title: Skull Base Surgery Training and Practice Patterns among Recent Otolaryngology Fellowship Graduates.
abstract: OBJECTIVE
  To collect data on skull base surgery training experiences and practice patterns of otolaryngologists that recently completed fellowship training.
  
  
  METHODS
  A 24-item survey was disseminated to physicians who completed otolaryngology fellowships in rhinology, head and neck oncology, or neurotology between 2010 and 2014.
  
  
  RESULTS
  During a typical year, 50% of rhinologists performed more than 20 endoscopic anterior skull base cases, 83% performed fewer than 20 open cases, and were more confident performing advanced transplanum (p = 0.02) and transclival (p = 0.03) endoscopic approaches than head and neck surgeons. Head and neck surgeons performed fewer than 20 endoscopic and fewer than 20 open cases in 100% of respondents and were more confident with open approaches than rhinologists (p = 0.02). Neurotologists performed more than 20 lateral skull base cases in 45% of respondents during a typical year, fewer than 20 endoscopic ear cases in 95%, and were very comfortable performing lateral skull base approaches.
  
  
  CONCLUSIONS
  Many recent otolaryngology fellowship graduates are integrating skull base surgery into their practices. Respondents reported high confidence levels performing a range of cranial base approaches. Exposure to endoscopic ear techniques is minimal in neurotology training, and rhinology training appears to offer increased exposure to skull base surgery compared with head and neck training.
authors.affiliation: Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, United States; Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, United States.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Dedmon
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Stanford University, Stanford, California, United States.
authors.forename: Garrett D
authors.initials: GD
authors.lastname: Locketz
authors.affiliation: Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, United States; Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, United States.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Chambers
authors.affiliation: Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, United States; Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, United States.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Naunheim
authors.affiliation: Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, United States; Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, United States.
authors.forename: Derrick T
authors.initials: DT
authors.lastname: Lin
authors.affiliation: Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, United States; Department of Otolaryngology-Head & Neck Surgery, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts, United States.
authors.forename: Stacey T
authors.initials: ST
authors.lastname: Gray
keywords: endoscopic skull base surgery; otolaryngology fellowship; practice patterns; survey