Dr Casler's article provides a valuable discussion of the rules and regulations that have modified oversight of surgical behavior over the last 25 years. Physicians are all under close scrutiny and must adhere to practicing otolaryngology as effectively, safely, and creatively as possible. This debate is an overview that is important for all of us.
As busy surgeons and teachers, we need to be reminded often of the subtle distinctions between novel employment of medical devices and modifying or extending surgical techniques. The availability of newer tools for surgery and changes in our surgical techniques are modifications meant to improve outcomes while maintaining and enhancing patients' safety.