title: Endoscopic ear surgery in Canada: a cross-sectional study.
abstract: BACKGROUND
  Endoscopic ear surgery is an emerging technique with recent literature highlighting advantages over the traditional microscopic approach. This study aims to characterize the current status of endoscopic ear surgery in Canada and better understand the beliefs and concerns of the otolaryngology - head & neck surgery community regarding this technique.
  
  
  METHODS
  A cross-sectional survey study of Canadian otolaryngologists was performed. Members of the Canadian Society of Otolaryngology were contacted though an online survey carried out in 2015.
  
  
  RESULTS
  The majority of participants in this study (70%) used an endoscope in their practice, with a large proportion utilizing the endoscope for cholesteatoma or tympanoplasty surgery. To date, 38 Canadian otolaryngologists (70% of respondents) have used an endoscope for at least 1 surgical case, but only 6 (11%) have performed more than 50 endoscopic cases. Of the otolaryngologists who use endoscopes regularly, the majority still use the microscope as their primary instrument and use the endoscope only as an adjunct during surgery. However, the general attitude surrounding endoscopes is positive; 81% believe that endoscopes have a role to play in the future of ear surgery and 53% indicated they were likely to use endoscopes in their future practice. Participants who were earlier in their practice or who had more exposure to endoscopic techniques in their career were more likely to have a positive stance towards endoscopic ear surgery (p < 0.05, p < 0.01, respectively). The main concern regarding endoscopic ear surgery was the technical challenge of one-handed surgery, while the primary perceived advantage was the reduced rates of residual or recurrent disease.
  
  
  CONCLUSIONS
  Endoscopic ear surgery is a new technique that is gaining momentum in Canada and there is enthusiasm for its incorporation into future practice. Further investment in training courses and guidance for those looking to start or advance the use of endoscopes in their practice will be vital in the years to come.
authors.affiliation: University of British Columbia, Division of Otolaryngology - Head and Neck Surgery, 4th Floor, 2775 Laurel Street, Vancouver General Hospital, Vancouver, BC, V5Z 1 M9, Canada. m.yong@alumni.ubc.ca.
authors.forename: Michael
authors.initials: M
authors.lastname: Yong
authors.affiliation: McGill University, Department of Otolaryngology - Head and Neck Surgery, Royal Victoria Hospital - D05.5712, 1001 Décarie Boul, Montreal, H4A 3 J1, Canada. tamara.mijovic@mcgill.ca.
authors.forename: Tamara
authors.initials: T
authors.lastname: Mijovic
authors.affiliation: University of British Columbia, Division of Otolaryngology - Head and Neck Surgery, ENT Clinic, 1081 Burrard Street, St. Paul's Hospital, Vancouver, BC, V6Z 1Y6, Canada. jlea@providencehealth.bc.ca.
authors.forename: Jane
authors.initials: J
authors.lastname: Lea
mesh_terms: D002170:Canada; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004427:Ear Diseases / Q000601:surgery*; D004432:Ear, Middle / Q000601:surgery*; D004724:Endoscopy / Q000706:statistics & numerical data*; D006801:Humans; D013506:Otologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*