June 26, 1989--The NIDCD Advisory Board held its first meeting.
September 18, 1989--The Advisory Council of NIDCD convened for the first time.
March 1, 1991--The NIDCD clearinghouse was established.
April 4, 1991--The board of scientific counselors of NIDCD held its first meeting.
November 19, 1991--The deafness and other communication disorders interagency coordinating committee met for the first time.
Dr. Snow became the first NIDCD director in February 1990. He is responsible for planning, implementation and evaluation of institute programs to conduct and support biomedical and behavioral research, research training, and public health information in human communication.
He received his M.D. cum laude from Harvard Medical School in 1956. He served his internship in surgery at Johns Hopkins Hospital in Baltimore and his residency and research training in otolaryngology at the Massachusetts Eye and Ear Infirmary in Boston. Beginning in 1960, he served as a captain in the U.S. Army Medical Corps for 2 years. He returned to his home state of Oklahoma and began work at the University of Oklahoma Medical Center where he rose to professor and head of the department of otolaryngology.
In 1972 Dr. Snow moved to Philadelphia to become professor and chairman of the department of otorhinolaryngology and human communication at the University of Pennsylvania School of Medicine. He was the medical director of the smell and taste center and the speech and hearing center of the hospital of the University of Pennsylvania and served as the principal investigator of the University of Pennsylvania Smell and Taste Clinical Research Center. He held hospital appointments at the Veterans Administration Medical Center, Children's Hospital of Philadelphia, the Graduate Hospital, the Pennsylvania Hospital and the Presbyterian-University of Pennsylvania Medical Center.
During the past 35 years, he has specialized in communication disorders. He has published more than 175 articles, books and abstracts about his specialty areas and research findings, which include studies on blood flow in the inner ear, radiation therapy and surgery of cancer of the head and neck, and the chemical senses.
As chairman of the education committee of the International Federal of Oto-Rhino-Laryngological Societies, he has fostered the establishment of national systems of accreditation of training and specialist certification in otorhinolaryngology on a worldwide basis. He has served on the editorial board of Chemical Senses and as editor of the Transactions of the American Broncho-Esophagalogical Association, the Transactions of the American Laryngological Association and the American Journal of Otolaryngology.
Dr. Snow is a member of numerous professional societies including the American Academy of Otolaryngology-Head and Neck Surgery, the American Neurotology Society, the American Otological Society, the Association for Chemoreceptive Sciences, the Association for Research in Otolaryngology, and the American Speech-Language-Hearing Association. His activities in organized medicine have included service on the council on scientific affairs of the American Medical Association, as a regent of the American College of Surgeons and as a director of the American Board of Otolaryngology.
He has served as president of the American Broncho-Esophagalogical Association, the Society of University Otolaryngologists-Head and Neck Surgeons, the Association of Academic Departments of Otolaryngology-Head and Neck Surgery, and the American Laryngological Association.
Dr. Snow was a 1970 recipient of the Regents' Award for superior teaching at the University of Oklahoma, held a consulting professorship at the Shanghai Second University of Medical Sciences in China in 1985, was elected honorary fellow of the Japan Broncho-Esophagological Society, and received the Golden Award of the International Federal of Oto-Rhino-Laryngology Societies in 1989. In 1991 he was elected to the Society of Scholars of the Johns Hopkins University, and in 1993 he received the distinguished Achievement Award of the Deafness Research Foundation. In 1994 he received the Senior Executive Service Presidential Meritorious Excecutive Rank Award for his government service. Through his guidance, the NIDCD has developed a strong national infrastructure to support research in human communication.
In recent years, the fields of cellular and molecular biology have furthered hearing research through the ability to clone genes for inner ear development and the assembly of human and animal cochlea-specific cDNA libraries. These advances offer researchers many new opportunities to study the characteristics of deafness, hereditary factors involved in hearing loss, and the genes that are critical for the development and maintenance of the human ear. Scientific advances have also been translated into cochlear implants, digital hearing aids, and tactile devices that provide information by stimulating the skin.
