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Ushering in a new era, the pioneer of laryngeal framework surgery remains an inspiration to this day.


Prof Nobuhiko Isshiki in 2016 (courtesy: Mr Yakubu Karagama).


The laryngological world has lost a great man. Professor Nobuhiko Isshiki passed away in August at the age of 92, surviving his wife Keiko by five years.

He graduated from the School of Medicine at Kyoto University in 1954 and, in 1962, extended his laryngeal research works for two years at UCLA at Dr Hans von Leden’s laboratory. After returning home, he performed intensive research into the mechanism of phonation using excised larynges at Kyoto University, during his work as instructor in the department of laryngology. In 1977, he became associate professor and, in 1980, professor of that department.

After 22 years, he changed career and moved to the newly established department of plastic surgery as a professor until his retirement in 1993. Thereafter, he became an emeritus professor and opened the Isshiki Memorial Voice Center. In 2011, he started working at the Hiroshiba ENT Clinic in Kyoto. The majority of his patients suffered from voice disorders and congenital anomalies such as cleft lip and palate. Even at the age of 90, he was still consulting with colleagues on, in his words, “some special cases”.

A pioneer of phonosurgery, he developed a series of surgical procedures to improve the voice of patients with vocal fold paralysis, atrophy, after laryngeal trauma, pitch problems and later spasmodic dysphonia.


Nobuhiko and Keiko in the cosmos field.


His scientific interest concerned voice and cleft palate patients, yielding more than 120 publications, starting in 1964.

Based on the results, he developed the laryngeal framework surgery, which permits a change in the position and tension of the vocal fold without touching it. This led to the famous book Phonosurgery: Theory and Practice, first published in 1989. The classification into thyroplasty Isshiki types I–IV was given to those interventions not by himself, but by the laryngological community.


Cover of Isshiki’s famous book Phonosurgery, Theory and Practice (1989).


Prof Isshiki organised workshops in Kyoto and all over the world. In addition, he worked as an instructor in Groningen and Amsterdam (Netherlands), Mayo Clinic (USA), Ankara (Turkey), Santiago (Chile), Seoul (Korea), Mumbai (India), Sao Paulo (Brazil), Riyadh (Saudi Arabia), Manchester (UK) and several other cities.


Nobuhiko and Keiko and the cherry trees near their house. 


His work has been recognised internationally. He was given several awards such as the Gould Award, Gutzmann’s Award for Clinical Laryngeal Research Work, the Acta Prize, and the Isshiki Award (Royal Society of Surgeons, England) which was named after him. He became an honorary member of societies including the Hungarian Society of Otolaryngology, and an honorable fellow of the American Laryngological, Rhinological and Otological Society.

With his creativity, ingenuity, courage and skills, he was the initiator of a new era. Decades after his first publications, we still all use his techniques and are inspired by his insights every day. The clinical contributions of Nobuhiko Isshiki will last for the years to come.

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FG Dikkers (Prof)

Amsterdam UMC, University of Amsterdam, department of Otorhinolaryngology/ Head and Neck Surgery, Amsterdam, Netherlands.

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Marc Remacle (Prof)

MD, PhD, Laryngology and Head & Neck Surgery, Centre Hospitalier de Luxembourg, Luxembourg.

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Yakubu Karagama

MBBS, DLO, MSc, FRCS (ORL-HN),  Guy’s and St Thomas’ NHS Foundation Trust, London, UK: Honorary Senior Lecturer, King’s College University, UK.

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