Dr. Thomas J. Balkany: Pioneer of Cochlear Implant Surgery

Dr. Thomas J. Balkany passed away on July 29, 2025, following a battle with cancer, ending one of the most influential careers in cochlear implant surgery and education. Over the course of four decades, he restored hearing to thousands of patients worldwide while personally training over 600 surgeons across six continents, helping transform cochlear implantation from an experimental procedure to standard medical care.

The making of a cochlear implant pioneer

Born and raised in Miami, Florida, Balkany decided at age 12 to become a physician after a positive medical experience treating his nasal obstruction. His calling to help deaf children crystallized during medical school when his wife Diane, director of a home for developmentally disabled children, introduced him to a 14-year-old resident named Deano. Deano was deaf, but this was unknown, and as such, the young man was treated as a severely developmentally disabled child. This discovery led to proper treatments, support, and education, drastically changing the course of the young man’s life. After graduating from the University of Miami School of Medicine in 1972, Balkany completed his otolaryngology residency at the University of Colorado in 1977 and completed a fellowship with Dr. William House, the father of cochlear implants, at the House Ear Institute in Los Angeles.

Following fellowship, Dr. Balkany established the Colorado Ear Clinic, a successful private practice; the Colorado Otologic Research Center (CORC), where he led research on cochlear implants and held international workshops on inner ear surgery; and the Children’s Deafness Foundation, which raised awareness of inner ear disorders and cochlear implantation. Dr. Balkany also served as the Chairman of Pediatric Otolaryngology at Denver Children’s Hospital and the Chief of Otolaryngology at Porter/Swedish Medical Center.

In 1990, Dr. Balkany was recruited to serve as the Vice Chairman of the Department of Otolaryngology and as the founding director of the University of Miami Ear Institute. He was also appointed as the Chief of the Division of Otology and Neurotology, Director of the Otolaryngology Residency Training Program, and a Professor of Otolaryngology - Head and Neck Surgery, Pediatrics, and Neurological Surgery. He spent the next 25 years building one of the world's leading cochlear implant programs. Under his leadership as Hotchkiss Endowment Professor and Chairman, from 2000 to 2010, the Department of Otolaryngology consistently climbed the U.S. News & World Report rankings, remaining in the top twenty nationally. University President Donna E. Shalala noted in 2010, "We are recognizing one of the University of Miami's true heroes, a man who can make miracles happen as he restores the sense of hearing to those who have never heard a sound." Dr. Balkany’s team consistently had some of the best CI patient outcomes on record. Medical School Dean Pascal J. Goldschmidt emphasized that "The UM Ear Institute would not exist if not for Tom Balkany, and it will truly be his legacy. Tom started the institute when he arrived at UM in 1990 and has built it into the best anywhere. It includes one of the world's busiest cochlear implant centers."

Revolutionary surgical innovations that changed the field

A Mensa member whose intellectual rigor matched his surgical precision, Balkany's technical contributions fundamentally improved cochlear implant surgery, safety, and outcomes. One of his significant innovations was the temporalis pocket technique, developed in 2009, which eliminated the need for bone drilling to secure receiver-stimulators. This anatomically-based approach created a secure subperiosteal pocket using natural tissue boundaries, reducing surgical time by 30% while achieving zero intracranial complications in 171 consecutive patients.

He also pioneered the adaptive cochleostomy concept, recognizing that surgical technique must be tailored to individual patient anatomy and electrode characteristics. His research on hearing preservation led to the development of electrocochleography monitoring protocols, which achieved 92% success rates in maintaining residual hearing during implantation. These "soft surgery" techniques dramatically reduced cochlear trauma and improved patient outcomes.

Balkany held 14 U.S. and international patents related to cochlear implant technology, including fundamental innovations in electrode array design and speech processing strategies. His surgical protocols became global standards, adopted by cochlear implant centers worldwide.

Building a global training empire through education

Perhaps Balkany's most significant legacy lies in education. In 1984, he developed the first multichannel cochlear implant surgeons' training course, establishing the template for specialized CI education. Throughout his career, he has personally trained more than 600 surgeons in the United States and internationally, across six continents.

His training philosophy centered on creating the "compleat CI surgeon" -- professionals with comprehensive knowledge spanning anatomy, audiology, radiology, electronics, and surgical techniques. He was one of the first surgeons to draw attention to the value of a multidisciplinary team in CI care. Balkany served as a visiting professor at over 40 universities worldwide, emphasizing evidence-based practice and using a team-based approach to achieve better patient outcomes.

In 1995, Balkany established the Microsurgery Training Laboratory at the University of Miami, providing state-of-the-art facilities for hands-on learning. His innovative combination of didactic instruction with intensive laboratory experience became the gold standard for cochlear implant surgical training.

The Institute for Cochlear Implant Training legacy

In 2012, Balkany founded the Institute for Cochlear Implant Training (ICIT) as a 501(c)(3) nonprofit foundation addressing critical gaps in cochlear implant education. Under his leadership, ICIT recruited over 70 influential and respected cochlear implant clinicians and researchers to serve as faculty, creating an unprecedented educational consortium. ICIT developed comprehensive, specialized training courses for surgeons, experienced CI audiologists, audiologists new to CI care, AuD students, and entire CI teams. Recognizing the importance of multidisciplinary care, in 2018, Balkany formed a partnership with the Oberkotter Foundation's Hearing First to develop specialized cochlear implant training courses for speech-language pathologists (SLPs), listening and spoken language specialists (LSLS), interventionists, auditory-verbal therapists, and deaf educators.

