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Howard Christian Naffziger

Born  1884
Died  1961

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American neurosurgeon, born 1884, Nevada City, California; died 1961.

Biography of Howard Christian Naffziger

Howard Christian Naffziger Naffziger graduated from the University of California in 1909. With Walter Edward Dandy (1886-1946) he then spent almost a year as assistant resident under Harvey Williams Cushing (1869-1939) in Baltimore, before he returned to the University of California in 1912. He joined the faculty as assistant in surgery in the School of Medicine and assistant surgeon at the University of California.

One patient who came to Naffziger in 1920 brought with him a letter which his consultant had sent to the patient's brother (a physician) as follows: “You and I know that surgical assaults upon the brain, although spectacular, do not give much promise from the patient's standpoint. Therefore, I am suggesting that a simple decompression be done by a competent surgeon. Should a dural growth be present, it can be dealt with.” In this case Naffziger verified a left frontal glioma by frontotemporal osteoplastic craniotomy, which allowed him to make a subtemporal decompression first.

During World War I Naffziger served with the expeditionary force in France. In 1927, Naffziger was asked by the president of University of California to survey leading eastern US medical centres with a view toward improving surgical teaching methods. His detailed report committed him to leadership in medical education and led to his appointment as professor and chairman of the department of surgery in 1929.

Naffziger was admired for his pioneering work in thyroid-related exophthalmos. Vogt and Torkildsen called the orbital decompression operation the Naffziger Operation. His name was also used in connection with the scalenus anticus syndrome, entered in this work as Adson's syndrome, and with radicular pain brought on by jugular vein compression - the Naffziger Test (1935).

In May 1944, a Naffziger number of the Journal of Nervous and Mental Disease honoured him on his 60th birthday.

During World War II Naffziger commanded U.S. Hospital No. 30 in the Far East and maintained his interest in that area, being chairman of WHO Mission (Medical) to the Philippines and visiting professor in Taiwan. In 1951 he was succeeded by Edwin Boldrey as chairman of the department of surgery. He died of reticulum cell carcinoma.

    “the fascination of brain surgery lies in its difficulties.”
    Brain surgery with special reference to exposures of the brain stem and posterior fossa . . .
    Surgery, Gynecology and Obstetrics, Chicago, 1928, 46: 241-248.

Bibliography

  • Methods to secure end-to-end suture of peripheral nerves.
    Surgery, Gynecology and Obstetrics, Chicago, 1921, 32: 193-204.
  • Spinal cord tumors (arachnoid fibroblastomata).
    Surgical Clinics of North America, Philadelphia, 1922, 2: 363-400.
  • Head injuries: Indications for surgical treatment.
    Surgical Clinics of North America, Philadelphia, 1923, 3: 699-710.
  • A method for the localization of brain tumors: The pineal shift.
    Surgery, Gynecology and Obstetrics, Chicago, 1925, 40: 481-484.
  • Brain surgery with special reference to exposures of the brain stem and posterior fossa: The principle of intracranial decompression and the relief of impactions in the posterior fossa.
    Surgery, Gynecology and Obstetrics, Chicago, 1928, 46: 241-248.
    Naffziger's art of surgery is nowhere better displayed than in this beautifully illustrated paper on cerebellar exposures. An occipital flap serves as a supratentorial approach to the cerebellopontine angle through a tentorial incision that extends to the petrous bone anteriorly, to the sinus rectus medially, and to the lateral sinus. His experience with this approach went back to 1923, when he biopsied an exophytic glioma. The subtemporal transtentorial approach is still used by some neurosurgeons for the removal of large meningiomas of the cerebellopontine angle. Also illustrated are the entirely straight midline incision without lateral offsets at the nuchal line, and the hockey-stick incision for unilateral cerebellar exposure.
  • Progressive exophthalmos following thyroidectomy: Its pathology and treatment.
    Annals of Surgery, Philadelphia, 1931, 94: 582-586.
  • Progressive exophthalmos following thyroidectomy: Its pathology and treatment. Report of 8 cases. Surgery, Gynecology and Obstetrics, Chicago, 1932, 54: 81-87.
  • Content of courses for adequate training in neurological surgery.
    Bulletin of the American College of Surgeons, Chicago, 1939, 24: 46-48.
  • Report of the activities of the Subcommittee on Neurological Surgery of the Medical Research Council.
    Transactions of the American Neurological Association, New York, 1943, 69: 28-31.
  • Progressive exophthalmos. Hunterian Lecture.
    Annals of the Royal College of Surgeons of England, London, 1954, 15: 1-24.
  • Regenerative capacities of nerves and muscle. Experimental study of factors causing faulty recovery of the neurovascular mechanism.
    Written with R. B. Aird. Journal of the Mount Sinai Hospital, New York, 1942, 9: 679-685.
  • The postgraduate training of students in surgery at the University of California.
    Written with H. G. Bell. Western Journal of Surgery, Seattle, Washington, 1932, 40: 384-389.
  • R. Wartenberg:
    Howard Christian Naffziger zum 70. Geburtstag.
    Deutsche medizinische Wochenschrift, Stuttgart, 1954, 79: 792.

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