Otolaryngology is the specialty that learned the usual treatment is not the only answer.

In June 1991, the New England Journal of Medicine published a trial about advanced cancer of the larynx. The larynx is the voice box. The usual treatment removed the whole larynx, followed by radiation. Patients could survive, but they lost their natural voice. The trial asked whether chemotherapy and radiation could treat the cancer and keep the larynx. It gave 332 patients either surgery and radiation, or three cycles of chemotherapy followed by radiation. Patients whose cancer did not respond, or came back, had the larynx removed anyway. Survival at two years was 68% in both groups. The chemotherapy group kept the larynx in 64% of patients. Its cancer came back more often at the original site, but it spread less often to other organs. Patients could now survive the cancer and keep their voice.

Twenty-two and a half years later, in January 2014, the same journal published a study about obstructive sleep apnea. The condition makes the airway close again and again during sleep. A mask that pushes air into the airway, called CPAP, keeps it open. But many patients cannot get used to the mask. The study tested another way: a device, implanted by surgery, that stimulates the upper airway during sleep. It enrolled 126 people who struggled with the mask. There was no comparison group at first. Their breathing pauses fell from 29.3 an hour to 9.0 an hour after a year. Then the researchers switched the device off at random in 23 patients who had responded. Their breathing pauses rose back to 25.8 an hour. The 23 patients who kept the device on stayed at 8.9 an hour. Serious problems from the operation affected fewer than 2% of patients. Patients who could not use the mask now had another way to breathe at night.

Almost six years later, in November 2019, The Lancet published two trials about nasal polyps. Nasal polyps are swellings inside the nose and sinuses. They block the nose, and they often keep coming back after steroid tablets and repeated surgery. Dupilumab is an antibody already approved for eczema and asthma. It blocks two signals that drive this kind of inflammation. The two trials gave 724 adults with severe polyps an injection of dupilumab or a placebo every two weeks. All of them still had symptoms despite steroid nose sprays. The polyps shrank on dupilumab. The blocked noses opened, and the sinuses cleared on CT scans. Side effects were more common on placebo than on dupilumab. An injection had shrunk what surgery kept removing.

These are three of the thousands of studies that shaped modern otolaryngology. They taught otolaryngology that a patient with cancer of the larynx could survive and keep their voice, that an implanted device could keep the airway open for patients who could not use the mask, and that an injection could shrink nasal polyps that surgery kept removing, and each time the answer was in a paper years before it was in a textbook.

It is still happening. Recently, in March 2026, the New England Journal of Medicine published a study of gene therapy for children born deaf. These children lack a working copy of a gene called OTOF. The gene makes a protein called otoferlin. The ear’s sensory cells need otoferlin to pass on sound signals. No medicine treated this deafness, so these children usually got cochlear implants. The study gave 12 children a single infusion of the missing gene into the inner ear. Every child started with profound deafness. They could not hear a lawn mower. Nine of the 12 children could hear well enough to avoid a cochlear implant after 24 weeks. Six of them could hear soft speech without any device. Three had normal hearing. This was a small study with no comparison group. None of the side effects made a child leave the study. A gene had given deaf children natural hearing. Practice follows the literature as it goes. It is a good culture. It has exactly one cost.