title: The learning curve of sialendoscopy with modular sialendoscopes: a single surgeon's experience.
abstract: OBJECTIVE
  To assess the learning curve of sialendoscopy with modular endoscopes based on operative parameters and a postoperative performance rating.
  
  
  METHODS
  Prospective study, case series.
  
  
  METHODS
  Tertiary referral hospital.
  
  
  METHODS
  The study included 50 consecutive patients who underwent sialendoscopy by a single surgeon (J.C.L.) between September 2007 and March 2009 at University Hospital of Cologne, Cologne, Germany. The patients were chronologically arranged into 5 groups of 10 patients.
  
  
  METHODS
  Diagnostic and interventional sialendoscopy using local anesthesia.
  
  
  METHODS
  Operative parameters and postoperative performance ratings.
  
  
  RESULTS
  The average operative time was 39 minutes, with a ratio of diagnostic to interventional sialendoscopy of 62%:38%. There was a significant improvement in the average operative time (P < .001) and in the average performance rating (P = .007) after the first 10 patients and again after the first 30 patients (P = .003 and P = .01, respectively). A continuous decrease in operation time was measurable up to the last patients. Performance ratings reached a level of excellence within the last group of patients.
  
  
  CONCLUSIONS
  The performance of sialendoscopy improves with time and experience. With endoscopes of a modular design, the surgeons have a remarkable learning curve. The surgeons' learning curve in this study required 30 cases to reach satisfactory operation times and performance ratings. Both parameters showed continuous improvement and a leveling off after 50 cases.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Cologne, 50924 Cologne, Germany. jan-christoffer.lueers@uk-koeln.de
authors.forename: Jan Christoffer
authors.initials: JC
authors.lastname: Luers
authors.forename: Michael
authors.initials: M
authors.lastname: Damm
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Klussmann
authors.forename: Dirk
authors.initials: D
authors.lastname: Beutner
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D003479:Curriculum; D004502:Education, Medical, Continuing; D019723:Endoscopes; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D013517:Otorhinolaryngologic Surgical Procedures / Q000193:education* / Q000295:instrumentation*; D010306:Parotid Gland / Q000601:surgery*; D015494:Salivary Gland Calculi / Q000175:diagnosis / Q000601:surgery*; D013363:Submandibular Gland / Q000601:surgery*; D013525:Surgical Instruments; D013996:Time and Motion Studies; D055815:Young Adult