Does microscopic experience influence learning curve in endoscopic ear surgery? A multicentric study

Abstract

The aim of the present study was to illustrate the learning curve of endoscopic type-1 tympanoplasty comparing experts in microscopic otology versus neophyte surgeons. Methods: Eight ear surgeons, from tertiary referral centers, who had performed at least 30 endoscopic type 1 tympanoplasties were included in the study. Demographic data and medical records regarding the first 30 endoscopic type-1 tympanoplasties were retrospectively collected by each surgeon. A 14-questions survey focused on subjective aspects of the learning curve was administered. Surgeons were divided in two groups: one with previous experience in microscopic ear surgery (group 1) and one with no previous experience in ear surgery (group 2). The learning curve of endoscopic type 1 tympanoplasty was compared between the groups. Results: Mean surgical time was 89.2 min in group 1 vs. 79.5 min in group 2 (p < 0.01). When divided in 5 surgeries-steps, the only significant difference was appreciated in the first 5 surgeries with a longer mean time in group 1 vs. group 2 (+ 28.4 min; p < 0.05). Conclusions: Surgeon's previous experience may influence the EES learning curve. Our results show that the first 5 surgical procedures are more challenging for surgeons experienced in microscopic surgery, subsequently the curve progression improves sharply and appears reversing the initial trend by the end of the 30 surgeries.

Effects of Total Intravenous Versus Inhalational Anesthesia on Bleeding During Endoscopic Ear Surgery: Preliminary Results From a Case-Control Study

“…As previously reported, the initial steps of EES, specifically the elevation of the TMF, are challenging for novice surgeons, as they require the frequent cleaning of the tip of the endoscope (2,25). Indeed, the most common localization of bleeding is in the posterior and superior portions of the EAC, where the main vascular supply is located.…”

External ear canal exostectomy: influence of surgeon’s experience on 3-years recurrence and occurrence of complications

“…13 In endoscopic stapes surgery, the learning curve has also been studied, with similar functional results to those of microscopic surgery, with the same rate of complications. 14,15 In Stapedotomy with a standardized laser-assisted surgical technique, Kwok et al found no difference between experienced and novice surgeons (58 vs 12 ears, respectively). 16 One limitation of this study is the difference in population size, with 76 ears in the senior group vs 10 in the junior group and 12 in the beginner group.…”

Endoskopische Ohrchirurgie in Deutschland

“…Allerdings kann auch erfahrenen Operateur*innen der Umstieg auf das Endoskop im Mittelohr schwerfallen. Meist gelingt jedoch eine Umgewöhnung bereits nach wenigen Eingriffen [ 13 ]. Mit zunehmender Anzahl durchgeführter EES-Eingriffe gewinnt diese Methode für Operierende meist an Nutzen.…”

“…An einer Studie von 8 erfahrenen Ohrchirurg*innen konnten Lucidi und Presutti am Beispiel der Typ-I-Tympanoplastik zeigen, dass besonders die ersten 5 Eingriffe langwierig waren. Nach etwa 30 Eingriffen kam es zu einer weiteren deutlichen Absenkung der Op.-Dauern [ 13 ].…”