Otolaryngology & Head and Neck Surgery

History of Tonsillectomy

2007-09-30T11:32:00.000+05:30

1000 BC: Tonsillectomy was first described in India.

50 AD: First primitive scalpel was used by Celsus to remove tonsil tissue.

625: The earliest description of the procedure was by Paul of Aegina.

Mid-eighteenth century: Caque of Rheims perform tonsillectomies on a regular basis.

Phillip Syng invented what would become the forerunner for the modern tonsillotome.

McKenzie further developed it turned it into the modern day tonsil guillotine.

1867: The early version of adenoidectomy involved using a ring forceps through the nasal cavity to remove adenoid tissue by William Meyer.

Dr. Pachan described electric cautery use for tonsillectomy.

Last twenty years: Newer techniques gain popularity: bipolar electrocautery, use of the microscope, lasers, ultrasonic scalpel, and most recently, high frequency ablation of tonsillar tissue.

History of Septoplasty

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3500 BC: The Ebers Papyrus, which contains the first known mention of rhinologic surgery, was written around this time in Egypt. Most of the procedures depicted in it were reconstructive because rhinectomy was a frequent form of punishment.

1757: Quelmatz was one of the earliest physicians to address septal deformities. His recommendation included daily digital pressure on the septum.

1875: Adams recommended fracturing and splinting of the septum.
Late 19th century: The most common operation in the United States was the Bosworth operation to correct nasal obstruction from nasal septal deviation. Using a specialized saw, the deviation was removed along with the corresponding mucosa. Results were suboptimal.
1882: Ingals introduced en bloc resection of small sections of septal cartilage. Because of this innovation, he is credited as the father of modern septal surgery. Around the same time, cocaine was becoming widely used in surgery. With its advent, anesthesia and hemostasis for nasal surgery improved significantly. Longer and more technically refined operations became feasible.
1899: Asch was the first to suggest altering the tensile curve of septal cartilage instead of resecting it. He proposed the use of full-thickness cruciate incisions.

1902 and 1904: Freer and Killian described the submucous resection (SMR) operation. This procedure is the foundation of modern septoplasty techniques. They advocated raising mucoperichondrial flaps and resecting the cartilaginous and bony septum (including the vomer and perpendicular plate of the ethmoid), leaving 1 cm dorsally and 1 cm caudally to maintain support.

1929: Metzenbaum and Peer were the first to manipulate the caudal septum, using a variety of techniques. The classic SMR was less effective in correcting this area of deviation. In addition, Metzenbaum advocated the use of the swinging door technique, and in 1937, Peer recommended removing the caudal septum, straightening it, and then replacing it in the midline position.

1947: Cottle introduced the hemitransfixion incision and the practice of conservative septal resections. Long-term follow-up studies of patients who had undergone SMR occasionally revealed dorsal saddling, retraction of the columnella, and alar widening; therefore, conservative resections during septoplasty were designed to avoid these complications.

History of Tracheostomy

2007-09-29T21:50:00.000+05:30

Tracheotomy is one of the oldest surgical procedures, which was dreaded with complications until 19th century.

The Ancient Period

The first and longest period (covering roughly 3,000 years from 1500 BC to 1500 AD)

2000 BC: The Rigveda described a healed tracheostomy incision.
Old Testament: Elijah performed mouth-to-mouth resuscitation on a child with heat stroke. This was the first example of assisted respiration.
100 BC: Asclepiades described a tracheostomy incision for improving the airway.
Approximately 400 BC: Hippocrates condemned tracheostomy, citing threat to carotid arteries.
Approximately 50 AD: Aretaeus of Cappadocia warned against the performance of tracheostomy for infectious obstruction because of the risk of secondary wound infections.
Approximately 100 AD: Antyllus described the first familiar tracheostomy as a horizontal incision between 2 tracheal rings to bypass upper airway obstruction. He also pointed out that tracheostomy would not ameliorate distal airway disease (eg, bronchitis).
131 AD: Galen elucidated laryngeal and tracheal anatomy. He was the first to localize voice production to the larynx and to define laryngeal innervation. Additionally, he described the supralaryngeal contribution to respiration (eg, warming, humidifying, filtering).
400 AD: The Talmud advocated longitudinal incision.
Approximately 400 AD: Caelius Aurelianus derided tracheostomy as a "senseless, frivolous, and even criminal invention of Asclepiades."
600 AD: The Susruta Samhita contained routine acknowledgment of tracheostomy as accepted therapy in India.
Approximately 600 AD: Dante pronounced tracheostomy "a suitable punishment for a sinner in the depths of the Inferno."

The Period Of Acceptance

1546: Brasavola published an account of tracheostomy for tonsillar obstruction. He was the first person known to actually perform the operation.
1561-1636: Sanctorius was the first to use a trocar and cannula. He left the cannula in place for 3 days.
1550-1624: Habicot performed a series of 4 tracheostomies for obstructing foreign bodies.
1702-1743: George Martine developed the inner cannula.
1718: Lorenz Heister coined the term tracheotomy, which was previously known as laryngotomy or bronchotomy.
1805: Viq d'Azur described cricothyrotomy.
1833: Trousseau reported 200 patients with diphtheria treated with tracheostomy.
1921: Chevalier Jackson codified indications and techniques for modern tracheostomy and warned of complications of high tracheostomy (cricothyrotomy).
1932: Wilson advocated prophylactic tracheostomy in patients with poliomyelitis.

The Period Of Rationalization

Present era starting in 1965
1965: the use of intubation and respiratory support for neonatal patients was described by McDonald and Stocks.