Published on November 9, 2016
Pleased to post an interview with Dr. Andrew Blitzer, laryngeal surgeon. He helped establish the field of neurolaryngology. Please share and credit The Voice Forum. #fellowshipofthelarynx
Where do you currently practice/teach?
I currently teach and practice at the New York Center for Voice and Swallowing Disorders. Through this center I see patients, do clinical research and run a Laryngology Fellowship Training program. We have trained 31 laryngologist over the past 20 years. Our center is located at 425 West 59th Street in Manhattan.
I am currently Professor Emeritus of Otolaryngology/Head and Neck Surgery, Columbia University College of Physicians and Surgeons. I am an adjunct Professor of Neurology at the Icahn School of Medicine at Mt. Sinai, and Director, NY Center for Voice and Swallowing Disorders, Co-Founder and Director of Research, ADN International.
Where did you complete your medical training? Laryngology?
I received my DDS degree from the School of Dental and Oral Surgery, Columbia University; MD degree from the Mt. Sinai School of Medicine, NYC; Otolaryngology Residency Training at the Mt. Sinai Medical Center, NYC; and have been full time and clinical faculty of the College of Physicians and Surgeons for over 30 years
TVF: How/why did you come to choose laryngology?
AB: I trained in Otolaryngology to be a Head and Neck Cancer surgeon and ran the H&N service at Columbia-Presbyterian Med. Ctr for 15 years. I was also taught a lot of laryngeal surgery by my mentors Drs Max Som and Hugh Biller at Mt. Sinai. During my early Columbia years my Chairman, Max Abramson assigned me to be the consultant to the Neurological Institute when I became involved in trying to help the neurologists with diagnosis and treatment of neural disease that affected voice and swallowing. This also allowed me to early on use Botulinum toxin for the management of hyperfunctional disorders of the H&N
TVF: What comes to your mind as one of the most pressing issues in contemporary voice disorders? Is it an international issue or specific to your country?
AB: My major focus in laryngology has been to better understand the pathophysiology and treatment of hypo functional voice disorders such as vocal cord immobility and hyperfunctional disorders such as tremor, spasmodic dysphonia, Parkinson’s disease, etc. These are indeed a problem world wide
TVF: What are your research interests?
AB: Much of my research has been in understanding sensory and motor circuits and reflexes affecting voice, speech and swallowing. We have also performed numerous clinical trials using Botulinum toxin for the management of hyperfunctional H&N disorders. These have led to the publication of 2 text books (Neurological Disorders of the Larynx and Botulinum toxin Therapy for Head and Neck Disorders).
We have also developed several surgical instruments to allow for more office surgery; lasers for laryngeal and other H&N lesions; new methods of diagnosis of Barrett’s esophagitis.
TVF: How do you hope your research will be applied in the clinical field?
AB: Many of our concepts elucidated over the past 30 years have been taught to many laryngologists, neurologists and speech pathologist and are in use now. We continue to expand our understanding of disease and management and hope to continue to improve patient care
TVF: In your opinion, what poses the greatest challenge in care of voice disorders?
Insurance companies denying treatments; patients bad habits and need for better habits and cultural changes; developing new treatments with better understanding of the pathophysiology of the disorders—this is limited by research funding and time constraints on practitioners
TVF: In your opinion, what are some of the most important advances made in the field of laryngology in the recent years?
AB: Most are related to new technologies and their application to our field—including fMRI of brain; DNA mapping; distal chip cameras on endoscopes; lasers; electromyography and pH testing; decrease in patients smoking; and many others
Laryngology has come of age and is an important part of every University program. At the beginning, those practicing laryngology after learning mirror examination in Europe from Czermak, were considered heretics and thrown off staffs of hospitals.
TVF: What is your vocal pet peeve and why?
AB: I hate complacency and those not excited about new information and afraid of change. This attitude slows advancement of our specialty
TVF: Which vocal myth would you like to dispel?
AB: Voice rest, reflux management, steroids and diet will cure all laryngeal problems
TVF: Your most memorable voice case?
AB: Our initial Spasmodic Dysphonia (laryngeal dystonia) patients whom we treated with Botulinum toxin and changed their lives. I still have one patient who I still treat (32 years) who was being thrown out of her university for not being able to speak and teach who after treatment maintained her teaching and is currently a Dean at the school.
TVF: As a laryngologist/surgeon, what keeps you on your toes?
AB: My patients and my fellows
TVF: What do you think the next steps are in growing the field of laryngology and voice rehabilitation?
AB: Through genetics; cell manipulation; stem cell transplants; 3-D printing of collagen and other matrices to replace parts; manipulation of the immune system we will better control and repair the vocal system
TVF: Who have been your most important/influential mentors?
AB: Dr. Max Som—Mt. Sinai- H&N surgeon and laryngologist
Dr. Melvin Moss—research at Columbia- Dean of the Dental School
Dr. Stan Fahn—Movement Disorders Neurologist- world’s expert in Dystonia—Columbia
Dr. Marshall Strome—friend and partner- former chair of the Otolaryngology service at the Brigham in Boston and the Cleveland Clinic—first to do a laryngeal transplant
TVF: What is your advice in mentoring future laryngologists?
AB: Teach them how to think and not how to do another procedure that will be out of vogue in 5 years. Let them explore themselves and be the best they can be in the things that interest them the most
TVF: What advice would you like to give to the general populace about voice care? How about to the professional voice users?
AB: For most people a good life style, diet and no smoking is very important; for those with lots of vocal demand, learn how to use your voice so as not to injure the vocal folds
For the professional, get a great vocal coach who understand the demands of your profession and will teach to accommodate your ability, style and demand
TVF: What advice do you have for aspiring laryngologists?
AB: Don’t let the social pressures, insurance companies, institutions dampen your zeal to be the best you can be and contribute more to the knowledge base that we have
TVF: Who are your favorite singers?
AB: Placido Domingo; Anna Netrebko; Eric Clapton; Adele; Sting
TVF: What sparks “joy” for you as a person?
AB: Learning something new; most people; my hobbies (skiing, running, cooking, woodworking, gardening, and playing with my grandkids)