ArticleThe journal of international advanced otology2021
Time Flow Study to Assess Opportunities to Improve Efficiency in Endoscopic Tympanoplasty.
Article in The journal of international advanced otology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Use of a Caprine Model for Simulation and Training of Endoscopic Ear surgery.The journal of international advanced otology · 2023Article
- Clinical Analysis of 85 Cases of External Auditory Canal Cholesteatoma Surgery under Specialized Endoscopy.BioMed research international · 2022Article
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Authors and funding
4 authors.
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Abstract
backgroundTo characterize the workflow during transcanal totally endoscopic tympanoplasty by recording the time and instrumentation used for different steps in the procedure. This analysis aims to identify aspects of instrumentation and surgical technique that could be modified to improve surgical efficiency.
methodsThirty-one endoscopic tympanoplasty procedures were observed at a single academic center. Patient age ranged from 2.7 to 17.8 years. The procedure was separated into distinct steps. The duration in minutes and the instruments used were recorded by an independent observer.
resultsRaising the tympanomeatal flap (median 9.82 minutes) and positioning the graft and replacing the flap (median 9.13 minutes) took significantly longer than all other steps (P < .05, Wilcoxon method). Teaching a trainee significantly increased step duration by a total of 32.8 minutes (P < .05, Wilcoxon method). There was no correlation between age of the patient, side of the ear, surgical technique, or graft type, and duration of surgery. Suction instruments with a functional tip (dissector or knife tip) were most commonly used to dissect and maneuver soft tissue while maintaining the surgical field clear of blood.
conclusionAs elevation of the tympanomeatal flap and graft placement are the most time-consuming steps in endoscopic tympanoplasty, especially for surgical trainees, surgical efficiency could most dramatically be enhanced by modification of instrumentation or technique to facilitate these steps. Modification of simpler steps such as hair trimming and ear canal packing have less potential for shortening surgical duration.
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