Importance: To provide a current evaluation of bibliometric trends in the Otolaryngology literature focused on randomized controlled trials (RCTs). RCTs hold an important role in research as bias controlled assessments of clinical interventions. Objective: The purpose of this study is to evaluate the proportion of published RCTs in the Otolaryngology literature. Design: Quality Improvement scoping bibliometric review. Setting: Published articles in eight Otolaryngology journals from January 1, 2016 - December 31, 2020. Main Outcomes and Measures: Included articles were categorized as a RCT, secondary research, other clinical research, case report, primary basic science, or other study type. Additionally, studies were categorized as American, Canadian, British, or other international origin according to the corresponding author’s institutional address. The proportion of published RCTs were compared by national origin and to an earlier bibliometric analysis investigating Otolaryngology journal publications from 2008-2012 using Pearson’s Chi-Squared testing with Bonferroni correction. Results: A total of 6797 articles were reviewed and included for analysis. There was a significant difference in the proportion of RCTs published by national origin, 1.3% USA, 2.2% Canada, 2.7% UK, 3.4% other (p < 0.01). There was a significant decrease in the proportion of RCTs published from 2008-12 to 2016-2020 (3.1% vs. 2.3% respectively, p < 0.01). Conclusions: Although the current study analyzed only a select sample of all Otolaryngology research output, this study suggests that North American researchers are publishing less RCTs than researchers in other countries. Moreover, RCTs are declining as a proportion of the published Otolaryngology literature over time, which is a threat to the evidence base for current and future Otolaryngological practice.

KEY POINTS 1. This is the first study to use a qualitative methodology to assess the potential advantages and disadvantages of the application of 3D endoscopes in pediatric otolaryngology surgery. 2. Open-ended, structured interviews were conducted with six pediatric Otolaryngologist operating at a tertiary pediatric centre, with a minimum one year of experience using a 3D endoscopy system. 3. Thematic analysis of the surgeon's responses identified 3D endoscopy to provide improved surgical field visualization which thus served as a valuable teaching tool. 4. The surgeons interviewed found 3D endoscopy to improve surgical outcomes in pediatric airway surgery, particularly in surgeries involving the larynx. 5. Further quantitative evaluation of patient outcomes could delineate the precise clinical role 3D endoscopy may hold in future pediatric Otolaryngology practice.