The Anatomy of Hearing and Balance Disorders and their Treatment: Welcome to a Brave New World

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JEFFREY T. LAITMAN*Center for Anatomy and Functional Morphology, Box 1007, Mount Sinai School ofMedicine, New York, 10029If New York City was a part our body, what do youthink the city would be (careful here, I’m a native NewYorker and I have friends who know people...)? Whilesome may say the cerebral cortex (for obvious reasons)or the heart (ditto) or larynx (as some of us are knownto talk a lot), I would vote for the temporal bone. Forthose of you whose world does not go much beyond themolecular level (poor souls!), let me give a little back-ground. The temporal bone in humans lies at the sideand bottom of our skull. Its name ‘‘temporal’’ arises fromthe Latin, temporalis meaning ‘‘of time.’’ A thought isthat the bone received its name as its flat, or squamosalportion, on the side of the head is where the passage oftime is first seen (i.e., where we begin to grey).While the side of our head may be fascinating to bar-bers and their ilk, the really alluring part of this bonelies largely on the bottom of the skull and is called the‘‘petrous’’ (from the Greek, petra meaning ‘‘rock’’) part ofthe temporal bone or petrous bone. It is, indeed, ‘‘rock-hard,’’ although not ‘‘rock-solid.’’ What lies within is whyI see it as the equivalent of my beloved city. The realmis extraordinary because the crucial structures—haircells, canals, nerves, bones, ligaments, membranes, flu-ids, vasculature, etc.—involved in two of our key senses,balance and hearing, reside within. The realm is one ofthe most congested and complex—like the streets of NewYork!—part of our anatomy and inherent physiology.And like little old New York, these parts have their owndistinct evolutionary histories. They have migrated,morphed, and changed over the millennia, arising fromdiffering areas in our ancestors to now co-habitat anincredibly congested and marvelously complex anatomi-cal ‘‘melting pot.’’ From the ‘‘Outer’’ Ear (insulted dailywith horrific piercings; do you think they evolved tohang ornaments from?!); to the ‘‘Middle’’ Ear with itsossicles and communications to the nasopharynx andportals to the respiratory system; to the ‘‘Inner’’ Ear, thesanctum of hearing and balance and one of the lastlargely unknown realms of mammalian biology. Indeed,the mysteries of our three ‘‘ears’’ continue to confoundand yet fascinate anatomists, physiologists, geneticists,evolutionary biologists, and physicians. From the days ofthe Egyptians, to the nascent anatomists and biologistsof the Renaissance, to today’s leading investigators, thebiology and diseases of our ears have riveted the bestminds of science and medicine (see Laitman, 2006; VanDe Water, 2012a.)This Special Issue of The Anatomical Record, ‘‘TheAnatomy and Biology of Hearing and Balance: Cochlearand Vestibular Implants,’’ is, most appropriately giventhe above, Guest Edited by Thomas Van De Water, whois as bone fide a New Yorker as it gets (Van De Water,2012b). Indeed, his lineage hails from the pre-Revolu-tionary War Dutch inhabitants of New Amsterdam (i.e.,my city before the English took it over and re-named itNew York in 1665). If one looks on the old maps of NewYork, you can find in the upper tip of Manhattan, ‘‘Van-dewaters farm.’’ Pretty impressive, to have yourancestral farm noted on a map of ‘‘Olde’’ New York. Ihad to pay to have my current address listed in ourcounty phonebook!Beyond his impressive pedigree (which, by the way, heproudly flaunts to us more ‘‘recent’’ 20th century arriv-als), Van De Water is an extraordinary scientist of thecells, fluids, and neurobiology of the cochlear and vestib-ular worlds. He is also an historian of his science, aperch that has enabled him to view the fascinatingattempts to decipher the anatomy, physiology and appli-cations of such to one of the most central, yet poorlyunderstood, realms of mammalian biology. Van De Waterhas also been an extraordinary teacher and mentor toscores in this field, myself included, by empowering ourability to pursue our science and our scientific advance-ments. Put these all together and you have aremarkable New Yorker with the inherent chutzpa andearned gravitas that empower him to enlist the best(and busiest!) minds in the cutting edge aspects of hear-ing and balance science to contribute to thisextraordinary issue.This Special Issue is unique in that it is The Anatomi-cal Record’s first truly ‘‘translational’’ issue. Its focus isnot only upon new advances in basic biology—as is ourtrademark—but now incorporates the ‘‘cutting edge,’’ orsoon to be cutting-edge, applications of the science.While some of our special issues in the past (e.g., Fried-land, 2006 on the auditory system; Marquez, 2008 onparanasal sinuses) have included some important trans-lational studies, this is the first full issue centering ontranslational, anatomically based, science. The combina-tion herein of outstanding reviews and presentations ofcurrent research meld an appreciation of the history,