What is the role of 'the letter to the editor'?

The letter to the editor plays a dual role in the literature. It serves a corrective critical function but also has the capacity to spread and share knowledge. We sought to identify the role and theme of letters to the editor published in four leading otorhinolaryngology journals, to elicit how well this form of communication is being utilised. All letters to the editor published in; Clinical Otolaryngology, The Laryngoscope, The European Archives of Otorhinolarygnology and The Journal of Laryngology and Otology, for the year 2012, were examined and the individual journal guidelines for submission of letters were noted. Seventeen different countries produced a total of 92 letters for the year 2012. The majority of letters originated from Otolaryngology/Head and Neck departments (78 %). Clinical Otolaryngology contributed to 58 % of total letters, of which 55 % were unrelated to original journal material (n = 29). The Laryngoscope published letters solely in response to original journal material. The Journal of Laryngology and Otology was the only journal to index letters with their corresponding article. More letters agreeing (49 %) than disagreeing (32 %) were published, with the remaining letters either clarifying or ignoring issues raised. Letters to the editor serve two main purposes; post-publication peer review and sharing experiences with fellow readers. Both are equally important in maintaining journals' high standards. Indexing needs to be improved otherwise valuable comment does not endure while the original manuscript's message lives on.