Trainee-trainer outcomes in mastoid surgery: a comparative study

Area of Science:

• Otolaryngology
• Surgical Education
• Neurosurgery

Background:

• Mastoid exploration is a crucial surgical procedure in Ear, Nose, and Throat (ENT) practice.
• The involvement and outcomes of surgical trainees in these operations have been a subject of ongoing discussion.

Purpose of the Study:

• To compare the outcomes of mastoid exploration surgeries performed by surgical trainees versus experienced consultants.
• To assess the safety and efficacy of trainee involvement in advanced ENT procedures.

Main Methods:

• A retrospective audit of 118 mastoid exploration surgeries (cortical mastoidectomy, atticotomy, atticoantrostomy, modified radical mastoidectomy, combined-approach tympanoplasty, revision mastoidectomy) conducted between 2009 and 2020.
• Complications including facial palsy, labyrinth injury, dead ear, and disease recurrence were evaluated.
• The chi-square test was employed to analyze statistical significance.

Main Results:

• Out of 118 surgeries, 35% (n=41) were performed by trainees and 65% (n=77) by consultants.
• Disease recurrence was observed in 5% of trainee cases and 7.8% of consultant cases (p=0.55), with no statistically significant difference.
• No other complications were reported in either group.

Conclusions:

• The study found no significant increase in complication rates when comparing surgical trainees to consultants in mastoid exploration.
• Trainees likely managed less complex cases, and their gradual integration did not negatively impact patient safety.
• These findings support the safe incorporation of trainees into advanced ENT surgical training.