Task performance in stapedotomy: comparison between surgeons of different experience levels.
OBJECTIVE
Two steps in stapedotomy are particularly challenging: (1) micropick fenestration of the stapes footplate (SF) and (2) crimping of the stapes prosthesis (SP) to the incus. We conducted trials to determine if experience correlates with differences in performance for these tasks.


METHODS
In a surgical model of stapedotomy, performance was measured for 3 experienced and 3 novice surgeons. For fenestration, we measured ability to target the fenestration and force applied to the SF. For crimping, we measured crimp quality, movement of the SP during crimping, and force applied to the SF.


RESULTS
Experienced surgeons demonstrated significantly better ability to target the fenestration and, during crimping, caused less SP movement and a significantly lower rate of SP dislodgment.


CONCLUSIONS
Clear differences in task performance are measurable between more and less experienced surgeons during critical steps of stapedotomy.


CONCLUSIONS
The observed differences in task performance may contribute to an understanding of maneuvers that increase the risk of inadequate prosthesis placement and cochlear trauma-factors likely responsible for variable hearing results with strapedotomy.
Rothbaum
Daniel L
DL
Department of Otolaryngology-Head and Neck Surgery, Center for Computer Integrated Surgical Systems and Technology, Johns Hopkins University, Baltimore, MD 21287, USA. rothbaum@robotics.me.jhu.edu
Roy
Jaydeep
J
Hager
Gregory D
GD
Taylor
Russell H
RH
Whitcomb
Louis L
LL
Francis
Howard W
HW
Niparko
John K
JK
D002983:Clinical Competence; D005276:Fenestration, Labyrinth / Q000379:methods; D006801:Humans; D008953:Models, Anatomic; D009998:Ossicular Prosthesis; D013506:Otologic Surgical Procedures / Q000193:education; D010818:Practice Patterns, Physicians'; D011336:Probability; D012680:Sensitivity and Specificity; D013201:Stapes Surgery / Q000379:methods*; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis