Department History

Department of Otolaryngology-Head and Neck Surgery established in 1933

The University of Southern California (USC) was founded in 1879. When it opened its doors to 53 students and 10 teachers in 1880, Los Angeles still lacked paved streets, electric lights, telephones and a reliable fire alarm system. Today, USC is home to more than 44,000 students and over 4,800 full-time faculty, and is located in the heart of one of the biggest metropolitan areas in the world.

Quoted from the 1909 USC Yearbook1:

Los Angeles is the metropolis of Southern California. Its population of about 300,000 represents almost every State in the Union and many foreign lands. The climate throughout the year is such that tourists from every quarter come to spend a part of the year, and many return to make this their permanent home. It is the greatest railroad center on the Pacific Coast. Four transcontinental lines are now complete. A network of electric roads connects the city with the numerous beaches, mountain resorts, and outlying towns. These are reached by delightful journeys through orange groves and orchards of semi-tropical fruits characteristic of the region. Los Angeles is known as the Convention City of the West. Every year brings large bodies of people here for the discussion of every kind of public interest known to science, politics, religion and the humanities. These great conventions afford the student an excellent opportunity to study the subjects of their discussion, while the resident population of the city is sufficiently large to afford import ant advantages for the study of sociology and kindred subjects. The diverse view-points of the groups of students in the nine colleges make their association an important educational factor.

The Department of Otolaryngology-Head and Neck Surgery at the Keck School of Medicine was established in 1933 and named John Mackenzie Brown, MD as the first Chair. He was originally trained as a General Practitioner and worked in a small farming community in Nebraska. However, the common occurrence of “brain fever” resulting from sinusitis and/or mastoiditis, presumably a brain abscess or meningitis, influenced him to undertake specialty training in otolaryngology. He then moved to Los Angeles in 1909 and initially held a faculty position within the College of Dentistry. At the time, a private university hospital didn’t exist and essentially all the clinical activities at the School took place at the Los Angeles County General Hospital. The faculty of the Department was comprised largely of volunteer community physicians, most whom also received their training there.

John Mackenzie Brown, MD

John Mackenzie Brown, MD

Quoted from an obituary of J. Mackenzie Brown2:

His ability and quiet unaffected manner won immediate approval. He was welcomed on the staff and as consultant in the leading hospitals where his recommendations were generally accepted as final. For many years he held a clinic on Wednesday afternoons at the Los Angeles County General Hospital for all who were interested regardless of staff appointments. For many years, he was known affectionately as the Chief or as J. M. Among the most notable of his contributions to our literature are his methods in diagnosis and treatment of infections of the frontal sinuses, the mastoids and their intracranial complications. These have become known wherever otolaryngology is practiced. He served as president of the American Laryngological, Rhinological, and Otological Society in 1941 and president of the American Academy of Ophthalmology and Otolaryngology in 1950.

In 1952, Howard P. House, MD became Chair. Dr. House had founded the Los Angeles Foundation of Otology in 1946 (later renamed the House Ear Clinic) and had developed a reputation for excellence. Dr. House perfected the wire loop technique, a procedure to correct otosclerosis. The Department’s stature grew steadily during this period as Dr. House recruited many talented and loyal volunteer faculty. During these years, most of the work done within the Department of Otolaryngology-Head & Neck Surgery was head and neck surgery and facial reconstructive surgery. Due to the increasing demands of the House Ear Clinic, Dr. House stepped down as Chair in 1961.


Howard P. House, MD

Howard P. House, MD

A ‘House’ call pays off for the Keck School of Medicine3:

One of the strangest outgrowths of the 1955 kickoff dinner for the Mudd and McKibben building campaign was a substantial gift from a first-time donor. Accounts vary, but the basic story is this: Around the time of the dinner, Ailene Bishop, an elderly woman staying at the Ambassador Hotel, called Howard House, complaining of noise in her head. She asked him to make a house call, and he agreed. After examining her, House diagnosed tinnitus. He explained the anatomy of the ear, reassured her that she wasn’t going deaf and prescribed treatments.

