title: Audiometric outcomes of tympanoplasty with hydroxylapatite prosthesis: consultant versus trainees.
abstract: OBJECTIVE
  To assess and compare the audiometric outcomes and surgical complication rates of tympanoplasty with hydroxylapatite (HA) prostheses performed by a single consultant and advanced trainees.
  
  
  METHODS
  A retrospective case review was undertaken.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  One hundred eighteen cases of primary and revision tympanoplasty were included in the study performed during a 6-year period.
  
  
  METHODS
  Tympanoplasty with HA prosthesis.
  
  
  METHODS
  Preoperative and postoperative audiometric data were compared for both the consultant and trainee groups. Details of the surgical procedure and operative complications were also recorded.
  
  
  RESULTS
  Fifty-eight procedures were performed by the consultant and 60 operations were performed by trainees. The average improvement in air-bone gap (ABG) for consultants was 14.8 dB, with a 95% confidence interval (10.4, 19.2) (paired t test; test statistic: t=6.80, 57 df, p<0.01), whereas for trainees, the average improvement in ABG was 7.8 dB, with a 95% confidence interval (4.1, 11.6) (paired t test; test statistic: t=4.19, 59 df, p<0.01). The difference of 7.0 dB in mean ABG between the 2 groups was significant (two-sample t test; test statistic: t=2.44, 116 df, p=0.02). There was no significant difference in the surgical procedure or in the number of revision operations performed by the consultant or trainees. Surgical complication rates were comparable for the two groups.
  
  
  CONCLUSIONS
  In this series, the consultant achieved a significantly better closure in ABG than trainees for tympanoplasty with HA prostheses.
authors.affiliation: Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK. sdcharlett@doctors.org.uk
authors.forename: Simon D
authors.initials: SD
authors.lastname: Charlett
authors.forename: A R F
authors.initials: AR
authors.lastname: Scott
authors.forename: Helen
authors.initials: H
authors.lastname: Richardson
authors.forename: Maurice R
authors.initials: MR
authors.lastname: Hawthorne
authors.forename: Anirvan
authors.initials: A
authors.lastname: Banerjee
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods*; D001672:Biocompatible Materials; D018424:Cholesteatoma, Middle Ear / Q000601:surgery; D002983:Clinical Competence; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D006314:Hearing Loss, Conductive / Q000628:therapy; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009998:Ossicular Prosthesis; D011182:Postoperative Care; D011300:Preoperative Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite