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July 2005

Head and Neck Surgery in Crisis: Preparing for the Future

Arch Otolaryngol Head Neck Surg. 2005;131(7):556-560. doi:10.1001/archotol.131.7.556

The origin of head and neck surgery can be traced back to Sushruta Samhita, when a glabellar flap was described by Sushruta for reconstruction of the nose.1 Not much has been described in history over the subsequent several centuries until a systematic description of the importance of cervical lymph nodes in head and neck cancer was reported by Maximilian von Chelius2 in 1847. Similarly, Warren3 recommended excision of cervical lymph nodes in the submandibular triangle for tongue cancer to improve the curability of that cancer. The American laryngologist Jacob Da Silva Solis-Cohen4 described the first curative partial laryngectomy for malignant disease in 1869 in Philadelphia, and the first total laryngectomy was reported by Theodore Billroth5 from Vienna in 1874. Theodore Kocher was the first surgeon ever to have received a Nobel Prize for his immense experience in thyroid surgery in 1909.6 The first textbook on head and neck surgery was written by Levi Cooper Lane7 in 1898. In his monograph on tongue cancer, the great British surgeon Sir Henry T. Butlin8 described the lymphatics of the tongue and recommended removal of lymph nodes in the supraomohyoid triangle. However, systematic dissection of cervical lymph nodes was first reported by George Crile9 in 1905 based on his personal experiences operating on more than 105 patients. The operation was well-conceived and proposed a systematic block dissection of regional cervical lymphatics in the lateral neck.

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