Sometime after the campaign kickoff she phoned again, insisting that he pay her another visit. When he arrived, she told him how pleased she had been with his care and said that she had read about the medical school’s fund drive in the Los Angeles Times. Why, she wanted to know, hadn’t he told her about the campaign? She mentioned her husband, who had died two decades earlier, and asked him how high the tallest building planned for campus would be. Ten stories, House replied off the top of his head. “How much would the building cost?” she asked. Again he answered off the cuff: $100,000 a floor. “Ten times $100,000 is $1 million,” she said, “and that will be my contribution to the USC Medical School. I want to construct the tallest building on the campus, which is to be named after my husband.”

Mrs. Bishop, an heiress of the Union Carbide Company, was as good as her word. Her family challenged the gift after her death, but the gift stood. It carried a strange stipulation, however: the building had to be completed within a year of receipt of the gift. Miraculously, everyone involved, from the Board of Trustees to the city and the contractor, cooperated, and the John Edward Bishop Medical Teaching and Research Building was completed in 1969.


The next Departmental Chair was Alden H. Miller, MD. Dr. Miller was a laryngologist and he has the dubious honor of being funded by tobacco companies to co-author a position statement with other leading otolaryngologists of the time arguing that cigarette smoking does not cause laryngeal cancer. Fortunately, it appears that this single document was the extent of Dr. Miller’s involvement with the tobacco industry.

Alden H. Miller, MD performing laryngoscopy

Alden H. Miller, MD performing laryngoscopy

From their original testimony presented at the Congressional Hearings4:

This joint statement is presented on behalf of Dr. Joseph H. Ogura, Dr. Alden H. Miller, Dr. George A. Sisson, and Dr. Harold G. Tabb.

We understand that this Committee is interested in receiving information relating to possible health problems associated with cigarette smoking. It has come to our attention that the Advisory Committee to the Surgeon General reported that cigarette smoking is a significant factor in the causation of laryngeal cancer in the male. This finding is of special interest to us as physicians whose specialty is the treatment of diseases of the larynx and related areas of the nose, mouth and throat. Each of us has devoted years of practice to the diagnosis and surgical treatment of cancer of these areas. Our total experience comprises in the neighborhood of 3000 cases of cancer of the larynx and adjacent areas. We naturally have great interest in any observations or judgments concerning the possible cause of cancer in this part of the body. However, it is our opinion that that discussion of the problem of laryngeal cancer in the Report of the Surgeon General’s Advisory Committee represents an inadequate review and evaluation of the pertinent data and that the conclusion is open to question on a number of grounds.

(Editorial note: They then go on to note many anecdotes of patients with throat cancer unrelated to smoking)

In conclusion, we would say that the attempt to assign causal significance to any one factor that appears with high frequency in case histories is not the way to make a scientific determination of the cause of a disease as complex as cancer.

During his tenure, the Los Angeles County General Hospital had become the largest, busiest hospital in the United States with an average daily census of 1,800 inpatients. Beginning in the 1960s, the medical school began to expand its mission beyond patient care and clinical research to include basic science research. Dr. Miller was a volunteer faculty and staffed the County Hospital only on Fridays. The rest of the week he was in his private clinic. This was commonplace back then. However, there were several full-time Departmental faculty based at the County Hospital including Drs. Whittaker, Simpson, Hawkins, and Keim. In 1983, Dr. Miller retired.


Dale H. Rice, MD

Dale H. Rice, MD


He was succeeded by Dale H. Rice, MD. The Department then began to hire more full-time faculty members. The research program was expanded by hiring four basic science faculty. In addition, several clinical faculty were hired to handle the increasing patient volume. Lastly, the teaching program was completely reorganized to strengthen the residency training program. Volunteer faculty from the LA area continued to help teach residents at the Los Angeles County General Hospital. This included a strong affiliation with the House Ear Clinic. Of particular note, John House, Jim Sheehy, and Derald Brackman regularly taught the fundamentals of otology to USC residents for many years. Otology fellows from the House Ear Clinic also dedicated their time in this way.


John K. Niparko, MD

John K. Niparko, MD

Quoted from an obituary of John Niparko5:

Dr. Niparko was a leading authority on cochlear implants and other implantable devices that improve hearing for the profoundly deaf and severely hard of hearing. Under his leadership, …the Keck School of Medicine at USC… garnered international reputations for excellence in cochlear implantation, post-operative training and rehabilitation, groundbreaking research, and participation in clinical trials of advanced implantable devices, such as the auditory brainstem implant…. His colleagues shared that “John was a dynamic and humble colleague and leader, whose good humor, compassion, and gentle nature earned our esteem and deep affection. We are all enriched for having known him.”

