Department of Otolaryngology - UT Memphis

Dr. Tom Robbins insisted that I record a history of the Department of Otolaryngology- Head and Neck Surgery at the University of Tennessee. I did not relish the job and have agonized through it. Only a UT Center-GRAMS article alludes to it and I composed that in 1966. Otherwise there is no recorded information concerning this subject. My information has been gathered word of mouth from former staff members and residents. Names, dates, places and activities may be incorrect. Your corrections are welcomed.

Dr. Richmond McKinney became the first chairman of the Department in 1911, when the school moved from Nashville to Memphis. He was a native Memphian and its first laryngologist. He had specialty training in Germany for 1 year. He had no residents. Dr. W. Likely Simpson assisted him for one year prior to his retirement in 1938.

Dr. Simpson became Chairman in 1937 following his graduation from the Illinois Eye and Ear Infirmary in 1905, The University of Vienna and Oxford, England where he received a degree in Ophthalmology and Otolaryngology. His mentors were Drs. Politzer, Barany and Killian. He trained 10 residents from 1939 to 1949. The program was accredited for 2 years. Dr. Simpson had unequaled talents in paranasal sinus and temporal bone surgery. The dental burr for mastoid surgery was introduced at this time. Antibiotic therapy for head and neck infection was inadequate. Under his direction radical mastoidectomies were common. Osteomyelitis of the skull was not uncommon, but could usually be controlled by excision of the skull an inch beyond evidence of disease. Adequate frontal sinus surgery with removal of all mucosal lining using a drill was the procedure of choice. With this technique, reconstruction of the nasofrontal duct was unnecessary. This was the cure in those days for all patients with nasal polyps without allergy. Radical mastoidectomy was the cure for all patients whose ear was draining with a tympanic perforation.

The Lynch suspension laryngoscope was the primary instrument used to examine the laryngo-pharynx. Endotracheal anesthesia was not regularly available. Local anesthesia was the procedure of choice. Glossopharyngeal, superior laryngeal nerve blocks and 10% topical cocaine anesthesia was unheard of in that era. Dr. Harold Tabb and I were residents at that time (1949-1951). Dr. Tabb subsequently became chairman at Tulane.

Dr. Simpson retired as Chairman in 1950. He was a dedicated teacher and trained 10 residents.

Dr. Charles Blassingame became Chairman in 1950. His primary interest was allergy, endoscopic removal of foreign bodies, irrigation of the maxillary sinus through the natural ostium, and an adenoidectomy technique designed to remove maximum adenoid tissue. He emphasized a thorough knowledge of the anatomy of the skull base and the selection of appropriate instruments to accomplish this procedure. He trained 3 residents and died in 1952.

Dr. Ralph Braund, a Sloan Kettering trained oncologic surgeon was invited by Dr. Simpson and Blassingame to direct the care of all Head and Neck tumor patients which he did from 1948 to 1951. He had developed a cancer clinic at the Gaston Hospital that by 1947 had moved to 787 Jefferson. By 1956 it became known as the West Tennessee Cancer Clinic and by 1964 the Van Vleet Clinic at 3 North Dunlap. This unique arrangement developed as Dr. Braund struggled to obtain beds for his Head and Neck charity patients. The general surgery department would only accept patients with thyroid disease and not patients requiring a careful head and neck examination that might subsequently require an operative procedure that involved control of saliva.

Dr. Braund taught and supervised Dr. Tabb and me to do head and neck surgery. Prior to this time, the most extensive head and neck procedure performed by an otolaryngologist in Memphis was a total laryngectomy. In 1948 Dr. Tabb and I did the first otolaryngology radical neck dissection.

Following a special fellowship at Memorial in New York, I was assigned to visit the Cancer Clinic with the residents each Monday morning for a one and a half hour conference followed by a patient clinic for 2 hours. I did this for 35 years. Dr. Neal Beckford became my replacement in 1986. Dr. George Bale, a Baptist Pathologist developed a weekly conference for the residents for 10 years. I frequented the operating room to assist the residents, but primarily the teaching was accomplished through interactions between the staff and trainees that included one on one teaching sessions between the residents.

Dr. Braund must be given primary credit for the initial development and training of oncologic head and neck otolaryngology surgery in Memphis. This paved the way for departmental recognition throughout the United States, development of an approved Head and Neck accredited oncologic training program and indirectly the initiation of an important National Head and Neck Surgical Society composed primarily of otolaryngologists.

The Department was without residents from 1951-53. Maximum effort was expended by the clinic staff to keep the Department afloat and not lose the credibility we had established. We had one temporary family practice resident for a few months. On occasion we would assist a general surgery resident with a head and neck clinic case.

It was during the 1940's, 50's, and 60's, that Otolaryngology suffered for lack of credibility. Unattractive nicknames identified the specialty. Dr. Hayes Martin, President of the "Head and Neck Society" its first four years and Director of the Head and Neck Service at Memorial in New York, saw no reason for the specialty to exist. Operative sterile techniques as well as procedures deserved criticism. I once saw a bare handed tonsillectomy performed by a staff member. Approval of construction of LeBonheur Hospital by the pediatricians gave them license to perform tonsillectomies and other procedures until the hospital came under the control of the appropriate credentialing agent and the University of Tennessee.

I would hope that each of you and the recently trained head and neck surgeons will reflect on the advancement that has been made in our specialty and what has been done politically and academically to make our continued progress unobstructed by other specialties.

