Microsurgery in otolaryngology: the future.

Five areas of active clinical research development in otolaryngology have been selected to illustrate the specific applications of microsurgical principles and the potential future of associated bioengineering research. These are: (i) biocompatible microelectronic circuitry and cochlear electrode implant in total cochlear deafness, with preservation of auditory nerve function; (ii) microneural surgery of the facial nerve in hemifacial spasm and the techniques available for reinnervation of the paralysed larynx; (iii) laser microsurgery of the larynx--a new surgical modality dependent on high-precision control through the operating microscope; (iv) microvascular free tissue transfer in head and neck reconstruction and its potential value following combined irradiation therapy for carcinoma; and (v) human laryngeal transplantation--its current status.