Alex Sweeney, M.D.

Alex Sweeney, M.D.

8 Minute Read

Alex Sweeney, M.D., assistant professor of otolaryngology–head and neck surgery at Baylor College of Medicine, met with William F. McKeon, executive vice president and chief strategy and operating officer of the Texas Medical Center, to discuss the incredible advances in the field of otolaryngology over the past 40 years and how science has helped restore hearing for even those suffering from total hearing loss.

Q | Tell us about your formative years.
A | I was born in Baltimore and raised in the Houston area. My mother and father are both physicians in the Texas Medical Center, and I grew up with two brothers and a sister. My siblings and I graduated from William P. Clements High School, and, coincidentally, we all left Texas for college, we all played a varsity collegiate sport, and we’ve all been lucky enough to return to Houston. During that process, we’ve had the good fortune to be united with a wonderful stepmother, stepfather, five new sisters and a new brother.

Q | Coming from two parents who were physicians, was that path determined for you?
A | It was anything but predetermined. My interest in medicine actually grew from a variety of sports-related injuries and from time spent doing gene therapy research in college. However, there’s no question that my parents were the primary reason that I was able to find a career that I love. No matter the task, they encouraged hard work and excellence. I can’t imagine having more wonderful parents, and my gratitude to them for their guidance is endless.

Q | When did you know that you wanted to go to medical school?
A | I started thinking seriously about medicine when I was in college. I had my fair share of injuries as a football player, and the time I spent around doctor’s offices made me realize how gratifying a medical career could be. I started volunteering in the emergency room at the Hospital of the University of Pennsylvania and the Children’s Hospital of Philadelphia after the football season ended during my freshman year, and I made some great friends who were taking pre-med classes. It wasn’t long before I felt like I had found my place in the world.

Q | How did you balance both the athletic and academic commitments at an Ivy League school?
A | The way I saw it, my life in college was one part academic, one part athletic and one part social, and I quickly learned that I had enough time to put myself simultaneously into two of those areas. My coursework always came first. Even though I was recruited to play football, I went to Penn for an education above all else. If I was going through the trouble of leaving Texas, bad grades weren’t going to be a part of the deal. Football practice started a few weeks before classes, so sports were on my mind from the very beginning. But when I wasn’t in practice, I was studying, and vice versa. As time went on, I branched out and ended up finding time to pledge a fraternity, run a tutoring service at a west Philadelphia elementary school, and I made some lifelong friends along the way.

Q | When did you turn your sights on medical school?
A | I knew that I was interested in health care during my freshman year in college, but I wasn’t firmly set on applying to medical school until my junior year. At the end of my sophomore year, I started a six-month internship in an ophthalmologic gene therapy lab at Penn. I met some remarkable people during this experience, and their mentorship guided me towards the idea of being a clinician-scientist.

As I explored this idea with my friends and family, it became clear that there was no career path better suited to my interests and personality.

Q | What led you to the field of ENT (ear, nose and throat)?
A | I’m not sure that I really knew much about otolaryngology–head and neck surgery or my particular subspecialty (otology/neurotology and skull base surgery) when I was a medical student. My experiences as an athlete and the desire to have the ‘ball in my hands’ made me interested in surgery, and once I saw the remarkable breadth of practice encompassed in the world of otolaryngology—otology/neurotology and skull base surgery, head and neck oncologic and endocrine surgery, facial plastic and reconstructive surgery, rhinology and sinus surgery, laryngology and care for the professional voice—I was hooked. The mentorship I had from the experts here in the Texas Medical Center sealed the deal.

Q | What was the focus of your otolaryngology residency?
A | A well-trained otolaryngologist can be an expert in the science and art of ‘communication,’ whether verbal, auditory or visual, and that idea caught my attention. Through rotations with the BCM and MD Anderson faculty as a BCM resident, I had the opportunity to train with some of the leaders in the field. It’s really a remarkable existence to spend one day resecting cancer from head and neck and reconstructing the resulting defect with grafts from another part of the body, only to spend the next day implanting a device into the inner ear that can rehabilitate profound hearing loss. As time went on, I became increasingly fascinated with the anatomy, physiology and pathology found in the base of the skull, and I was lucky to have Jeffrey Vrabec, Robert Williamson, Paul Gidley and William Brownell as examples of how my interests could be channeled into a comprehensive specialty.

