Q: What are the most common conditions you treat among international patients?
Dr. Lee: Many of our international patients come to Mass Eye and Ear with complex forms of hearing loss. Some were born with congenital hearing loss, while others developed it over time due to underlying medical conditions (acquired). Most commonly, our team treats patients with advanced hearing loss who may benefit from auditory implants, such as cochlear implants, bone conduction implants, and auditory brainstem implants.
I also see patients with:
- Chronic ear infections and balance disorders that can be difficult to diagnose
- Acoustic neuromas (vestibular schwannomas), noncancerous tumors that affect hearing and balance
- Superior canal dehiscence syndrome, a rare but impactful condition that can affect hearing and balance
In addition, I have specialized expertise in endoscopic ear surgery, which allows for minimally invasive removal of cholesteatoma. This is a condition that can occur from birth or as a complication of chronic ear infections.
Q: What is endoscopic ear surgery?
Dr. Lee: Endoscopic ear surgery is a minimally invasive technique that uses small rigid telescopes, called endoscopes. It can be used to:
- Patch a hole in the eardrum (tympanoplasty)
- Remove cholesteatoma
- Repair the hearing bones through the ear canal
- Remove middle ear or inner ear tumors (glomus tumors or intralabyrinthine or intracochlear schwannomas)
Mass Eye and Ear is a global leader in endoscopic ear surgery. We care for patients who come to our center from all around the world as well as train surgeons who want to incorporate endoscopic ear surgery into their own practice.
Q: What is superior canal dehisence syndrome and how is it treated?
Dr. Lee: Superior canal dehiscence syndrome (SCDS) is a condition caused by a small opening or thinning in the bone that covers your inner ear canals. It leads to issues with balance and hearing. Although first identified about 25 years ago, it remains underdiagnosed in the U.S. and around the world.
Symptoms can include:
- Vertigo (a spinning sensation) triggered by loud noise or pressure changes
- Extreme sound sensitivity
- Pulsatile tinnitus (a rhythmic “whooshing” sound in the ear)
Treatment depends on the severity of the symptoms. For milder cases, we may recommend careful observation and conservative symptom management. For patients with more severe or worsening symptoms, surgery may be an option. This procedure involves resurfacing or sealing the opening in the bone (the “dehiscence”) and resurfacing other holes in the skull (tegmen dehiscence) using either a transmastoid approach or with a minimally invasive keyhole middle fossa craniotomy.
Mass Eye and Ear has a dedicated center of excellence for SCDS, giving us unique depth of experience in diagnosing and treating SCDS.
Q: What complex ENT conditions do you treat, and how?
Dr. Lee: Some of the most challenging cases involve patients with Neurofibromatosis Type 2 (NF2), a rare genetic disorder that causes vestibular schwannomas. These tumors may appear on one or both sides of the head and affect the nerves that control hearing and balance. In such cases, we often work closely with other specialists across Mass General Brigham to offer a combination of chemotherapy, tumor resection, auditory brainstem implant surgery when hearing is lost, and other personalized interventions.
We also care for children with severe inner ear malformations (small or absent cochlea or cochlear nerve), where conventional cochlear implants are not an option. For these specialized infants and children with deafness, an auditory brainstem implant may be one treatment to provide sound and speech sensations.
Additionally, I treat patients who have brain that enters the ear cavity (temporal lobe encephaloceles) that occurs without a prior ear history or from prior ear (mastoid) surgery. In some cases, there is a brain fluid, or cerebrospinal fluid (CSF) leak. We have pioneered a keyhole craniotomy approach to repair these holes in the skull to reduce the risk of infection from bacterial meningitis.
Q: Why do international patients choose Mass General Brigham for eye, ear, nose, and throat care?
Dr. Lee: We deliver world-class care through a collaborative, multidisciplinary approach. Because we treat a large number of both children and adults, our clinicians have extensive experience managing the rarest and most complex conditions. Many of our physicians specialize in just one area of care, allowing them to develop deep expertise.
When surgery is needed, international patients benefit from expert anesthesiologists, highly trained nurses, and access to advanced technologies and techniques that may not be available elsewhere.
As part of the Mass General Brigham system, our expertise isn’t limited to just one institution. We leverage the collective knowledge of leading hospitals and researchers across the network, delivering truly comprehensive, integrated care.
We’re also constantly looking ahead. For example, we’re leading pediatric gene therapy clinical trials for inner ear regeneration, which would be an entirely new way to treat hearing loss. We will also serve as a lead center for an upcoming pediatric study of gene therapy for congenital hearing loss caused by Connexin 26 (mutations of the GJB2 gene), one of the most common genetic causes of deafness in children.
Finally, our International Patient Center provides culturally sensitive, multilingual support to help patients and families. They understand the challenges of seeking care in a different country, and are dedicated to making patients feel supported every step of the way.
