Tissue Banking for Auditory Research: Current Practice and Perspectives from Aotearoa New Zealand

Abstract

Background: Diseases with pathology in the inner ear, such as the majority of sensorineural hearing loss and peripheral vestibular disorders, are difficult to treat due to our lack of understanding about their disease mechanisms. To understand the underlying pathology and develop novel treatments for these conditions, research using human inner ear samples is critical. The challenge is that the inner ear is embedded in the temporal bone, hindering access in living patients, leaving post-mortem tissue collection as the primary option. In Aotearoa New Zealand (NZ), we currently do not have resources allocated to support ear tissue banking dedicated to post-mortem collection of the temporal bone to support our understanding of inner ear disease in the NZ population. Aims: To inform future ear tissue banking in NZ nationwide, this thesis explores: current practices in existing NZ tissue banks to identify points of consideration specific to an ear tissue bank (Part I) and; perspectives from otologists and neurotologists towards such ear tissue bank as a resource (Part II). Methods: In Part I, a semi-systematic search using an approach similar to a scoping review was conducted to identify existing tissue banks in NZ to extract information from key cultural and donor information practices. In Part II, semi-structured qualitative interviews were conducted to gain insight into clinician perceptions about ear tissue banking in NZ. Results: Nine existing NZ tissue banks were identified, and four provided donor information packages and donor consent forms for subsequent analysis, which identified unique constraints in tissue banking in NZ regarding cultural safety considerations. There were seven interview participants, and four themes were identified: perceived roles, perceived benefits, perceived barriers, and collaborative efforts in relation to ear tissue banking in NZ. Conclusion: The present study identified overall positive attitudes from clinicians towards tissue banking to support otologic research and how an ear tissue bank would follow key practices of currently operating tissue banks. It also identified some challenges specific to temporal bone collection and interest in intraoperative methods. Strategies to address these barriers were identified in current tissue banks’ practices, but investigation into how they would be modified to specifically suit ear tissue banking should be explored to facilitate clinician engagement, as an ear tissue bank in NZ would foster expansion of otology as a subspeciality.