decibels.
This was just from the crowd
cheering on and that’s louder
than a jet engine.
So most surely everyone there
who was not wearing hearing
protection ended up with some
permanent hearing loss,
which is a scary thought.
So the bottom line is we
have to be proactive.
We need to educate everyone from
little kids in preschool
to mature adults,
how delicate this organ is and
how important it is
to protect it,
because today we don’t yet
have curative therapies.
Well,
thank you for that important
warning. I agree.
That’s really good information.
So my family and I have been
supporters of SICHL’s
research for many years.
And if others are interested
in doing that,
what’s the best way for them to
learn more about the research
and how they can be helpful?
We’d be delighted to connect with
your audience members who are
interested in supporting
our work.
Philanthropy makes a huge impact
on accelerating our advances.
I encourage people to go to our
website at sichl.stanford.edu.
so that’s sichl.Stanford.edu
for details about research and
for information about
how to make a gift.
We always try to accommodate our
potential partners using
different modalities from zoom
to in person visits.
And as you know,
we are blessed with gorgeous
weather and a magnificent
campus here,
so I strongly encourage people
to come visit us in person.
Absolutely. Wonderful. Well,
thank you so much, Tina,
for being on the podcast today
and sharing these exciting
updates.
It’s been a pleasure
to talk with you.
Thank you so much, Shari.
Thank you.
Konstantina (Tina) Stankovic, MD, PhD, FACS, is the Bertarelli Foundation Professor and Chair of the Department of Otolaryngology–Head and Neck Surgery at Stanford University School of Medicine. An accomplished otolaryngologist and auditory neuroscientist, she specializes in improving diagnostics and therapeutics for hearing loss. Dr. Stankovic earned her MD and PhD through the Harvard-MIT Program in Health Sciences and Technology and completed her surgical training at Harvard Medical School. In recognition of her contributions to understanding the causes and treatments of hearing loss, she was elected to the National Academy of Medicine in October 2024.
Shari Eberts is a passionate hearing health advocate and internationally recognized author and speaker on hearing loss issues. She is the founder of Living with Hearing Loss, a popular blog and online community for people with hearing loss, and an executive producer of We Hear You, an award-winning documentary about the hearing loss experience. Her book, Hear & Beyond: Live Skillfully with Hearing Loss, (co-authored with Gael Hannan) is the ultimate survival guide to living well with hearing loss. Shari has an adult-onset genetic hearing loss and hopes that by sharing her story, she will help others to live more peacefully with their own hearing issues. Connect with Shari: Blog, Facebook, LinkedIn, Twitter.
