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This research aims to summarize the current state and geographic variation of ear and hearing care (EHC); specifically, we will survey providers globally to assess the availability of infrastructure, including equipment, materials, and ancillary services necessary to deliver care, facilitate training and educational opportunities, and overcome barriers to ear and hearing care service (EHC) delivery. EHC providers include the multidisciplinary care team of ENTs (Ear, Nose and Throat Surgeons), audiologists, audiology technicians, ENT clinical officers, hearing healthcare workers (village healthcare workers trained in ear and hearing care), speech and language therapists, teachers of the deaf and primary health care professionals with specific audiology training. This is a complementary study to ongoing global otolaryngology head and neck surgery (OHNS) and audiology workforce studies which aim to capture the quantity and distribution of OHNS and audiology providers in each country. Taken together, these studies serve as a baseline needs assessment for audiology capacity on an international level, providing novel data needed to inform interventions and policies. These international studies have been developed by members of the Global OHNS Initiative, an international collaborative of over 250 care providers, trainees, and students from over 35 countries. This team has fostered discussion and mentorship across institutional and national boundaries. Beyond the discrete research outputs from this study, this study will facilitate research skill development for trainees who may otherwise have limited opportunities for research involvement and mentorship through their own institutions.
Vestibular Migraine (VM) patients present with auditory symptoms such as aural pressure, tinnitus, and sudden sensorineural hearing loss. Half of Meniere’s Disease (MD) patients present with migrainous features, such as a headache with photophobia or positive family history of migraine. Moreover, about a quarter of VM and MD patients meet both diagnostic criteria. So far, the MD’s pathophysiology remains unknown. Nevertheless, depending on post-mortem temporal bone analyses, endolymphatic hydrops (EH) was noted as a potential MD marker. Current migraine treatment options have shown success in treating some of the patients with MD. In MD when medical treatment fails, the recommendation is to use a second-line treatment, such as the intratympanic injection of steroids. A third-line treatment could be either endolymphatic sac surgery or the intratympanic injection of gentamicin, which has a higher risk of hearing loss. The very last option is destructive surgical treatment labyrinthectomy, with or without cochlear implantation. Since VM and MD overlap, in a nitroglycerin-induced animal model of migraine, we may encounter endolymphatic hydrops experimentally and try to reverse the effect of NTG with migraine treatment. If our hypothesis is true; intractable Meniere’s disease’s treatment options would change and there would be no more destructive treatment methods like labyrinthectomy or intratympanic gentamicin injections and it could be treated conservatively.
