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By Michael M.
Paparella, M.D.
Unlike many other diseases, otological problems, including
hearing loss, often cannot be seen and their seriousness
is frequently ignored. Helen Keller said that of all
of her afflictions her deafness was her greatest handicap.
A most import quality of humans is our ability to communicate.
Millions, young and old, have diseases of the ear resulting
in discomfort, pain, disability and sometimes, through
complications, death.
Approximately 30 million Americans have a significant
hearing loss or deafness, 90 million suffer from dizziness
or imbalance and 30 to 40 million have tinnitus, a constant
ringing, buzzing or roaring in the ear. According to
the National Institute on Deafness and Other Communication
Disorders (NIDCD), one in three people older than 60,
and half over 85, have a hearing loss. Almost all children
will have at least one episode of middle ear infection
(otitis media) by the time they are one year old, while
10 percent of children have chronic ear infection resulting
in hearing loss and other problems. If left untreated,
hearing disorders in the young can interfere with fundamental
language development and lead to other serious otological
sequelae.
Yet the medical community has only scratched the surface
in terms of understanding, diagnosing, treating and
preventing the many diseases that exist in the field
of otology. As elaborated further below, the need for
more research is especially urgent given the dwindling
number of active laboratories collecting, processing
and studying temporal bones, a function critical to
advances in this field. Recent breakthroughs in genomics
and cellular and molecular biology have profound potential
for future research and progress relating to otopathology
and in understanding ear diseases.
At this very promising moment in time, however, otopathological
research is in danger. In 1976 there were 28 active
otopathology laboratories in the United States devoted
to collecting temporal bones and tissue samples for
research. Today only 15 facilities remain and they suffer
from a decline in funding and number of donated specimens.
Every discipline in medicine has pathology as its basis.
Whether it is tissue removed from surgery, frozen biopsy
or postmortem autopsy studies, pathology is a vital
path to knowledge about disease. All hospitals have
pathology departments; no hospital in the world has
an otopathology laboratory or department. Therefore,
it is of paramount importance to continue the efforts
to maintain and to expand temporal bone collections.
With sufficient resources, these labs will be able to
build on their inherent strengths and forge a path to
leadership on ear disease research that will result
in a better quality of life for the millions affected
by hearing loss and related ear diseases.
More than ever, our ability to diagnose and treat otological
diseases depends on our understanding of their causes
and effects. We are in a period of crisis where otopathology
needs to survive in order to treat the patients of today
and tomorrow.
Each otolaryngologist should recognize this and encourage
patients to bequeath their temporal bone specimens.
Patients should be sure to contact the National
Temporal Bone, Hearing and Balance Pathology Resource
Registry to find out how to take part in this research.
And funding is desperately needed for acquisition and
processing of temporal bones. Each of us can help by
notifying our national congressional representatives
as well as encouraging private and national funding
agencies to create a higher priority for this most important
clinical research endeavor.
Michael M. Paparella, M.D., is the
chairman emeritus of Otolaryngology, University of Minnesota
and practices with the Minnesota Ear, Head & Neck
Clinic.
For more information, contact: National
Temporal Bone, Hearing and Balance Pathology Resource
Registry, 800.822.1327 V, 888.561.3277 TTY, www.tbregistry.org. |
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