title: Time trend analysis of otological procedures performed in England, 1989 to 2005.
abstract: OBJECTIVE
  To observe trends in the number of major otological procedures performed in England, in the context of advances in the understanding of disease.
  
  
  METHODS
  The data used were obtained from the Hospital Episode Statistics statistical database, published by the UK Department of Health, for England, 1989 to 2005. Specific otological procedures were identified using the Classification of Surgical Operations and Procedures system (fourth revision) of the Office of Population, Censuses and Surveys. Trend analysis of different procedures was performed using exponential smoothing (using the Statistical Package for the Social Sciences version 13 software).
  
  
  RESULTS
  Our study did not confirm any reduction in the number of surgical procedures performed for cholesteatoma or otosclerosis. We noted a sharp decline in the number of endolymphatic sac surgical procedures performed, probably attributable to the increased use of intratympanic therapy.
  
  
  CONCLUSIONS
  The number of major otological procedures (other than endolymphatic sac surgery) was consistent over the period examined. The generally perceived reduction in the number of procedures performed by individual surgeons may be due to a dilutional effect. This can only support the need for subspecialisation, particularly regarding the training of junior surgeons.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Royal Devon and Exeter Hospital, Exeter, UK. ckhari@doctors.org.uk
authors.forename: C K
authors.initials: CK
authors.lastname: Hari
authors.forename: R
authors.initials: R
authors.lastname: Powell
authors.forename: G M
authors.initials: GM
authors.lastname: Weiner
mesh_terms: D018424:Cholesteatoma, Middle Ear / Q000453:epidemiology / Q000601:surgery; D016208:Databases, Factual; D004429:Ear Ossicles / Q000601:surgery; D004712:Endolymphatic Sac / Q000601:surgery; D004739:England / Q000453:epidemiology; D006801:Humans; D008416:Mastoid / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000706:statistics & numerical data / Q000639:trends*; D010040:Otosclerosis / Q000601:surgery; D013201:Stapes Surgery / Q000706:statistics & numerical data / Q000639:trends; D013222:State Medicine / Q000706:statistics & numerical data / Q000639:trends