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Trainee-trainer outcomes in mastoid surgery: a comparative study.

M F Flynn1, A Sheldon1, M Bannister1

  • 1Department of Otolaryngology - Head and Neck Surgery, Victoria Hospital, Kirkcaldy, Scotland, UK.

The Journal of Laryngology and Otology
|October 27, 2021
PubMed
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Surgical trainees performing mastoid exploration operations showed no significant increase in complication rates compared to consultants. This indicates that integrating trainees into these advanced ENT procedures does not compromise patient safety.

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.
Keywords:
EarMastoidectomyOtolaryngology

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  • 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.