In 1896, Dr. Hal Foster – an otolaryngologist in Kansas City, Missouri – called the first meeting of what would later become the American Academy of Otolaryngology-Head and Neck Surgery. He sent out more than 500 invitations to ophthalmologists and otolaryngologists practicing in the southern and western states with the hope of creating a medical society in the region. A small number of doctors responded to Dr. Foster’s call and helped to form the Western Ophthalmological, Otological, Laryngological and Rhinological Association. During the first few years that the new association met, the foundations for the organization were laid. Officers were elected, a constitution and bylaws were written, and committees were instituted. In 1898, the association became known as the Western Ophthalmologic and Oto-Laryngologic Association. By 1901, however, the group realized that its members were drawn from all over the country, not just the west. So in 1903, the organization became the American Academy of Ophthalmology and Oto-Laryngology. By then, the membership had reached 185. Just four years later, at 434 members, the Academy was the largest specialty society in the United States.
Early in its history, the Academy took upon itself the task of improving graduate education. In 1913, the Academy organized two committees to develop plans for standardizing graduate training in ophthalmology and otolaryngology. Working with similar committees in sister societies, these committees led to the creation of the first specialty boards – ophthalmology in 1913 and otolaryngology in 1924. These boards set standards for medical specialty education. Those who wished to practice either specialty had to pass the appropriate board examinations.
The Academy further instituted the Postgraduate Course, later known as instruction courses, in 1921 to supplement the education already received at the annual meetings. Almost 600 were registered the first year. These courses were first given after the annual meeting, but by 1927 they were incorporated into the structure of the meeting itself.
In 1938, Academy secretary Harry Gradle suggested an innovative – and slightly outrageous – idea to further specialty education: the development of home study courses by the Academy. Initially designed as a ‘stop-gap’ measure to help fill the holes of specialty education, they evolved into a useful resource for continued education. The courses first began in 1940 with 485 registrants. Nine sections were included in the otolaryngology course: anatomy I and II; histology-pathology; physiology; bacteriology; biochemistry; otolaryngologic examination; hearing tests; and vestibular tests.
The Academy continued to develop educational resources for its members. It began to publish monographs, guides, and other materials in earnest soon after 1940, as supplements to the home study courses. Self-instructional packages, or SIPacs, were introduced in 1976. Each SIPac contains a review of one otolaryngology-related topic.
The Importance of Research
The Academy’s Research Fund began in 1921 with $27,000 in WWI Liberty Bonds. Yearly, a small portion of each member’s dues was marked for the fund, providing it with resources for steady growth. Research grants were given to a variety of projects and recipients frequently gave scientific papers at the annual meeting. In 1950, however, the purpose of the fund gained a more educational nature, and was so renamed. The Educational Fund was used to award research already completed. In addition, selected research reports were published in the Academy’s Transactions. A decade later, the fund was reestablished as the Educational Trust Fund and was used to support fellowships in pathology and yearly research awards.
The commitment to research continued with the AAO-HNS. A series of awards have been established to foster research in a variety of areas. In addition, the Academy successfully lobbied for the creation of a National Institute for Deafness and Other Communication Disorders within the National Institutes of Health in 1988.
Advocacy for Otolaryngology
The advocacy arm of the Academy began with the establishment of committees in 1924 to work on issues such as hearing tests, trachoma eradication, and legislation requiring lye to carry a poison label. These efforts remained a key part of Academy activities.
Academy advocacy efforts significantly expanded during the late twentieth century. In 1981, the American Council of Otolaryngology merged with the American Academy of Otolaryngology, an event which led to many of the Academy’s current advocacy programs. The Council, formed in 1968, provided national representation for otolaryngology, which was particularly significant for the specialty’s relationships with other medical organizations and the federal government.
This advocacy role continued after 1981 through the programs of the Academy. Issues that have developed along with managed care, including physician reimbursement, remain at the fore of the Academy’s advocacy efforts. State and local advocacy was accomplished largely through the Board of Governors, which first met in 1982. In 1984, the Academy began holding a yearly Legislative Briefing Day to get more members involved in advocacy.
Ophthalmology and Otolaryngology Separate
With a large membership and the consequent problems of finding appropriate facilities for the yearly annual meeting, the issue of splitting the Academy came to the fore. In 1962, the Triological Society passed a motion calling for a separate Academy of Otolaryngology. However, it wasn’t until the early 1970s that separate continuing education offices, separate finances, separate publications, and separate files were established.
