Clinical Review

Recent advances: Otorhinolaryngology

BMJ 1997; 315 doi: (Published 09 August 1997) Cite this as: BMJ 1997;315:354
  1. Jochen A Werner, assistant medical director (,
  2. Stefan Gottschlich, registrara
  1. a Department of Otorhinolaryngology, Head and Neck Surgery, University of Kiel, 24105 Kiel, Germany
  1. Correspondence to: Dr Werner


    Otorhinolaryngology has developed over the past few decades into a wide diversity of subspecialties, each with its own changes, developments, and trends. One important area where much development is still needed is head and neck oncology. Nearly 5% of human cancers originate in the upper aerodigestive tract, and mortality has hardly changed in recent years. The incidence of head and neck cancer has increased slightly, and it is still accompanied by a high rate of morbidity due to impairment of breathing, swallowing, chewing, and speaking despite considerable effort being put into developing alternative treatments and methods to restore form and function.

    Computer technology has made remarkable advances possible for some groups of patients. Cochlear implants have allowed deaf patients to regain their hearing ability, and the miniaturisation of hearing aids has greatly helped people with impaired hearing. Use of computer guided surgery also seems likely to improve outcomes, especially in patients whose anatomy has been affected by previous surgery or malignancy.

    Digital hearing aids

    The recent development of digital hearing aids has been a big step forward in overcoming hearing impairment.1 2 The hearing aids work by converting an incoming analogue signal into a digital one, which is then processed by a microprocessor and then changed back into an analogue signal before output (fig 1).3

    Fig 1

    Schematic illustration of a digital hearing aid (modified according to Steffens34 A>)

    The main advantages of the digital technique are that the signal can be processed to suppress noise or to amplify specific frequencies or sounds.4 The latest generation of digital hearing aids can recognise speech, which allows them to suppress other noise and make hearing clearer. The multiprogram devices can adapt to specific situations in the patients' everyday lives, especially with noise suppression, which further improves the ability to hear. …

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