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Comments on "Funding of Temporal Bone Laboratories--Sources and Needs Assessments"

Isamu Sando, M.D., D.Med.Sc.

Supporting and maintaining the Temporal Bone Registry and its associated laboratories is essential. The reason is that human temporal bone histopathological studies are unique for investigating, three-dimensionally and functionally, well-preserved pathological conditions produced by human ear diseases in a wide area within large temporal bone specimens. The results of this study contribute significantly to care of patients, education, and research in the otological field. It should be mentioned that, even though the participating laboratories are not funded by an NIDCD R01 grant since their study is not directly related to the requested specific research project, they still have been very productive in publishing and presenting numerous clinically important findings, and for teaching otopathology to researchers, residents, and students. Accordingly, the National Temporal Bone Registry System has been successfully contributing to the society and has maintained its international reputation as the center of temporal bone histopathology. Further, in the near future, histopathology will be a basic core of advanced research studies recently developed, such as moleculo-biological and immunohistochemical studies for various diseases and/or pathological conditions of the ear.

With those facts mentioned above, I am enthusiastic for funding 4-5 currently active temporal bone histopathology laboratories, not only for continuing their on-going activity but also for maintaining their collection through the National Temporal Bone Registry System. This would not only support clinical research, but also education and the care of patients.

Maintaining well-trained technicians is essential for this project. For that reason, a competitive salary should be given to her as she holds unreplacable skills and experience in extraordinary processing techniques for preparing hundreds of serial histology sections successfully from numerous temporal bone specimens. Losing such a valuable technician would be as devastating as losing an otopathologist. Finding another patient skilled technician is almost impossible and to train a new technician would take many years.

As for maintaining the temporal bone collection for both stained and unstained specimens at institutions where inactive or closed temporal bone laboratories are located, a discussion should be held as to whether or not NIDCD should help support them as part of the National Temporal Bone Registry System. Many are priceless specimens such as those with Eustachian tube, brain tissue, and/or various clinically important ear diseases, including Meniere's disease, congenital ear anomaly, otosclerosis, Bell's palsy, etc. My personal opinion is that, being supported by NIDCD, the collection should be kept in those institutions under the supervision of the National Temporal Bone Registry to help increase young otologists to become interested in otopathology, and to let those inactive laboratories be re-activated for expanding activity of this clinically important project, Human Temporal Bone Histopathology.