Comments of Dr. Paprella [NIDCD Funding for Research]

Comments of Dr. Paprella

Training of Temporal Bone Researchers
Funding & Needs

(Panel 1:30-2:30 p.m.)

Personal History of Training M.D.'s and Ph.D.'s
Over the years I have had the privilege of training more than 230 M.D.'s and Ph.D.'s. Included in this group are 25 Professors and Chairmen of Otolaryngology in the United States and especially other countries; and many full and part time academic faculty. The basis for research training was the Otopathology Laboratory with our other affiliated disciplines and laboratories. Many of these individuals have branched into other research disciplines and have greatly aided the mission of the NIDCD. For example, my first independent fellow was Dr. David Lim, in 1964. Thus, otopathology laboratories have in the past, and even more so in the future, the opportunity to train individuals for research.
Research Assistants and Technicians
There is a concomitant need to train research assistants and technicians. These skills require special knowledge and training and many years of experience. Photomacrography and micrography are part of these necessary skills. Our research assistants and technicians have, and are trained to participate in the design, execution, and when appropriate, publication of research findings, and are inherent members of the team, which enhances the research team's effort and productivity. It is amazing how creative and productive these individuals are to the research process.
The Otopathology Laboratory has routinely been used to teach medical students, residents, fellows, and faculty the pathology and pathogenesis of otologic diseases which leads to more optimal patient care, but also to new research ideas and collaborative study.
In the past decade or more there has been a great paucity of American residency graduates entering the research realm of otopathology. Fortunately there are many from other countries who arrive as fellows for 1 to 2 years to study otopathology and related disciplines such as electron microscopy, immunocytochemistry, in situ hybridization, and molecular biology.

For example, in my laboratory at the present time, we are fortunate to have seven research fellows: five from Japan, one from Turkey, and one from Brazil who is on a Fulbright scholarship. He will soon return to the University of Brasilia where the Professor and Chairman Dr. Carlos Oliveira was my resident years ago. Dr. Oliveira took a fellowship with Harold F. Schuknecht. With the International Hearing Foundation (IHF) and Rotary funds, we will help establish an otopathology laboratory at the University of Brasilia, the first I am aware of in Latin America. This will provide a means of looking at various pathologies from another country in cooperation with our own laboratory.
Two new fellows will soon arrive, one from India and one from China. These individuals pay their own room, board, and travel and we provide the expenses for their research activities, publications, travel to meetings, etc. Although we have been pleased and grateful with the productivity of foreign fellows, American graduates are needed to enter the field of otopathology. The reason they do not is their awareness of lack of support of otopatholoy laboratories and perceived lack of funding for training.
What Do We Need?
1. We need basic funds to support all temporal bone histopathological research laboratory personnel including research assistants and technicians and faculty to provide guidance and supervision and funds to support training for future otopathology researchers especially to include American residency graduates. Although M.D. and Ph.D. faculty are encouraged to enter this research area, a special need is to train clinical otologists and neurotologists who have an active interest in otopathological research which greatly enhances transference of research data to the bedside. The best role models in American to date, such as Lindsay, Schuknecht, etc., have been individuals of this type. Questions for research arise from the clinic, which can then be taken to the temporal bone laboratory and cross fertilization takes place in which questions from the laboratory can be taken to the clinic for clinical correlative and collaborative study. The fact that we have new technology for improved diagnosis of otological diseases only enhances the possibility of encouraging corollary clinical otopathological studies.
2. Specifically it would be desirable, as a beginning, if funds were available to train two such otopathology individuals per year in the "active" core centers. This is in addition to basic lab support of approximately $300,000 (or approximately equal to one R01 grant). The core lab can also train research assistants and technicians.