Neurolaryngology Study Group (NLSG)

During spring of 1989, Drs. Gayle Woodson and Roger Crumley collaborated to organize a small informal meeting of otolaryngologists and voice scientists interested in neural disorders of the larynx (neurolaryngology).   The term neurolaryngology was not in common usage at the time, and was proposed at that meeting as a descriptor of a sub-discipline dealing with such problems as laryngeal paralysis, paresis, spasmodic dysphonia, other hyperkinetic laryngeal disorders, hypoesthesia, and anesthesia; e.g. all laryngeal disorders of neural origin.   The meeting was held simply to see whether the group felt there would be interest in meeting annually or bi-annually to discuss such issues.

The group met during COSM 1989, in a small room at the Fairmont Hotel in San Francisco.   The group discussed management of vocal fold paralysis and spasmodic dysphonia. Those present at that first meeting included:
·        Roger Crumley
·        Gayle Woodson
·        Charles Cummings
·        Charles Ford
·        Andrew Blitzer
·        Paul Flint
·        Ira Sanders
·        (and some others)
 
The interest level was high and accordingly it was decided to have a second meeting at the 1989 fall meeting of the American Academy of Otolaryngology-Head & Neck Surgery.     During this second 1989 meeting it was decided by a somewhat larger group to have meetings twice/year (one during COSM, and again during AAO-HNS).    The format was generally to have a scientific speaker from some related field, generally basic or clinical science related to neurolaryngology, and then to have a roundtable discussion of basic science and clinical issues and problems.   Indeed with a group of 15-25, the first 4-5 meetings of the NLSG yielded some very high level, occasionally contentious discussions about how to manage certain clinical problems, and demonstrated that there were indeed highly variable opinions regarding management.   This occasionally involved differing opinions regarding the roles of vocal cord injection (now more appropriately called injection laryngoplasty), Isshiki thyroplasty, arytenoid adduction, and laryngeal reinnervation in treatment of unilateral laryngeal paralysis, or whether spasmodic dysphonia was best treated with unilateral or bilateral Botox vocal fold injections. (Indeed many of the issues which are still debated today.)
 
The NLSG meetings were generally scheduled by either Dr. Woodson or Dr. Crumley and notification of the meeting time and place was disseminated to the members usually via email, Fax, or word of mouth. Dr. Crumley’s email list for the NLSG grew rather quickly, and came to include many non-U.S. physicians interested in neurolaryngology, such as Jean Abitbol, Mark Remacle, Hans Mahieu, Martin Birchall, Hongliang Zheng, John Rubin, Jean-Paul Marie, Sophie Perie, Berit Schneider, and others.   In addition neurologists such as Mitchell Brin were added, and occasionally attended, as did distinguished speech-language scientists and clinicians, such as Ingo Titze, Tom Murry, Christy Ludlow, James Till, and others. 
 
As the group and meetings enlarged, funding became an issue.   A laptop computer and LCD projector replaced the old 2X2 slides, and we began to incur room rental, food and beverage and other expenses. Initially we paid for our meetings by “passing the hat” at the actual meeting.  Occasionally we were able to procure minor corporate support from such companies as Kay Elemetrics, Allergan, and Xomed-Treace (as they were named at the time).   In approximately 1994 Drs. Woodson and Crumley were able to convince AAO President Richard Farrior for the need for committee representation, and the Neurolaryngology Committee of the AAO was formed.   During the first year however this became a sub-committee of the Speech, Voice, and Swallowing committee, but nonetheless the Neurolaryngology Committee was awarded a mini-seminar time slot every other fall, which allowed for further growth.   A second and even more meaningful happening was the “adoption” of the Neurolaryngology Study Group by the American Laryngological Association.   This gave the NLSG more official status within the overall structure of Otolaryngology-Head & Neck Surgery societies. Accordingly the spring COSM version of the NLSG came to be held at the conclusion of the 2nd ALA half-day scientific session, and finding (and funding) a meeting room was no longer a problem.
 
Several scientific studies (at least 2 of which were multi-institutional) were launched after discussions at the NLSG, and many others were derived, nurtured, and fostered by the dialogue and rich intellectual milieu engendered by the NLSG. The current chair/leader of the NLSG is Dr. Lucian Sulica of New York. 
 
Written 1/15/2009 by Roger Crumley
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