Totally endoscopic cartilage tympanoplasty: a hierarchical task analysis

Area of Science:

• Otolaryngology
• Surgical Innovation
• Patient Safety

Background:

• Totally endoscopic ear surgery represents a novel approach to otological procedures.
• Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) are effective methodologies for dissecting surgical skills.
• These methods are crucial for understanding and optimizing complex surgical workflows.

Purpose of the Study:

• To deconstruct the procedure of totally endoscopic tragal cartilage tympanoplasty using HTA.
• To apply SHERPA to identify and mitigate potential risks and errors in this surgical technique.
• To establish a standardized and safe protocol for endoscopic tympanoplasty.

Main Methods:

• Observation of 25 cases of endoscopic tragal cartilage tympanoplasty.
• Application of Hierarchical Task Analysis to identify procedural tasks and subtasks.
• Utilizing SHERPA to assess and address potential risks and error remediation strategies.

Main Results:

• A detailed HTA identified 8 main tasks and 50 subtasks for endoscopic tympanoplasty.
• Risk scores were calculated for each subtask, facilitating error identification.
• SHERPA analysis highlighted specific areas for risk reduction.

Conclusions:

• The HTA provides a clear, referenceable method for performing endoscopic tympanoplasty.
• SHERPA implementation effectively reduces risks associated with endoscopic procedures.
• This systematic approach enhances patient safety during endoscopic tympanoplasty.