As 2024 comes to a close, we asked members of the ENTtoday editorial board two questions: What’s been the biggest success in otolaryngology in the last five years and what are you most excited about for the next 5-10 years of ENT medicine? Here’s what they had to say.
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December 2024Travis Tate Tollefson, MD, MPH, director, division of facial plastic and reconstructive surgery, director, AAFPRS UC Davis fellowship, co-director, UC Davis cleft and craniofacial program, and professor, department of otolaryngology at UC Davis Health in Sacramento, Calif.
Evolving over the last decade, the applicability of augmented reality technologies in the operating room is now pushing forward into an exciting new era of growth. Twenty years ago, we used navigation on CT scans to guide anterior skull base and sinus procedures, yet the reality of superimposing that radiographic anatomy onto the surgical patient seemed like a science fiction novel. I believe that the burden of applying augmented reality in the OR is decreasing at an exponential rate. Surgeons will benefit from projecting the patient-specific anatomy onto the surgical field, reducing risk and guiding patient outcomes.
Matthew Naunheim, MD, MBA, associate vice chair, quality and safety at Massachusetts Eye and Ear, and assistant professor of otolaryngology-head and neck surgery at Harvard Medical School, both in Boston
Biggest success: After many years of promise, academic researchers and private industry are now restoring hearing using gene therapy. These proof-of-concept studies—which have what can only be described as nearly miraculous outcomes—serve as a proof of concept that gene therapy can restore certain types of hearing loss.
Most excited about: Laryngology is currently the best-positioned subspecialty within otolaryngology, and perhaps within all of surgery, to benefit from AI. Diagnosis in laryngology is difficult because there are so many modalities to consider—laryngoscopy, stroboscopy, electromyography, acoustics, aerodynamics—the interpretation of which is very much in the eye of the beholder. This leads to information overload, diagnostic inconsistency, and discrepancy even among experts. With advanced machine learning algorithms, the often-messy information overload of laryngology has suddenly become its greatest strength.
Eric Gantwerker, MD, MSc, MS, pediatric otolaryngologist, Northwell Health, and associate professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New Hyde Park, N.Y.
Biggest success: Advancing more in-office procedures.
Most excited about: More advanced technologies, including extended reality (XR) and AI integration.
Sarah Rapoport, MD, otolaryngology/head and neck surgeon and assistant professor at Georgetown University Hospital in Washington, D.C.
Biggest success: The continued growth and support of women in leadership in our field. It’s critical to the continued growth and development of our field. Women as chairmen, deans, editors-in-chief of core journals, and professors.
Most excited about: I hope that our field fights for equitable reimbursement from the Centers for Medicare and Medicaid Services and continued fiscal value for physicians’ work. And I hope that otolaryngology’s pay equity issues improve so we serve as leaders for gender pay equity among surgical specialists.
Stephen S. Park, MD, G. Slaughter Fitz-Hugh professor and chair, department of otolaryngology-head and neck surgery, director, division of facial plastic surgery at the University of Virginia in Charlottesville, Va.
Biggest success: Biologics in the treatment of benign and chronic inflammatory sinus disease. It has impacted the need for sinus surgery dramatically.
Most excited about: Rolling out AI and machine learning.
Jonathan M. Bock, MD, professor, division of laryngology and professional voice, department of otolaryngology and communication sciences at the Medical College of Wisconsin in Milwaukee
Biggest success: I think our specialty demonstrated amazing resiliency and courage in facing the COVID-19 pandemic head-on as frontline workers managing airway issues and sequelae of this generational moment. Otolaryngologists risked their own lives to provide care for their patients on a daily basis, and I continue to be so proud of our role in helping get us through this awful public health event.
Most excited about: I think the evolution of AI into our practices is very exciting and may help automate many of the more tiresome pieces of daily practice, including documentation and billing, and even extend into clinical care.
Sonya Malekzadeh, MD, residency program director, professor of otolaryngology-head and neck surgery at Georgetown University Medical Center and MedStar Georgetown University Hospital, both in Washington, D.C.
Biggest success: In the context of education, the most exciting success in otolaryngology has been the development of a long-awaited national residency curriculum. This program standardizes how residents are trained, ensuring that the next generation of otolaryngologists receives high-quality, uniform education across institutions. The curriculum focuses not only on core clinical knowledge but also incorporates a variety of teaching modalities to accommodate different learning styles.
Also, the adoption of simulation-based surgical education has been key. Simulation labs allow trainees to refine their technical and patient management skills in a risk-free environment. High- and low-fidelity simulators, coupled with 3D-printed models, offer invaluable practice before real-world applications, improving both competency and patient safety.
Most excited about: Advances in augmented reality (AR) and virtual reality (VR) for surgical training are also exciting. These tools allow residents to immerse themselves in complex surgical scenarios, providing a new way to teach anatomy, pathology, and surgical techniques without needing a live patient. This next level of experiential learning can help bridge the gap between didactics and real-life operations, giving trainees more confidence and competence earlier in their careers.
Sujana S. Chandrasekhar, MD, leading otologist and neurotologist at ENT and Allergy Associates, LLP, with offices in Manhattan, NYC, and Parsippany, N.J., and clinical professor of otolaryngology at the Zucker School of Medicine, Hofstra-Northwell in Hempstead, N.Y.
Biggest success:
- Endoscopes for ear surgery that are easy to use
- Better and more accessible genetic testing for hearing loss
- New meds for neurofibromatosis type 2 (NF2), like vascular endothelial growth factor (VEGF) blockers
Most excited about: Personalized medicine and surgery for inner ear disorders, including drug-eluting cochlear implants, and targeted meds for hearing loss.
Lisa Casinger is editor of ENTtoday.