Myron Metzenbaum and the Perfect Tonsillectomy Scissors

Metzenbaum scissors are the favorite dissecting scissors of surgeons throughout the world. ¹ Yet few know that they were invented by an otolaryngologist with tonsillectomy in mind. Myron Firth Metzenbaum was born on April 1, 1876, in Cleveland, Ohio to Joseph Metzenbaum and Fanny Firth. Metzenbaum aspired to be a physician from a young age. After graduating from Adelbert College of Western Reserve University, he attended medical school at Wooster University. In his first year of study, he met George Crile, a prolific thyroid surgeon and developer of the radical neck dissection. Metzenbaum volunteered to live and work at St. Alexis Hospital, where Crile operated, to fill in during a house staff shortage. ² The St. Alexis mentorship lasted through medical school and internship.

After internship, Metzenbaum joined the Crile Clinic, a precursor to the Cleveland Clinic. In 1901, he traveled to Berlin, Budapest, and Vienna to expand his surgical knowledge. Returning to Cleveland, he focused on Otolaryngology and reconstructive techniques. In 1908, Metzenbaum became a member of the American Academy of Ophthalmology and Otolaryngology, and in 1910, he was certified by the American Board of Otolaryngology. ² Shortly thereafter, he left the Crile Clinic to start his own practice. Metzenbaum’s career flourished, and he became a highly regarded surgeon throughout the state of Ohio. He was known for his generosity and patient-focused care.

Metzenbaum was an innovator. He explored the uses of radium for head and neck lesions ³ and developed an open-drop ether technique for general anesthesia. ⁴ Among the surgical tools he developed were a septal chisel, posterior septal knife, adjustable septal speculum, flexible mucous membrane retractor, and posterior septal pliers. ⁵ He created a flip-up pair of bifocal operating spectacles to provide a full field of view during fine dissection (Figure 1). ⁶ But of all his accomplishments, he is best remembered for the Metzenbaum scissors.

Figure 1.

Metzenbaum wearing his flip-up full-field bifocal spectacles. ⁶

Metzenbaum’s family claims that he built his prototype scissors in his garage workshop. That first pair remained in the possession of his daughter who kept them in her sewing kit. His scissors are mentioned as early as 1912 under “New Instruments and Devices” in the Detroit Medical Journal ⁷ :

The Metzenbaum dissecting scissors are especially adapted for the enucleation of tonsils and perineal operations, but are also useful for any operation where a keen-cutting, blunt-pointed dissecting scissors are desired. . . The blades are curved and on the flat and very keen. The scissors are made in two lengths, 5¾ inches and 7 inches. Price $2.00 and $2.25 net.

The scissors are thin with long handles, curved blades, and blunt ends. The freedom of movement enabled by their delicate design and the dissecting ability of the blunt ends provide surgeons with ample control to separate tissue planes and divide structures. Although initially designed for tonsillectomy, the Metzenbaum scissors are well suited for soft-tissue dissection anywhere in the body.

A wide variety of instruments were developed in the late 19th and early 20th centuries to achieve rapid tonsil removal and minimize bleeding. Surgeons each claimed best results with the variety of tonsil guillotines, snares, serrated dissectors, and specialized scissors built for the purpose. The 1915 Kny-Scheerer catalog ⁸ has no less than 36 pages of devices for tonsil and adenoid removal (including the Metzenbaum scissors, Figure 2) While most of these instruments have fallen out of favor, the Metzenbaum scissors have stood the test of time (Figure 3). A bipolar, electrified version of Metzenbaum scissors remains popular for tonsillectomy, especially in Europe. ⁹

Figure 2.

A page from the 1915 Kny-Scheerer catalog showing a variety of tonsillectomy scissors. ⁸

Figure 3.

A well-worn pair of Metzenbaum scissors.

Metzenbaum died on January 25, 1944, at the age of 67. His family proudly carries on his surgical legacy. Metzenbaum’s grand-nephew, Ralph Metson, is a Boston otolaryngologist. He remembers his family watching M*A*S*H when he was a child and cheering each time a surgeon on the show asked for a pair of “Metz.”