Would Dr. Ogura approve of endoscopic resection of esthesioneuroblastomas? An analysis of endoscopic resection data versus that of craniofacial resection.

President Pillsbury, Triologic members, and guests. It is a great honor to present the Ogura Lecture and provide for you a perspective on the treatment of esthesioneuroblastomas. I would like to begin by sharing with you some of the significant accomplishments of Dr. Ogura. I hope to convey in the brief time allotted, to those unaware of his place in our specialty’s history, the significant impact that he had upon the field of head and neck surgery, in particular the evolution of partial laryngeal surgery for laryngeal cancer. Some of our more senior members have trained with him; others like myself, have had a brief encounter with him. All otolaryngologist-head and neck surgeons have been impacted by his contributions that changed the surgical approach to cancer of the larynx. This great surgeon and educator, though small in stature, was very intimidating as he peered over his half glasses that consistently were perched at the end of his nose with his unlit pipe expertly balanced from his right oral commissure (Fig. 1). This was especially true when he was an oral American Board of Otolaryngology examiner. My introduction to him was by my chairman, Dr. John Kirchner, at this meeting held in Bermuda in 1977. Dr. Ogura was a clinical innovator and prolific author regarding the treatment of head and neck cancer (Fig. 2). He developed many of the principles of conservation surgery of the larynx, and his vast experience was recognized internationally as the head and neck surgeon to seek if you were afflicted with squamous cell carcinoma of the laryngopharynx. During the sixteen years he was the chairman of Otolaryngology at Washington University in St. Louis, he authored over 300 publications and trained many outstanding otolaryngologists who went on to have stellar careers of their own. The reverence and esteem shown by his trainees for him reflected the commitment and endless energy that he always exhibited in his pursuit of academic and clinical excellence. His personal commitment to his patients was legendary, with many tales still being shared 25 years following his death. He, to this day, remains one of the very few in our specialty who were granted all three American Laryngological Awards, The Casselberry Award, The James Newcombe Award, and The De Roaldes Gold Medal Award. His list of additional accolades is far too great to share at this time. His greatest legacy was his indefatigable zeal to learn the truth and provide the best possible patient care based upon expert, exhaustive clinical science. He demanded this level of excellence from himself and from all with whom he interacted and trained. Sixty years ago, it was almost considered heresy to suggest doing anything less than a total laryngectomy for advanced carcinoma of the larynx. Dr. Ogura, using acquired information on the growth patterns of cancer within the larynx, persisted and proved that one could obtain cure rates equal to or better than those following total laryngectomy by using conservation surgical techniques. That stated, he would always consider performing a total laryngectomy when mandated by the clinical circumstances. What he did was to perform a procedure, document the course of the patient through careful observations, and collect the data. In this sense, he was the pure clinical scientist allowing the data to speak for itself. It is with this brief background that I wish to share with you some From the Department of Otolaryngology–Head and Neck Surgery, University of Virginia Health System, Charlottesville, VA, U.S.A. Editor’s Note: This Manuscript was accepted for publication August 8, 2008. Paper presented at The Triological Society 111 Annual Meeting, Orlando, Florida, USA, Thursday, May 1, 2008. Send correspondence to Paul A. Levine, MD, University of Virginia Health System, Department of Otolaryngology–Head and Neck Surgery, P.O. Box 800713, Charlottesville, VA 22908. E-mail: pal@virginia.edu