Letter from the Editor: Recent Feats of Innovation in Otolaryngology

We’re now in the dog days of summer, and some things haven’t changed. Many parts of the country, mine included, are in the midst of another COVID-19 surge as our hospitals and local officials struggle with rising inpatient numbers and attempt to enact the right public measures to curb the spread and encourage the unvaccinated to get a vaccine.

But, unlike last summer, there are some exciting new things happening. In their own personal race, the private journey to space tourism for two billionaires has captured the nation’s attention.

Jeff Bezos’ and Richard Branson’s successful flights to the edge of space were remarkable feats of engineering. And, no matter what one thinks about the circumstances surrounding their achievements, it’s still amazing to think that there’s a near future in which anybody (with enough money) will have the chance to visit space. This moment was two decades in the making. Bezos created his space venture Blue Origin in 2000 and was soon followed by Branson’s Virgin Galactic and Elon Musk’s Space X ventures.

Although space tourism is the immediate payoff, all three tycoons have bigger visions. Commercial operations in space and on the moon such as mining water ice for rocket fuel, carrying humans to Mars, and hypersonic point-to-point travel are all big-picture dreams. It got me thinking: What are the recent feats of innovation in otolaryngology? How have they impacted our specialty and is there a bigger vision for their use?

Speaking firsthand as a rhinologist, I believe the FDA approval and widespread use of biologics since 2019 has drastically improved the lives of some of our most difficult-to-treat nasal polyp patients. I remember hearing Don Leopold talk at a FESS course in 1998, telling the audience that sinus surgery likely wouldn’t be needed, as the first anti-IL-5 drug had been studied in Europe. Twenty years later, that drug and its cousins have made the market. They haven’t yet made sinus surgery obsolete, but they have narrowed the indications for nasal polyp surgery.

I asked my wonderful editorial board about other great breakthroughs in their subspecialties. Kathy Yaremchuk brought up hypoglossal nerve stimulation and its impact on sleep apnea patients unable to tolerate CPAP. I remember hearing Dave Eisele talk at an AAO-HNS meeting in the late 1990s about this and thinking, “Wow, that is crazy.” Andrés Bur and Brian Nussenbaum talked about immunotherapy for head and neck cancer and its potential to replace traditional chemotherapy. Hinrich Staecker brought up single-sided deafness cochlear implantation and synaptopathy as exciting new developments. Julie Wei sent me a list of breakthroughs in pediatric otolaryngology too long for this space but perfect for the start of a future series of articles in ENTtoday on what the future holds for each otolaryngology subspecialty.

There’s plenty to look forward to that isn’t COVID-related, and we’re excited to talk about it with you. Have a great summer.

—Alex