The medical landscape has gone over tremendous changes in the past 40 years. With the society getting more affluent, the social hygiene improved. It follows that the disease pattern also changes. Diphtheria that requires emergency tracheostomy has become history. Kids with mastoid abscess, who used to be regular visitors to the ENT outpatient clinic, have become a rarity. Even cholesteatoma and otosclerosis are getting less and less. Serous otitis media, which was almost non-existent among Chinese in the 60's, has now become endemic. Is this due to allergy, environmental or dietary changes? These remain to be explored. Fulminant sinusitis with proptosis is rarely seen nowadays. Nasal allergy continues to annoy a large portion of the population. There does not seem to have any age or social limitation but city dwellers appear to fare worse. Modern life style and increasing pollution are probably the culprits.

Our specialists have long been struggling with visualisation. The operating microscope came in the 60'S. This eased the life of otologists and later laryngologists. Many breakthroughs were made in ear surgery and neurootology. By the 70's, the invention of Hopkins lens system and fibre optics really threw a lot of light to ENT diagnosis and surgery. With the modern advances in video technology, students and observers can even share the same views with the surgeon. This also facilitates more accurate documentation. Advances in imaging (such as CT and MRI) contributed to more accurate diagnosis and assessment of patient's condition pre- and post-operatively.

​ Destructive, sometimes even disfiguring, surgeries like Caldwell-Luc and external frontal surgery are being rapidly replaced by the delicate functional endoscopic sinus surgery. Everything is aiming at minimally invasive to the body but not so to the health budget. All these equipments are getting more sophisticated and more expensive everyday. The upside is less complication, less morbidity and shortened hospital stay. So it is money well spent. Our work, particularly in dealing with cancer, has extended to include head and neck diseases. Head and neck surgery became an important part of training syllabus. So after the formation of the College of Otorhinolaryngology in 1994, we renamed our Society as the Hong Kong Society of Otorhinolaryngology, Head & Neck Surgery.

The hospital environment has also change days of crowd steamy the establishment of the Hospital Authority in the 8O's. Gone are the days of crowded Steamy waiting room with wooden benches. Patients used to queue up at the crack of dawn outside the government clinic for an appointment in the afternoon. With the rapid increase in the number of ENT consultants and medical officers, all appointments are now pre-arranged and waiting areas are comfortably air-conditioned.

Consultation rooms now have endoscopes, video monitor and microscope as standard equipments. To get in line with the trend, private clinics have to be equally well equipped and luxuriously decorated, and thus the rising overhead.