Recent Advances in Diagnosis, Treatment and Observation in Otorhinolaryngology

Dear Colleagues,

Since the 1980s, the field of otorhinolaryngology has benefited from constant technological developments. Diagnostic pathways have been refined thanks to radiological advances and the increasing use of MRI scans. Optical fibers with chip-on-tip cameras combined with light filters favor early detection of oncological lesions. Moreover, advances in the field of immunology have brought changes to the clinical and therapeutical approaches applied in head and neck oncology as well as that part of ENT that deals mainly with functional disorders; a clear example is the recent introduction of monoclonal antibodies in the treatment of chronic rhinosinusitis with nasal polyps.

Surgery-wise, developments in otorhinolaryngology have been significant. Innovative approaches to the lateral cranial fossa and new devices have been developed for treating hearing loss. Likewise, advances in endoscopy have allowed a conceptual change in the gold-standard approach to sinonasal inflammatory disease, which has played an increasingly important role in the management of benign and malignant pathology. Indeed, similar to what happened with laryngeal laser surgery over time, not only did the endoscopic approach debunk the myth of en-bloc resection in favor of piecemeal resection in sinonasal oncology; it also exceeded the boundaries of the nose. Various approaches have been established to control disease in the anterior skull base, in the lacrimal fossa and the orbital content laterally, and from the apex of the orbit to the middle cranial fossa; additionally, further posterior approaches have allowed us to reach the pterygomaxillary and infratemporal fossas, the pituitary gland, the clivus and the tooth of the epistropheus, and posterolaterally the cavernous sinus and the first cranial nerves.

Advances have been seen in laryngeal surgery as well, drastically transforming its therapeutic pathways, from unfortunate mutilating surgeries (with total laryngectomies) to organ preservation surgeries, currently carried out with CO₂ lasers—thanks to the insights of Dr. W. Steiner—and so-called open partial horizontal laryngectomies (OPHLs).

While oncological procedures have changed, so too has functional surgery, with the implementation of small yet relevant devices. One example is seen in snoring and sleep apnea surgery, which saw a huge conceptual revolution and achieved minimal invasiveness with the introduction of barbed sutures.

Finally, it is very likely that artificial intelligence will transform our clinical approaches in the near future, offering predictive models of pathology as well as assisting clinicians in remote disease monitoring while saving on one of the most precious assets in this era: time!

The aim of this Special Issue is to promote modernity and innovation in otorhinolaryngology. In an era marked by technology that is enormously helpful in our daily lives yet still at times inefficiently applied in the medical field, defining its role is fundamental to optimize its application. Furthermore, we must not forget the humanistic aspect of medical science, which is essential and cannot be replaced by technology.

The rational pragmatism of considering technology an advantage ought to be combined with the necessary communication skills and the desire to always place the patient at the center of our clinical pathways. Besides focusing on the best processes of diagnosis, treatment, and follow-up, I invite you to predict, describe, and present innovative procedures for the good of our patients and draw on possible inferences for the near future.

I look forward to collaborating with you all!

Dr. Luca Malvezzi
Guest Editor

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• otology

• rhinology
• head and neck
• OSAS
• laser surgery
• diagnosis in otorhinolaryngoly
• biological therapy
• evolution in ENT surgery
• sleep disorders
• artificial intelligence
• nasal polyps
• CRS
• laryngeal cancer
• audiology
• hearing loss
• medical counseling