25 years of Operative Technique

Abstract

As a resident in 1974, I attended the centennial celebration of the first total laryngectomy performed in 1874, hosted by the American Laryngological Association. Very little had changed in laryngeal oncologic surgery in the first 100 years. Since 1974, laryngeal surgery has continued to evolve with ongoing changes year after year. By 1990, many patients who had laryngeal cancer no longer required total laryngectomy. A variety of partial laryngectomy procedures evolved that provided comparable cure rates with voice preservation. In 1980, Pearson published an article in The Laryngoscope describing a near total laryngectomy for extensive laryngeal tumors. The technique, then presented and published, allowed for speech and swallowing after near-total resection. Anxious to learn new techniques and make it available for my patients, I diligently studied his paper. Unfortunately after many reviews, I felt inadequate that I could not understand the technique. I asked for help from friends, colleagues, and professors. Ultimately, it became clear to me that no one really understood how to recreate the complicated surgical procedure. A lengthy description and primitive sketches in the original article did not clarify the surgical step and with that the concept of a journal that focuses on high quality medical illustrations was born. With the backing of W.B. Saunders (now part of Elsevier), Operative Techniques in Otolaryngology- Head and Neck Surgery was planned. The inaugural issue was planned to focus on laryngeal surgery and Dr. Pearson was invited to contribute the featured article on near total laryngectomy. The issue underwent multiple delays as Dr. Pearson realized illustrating his technique was more difficult than performing the surgery. After hours of work with a talented medical illustrator, his technique was published and taught to physicians around the world.