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Adventures in Innovation: Dr. Silverstein to Reflect on Contributions to Neurotology

Howard P. House, MD Memorial Lecture for Advances in Otology

  • 2:15 – 3:15 pm
  • Sunday
  • Room E450A

Seven years after serving on the academic staff at Harvard’s Massachusetts Eye and Ear Infirmary and the University of Pennsylvania, Herbert Silverstein, MD, MS, walked away to open a practice in a 1,000-square-foot storage space in Sarasota, FL. Little did he know that he was starting a unique journey that would impact otology/neurotolgy research and treatment.

Dr. Silverstein will recall that journey—which started with his mother telling him he was crazy—when he presents an Honorary Guest Lecture Sunday. He also will reflect on the unique academic practice he established and his contributions to the field. Those contributions include the development of a facial nerve monitor, the vestibular neurectomy through the retrolabyrinthine mastoid approach, the Silverstein MicroWick, conservative management of acoustic neuromas, the Laser STAMP, and round and oval window reinforcement for hyperacusis.

Herbert Silverstein, MD, MS

“The only thing that’s constant is change,” Dr. Silverstein said in looking back at his career. “The number of things I’ve added to the specialty—I don’t think they have been major, but they have added to our specialty. I just added a few things to improve procedures and techniques.”

When he left the University of Pennsylvania, Dr. Silverstein was frustrated by the academic bureaucracy and inability to treat patients efficiently, he said. So he moved to Sarasota to start a private practice in 1973.

“I got the seven-year itch and decided to change my life. I guess I had a midlife crisis,” Dr. Silverstein said.

That small practice started in a storage space, eventually blossoming into the 20,000-square-foot Silverstein Institute. Today, the institute has four divisions and has been a pioneer in neurotology research and practice. Along the way, he teamed up with Horace Norrell, Jr., MD, who once tried to prevent Dr. Silverstein from performing a middle fossa vestibular neurectomy in his early days in Sarasota.

“We became good friends and became the team of otology/neurotology and neurosurgery,” Dr. Silverstein said. “We developed several procedures and wrote a number of academic papers. We started the first symposium in 1977 on neurological, ear, and skull-based surgery in Sarasota. That was the first time neurosurgeons attended a meeting with otologists.”

Dr. Silverstein started the Ear Research Foundation in 1979. The foundation presented seminars and developed the third clinical fellowship in otology/neurotology and provided community service treating indigent patients.

“I don’t think a doctor today could do what I did,” Dr. Silverstein said. “It would be difficult with the way medicine is today to start an innovative practice by yourself. The days of individual practice are going to go away.”

Still, that should not stop physicians from trying to make an impact on the treatment of patients, he said.

“Anybody can do it if you have the will. If you have an idea and believe in it, it is worth trying to innovate and advance the specialty,” Dr. Silverstein said. “In my career, I’ve learned that any new innovation seems to last about 20 years, then something else better comes along to replace it. That is a good lesson to learn.”

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