Training in neurorhinology: the impact of case volume on the learning curve

This article presents a current view of training in neurorhinology and focuses on the level of evidence for the clinical question of "how many cases are needed to achieve proficiency in endoscopic endonasal skull base surgery?" The authors discuss what defines surgical proficiency, what makes up the learning curve and how it shifts with increasing experience, comparisons of learning curves for different skull base surgeries, and conclude with a discussion and recommendations for achieving high-level proficiency.