The Academy focused a considerable amount of time and effort into carefully examining the pros and cons of dividing. In 1974, the Academy members adopted a resolution for “internal restructuring of the Academy into two separate operating divisions.” Then-president John J. Conley referred to this division as a ‘trial experience’ that would help the membership to determine if a complete separation was desirable. In 1978, a year after the Academy incorporated, the membership voted to dissolve the AAOO and create an American Academy of Otolaryngology and an American Academy of Ophthalmology. In 1979, the AAOO was officially dissolved.
Otolaryngology (pronounced oh/toe/lair/in/goll/oh/jee) is the oldest medical specialty in the United States. Otolaryngologists are physicians trained in the medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck. They are commonly referred to as ENT physicians. Their special skills include diagnosing and managing diseases of the sinuses, larynx (voice box), oral cavity, and upper pharynx (mouth and throat), as well as structures of the neck and face. Otolaryngologists diagnose, treat, and manage specialty-specific disorders as well as many primary care problems in both children and adults.
What Do Otolaryngologists Treat?
Hearing loss affects one in ten North Americans. The unique domain of otolaryngologists is the treatment of ear disorders. They are trained in both the medical and surgical treatment of hearing, ear infections, balance disorders, ear noise (tinnitus), nerve pain, and facial and cranial nerve disorders. Otolaryngologists also manage congenital (birth) disorders of the outer and inner ear.
About 35 million people develop chronic sinusitis each year, making it one of the most common health complaints in America. Care of the nasal cavity and sinuses is one of the primary skills of otolaryngologists. Management of the nasal area includes allergies and sense of smell. Breathing through, and the appearance of, the nose are also part of otolaryngologists’ expertise.
Communicating (speech and singing) and eating a meal all involve this vital area. Also specific to otolaryngologists is expertise in managing diseases of the larynx (voice box) and the upper aero-digestive tract or esophagus, including voice and swallowing disorders.
The Head and Neck
This center of the body includes the important nerves that control sight, smell, hearing, and the face. In the head and neck area, otolaryngologists are trained to treat infectious diseases, both benign and malignant (cancerous) tumors, facial trauma, and deformities of the face. They perform both cosmetic plastic and reconstructive surgery.
Training & Patient Care
Otolaryngologists are ready to start practicing after completing up to 15 years of college and post-graduate training. To qualify for certification by the American Board of Otolaryngology, an applicant must first complete college, medical school (usually four years), and at least five years of specialty training. Next, the physician must pass the American Board of Otolaryngology examination. In addition, some otolaryngologists pursue a one- or two- year fellowship for more extensive training in one of seven subspecialty areas. These subspeciality areas are pediatric otolaryngology (children), otology/neurotology (ears, balance, and tinnitus), allergy, facial plastic and reconstructive surgery, head and neck, laryngology (throat), and rhinology (nose). Some otolaryngologists limit their practices to one of these seven areas.
Areas of Specialty Expertise
Diseases of the ear, including trauma (injury), cancer, and nerve pathway disorders, which affect hearing and balance. Examples: ear infection; swimmer’s ear; hearing loss; ear, face, or neck pain; dizziness, ringing in the ears (tinnitus).
Diseases in children with special ENT problems including birth defects in the head and neck and developmental delays. Examples: ear infection (otitis media), tonsil and adenoid infection, airway problems, Down’s syndrome, asthma and allergy/sinus disease.
Head and Neck
Cancerous and noncancerous tumors in the head and neck, including the thyroid and parathyroid. Examples: lump in the neck or thyroid, cancer of the voice box.
Facial Plastic and Reconstructive Surgery
Cosmetic, functional, and reconstructive surgical treatment of abnormalities of the face and neck. Examples: deviated septum, rhinoplasty (nose), face lift, cleft palate, drooping eyelids, hair loss.
Disorders of the nose and sinuses. Examples: sinus disorder, nose bleed, stuffy nose, loss of smell.
Disorders of the throat, including voice and swallowing problems. Examples: sore throat, hoarseness, swallowing disorder, gastroesophageal reflux disease (GERD).
Treatment by medication, immunotherapy (allergy shots) and/or avoidance of pollen, dust, mold, food, and other sensitivities that affect the ear, nose, and throat. Examples: hay fever, seasonal and perennial rhinitis, chronic sinusitis, laryngitis, sore throat, otitis media, dizziness.
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