Nicole Tin-Lok Jiam, M.D.
Meet the Researcher
Jiam received her medical degree from the Johns Hopkins School of Medicine. Formerly a neurotology and skull base surgeon–scientist at Mass Eye and Ear/Harvard Medical School, she is now a neurotology and Skull Base Surgeon at the University of California, San Francisco. A 2024 Emerging Research Grants scientist, she is the recipient of an Elizabeth M. Keithley, Ph.D. Early Stage Investigator Award, generously supported in part by Susan and Steve Kaufman and renewed for a second year in 2025.
When I was 3, I toppled out of a window and fell face first into a thorny rose bush. There were sirens, there was blood, and when I regained consciousness, I had eight deep lacerations on my left cheek, permanently changing my visage. An otolaryngologist closed the wounds, and though I did not know it at the time, this was my first encounter with the field that I would come to love.
My parents encouraged me to focus on traits invisible to the eye and emphasized hard work, pursuit of excellence, and courage. This evolved into a passion for music because it conveyed what the physical world could not. Music quickly became my identity, and through this medium, I forgot I had scars.
While an undergraduate at Johns Hopkins, I met an intelligent, 27-year-old man with severe cerebral palsy. He was limited in his ability to communicate and connect with others, and it was a constant source of the implicit biases he encountered. Moved by his story, I secured funding to develop a mobile application. Still in use today, it is the only mobile platform that equips neurodevelopmentally disabled individuals with the tools to communicate their identity and needs with the world around them.
In medical school when I assisted in an otoplasty for a child born with microtia, I felt something click. Being a part of that ear reconstruction surgery ignited a desire to broaden my understanding of all fields within otolaryngology, and over the summer I began studying the perception of music in individuals with cochlear implants. This represented a perfect union of my interests in music, biomedical technology, and neuroscience—work that I now continue as a surgeon-scientist investigating how to improve outcomes for pediatric patients with cochlear implants. My current research builds on my investigations from the past 10 years, while developing additional psychophysical and perception methodology training for personalized programming strategies.
As a surgeon–scientist, I am often reminded of the extent to which visible and invisible domains shape our identities. When I was a medical student I met a 3-year-old girl with severe facial tissue loss after being attacked by the family dog. In tears, the mother asked about her daughter’s well- being, and if there would be a scar. That evening, I sat with her parents, provided reassurance, and shared my story with them. As I walked home the following morning, I felt grateful for the opportunity to have helped this family in some small way, secure in the knowledge that I am pursuing a field lying uniquely at the intersection of self-identity, creativity, science, and function.
Nicole Tin-Lok Jiam, M.D., is the recipient of an Elizabeth M. Keithley, Ph.D. Early Stage Investigator Award, generously supported in part by Susan and Steve Kaufman. HHF is grateful for the support of these projects that address the full range of hearing and balance science.
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The Research
University of California, San Francisco
Age-specific cochlear implant programming for optimal hearing performance
Cochlear implants (CI) offer life-altering hearing restoration for deafened individuals who no longer benefit from hearing aid technologies. Despite advances in CI technology, recipients struggle to process complex sounds in real-world environments, such as speech-in-noise and music. Poor performance results from artifacts of the implants (e.g., adjacent channel interaction, distorted signal input) and age-specific biological differences (e.g., neuronal health, auditory plasticity). Our group determined that children with CIs require a better signal input than adults with CIs to achieve the same level of performance. Additional evidence demonstrates that auditory signal blurring in adults is less impactful on performance outcomes. These findings imply that age should be considered when programming a CI. However, the current clinical practice largely adopts a one-size-fits-all approach toward CI management and uses programming parameters defined by adult CI users. Our project’s main objective is to understand how to better program CIs in children to improve complex sound processing by taking into context the listening environment (e.g., complex sound processing in a crowded room), differences between age groups, and variations in needs or anatomy between individuals.
Long-term goal: To advance our understanding of age-dependent differences in auditory processing and to optimize hearing restoration in implanted children and adults. My aim is to develop personalized precision programming strategies, post-implant rehabilitation programs, and next-generation devices to improve real-world hearing performance for CI users, and eventually to develop practice guidelines for age-specific programming interventions in audiology and otolaryngology clinics.