In 1983, at the 25th reunion of the ASHNS, I made this comment to the general assembly - "I believe now we know where we are, where we have been, and with God's help, where we are going." Having been one of the 6 originators of the ASHNS in 1957, 1 am grateful and applaud this monumental progress.

I note that Dr. Bob Byers is presenting a paper next month at the 5th International Conference on Head and Neck Cancer entitled, "Dr. Martin: How are we doing in 2000?" Dr. Martin would turn over in his grave. Dr. Martin’s Head and Neck Society has dissolved and joined our original otolaryngology group that has sympathetically changed its name to the American Head and Neck Society. Dr. Robbins was its first president.

Dr. Sam Houston became Departmental Chairman in 1954, retired in 1970, but continued to practice until the age of 85. His inner character, understanding, penetrating judgment, inspirations, close longstanding relationship with national leaders in Otolaryngology and his insight into Memphis medicine, University of Tennessee and its training program made him second to none. Mutual genuine love existed between him and the residents- HIS BOYS. The program prospered from this unselfish advice. 33 residents were trained by him. Dr. Sanders' primary resident was Mike Glasscock who later developed an outstanding international reputation as an otologic and skull base surgeon at Vanderbilt.

Otology played a significant role in the training program. Dr’s. Gale Gardner, Coyle Shea, David Austin and Mike Glasscock directed their attention to middle ear disease. Dr. John Shea received outstanding recognition for his first stapedectomy with teflon piston implant in 1956. They all continue to share their educational experience at meetings and in the literature.

Gale Gardner, John Robertson and I contributed to the development of a technique for the management of lateral and central skull base tumors.

Dr. Charles Gross became director of training in 1968 and chairman in 1977. He trained 36 residents. The Memphis Speech and Hearing Center was transferred to Memphis State University. A temporal bone laboratory was developed on the top floor of the pathology building. Private patients were seen in one room in the Bowld Hospital and one room at LeBonheur. In 1969 the Veteran’s Administration Hospital residency program was combined with the University of Tennessee. Ed Franklin and Leonard Wright directed the clinic at the Methodist Hospital. Three seminars were developed each year until 1977. They involved head and neck oncology (Donald Harrison, Joe Ogura, Cocke), Rhinoplasty (Jack Anderson, Farrior, T. Smith, McCullough, Simmons, Tardy) and otology (Stores). Gale Gardner co directed the otology specialty. Resident exchange was established with the Alabama and Indiana training departments. Residencies were established at St. Joseph, Baptist and Methodist Hospitals.

Dr. James Grant was a member of the staff for several years before leaving for private practice in San Diego.

Dr. Larry Duberstein joined the department in 1975 full time. He left for private practice in 1979. He Identified that this department’s quality during his tenure was ranked 5th or 6th in the nation.

Dr. Baldev Devgan joined the department in 1974 and resigned some few years later. Dr. Brent Segal was a staff member as was Dr. Nakmur and John Fletcher Ph.D.

Dr Mac Hodges completed his residency at UT in 1970. In 1971 he developed the first cleft palate team in Memphis and did the first face lift in the department. He was responsible for developing with the Lions Club a temporal bone laboratory at the Methodist Hospital in 1989. It was since modified by Dr. Ruckenstein. He has represented the department as director of training at Methodist Hospital since 1978. He assisted in the development of the ENT clinic and secured additional salaries for the residents.

Dr. Winsor Morrison became director of the Veteran’s Hospital department in 197Dr Morrison became chairman of the UT department from 1978 to 1981. He related to the training of 12 residents. Dr. Moshe Harrell was departmental chairman in 1982.

Dr. Mac Hodges was chairman of the department from June 1982 to June 1983. He related to the training of 12 residents. He gave them maximum exposure to head and neck, plastic, and otologic training.

Dr. Richard Babin came to the department from the University of Iowa and was chairman from 1983 to 1991. He trained 33 residents. They were well trained. All passed their boards. Dr. Babin was recognized as an authority on vestibular physiology.

Dr. Neal Beckford joined the staff from the Pittsburgh training program in 1985. His primary interest was head and neck oncology. He became temporary chairman in 1990 and resigned in 1993.

Dr. K. Thomas Robbins became chairman of the department in 1993. He and his wife Gayle Woodson arrived here from the University of California, San Diego. In every respect the department has expanded to an unprecedented level of accomplishment under Dr. Robbins' leadership. He developed the Radplat research protocol, and published numerous contributions to the Otolaryngology literature during his tenure here. He recruited the entire current UT faculty. In 2000, he and his wife Gale Woodson left for Florida.

Gale Woodson developed a laryngology center for the department during her tenure here. Her expertise in laryngology and voice is displayed by the large contribution she has made to the Otolaryngology literature.

Dr. Debra Gonzalez was here from 1993 to 1994. Her primary interest was oncology.

Dr. Wayne Colin was with the department for about a year and resigned in 1999. He was a well-trained oral surgeon as well as an otolaryngologist. His primary interest was oncology, microvascular flap reconstruction and the management of patients with sleep apnea.

Dr. Michael Ruckenstein joined the department in 1995. He left to join the full tine staff a the university of Pennsylvania in 1998. His primary interest was neurotology. He revised the Methodist Hospital temporal bone laboratory.

Dr. Frank Wong joined the staff in 1994. He was responsible for the didactic lecture series and grand rounds. He held 85 sessions in the past 2 years. Additional responsibilities included a monthly journal club, consultations and supervision of resident operative cases. He resigned in 1999 to return to private practice in Canada. His understanding of head and neck oncology and operative techniques were outstanding.