The institute's hybrid learning mode, combining 3-month comprehensive didactic courses with live web classes and hands-on training, including the temporal bone laboratory for surgeons and the advanced programming practicum for audiologists, has been used to train 1,568 hearing healthcare professionals in cochlear implantation worldwide, directly improving access to cochlear implants and enhancing patient outcomes in over 45 countries.

Prolific research and scholarly contributions

Balkany's scholarly impact includes over 250 peer-reviewed publications and numerous books, textbooks, training manuals, and book chapters. His research spanned hearing preservation techniques, pediatric cochlear implantation, device reliability, and surgical outcomes in elderly patients. He served on the editorial boards of 19 indexed journals, including Otology and Neurotology, Laryngoscope, American Journal of Neuroradiology, New England Journal of Medicine, Cochlear Implants International, ACTA Oto-Laryngologica, and Otorhinolaryngology Clinics. His NIH-funded studies on cochlear implants in children and language development outcomes, as well as his testimony at the FDA, were instrumental in the regulatory approval of cochlear implant devices and pediatric cochlear implantation. Research on device soft failures led to international consensus statements on reliability standards, while his hearing preservation studies demonstrated techniques achieving up to 92% success rates in maintaining residual hearing.

Recognition and honors that defined excellence

Balkany received unprecedented recognition for his contributions. In 2020, he became the first recipient of the Noel L. Cohen Award for Significant Contributions to Otology and Neurotology from the American Neurotology Society. Other major honors included the President's Citation from the American Academy of Otolaryngology-Head and Neck Surgery (received twice), the Presidential Citation from the American Otological Society, the Graham Frasier Award from the Royal College of Surgeons, and the Hallpike-Nylen Prize for Clinical Research from the Bárány Society in Sweden. The Prime Minister of Israel honored Dr. Balkany for establishing the first cochlear implant centers in Israel and performing the country's first implantations.

He served in leadership roles across professional organizations, including Vice President of the Triological Society, founding chairman of the AAO-HNS Cochlear Implant Committee, and senior examiner for both the American Board of Otolaryngology and American Board of Neurotology. He was a founding board member of the American Cochlear Implant Alliance and President of the Florida Society of Otolaryngology.

The scope of Balkany's direct patient impact is remarkable: over 3,000 cochlear implant surgeries performed at the University of Miami, treating patients from around the world. Notable cases included humanitarian efforts like cochlear implantation on a deaf Iraqi child transported from a battle zone, demonstrating his commitment to serving patients regardless of circumstances.

His influence extended far beyond direct patient care through the hundreds of surgeons he trained, many of whom now lead cochlear implant programs worldwide. Colleagues describe him as "the ultimate example of a physician, a scholar and a gentleman" whose "quiet leadership" inspired generations of ear surgeons.

Continuing impact through institutional legacy

Dr. Balkany's death signifies the conclusion of an era, but his lasting contributions persist. The University of Miami Ear Institute, which he established, remains a top cochlear implant center, and the Thomas Balkany Institute for Cochlear Implant Training offers extensive training programs for CI professionals worldwide. His surgical techniques, multidisciplinary team approach for CI care, and educational methods continue to set standards in cochlear implant centers globally.

Personal

Born in 1948, Dr. Balkany was the eldest child of four to parents Marilyn and John. He is survived by his wife, two children, and sister, Caron. Tom met the love of his life, Diane, in Copenhagen when both were graduate students. They married in 1970 at the Palace of Vizcaya in Miami and spent the next 55 years together. He was a loving, proud, and present father to Jordan and Sarah Balkany, both of whom he cherished deeply. Whether attending science fairs or coaching from the sidelines of a soccer game, he was always there for his family.

Both of his children were inspired early on by his brilliance and dedication to helping people. Starting in third grade, Jordan spent his summers working in his father's clinic, where he would call patients from the waiting room and escort them back to their exam rooms. Throughout high school, Jordan volunteered over 2,000 hours at Jackson Memorial Hospital's Otolaryngology Clinic and the University of Miami Otology research lab.

His daughter, Sarah Balkany, was also inspired by her father and his dedication to helping people. At the age of 12, Sarah began volunteering at the Debby School, located at the University of Miami Miller School of Medicine, an alternative school for the Deaf. Many of the children in attendance had received a cochlear implant from Dr. Balkany, allowing Sarah to see the transformative results of cochlear implantation personally. Witnessing the impact of language on early childhood development would begin a lifelong calling to work with young people. Now, Sarah is an adolescent and family psychotherapist.

Outside of medicine, Tom lived life to the fullest. He was an avid skier, sailor, hiker, scuba diver, and cyclist. The Balkany family traveled frequently, visiting destinations across six continents. Tom and Diane volunteered together at the Inter-Canyon Mountain Fire Protection District in Colorado, where he served as medical director. In that role, he trained first responders, rappelled from helicopters into wildfire zones, and once famously delivered a baby inside a Dairy Queen during a winter storm. Tom and his family have been proud residents of Summit County, Colorado, for more than four decades.

In his later years, he turned his focus to family, writing poetry, travel, and continuing education through ICIT. His legacy lives on through his family’s continued leadership and involvement in the institute, as well as their dedication to carrying forward the same mission.