Outgoing ALA President Forecasts Bright Future

PHOENIX-Laryngology is enjoying a resurgence in the world of endoscopy and the future of the field is promising, outgoing American Laryngological Association (ALA) President Roger L. Crumley, MD, MBA, said in his presidential address at the 130th annual meeting of the association, an address that touched on the discipline’s past as well as challenges it is facing.

Our endoscopic future is, in my view, evolving and growing before our eyes, and it is as bright as the brilliant light sources in these new scopes, Dr. Crumley said. Indeed, our specialty is once again assuming its proper leadership role in these venues.

Even as laryngology is improving its ability to attract new doctors interested in endoscopy, though, Dr. Crumley called on the association members to help improve the bottom line of the organization in unveiling a Sustainers’ Fund capital campaign.

Dr. Crumley’s lecture came just before his tenure ended and the reins were passed on to new President Marvin Fried, MD.

Laryngology’s Role in Endoscopy

Dr. Crumley traced the arc of laryngology’s role in the realm of endoscopy, which has gone from a prominent role, to a less prominent one, to a role he said is now on the rebound.

I find it very interesting to think of the hard-core otolaryngic time when we owned esophagology and bronchoscopy-in the era when otolaryngology clearly dominated airway endoscopy, he said. And even later, when I trained in the early ’70s, otolaryngology did virtually all the bronchoscopies and esophagoscopies in many, if not most, university centers in those days. However, our colleagues in the pulmonary and gastrointestinal subspecialties of internal medicine were astute and keen to perform endoscopy.

The role began to wane from the late 1970s through the early 1990s, he said.

Esophagoscopy evolved in some centers to be more frequently performed by non-otolaryngic physicians, Dr. Crumley said. In fact, by approximately 1990, it was noted that there were some ENT residents who would sit for their board exams who finished their residency training with very few, or no, bronchoscopies or esophagoscopies.

The times are changing, he said.

Maybe, as some have asserted, we as laryngologists were asleep at the switch, but the good news is that that has changed and continues to change. In the past year, for example, I have spoken with many younger otolaryngologists and laryngologists, all of whom devote a rather large percentage of their time to doing many transnasal esophagoscopies, TNE bronchoscopies, percutaneous gastroscopy, and some truly gastric procedures through today’s advanced endoscopes.