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How difficult is it to learn different steps of a cortical mastoidectomy?
Jesslyn Clarance Lamtara1, Sudanthi Wijewickrema2, Stephen O'Leary2,3
1Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Victoria, Australia. jlamtara@student.unimelb.edu.au.
Summary
Novice and intermediate surgeons find different cortical mastoidectomy steps challenging compared to expert opinions, highlighting a need for targeted surgical training and assessment.
Area of Science:
- Otolaryngology
- Surgical Education
- Medical Simulation
Background:
- Effective surgical training requires understanding difficulty levels of specific surgical steps.
- Cortical mastoidectomy training needs clear assessment of trainee performance against expert benchmarks.
Purpose of the Study:
- To identify challenging steps in cortical mastoidectomy for novice and intermediate surgeons.
- To compare trainee performance with expert opinions on surgical difficulty and teaching challenges.
Main Methods:
- 30 participants (novices, intermediates, experts) performed virtual reality cortical mastoidectomy on 8 specimens.
- Performance was evaluated using the Melbourne Mastoidectomy Scale (MMS).
- Expert otologists also rated the teaching difficulty of MMS items.
Main Results:
- Novices excelled at mastoid definition and antrum entry.
- Intermediates struggled with sigmoid sinus and semicircular canal tasks.
- Experts found facial nerve and middle fossa plate exposure difficult to teach, yet intermediates performed similarly to experts on these.
Conclusions:
- Discrepancies between intermediate performance and expert opinion suggest training may overemphasize complex skills.
- Findings support targeted feedback, assessment, and curriculum refinement for cortical mastoidectomy training.
- Virtual reality simulation offers a platform for objective surgical skill evaluation.
