In this month's issue of the Journal of Laryngology & Otology, Robert Jackler presents a written synopsis of his learned JLO visiting Professorship Lecture, presented at the Royal Society of Medicine in May 2019.Reference Jackler and Jan1 The field of otology is increasingly at the forefront of innovation in science and medicine, and he argues that we can expect much progress in the field of inner-ear drug delivery systems, auditory genetics, ototoxic chemoprevention, organ of Corti regeneration, artificial intelligence and the rise of robots, among other areas, in the years to follow. Many of these areas are already starting to bear fruit.Reference Lou, Lou and Xiao2–Reference Hardcastle and Wood5 The article provides a fascinating overview of emerging (and sometimes disruptive) technologies. It is apparent from reading this article that as more non-surgical, advanced, biological methods of curing middle- and inner-ear diseases are discovered, management of implanted devices will likely become a progressively more dominant component of otology. The evolution of technological advances will be driven by our creativity, perseverance, and especially our ability to recruit experts in other fields of science and technology to engage in innovation relevant to hearing and balance.
Two articles in this month's issue revisit coblation tonsillectomy. Lieberg et al. compared the extent of tissue damage produced by conventional cold steel and coblation tonsillectomy by histopathologically evaluating excised tonsils.Reference Lieberg, Aunapuu and Arend6 The authors conclude that coblation tonsillectomy is superior in terms of decreased early post-operative pain and less damage to surrounding tissues. The authors hypothesise that the reduction in post-operative pain may be due to lower mast cell degranulation in coblation tonsillectomy. Junaid et al. compare extracapsular and intracapsular coblation approaches, and conclude that intracapsular techniques result in lower post-operative pain scores and reduced overall morbidity.Reference Junaid, Sood, Walijee, Dorgham and De7 However, as the authors point out, the main disadvantage of the intracapsular technique is the increased likelihood of remnant tonsil tissue with the future risk of tonsillar regrowth and recurrent tonsillitis requiring further tonsillectomy. Both these articles concur with a previously published prospective, randomised, single-blind study comparing coblation and bipolar tonsillectomy techniques published in this journal last year.Reference Wiltshire, Cronin, Lintern, Fraser-Kirk, Anderson and Barr8 A study estimating the cost-effectiveness of coblation, also published last year, appeared to show that coblation is as least as cost-effective an intervention as cold steel techniques for adult and paediatric patients.Reference Guest, Rana and Hopkins9
Finally, Cayir et al., in this month's issue, investigate the effects of nasal surgery on sexual function in patients with perceived nasal obstruction.Reference Cayir, Hizli and Gul10 The authors conclude that surgical treatment of nasal obstruction by septoplasty, endoscopic sinus surgery, concha bullosa excision or radiofrequency can significantly improve sexual performance in patients with perceived nasal obstruction. Future studies assessing the effects of nasal surgery on quality of life should therefore consider this also as a quality of life measure.
