The learning curve revisited: stapedotomy.
OBJECTIVE
To determine whether the outcome of stapedotomy changes with experience.


METHODS
Retrospective case review of an academic otologic practice of a fellowship-trained otologist that consisted of 50 consecutive patients who underwent primary stapedotomy. The main outcome measures were preoperative and postoperative audiograms for both the operated ear and the opposite ear (control).


RESULTS
There were no major complications or loss of hearing among the 50 patients. Minor complications included 1 middle ear infection, 2 torn flaps, and 1 tympanic membrane perforation. One patient had worse conductive hearing loss after surgery. The hearing of 2 patients was unchanged. Hearing for the entire group improved (P > 0.001) from a speech reception threshold of 55 dB (SD, 17 dB) to 30 dB (SD, 19 dB). Complete closure of the air-bone gap was achieved in 20% of the first 10 patients and 30% of the last 10 patients.


CONCLUSIONS
The results of stapedotomy improve with experience, although the learning curve seems less steep than has been reported for total or near-total footplate removal.


CONCLUSIONS
Stapedotomy can be successfully performed early in surgical experience, but the learning curve should be acknowledged and discussed with the patient.
Sargent
Eric W
EW
Department of Otolaryngology, Division of Otology and Neurotology, St. Louis University, Missouri, USA. sargente@mac.com
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D013067:Speech Perception; D013201:Stapes Surgery / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*