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The Microscopic Transcanal Approach in Stapes Surgery Revisited
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Does microscopic experience influence learning curve in endoscopic ear surgery? A multicentric study.

Daniela Lucidi1, Ignacio Javier Fernandez1, Cecilia Botti2

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Modena and Reggio Emilia, University Hospital of Modena, Via del Pozzo 71, Modena, Italy.

Auris, Nasus, Larynx
|July 19, 2020
PubMed
Summary
This summary is machine-generated.

Surgeons experienced in microscopic ear surgery faced initial challenges learning endoscopic type-1 tympanoplasty. However, their learning curve improved significantly, surpassing novices by the end of 30 procedures.

Keywords:
EESEndoscopic ear surgeryLearning curveTrainingTympanic membrane perforationType I tympanoplasty

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Area of Science:

  • Otolaryngology
  • Surgical Education
  • Minimally Invasive Surgery

Background:

  • Endoscopic ear surgery (EES) is a rapidly evolving field.
  • Understanding the learning curve for new surgical techniques is crucial for safe and effective patient care.
  • Comparing the learning trajectories of surgeons with and without prior microscopic experience is essential for training programs.

Purpose of the Study:

  • To compare the learning curve of endoscopic type-1 tympanoplasty between surgeons with and without prior microscopic otology experience.
  • To identify specific challenges and progression patterns during the initial stages of adopting endoscopic tympanoplasty.

Main Methods:

  • Retrospective analysis of demographic data and surgical records for the first 30 endoscopic type-1 tympanoplasties in eight surgeons.
  • Surgeons were divided into two groups: experienced in microscopic ear surgery (Group 1) and neophytes (Group 2).
  • A survey assessed subjective learning curve experiences.

Main Results:

  • Mean surgical time was significantly lower in Group 2 (neophytes) compared to Group 1 (experienced) (79.5 min vs. 89.2 min, p < 0.01).
  • The most significant difference in surgical time was observed in the first five procedures, with Group 1 taking longer (p < 0.05).
  • Group 1 showed a sharp improvement after the initial surgeries, reversing the initial trend by the end of 30 procedures.

Conclusions:

  • Previous microscopic ear surgery experience influences the learning curve for endoscopic type-1 tympanoplasty.
  • Neophyte surgeons may initially perform faster, but experienced surgeons demonstrate rapid improvement and potentially superior long-term outcomes.
  • Training programs should consider tailored approaches for surgeons transitioning from microscopic to endoscopic techniques.