Does microscopic experience influence learning curve in endoscopic ear surgery? A multicentric study

Daniela Lucidi, Ignacio Javier Fernandez, Cecilia Botti, Luca Amorosa, Matteo Alicandri-Ciufelli, Domenico Villari, Livio Presutti

Research output: Contribution to journalArticlepeer-review


Objective: The aim of the present study was to illustrate the learning curve of endoscopic type-1 tympanoplasty comparing experts in microscopic otology versus neophyte surgeons. Methods: Eight ear surgeons, from tertiary referral centers, who had performed at least 30 endoscopic type 1 tympanoplasties were included in the study. Demographic data and medical records regarding the first 30 endoscopic type-1 tympanoplasties were retrospectively collected by each surgeon. A 14-questions survey focused on subjective aspects of the learning curve was administered. Surgeons were divided in two groups: one with previous experience in microscopic ear surgery (group 1) and one with no previous experience in ear surgery (group 2). The learning curve of endoscopic type 1 tympanoplasty was compared between the groups. Results: Mean surgical time was 89.2 min in group 1 vs. 79.5 min in group 2 (p < 0.01). When divided in 5 surgeries-steps, the only significant difference was appreciated in the first 5 surgeries with a longer mean time in group 1 vs. group 2 (+28.4 min; p < 0.05). Conclusions: Surgeon's previous experience may influence the EES learning curve. Our results show that the first 5 surgical procedures are more challenging for surgeons experienced in microscopic surgery, subsequently the curve progression improves sharply and appears reversing the initial trend by the end of the 30 surgeries.

Original languageEnglish
Pages (from-to)50-56
Number of pages7
JournalAuris Nasus Larynx
Issue number1
Publication statusPublished - Feb 2021


  • EES
  • Endoscopic ear surgery
  • Learning curve
  • Training
  • Tympanic membrane perforation
  • Type I tympanoplasty

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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