Modern Trends in Otologic Surgery and Implications for Residency Training

Area of Science:

• Otolaryngology
• Surgical Trends
• Medical Education

Background:

• Stapedectomy and ossiculoplasty are key skills for otolaryngologists.
• Surgeons face challenges in acquiring and maintaining proficiency in these procedures.
• Pre-pandemic trends in these surgeries are not well-characterized.

Purpose of the Study:

• To analyze trends in stapedectomy and ossiculoplasty procedures before 2020.
• To understand the volume changes in these middle ear surgeries over a decade.

Main Methods:

• A review of the Tricare database for procedures performed between 2010 and 2019.
• Identification of stapedectomy and ossiculoplasty cases using Current Procedural Terminology (CPT) codes.
• Analysis of data from civilian and military treatment facilities.

Main Results:

• A total of 3052 stapedectomies and 7197 ossiculoplasties were performed.
• Stapedectomy cases decreased by 23% (average annual rate of -2.7%).
• Ossiculoplasty cases declined by 18% (average annual rate of -1.9%).

Conclusions:

• Both stapedectomy and ossiculoplasty surgeries have shown consistent declines.
• Cochlear implantation volumes may soon exceed combined stapedectomy and ossiculoplasty rates.
• These shifts necessitate a re-evaluation of otolaryngology residency training priorities, potentially replacing stapedectomy/ossiculoplasty with cochlear implantation as a key indicator.