Chapter 10: MD Anderson Head & Neck Surgery Advances with Dental Oncology, Plastic Surgery and Neurosurgery

Title

Chapter 10: MD Anderson Head & Neck Surgery Advances with Dental Oncology, Plastic Surgery and Neurosurgery

Files

Description

Dr. Byers talks about the role of dental oncology under Dr. Joe B. Drane, Head of UT Dental Branch/Dental Oncology, and the work done by Drs. James (Jim) C. Lemon and Jack W. Martin in managing dental problems with radiotherapy patients and fabrication of dental prostheses (ears, noses, dentures, swallowing apparatus). He then discusses the “free flap” plastic surgical method, and ENT/plastic surgery doctors Stephen S. Kroll, Mark A. Schusterman, Geoffrey L. Robb and David L. Larson who performed the surgery. Finally he mentions the role of neurosurgery, praises Neurosurgical Drs. Milam Leavens and Ray Sawaya, and finally discusses the Head & Neck department’s prominence in terms of MD Anderson case admission volume.

Identifier

ByersR_01_2019014_C10

Publication Date

10-14-2019

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Univeristy of Texas MD Anderson Cancer Center - Institutional Change; Devices, Drugs, Procedures; Multi-disciplinary Approaches; Growth and/or Change; Funny Stories; Giving Recognition

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History | Surgery

Transcript

Charles Balch, MD

That’s important history.

Robert Byers, MD

Thank God.

Charles Balch, MD

Let me go back to some of the other origins. One of the things as you did complicated head and neck patients was having dental oncology. What was their value or their role as you saw that in the management of head and neck patients? Because there’s not very many places that have a—

Charles Balch, MD

Drane was the head of that when I came, Joe Drane. Wonderful man. And then they had several of his assistants that we got very close with. But basically they were people who helped us manage the dental problems with the radiotherapy patients. What they did with prosthodontics. They would help with the—

[Redacted]

But anyway, so they hired people to do the—Jim Lemon and Dick Martin. They did what you call dental prostheses you’d say. And they made ears and made noses and made dentures with things that they would help with the swallowing, palate. So I would say what changed significantly was the coming of Geoff Robb and Mark Schusterman and there was a David Larson that was on the staff as a plastic surgeon and ENT both. He had double boards. And then there was another one who did the free flap beginnings. A guy from somewhere, I don’t know where he came from. But he was the guru [Redacted] And then it wasn’t long—

Charles Balch, MD

Mark Schusterman was first from Pittsburgh.

Robert Byers, MD

Wasn’t long before Schusterman, Steve Kroll.

Charles Balch, MD

Steve Kroll, yes.

Robert Byers, MD

Steve Kroll was doing that stuff.

Charles Balch, MD

He was an ENT doc.

Robert Byers, MD

ENT and plastic combo, yeah. So that’s what changed us in terms of doing a lot of the flaps and the reconstruction, and like Oscar used to say, head and neck patients don’t change places, they just change faces.

Charles Balch, MD

What about Marga Sinclair? What was her role in the early days?

Robert Byers, MD

Marga was a very low—is it getting time?

Charles Balch, MD

That’s OK.

Robert Byers, MD

Was a low player in this. She was not that aggressive.

Charles Balch, MD

She was part-time.

Robert Byers, MD

Yeah. I would say she’s not—

Charles Balch, MD

Didn’t have really a major role in major reconstruction of the head and neck.

Robert Byers, MD

No.

Charles Balch, MD

So it really started when the Head and Neck Department was formed and Dr. Larson—

Robert Byers, MD

Larson was the first joint-boarded person, ENT and plastic.

Charles Balch, MD

And Steve Kroll.

Robert Byers, MD

And Steve Kroll, he was in actually the section of plastic surgery, they became.

Charles Balch, MD

And also in the Head and Neck Department was the first neurosurgery with Milam Leavens.

Robert Byers, MD

Yeah, with Milam Leavens. Was outstanding. You think of neurosurgeons as egotistical you-know-what. He was just the opposite.

Charles Balch, MD

He was a real gentleman.

Robert Byers, MD

And so good to work with. Then they had others that came. Ray Sawaya became world-famous in that.

Charles Balch, MD

I think historically before that time in the ’80s the Head and Neck Department did all the head and neck areas, did a lot of the thyroid, did the reconstruction, did the neurosurgery, and coordinated the multidisciplinary care of the head and neck cancer patient, and it was one of the leading places in the world, still is.

Robert Byers, MD

I hate to say this to you as a general surgeon, but it was the flagship of MD Anderson for many years.

Charles Balch, MD

Actually I have the data. From when Lee Clark first started all the way up to where there were records, almost half of the admissions and the clinical activity of MD Anderson were either head and neck or gynecology. And so you were the flagship. I certainly agree both in terms of excellence and volume.

Robert Byers, MD

It may be pejorative but in my mind I think it—

Charles Balch, MD

Let me ask you because you practiced in the ’70s. Tell me about anesthesia in the ’70s when you’re doing these complex cancer patients and how you managed to get them through with anesthesia, which was still in its infancy then.

Robert Byers, MD

It was a struggle for them because many of our patients had airway problems based on their cancer, and so many of those patients, we had to intubate them ourselves, they couldn’t do it. To be honest, we had to. And many of them had to be trached.

Charles Balch, MD

I remember when I came there were a few MD anesthesiologists, but many of them were nurse anesthetists.

Chapter 10: MD Anderson Head & Neck Surgery Advances with Dental Oncology, Plastic Surgery and Neurosurgery

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