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 Regentsí 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.
Other cochlear-specific genes have been isolated from enriched membranous labyrinth cDNA libraries. New technology, including the development of detailed maps of expressed sequence tags (EST) coupled with the use of inner ear specific cDNA libraries, exon trapping and cDNA library enrichment procedures, will facilitate gene cloning. Once cloned, the molecular biology of hearing and the role of particular proteins in the development and/or maintenance of the inner ear can be determined.
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. Research has verified that despite substantial variability in the performance of children who have received cochlear implants, most demonstrate an improvement in speech perception and production. Speech produced by children who use multichannel cochlear implants is usually more accurate than the speech produced by children with comparable hearing impairment using vibrotactile devices or hearing aids. Cochlear implants also positively influence children's receptive and expressive language skills. The longer children use their implants, the greater their language ability.
To achieve the most benefit from their implants, however, children generally need extensive oral-auditory training following implantation and also benefit from periodic audiological assessments. Cochlear implants have benefited children who are congenitally deaf as well as those who are postlingually deaf. The vast majority of adult implant recipients derive substantial benefit in conjunction with speechreading, and many can communicate effectively without speechreading and are able to communicate by telephone. Dedication to research on cochlear implants throughout the world will improve the capabilities of current implant users and improve our understanding of the auditory system.
New insights have been gained concerning the encoding of complex signals transmitted from the auditory nerve to the brain. The relationship between the neural codes for sound intensity, frequency, duration and temporal characteristics of auditory signals and the perception of the stimulus variables has been further clarified. Valuable progress has been made in understanding the structure and function of efferent feedback pathways to the inner and middle ear. There is now good evidence that this system may aid in the detection of signals in noisy environments and serve to protect the ear from acoustic injury.
Gains have been made about the ways in which the brain creates maps of auditory space and how these maps interact with visual space. This research may have implications in the treatment of children who acquire hearing loss in infancy or early childhood. Further, psychoacoustic and electrophysiologic studies of infants and children are providing important new insights into the development of functional hearing.
In the aging auditory system, discoveries have been made demonstrating changes in the regulation of fluid composition and autoregu-lation of cochlear blood flow whcih may underlie some of the biologic effects of aging on auditory function. Improved behavioral and electrophysiological techniques for measuring auditory function are providing more accurate assessments of the peripheral and central components of age-related hearing impairment.
Recent development of animal models for bacterial and viral infections hold promise for new diagnostic and therapeutic approaches to sensorineural hearing loss caused by infections. Antiviral drugs may find rapid application in the treatment for these conditions with the advent of suitable animal models in which to test efficacy. In addition, the models will allow a greater understanding of why and to what degree infants and children are susceptible to ototoxic drugs used in the treatment of infections.
Otitis media continues to be a significant focus of research because of its prevalence and cost to society. Important risk factors have been identified. Studies of the eustachian tubes have provided new information on tubal mechanics, surfactant-like (fluid) substances and middle ear pressure regulation. Progress has been made toward defining the role that viruses may play in otitis media and the cellular and molecular changes that occur during viral and bacterial infection of the middle ear.
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 function. Computer-controlled systems measuring the responses activated by stimulating specific parts of the vestibular sense organ are now available. Improved tests of functional disability will have important implications for planning programs of physical rehabilitation for patients with balance and vestibular disorders.
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.
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.