Advances in diagnostic and therapeutic technologies in otolaryngology: A comprehensive review of ear, nose, and throat disorders

Background: In Otolaryngology, impressive innovations in diagnostic, minimally invasive procedures, implantable hearing devices, endoscopic and robotic surgery, image guidance, biologics, and AI-enabled decision support continue apace. However, the availability of evidence throughout the technology life cycle is uneven; often strongest for development/validation and weaker for real-world impact, health technology assessment (HTA) and implementation. Objective: The goal is to synthesise important advances in diagnostic and therapeutic technologies related to ear, nose and throat disorders and to collate evidence using a life-cycle framework (Preparation ? Development ? Validation, Software Application ? Impact Assessment ? Implementation). Data Sources: The synthesis of evidence was performed based on landmark studies, clinical practice guidelines, pivotal randomised trials, systematic reviews/meta-analyses and selective regulatory/implementation literature throughout audiology, rhinology, laryngology, head and neck oncology and sleep medicine. Review Methods: Through PRISMA-style logic for transparency of evidence sourcing and a life-cycle-based evidence mapping approach that illustrates where evidence is strong vs limited (eg, implementation planning, monitoring, and HTA), a structured narrative review was developed. Results: Progress in diagnostics involves techniques like auditory brainstem response (ABR), otoacoustic emissions (OAE), diffusion-weighted MRI for cholesteatoma, narrow-band imaging (NBI) for laryngeal lesions and FEES for dysphagia. Head and neck cancers may benefit from PET-CT strategies. Therapeutic advances comprise of endoscopic ear surgery, endoscopic sinussurgery and balloon dilatation, eustachian tube balloon dilation, biologics for chronic rhinosinusitis with nasal polyps (CRSwNP), cochlear implant and bone-conduction systems, transoral robotic surgery (TORS), office-based laryngeal procedures, hypoglossal nerve stimulation for obstructive sleep apnoea (OSA), transoral endoscopic thyroidectomy vestibular approach (TOETVA). It was stated that even though diagnostic accuracy of AI applications in otoscopy and laryngoscopy is promising, its reporting and implementation are inconsistent. Conclusions: Technologies that are ear, nose and throat specific are improving patient outcomes but widespread adoption is lacking complete evidence across all cycles and even impact assessment and monitoring.