This House of Noble Deeds: The Mount Sinai Hospital, 1852-2002

25 Department of Otolaryngology

25 Department of Otolaryngology STORIES AND ANECDOTES about the Great Blizzard of 1888 abound, and, like most hospitals in New York, Mount Sinai did not go untouched by the storm. Ironically, the blizzard provided an opportunity for an important Mount Sinai first: the first performance in America of a complete mastoidectomy, by Emil Gruening. As a result of the high incidence of influenza caused by the storm, a large number of patients with the complication of mastoiditis appeared at the Hospital. In fact, in the three years following the blizzard, more operations on the mastoid were performed at Mount Sinai than during any other previous triennial period. It was during this time that Emil Gruening perfected his technique , which included cleaning out the entire mastoid cavity and establishing a communication with the middle ear.1,2 Earlier, incomplete procedures had led to continued drainage and the always present threat of cerebral complications. Word of Gruening’s improved results became known, and physicians from outside the Hospital would frequently come to Mount Sinai to watch Gruening perform his operation.3 An 1862 émigré from East Prussia, Gruening served as a private in the Union Army before attending medical school in New York. In 1879, he established the Ear and Eye Service at Mount Sinai. At this point in history, otology was still in its infancy, and operations on the ear were limited. Gruening later opened the Eye and Ear Clinic for outpatients in 1884, and in 1890 he organized the Ear, Nose, and Throat Clinic. When the Hospital moved from Lexington Avenue to Fifth Avenue in 1904, the Service was assigned eighteen beds. In 1906, Gruening was elected President of the American Otological Society. In the words of Arpad Gerster, Gruening was “a well-knit man of small stature, and had a fine cut profile.”4 Others recalled his long beard, which in the early days before asepsis would occasionally touch a patient’s wound during surgery . All those who remembered him agreed upon his remarkable capabilities in surgery; his hands, though large, were noted as having great lightness and deftness. According to Gerster, Gruening was able 276 to raise the field of otology “from the slough of inefficiency in which he found it.”5 In 1910, with the separation of Otology from Ophthalmology, Mount Sinai established the first independent Otology Service in any New York hospital, and Frederick Whiting was appointed Mount Sinai’s first Attending Otologist and Director of Otology. Whiting had previously published the first book on ear surgery written in English, in 1905.6 During his time as Director, Whiting introduced newly developed procedures to manage chronic ear suppuration with cholesteatoma. He was also Mount Sinai’s first surgeon to perform resection of the jugular vein for sigmoid sinus thrombosis and bulbar DEPARTMENT OF OTOLARYNGOLOGY 277 A sketch by Arpad Gerster, M.D., Chief of the Surgical Service, showing Emil Gruening, M.D., performing a mastoidectomy. Gruening was perhaps the first to do a mastoidectomy in this country. The man on the left with his back to the viewer is Abraham Jacobi, M.D., “Father of Pediatrics in America” and Mount Sinai’s first pediatrician. thrombosis and operated for abscesses located in the sphenoid portion of the temporal bone. By the time of his retirement, in 1921, Whiting had both witnessed and contributed to the birth of modern otology. Upon Whiting’s retirement, Isidore Friesner, who had come to Mount Sinai in 1920, was appointed Director of Otology. Friesner had earlier written the first book in English on the inner ear.7 He established Mount Sinai’s first residency program in otology in 1923, a move that would yield enormous benefits in the years to come. Among the early residents were men who would later make important contributions to the field, including Samuel Rosen, Irving Goldman, Harry Rosenwasser , and Joseph Goldman. During the 1920s, research in otology at Mount Sinai focused on sinus thrombosis,8 pathology of the labyrinth, the pathways of intracranial infection from the mastoid,9 and tests for the early diagnosis of pontine angle tumors. Friesner established a histopathology laboratory in conjunction with Otology, and, in 1928, Joseph G. Druss established the Otopathology Laboratory. Originally located in a corner of the Pathology Museum in the basement, this laboratory eventually became part of the Eye and Ear Laboratory in the Laboratory Annex and contained one of the largest collections...