Chiron Speaks: What Was the Genesis of the Fellowship for Advanced Training in Head and Neck Oncology?

Abstract

During the mid-1950s, it became apparent to the leaders in otolaryngology that training beyond the standard three-to four-year residency was necessary to keep abreast of the rapid surgical advances taking place in the treatment of head and neck neoplasms. This was particularly true in the treatment of laryngeal cancer. Heretofore, early cancers of the larynx had been treated by irradiation or laryngeal fissure (cordectomy). Supraglottic laryngectomy, hemilaryngectomy, and radical neck dissection in continuity with laryngectomy were just developing as possible alternatives for control and cure. Other neck and throat procedures, such as incontinuity jaw-neck excision and preservation of the facial nerve in parotid surgery, were considered extreme, technically difficult, and outside the purview of the standard otolaryngological, general surgical, or plastic surgical programs. Hence, several preceptor arrangements with master surgeons flourished, each with its advantages. However, there were shortcomings, ie, formal university affiliation lacking, small case loads, little hands-on experience,