Great strides are being made in the study of the properties of auditory sensory cells, and of the characteristics of the response of the inner ear to sound. For many years, it was thought that sensory cells in the auditory and vestibular epithelia of birds and mammals were produced only during embryonic development. Thus, any loss of these cells as a result of drug treatment, noise trauma or aging was thought to result in permanent hearing deficits. However, recent research has shown that sensory cells in the vestibular epithelia of most vertebrates, including humans, can be regenerated.
Hearing impairment, a problem that crosses all ethnic and socioeconomic lines, is studied through NIDCD supported research. This research provides important information on otitis media, the most common cause of hearing loss in children, and presbycusis, hearing loss in the aging population.
NIDCD supports research on balance and the vestibular system. These disorders afflict a large proportion of the population, particularly the elderly. The vestibular system, with its primary receptor organs located in the inner ear, is largely responsible for the maintenance of one's orientation in space, balance, posture and for visual fixation of objects during motion and regulation of locomotion and other volitional movements. Vestibular disorders can, therefore, yield symptoms of imbalance, vertigo (the illusion of motion), disorientation, instability, falling and visual blurring (particularly during motion). Major disorders affecting the vestibular system result from infection, trauma, impaired blood supply, impaired metabolic function and tumors.
In addition to its roles in the stabilization of gaze and balance, recent findings suggest that the vestibular system plays an important role in regulating blood pressure. This information holds potential clinical relevance to the understanding and management of orthostatic hypotension (lowered blood pressure related to a change in body posture).
The institute supports research to develop and refine tests of balance and vestibular disorders. Computer-controlled systems measuring the responses activated by stimulating specific parts of the vestibular sense organ are now available. Improved tests of vestibular disability will have important implications for planning programs of physical rehabilitation for patients with balance and vestibular disorders.
Smell and Taste
NIDCD investigators study the chemical senses of smell and taste to enhance understanding of how individuals communicate with their environment. For example, this research is providing insight into changing preferences and aversions for specific foods and flavors. Improved understanding of the interaction between chemoreception and food consumption will lead to improved nutrition from birth to old age.
Both the olfactory and gustatory systems offer special approaches for understanding fundamental mechanisms of plasticity. NIDCD scientists have found that smell and taste cells have the capacity to replace themselves throughout life. These are the only known mammalian sensory cells with this property.
Advances in the molecular and cellular biology, biophysics and biochemistry of the olfactory and gustatory systems are paving the way for improved diagnosis, prevention, and treatment of chemosensory disorders. The vertebrate olfactory receptor neuron has become an important biologic model system in the area of molecular and cellular biology. The olfactory receptor gene family was recently described in mammals and may contain as many as 1,000 olfactory receptor genes. NIDCD scientists are presently characterizing genetic mechanisms of olfaction which will provide the opportunity to study the molecular pharmacology of the process of smell. In addition, the use of available biochemical and molecular probes will lead to a more complete characterization of the neurotransmitters throughout the gustatory system.
Voice, Speech and Language
Studies of voice and speech disorders are aimed at determining the nature, causes, treatment and prevention disorders such as stuttering, spasmodic dysphonia, and dysarthria. A recent study has demonstrated a new, effective treatment for one such disorder, spasmodic dysphonia--a hyperactivity of the muscles of the larynx which constricts the vocal folds and severely distorts speech. This treatment involves the injection of minute amounts of botulinum toxin into the laryngeal muscles. The toxin blocks the muscle stimulation and eliminates the hyperactivity, rendering a patient free of the symptoms for as long as 4 months.
Oral speech communication may not be a realistic option for individuals with severe dysarthria. Substantial progress has been made in the development of augmentative communication devices to facilitate the expressive communication of persons with severe communication disabilities. An investigation of conversational performance by augmentative communicative device users is in progress. Other funded research evaluates whether a low cost, laser activated keyboard for accessing personal computers is feasible. By providing access to computers, individuals with disabilities can immediately use personal computer software programs and speech synthesizers for augmentative communication.
Language research continues to expand our understanding of the role of each hemisphere of the brain in communication and language, of early specialization of the brain, and of the recovery process following brain damage. This research is intended to further understanding of the neural bases of language disorders. Research on acquistion, characterization and utilization of American Sign Language is expanding our knowledge of the language of people who are deaf.