A "royal" total laryngectomy that never was.

With this historical vignette, ending the series dedicated to the pioneers of total laryngectomy, published in the EuropeanAnnals of Otorhinolaryngology Head & Neck Diseases to mark the 150th anniversary of the first description of this surgical procedure in humans, the authors recount what history called "The Crown Prince's illness", and wonder what might have happened if the total laryngectomy proposed for Crown Prince Friedrich had finally been performed.

Probable fatal mastoiditis by the around 2300 year old Heidelberg's Egyptian mummy Djed-Hor.

The universal use of computed tomography (CT) has opened up new possibilities in the noninvasive examination of human mummies, and particularly the detailed study of the fine structures of the temporal bone. The aim of this study was to describe the morphological changes, as seen on CT, found in the right temporal bone of Djed-Hor, an around 2300 year old Heidelberg's Egyptian mummy, and to discuss their possible causal relation to his death. Here we showed the presence of a compress on the auricle, and of probable pus in the mastoid, middle ear, and external ear with erosion of the tegmen tympani probably related to a fatal acute mastoiditis. These typical morphological changes of such a disease were demonstrated in the same way as in living patients of today. This would be the first depiction of a compress on an auricle associated with pus in the ear of an Egyptian mummy.

1885: First total laryngectomy and artificial larynx in France.

This year, 2023, is the 150th anniversary of the first total laryngectomy for cancer, by Theodor Billroth. The authors reconstruct the conditions under which, on March 12, 1885, this operation was then performed for the first time in France, by Leon Labbé, and present the man himself, and also M. Cadier, the inventive genius who designed the first artificial larynx used in this country.

Carl Gussenbauer and the first artificial larynx after total laryngectomy.

The aim of this historical vignette is to delve into the description and use of the first artificial larynx, developed by Carl Gussenbauer, and used after Theodor Billroth's first total laryngectomy, performed on December 31, 1873.

Friedrich Trendelenburg's tracheal tampon-cannula.

The aim of this historical vignette is to analyze the role of Friedrich Trendelenburg's tracheal balloon cannula in the development of laryngeal surgery in the early 1870s. The purpose of this cannula was to prevent bleeding into the airway in cases of extensive laryngeal surgery requiring a tracheostomy.

Themistocles Gluck and the premises of modern total laryngectomy.

The aim of this historical vignette is to recall the importance of the German surgeon Themistocles Gluck in the development of total laryngectomy with primary closure of the pharyngeal orifice, a technique proposed a few years after Theodor Billroth's first total laryngectomy in 1873.

Total laryngectomy for laryngeal cancer 150 years after its first description: A boon more than a calamity: A STROBE analysis.

OBJECTIVE: To illustrate the boon rather than a calamity that total laryngectomy can be for a patient with laryngeal cancer in the 21st century. MATERIAL AND METHOD: An observational retrospective analysis using the STROBE guideline compared two cohorts of patients with previously untreated cancer, managed by total laryngectomy: the first consisting of 123 patients collected by Morell Mackenzie during the fifteen years (1873-1887) following the initial description, and the second consisting of 53 patients consecutively treated in a French university otorhinolaryngology department during the fifteen years (2006-2020) preceding the 150th anniversary of the first performance. The main endpoint was the comparison of survival and locoregional control estimates (Kaplan-Meier life table method). Secondary endpoints comprised mortality estimates and causes, adjuvant treatments, and phonation modalities. RESULTS: The 26.2%, 13.1%, and 13.1% 1-, 3-, and 5-year actuarial survival estimates in the Makenzie cohort increased to 88.6%, 68.4%, and 60.9% in the recent French cohort (P<0.0001). The 50.1%, 40.4%, and 34.7% 1-, 3-, and 5-year actuarial locoregional control estimates in the Mackenzie cohort increased to 83.7% (P<0.0001). The 77.7% overall mortality in the Mackenzie cohort decreased to 37.7% (P<.0001). In the Mackenzie cohort, 97.8% of deaths were related to postoperative complications and locoregional recurrence, compared to 50% in the recent French cohort. Distant metastasis, metachronous second primary tumor and intercurrent diseases, not mentioned in the Mackenzie cohort, generated 45% of deaths in the French cohort. Adjunctive treatment was not used in the Mackenzie cohort, whereas neck dissection and postoperative radiation therapy were associated in respectively 98.1% and 69.8% of cases in the French cohort. Phonation was not documented in the Mackenzie cohort; 50% of survivors in the French cohort used a phonatory implant. CONCLUSIONS: The 20th century witnessed an incredible turn-around. Total laryngectomy, with limited indications, has transformed the etiology of deaths and no longer leaves patients "in a state of abject misery" as Morell Mackenzie put it in 1888.

