A history of rhinology in North America

The history of rhinology is the story of the efforts of men and women who have tried to help patients who have nasal and sinus disorders or other conditions thought to be related to the nose or sinuses. Woven through this story are the subplots of the progress of surgical technology, the understanding of anatomy and physiology, and the hit-or-miss relationship between them. Through the last half of the nineteenth century, great strides were made in understanding nasal and sinus anatomy and physiology. As that century ended and as the twentieth century began, there was a surge of technology that allowed a marked increase in the type and number of surgeries performed. Unfortunately, nasal and sinus surgery holds the awesome potential to promote health or to severely hurt someone. The knowledge of nasal physiology and anatomy had been exceeded, and often those operations were not in the patient's best interest. Through the middle of the twentieth century the basic science knowledge seems to have caught up with the care being provided, but as the end of the century approaches, another tide of surgical activity seems to be upon us. Perhaps in no other area of surgery has this disparity between biologic knowledge and surgical activity been so well demonstrated. Perhaps the next 100 years will witness a better coordination of these activities.