Related Experiment Video
Updated: Aug 22, 2025
Endaural Endoscopic Atticoantrotomy Retrograde Mastoidectomy using a Constant Suction Bone-drilling Technique
Published on: May 23, 2021
Video Analysis of Otologic Instrument Movement During Resident Mastoidectomies
Royal M Pipaliya1, Mallory J Raymond, M Andrew Rowley
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.
Objective:
To measure surgical instrument movement during resident mastoidectomies and identify metrics that correlate with experience.
Study Design:
Retrospective case series.
Setting:
Tertiary care center.
Subjects:
Ten postgraduate year (PGY) 2, 6 PGY3, 7 PGY4, and 19 PGY5 recordings of mastoidectomy performed by otolaryngology residents.
Interventions:
One-minute intraoperative recordings of mastoidectomies performed during cochlear implantation were collected. Drill and suction-irrigator motion were analyzed with sports motion tracking software.
Main Outcome Measures:
Mean instrument speed, angle, and angular velocity were calculated. Mann-Whitney U tests compared mean instrument metrics between PGY levels. Change in drill speed for seven residents between their PGY2 to PGY5 years was individually analyzed.
Results:
Mean drill speed was significantly greater for PGY5 residents compared with PGY2s (2.9 versus 1.8 cm/s, p = 0.001). Compared with PGY2 residents, suction speed was greater as a PGY5 (1.2 versus 0.9 cm/s; p = 0.201) and significantly greater as a PGY4 (1.5 versus 0.9 cm/s, p = 0.039). Of the seven residents individually analyzed, group mean drill speed increased by 0.4 cm/s, yearly.
Conclusions:
Drill and suction-irrigator movement during the second minute of drilling of a cortical mastoidectomy seems to increase with resident level. Objective video analysis is a potential adjunct for differentiating novices from more experienced surgeons and monitoring surgical skills progress.