150 years ago: First complete removal of the larynx by Theodor Billroth.

This historical vignette celebrates the first total removal of the larynx in humans, performed by Theodor Billroth 150 years ago and stresses the importance of the prior experimental study of laryngeal ablation performed in dogs by Vincent Czerny. A part of the original article, written by his assistant Carl Gussenbauer, is reproduced, to help readers immerse themselves in this operation which opened up new perspectives in the treatment of laryngeal cancer.

Politzer's test - but which one? A plea for standardisation of terms in otology.

BACKGROUND: Politzer's tuning fork test is a little-known special examination with a chequered history. OBJECTIVE: This paper gives Politzer's original description, and explains how he intended it to be used. METHODS: The historiographical research in this study is based on primary references. Secondary documentation is only cited when it is necessary to substantiate any historical argument. RESULTS AND CONCLUSION: After the apparent disappearance of Politzer's tuning fork test from the otological scene in the 1950s, its consequent resurrection was not what it seemed. This story underlines the need for a standardisation of otological nomenclature, particularly when eponyms are used.

Polluting and harassing "otorhinolaryngological" emails: Has the time arrived to talk openly about it?

Over the last few years, unwanted emails daily fill the mailboxes of many scientists. Usually, they ask the recipient to send a paying article to a journal, generally with a deadline of two weeks. Now the time is coming to openly discuss and mention such kinds of demand and to name the journals behind them. The aim of this paper is thus to present, using some selected examples collected during five days (14-19 October, 2021), the dangers of responding to such a request and to specify the names of the journals concerned. Three otorhinolaryngological journals are particularly discussed: Journal of Otology and Rhinology, American Journal of Otolaryngology Head and Neck Surgery, and Global Journal of Otolaryngology. In selecting some pertinent papers, it is easy to demonstrate that these three journals can easily be considered as predatory journals. Certainly, many other predatory, otorhinolaryngological journals exist. Hopefully, this paper will finally open a serious and scientific discussion about these predatory otorhinolaryngological journals, to definitively establish an available and valid list.

Simultaneous enucleation of the tonsils in "Pickwickian patients".

Tonsillar surgery was, from the 19th century, the reference treatment for apneic patients. Adapting to the technical limitations of the time, surgeons devised ingenious procedures. The purpose of this historical note is to travel back to that time and rediscover one of the techniques favored by Chassaignac: "simultaneous enucleation" of the tonsils.

Ephemeral history of the three-bladed tracheostomy dilator.

Tracheostomy remains a topical surgical procedure. The history of tracheostomy is marked by the development of various instruments, including the three-bladed tracheostomy dilator from the middle of the 19th century. The purpose of this historical note is to recall the use of this unusual instrument.

Nose like the foot of a pot.

Saddle nose is defined as a depression of the nasal dorsum, regardless of its dimensions or the anatomical structures involved. The purpose of this historical note is to discuss the term "nose like the foot of a pot (nez en pied de marmite)" used to describe this deformity in France between the 17th and 19th centuries and to recall its link with syphilis in the light of the texts of the time.

Sponges, apples or almonds in the isthmus of the throat.

Removal of the tonsils is one of the most commonly performed surgical procedures in children. The purpose of this historical note is to analyse the first description of this surgery, understand the first terms used to name the tonsil, and describe the first instruments used to perform this surgery.

Throat cancer surgery training in France.

This article reviews the development of practical and theoretical teaching of surgical management of throat cancer, from the dialectic of the Middle Ages to computer simulation of the 21st century. This work is essentially based on original historical publications, analysed from secondary references relevant to the interpretation of the original texts. The literature search was essentially conducted in the "bibliothèque universitaire de médecine de Tours", the "bibliothèque inter-universitaire de médecine de Paris", the "Assistance publique-Hôpitaux de Paris archives" and the "bibliothèque nationale de France". PubMed was used for the most recent references. The search terms focused on surgical training, the history of otorhinolaryngology and throat cancer. Up until the 19th century, throat cancer surgery training was provided by general surgeons. The otorhinolaryngology specialty was created at the turn of the 20th century: throat cancer surgery became a subspecialty, but certain university obstacles prevented the creation of formal throat cancer surgery training. In the 20th and 21st century, throat cancer surgery training was enhanced by technical innovations as well as ethical imperatives. The principle of mentoring, essential in surgical training, has remained a constant feature throughout the ages, regardless of the scientific progress described in this historical review.

The billy goat and the goatee of the ear.

The term tragus is used to describe the small, flat, triangular cartilaginous prominence situated anteriorly to the entrance of the external auditory canal. The purpose of this historical note is to study the etymology of the term tragus, meaning billy goat, and to analyse the process that led to its current anatomical definition and the various interpretations of this term in the medical literature.