Otolaryngology – head and neck surgery is, by its nature, a broad-based specialty, encompassing a wide range of anatomical regions, disease processes and surgical techniques. Reflecting this diversity, the February edition of The Journal of Laryngology & Otology features articles that illustrate the breadth of ENT sub-specialties while emphasising the principles that make patient-centred practice possible, principles that are diverse, evolving and firmly grounded in comprehensive patient care.
This month’s edition highlights sub-specialities that have a high degree of technological innovation, refined surgical techniques and evidence-based research. A review of simulation in endoscopic ear surgery demonstrates how simulation has become an essential component of surgical training in otolaryngology. This is so important in these post coronavirus disease 2019 years where there is reduced operative exposure, increasing service pressures and heightened expectations of patient care. Simulation in all aspects of otolaryngology surgery complements, not replaces, clinical experience and helps to standardise training, accelerate surgical learning curves and maintain surgical competency.Reference Jegatheeswaran, Naing, Choi, Collins, Luke and Gokani1–Reference Chin, Chin, Roth, Rotenberg and Fung4
The main articles reflect both progress and persistent challenges. From nuanced decision making in Eustachian tube dysfunction in children, fungal ear infections in high-risk populations to the enduring debate on the outcomes of stapes surgery, which have raged on since the procedure was first established and reported in 1952.Reference Rosen5
Eustachian tube balloon dilatation in children with cleft palate and middle-ear effusion remains an area of cautious optimism; its aetiology is thought to be multifactorial and often a muscular problem rather than obstruction.Reference Demir and Batman6 It is not only children with cleft palate that suffer from Eustachian tube dysfunction: it has been found to have a high prevalence in children with sleep-disordered breathing, as seen in the large study by Xiong et al. in this edition.
Button battery ingestion is a true emergency because these tiny batteries can cause serious and very rapid tissue damage within a very short period of time. Their ingestion needs immediate recognition and urgent removal is absolutely essential to prevent perforation, bleeding and life-threatening complications. We make no apology for emphasising this issue again; its urgency and the potential consequences demand our full attention.Reference Gohil, Culshaw, Jackson and Singh7
Advances in nasal surgery highlight the importance of prioritising both reconstruction and cosmesis, the aim being to improve contour while preserving function. Dorsal preservation rhinoplasty is a growing field in facial plastic surgery. This edition’s review article on dorsal rhinoplasty highlights advances in technique, graft choice and thickness, demonstrating that nasal form and function are inseparable, not opposing goals.
Finally, a few words on artificial intelligence (AI). AI can transform patient information by organising, analysing and summarising information, and it is becoming integrated into our everyday clinical life. It has huge potential to improve patient care, and a stakeholder perspective is presented in this edition. Artificial intelligence must be applied thoughtfully, ethically and securely. It should assist and not replace clinical judgement and the challenge ahead is integration: to embed AI within our clinical frameworks in an ethical and robust way.Reference Bozhoyuk and Yucel8–Reference Jongbloed and Grover10
ANN-LOUISE MCDERMOTT
JONATHAN FISHMAN
STEPHEN JONES
Senior Editors