In 2000, after decades of not wanting a University Hospital, USC changed its mind an entered into an agreement with National Medical Enterprises (NME). NME built a private hospital close to the Los Angeles County General Hospital, and USC staffed it with its physicians. This was the first For-Profit hospital associated with a medical school, and it gave the clinical faculty a place to see private patients. NME eventually was renamed Tenent Healthchare. However, Tenent began having financial difficulties and in 2012, USC bought the hospital from Tenet with a gift from the Keck Foundation. The renamed Keck Hospital of USC is now a non-profit hospital owned by the University. It became the home base for the Departmental clinical and educational programs, although the County Hospital remained as the major component of the residency training program.

In 2013, John K. Niparko, MD became Departmental Chair. Dr. Niparko broadened the clinical expertise within the Department by recruiting faculty with specializations in otology, neurotology, and skull base surgery, sleep medicine and surgery, laryngology, and facial plastic and reconstructive surgery. Because of this growth, both the clinical enterprise at the Keck Hospital and faculty staffing at the LA County Hospital increased, substantially helping the residency training experience.

In addition, because of constraints that faced many non-profit institutions as donations dried up in the wake of the 2008 financial crisis, the non-profit arm of the House Ear Clinic closed. a large group of audiologists, speech language pathologists, and other support staff moved from the House Ear Institute to form the first pediatric cochlear implant program at USC. Several world-renowned research laboratories moved to USC, dramatically increasing the NIH research portfolio within the Department.

A milestone in the Department’s history was the large philanthropic gift to endow and name the USC Tina and Rick Caruso Department of Otolaryngology – Head and Neck Surgery. This exceptionally generous gift also named the Department’s affiliated treatment center for young children with severe hearing loss. This funding for the USC Caruso Family Center for Childhood Communication enabled the center to expand its leadership as the region’s top resource for testing and therapies that enable children to hear. With a daughter impacted by hearing loss at birth, the Carusos experienced first-hand the challenges of early-onset hearing loss. Inspired by their experiences, Rick and Tina Caruso sought to support the pioneering research, health care and education taking place at USC with this gift. As a result, two more research faculty could be recruited to the Department and research space could be developed to optimize productivity. In the spring of 2016, Dr. Niparko sadly passed away.


John S. Oghalai, MD

John S. Oghalai, MD


The next Chair was selected after a one-and-a-half-year nationwide search, and John S. Oghalai, MD started in August 2017. Dr. Oghalai is a clinician-scientist and moved his NIH-funded laboratory from Stanford University to USC. He specializes in otology, neurotology, and skull base surgery, and has co-authored a surgical atlas to teach these complex procedures to trainees and to clinicians around the world. He carries forward a vision and passion for improving the lives of adults and children with hearing loss. Furthermore, he is dedicated to the concept that basic science, translational, and clinical research leads to cures for disease and improves human health. This sets the vision for the coming years.


References

  1. University of Southern California. Circular of Information – Books on Google Play. (1909). Available at: https://play.google.com/store/books/details?id=p5oeAQAAMAAJ&rdid=book-p5oeAQAAMAAJ&rdot=1. (Accessed: 21st September 2017)
  2. D.H. JOHN MACKENZIE BROWN, 1878-1955. Trans Am Laryngol Assoc. 77, 241–4 (1956).
  3. University of Southern California. Howard P. House, pioneering ear specialist, 95. USC News (2003). Available at: http://news.usc.edu/1312/Howard-P-House-pioneering-ear-specialist-95/. (Accessed: 21st September 2017)
  4. OGURA, J. H., Miller, A. H., Sisson, G. A. & Tabb, H. G. STATEMENT OF JOSEPH H. OGURA, M.D.; ALDEN H. MILLER, M.D.; GEORGE A. SISSON, M.D.; AND HAROLD G. TABB, M.D. (1965).
  5. Passings: Renowned ENT Surgeon-Scientist John Niparko, MD. The Hearing Review (2016). Available at: http://www.hearingreview.com/2016/04/passings-renowned-ent-surgeon-scientist-john-niparko-md/. (Accessed: 23rd September 2017)
  6. Oghalai, J. S. & Driscoll, C. L. W. C. Atlas of Neurotologic and Lateral Skull Base Surgery. (Springer, 2016). doi:10.1007/978-3-662-46694-0