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Updated: Jun 12, 2026
Endaural Endoscopic Atticoantrotomy (Retrograde Mastoidectomy) using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Objective assessment of mastoidectomy skills in the operating room
Howard W Francis1, Hamid Masood, Kashif N Chaudhry
1Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Objective(S):
To determine the feasibility and validity of an objective assessment tool designed to measure the development of mastoidectomy skills by resident trainees in the operating room.
Study Design:
Prospective longitudinal validation study.
Setting:
Tertiary referral center and residency training program.
Subjects:
Otolaryngology residents.
Main Outcome Measure:
Technical performance as measured over time using Task-Based Checklist (TBC) and Global Rating Scale (GRS) developed for assessment of mastoidectomy skills.
Results:
: Seventy pairs of evaluations were completed on 15 residents, showing strong correlation between both instruments (r = 0.93; p < 0.0001). Our instrument demonstrated construct validity for both TBC and GRS, showing higher scores with increasing surgical experience in otology. Both instruments showed high interitem reliability with Cronbach alpha coefficients of 0.98 and 0.95 for TBC and GRS, respectively. Regression analysis showed that thinning posterior external auditory canal (p < 0.05) and opening antrum to deepen dissection at sinodural angle (p < 0.05) were the strongest predictors of overall surgical performance.
Conclusion:
Our assessment tool is a feasible and valid method of evaluating acquisition of mastoidectomy skills in the operating room. It can be integrated into surgical teaching in the operating room and yields information for direct formative feedback.