PROSPECTIVE-STUDY OF RESIDENT-PERFORMED STAPEDECTOMY

Because of the diminishing number of patients diagnosed with otosclero sis, the adequacy of residency training in stapedectomy techniques rem ains controversial. A prospective study, conducted from 1986 to 1991, assessed whether or not surgical outcome obtained by residents, under close supervision by otologic faculty, could be improved using a singl e stapedectomy technique. Comparison of pre- and postoperative hearing results (pure-tone averages of 500, 1 000, and 2000 Hz) from 49 cases revealed closure of the air-bone gap to within 10 dB in 68 percent of procedures. Complications included failure to improve the conductive hearing loss, tympanic membrane perforations, transient facial nerve w eakness, subluxation of the incus, and adhesions. The failure to impro ve the success rate in resident-performed procedures relates to the in dividual learning curve and the limited number of training cases.