Following residency, I completed a two-year fellowship with the otology group of Vanderbilt, under the mentorship of David Haynes, Michael Glasscock, George Wanna, Marc Bennett, Alejandro Rivas, Robert Labadie and Reid Thompson, during which I was able to focus on complex surgeries of the ear, facial nerve and skull base, as well as the science behind our understanding of auditory function and the natural history of skull base tumors. It was a wonderful experience. Through the collaborative efforts of the skull base team at Vanderbilt during just those two years, there were approximately 10,000 patient encounters, 400 cochlear implants, 200 skull base surgeries, 90 scientific publications and book chapters, 10 workshops and CME courses sponsored and five NIH-funded grants.

Q | Tell us about cochlear implants and the advancements that excite you the most?
A | Cochlear implants represent one of the greatest recent technological breakthroughs within our field. We’ve known for quite some time that electrical currents can be perceived as sound by our auditory system. However, over the past 40 years, the brilliant work of scientists and surgeons around the world has revealed that a device can be implanted into the inner ear through a relatively short, straightforward surgery, and, with the help of an advanced processor, sound can be delivered electronically to your brain and interpreted in a meaningful fashion. In essence, we are able to rehabilitate one of the major ways people interact with the world—through speech and sound. In fact, hearing is the only one of the five senses that we can reliably restore after a complete loss. Over time, the field of cochlear implantation has only become more exciting. In recent years, we’ve learned that cochlear implants can potentially complement natural, acoustic hearing. Implant candidacy criteria are expanding, and there’s been an explosion of new knowledge regarding surgical technique, implant design and programming. I firmly believe that the present and future are bright for patients who suffer from hearing loss.

There have been some intriguing advancements in the field of lateral skull base surgery in recent years, as well. The most common tumors treated are vestibular schwannomas, which are also called acoustic neuromas. These are generally non-cancerous tumors that grow on the hearing and balance nerve between the brain and the inner ear. More than ever, research is exploring the factors that drive quality of life in patients with these tumors.

At different times in the history of vestibular schwannoma treatment, it has been thought that either surgery or radiation was the best option for every patient. However, tumor management is becoming much more patient-centric, and with the emergence of multidisciplinary care teams that specialize in the management of skull base tumors, it’s becoming easier to tailor-make treatment plans that optimize outcomes. I feel very fortunate to be a part of such a team, made up of skilled neurosurgeons, neurologists, audiologists, speech pathologists, voice and swallowing specialists, balance therapists, and plastic and reconstructive surgeons, among others. The collective expertise of this group allows us to provide very comprehensive care for patients with skull base tumors as well as those with advanced hearing loss.

Q | Looking forward, what excites you about the future of this field?
A | In one word, ‘potential.’ There have been some remarkable discoveries regarding hearing loss and skull base tumor management, but there is so much left yet to discover. With a growing emphasis on translational research and multidisciplinary approaches to complex problems, I feel like we are knocking on the door of a revolution in the ways we diagnose and treat skull base tumors as well as hearing, facial nerve and balance disorders.

Q | Do you imagine a day when we will be able to implant devices that will provide quality hearing for the remainder of someone’s life?
A | I think that day has already come, and the newest research makes me very excited for the future. This fall, I participated in an international cochlear implant conference in which scientists and surgeons from around the world came together to discuss the newest developments. The current rate of innovation is absolutely breathtaking. Both the surgical techniques and the devices have changed quite a bit in the past decade, and there’s no telling what we’ll be able to achieve in the near future.

Q | Any closing thoughts?
A | I am honored to have the chance to do what I do. Working as an otologist, neurotologist and skull base surgeon in Houston is a dream come true for me. I don’t know of another place in the world where there are as many brilliant minds and excellent institutions so close to each other. Through collaborative relationships, I think we can solve some of the perplexing issues that have plagued human health for centuries. It is a very exciting time to be in Houston and the Texas Medical Center.

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