First 100 stapedotomies of a surgeon: learning curve and functional results

First 100 stapedotomies of a surgeon: learning curve and functional results. Objective: Otosclerosis is a common otologic disease that mostly requires surgical treatment. This study aimed to analyse stapedotomy results and establish a learning curve. Method: This retrospective study analysed the first 100 stapedotomies of a young surgeon. We measured the pre- and postoperative bone conduction (BC), air conduction (AC) threshold, and mean air-bone-gap (ABG) values. The Amsterdam Hearing Evaluation Plots method, proposed previously, was used to represent audiometric results. We also reproduced the learning curve described previously. Results: We identified 9 cases with post-operative complications. No dead ear outcome occurred. BC deterioration appeared in 5 cases, but they were not related to surgeon experience. A post-operative ABG <20 dB was observed in 81% of the operated ears, consistent with results from previous studies on other young surgeons. The stapes surgery learning curve showed 2 peaks with post-operative ABGs <10 dB. However, these results were not sustainable, probably due to the introduction of new devices and the increasing difficulty of the cases. Conclusions: Stapes surgery involves surgical skills that are acquired after training. This learning is facilitated by the use of one single device, rather than several devices. Sufficient patient recruitment is required to preserve expertise.