Learning curve in endoscopic sinus surgery

The existence of a long learning curve for endoscopic sinus surgery has bee n proposed as a reason for rigorous and extensive training to prepare physi cians to perform this surgery. In this article, the author-who participated in this type of training program-examines his experience over a 5-year per iod to assess the effect of rigorous training on the learning curve for end oscopic sinus surgery. Beginning with the first day of practice after train ing, 5 years with 393 cases were evaluated for complications and the need f or revision surgery. The results were analyzed in 100-case groups. The resu lts show no difference in major and serious complications or revision surge ry rates. However, a statistically significant difference in the minor-comp lication rate, specifically frontal-sinus stenosis, was found from the firs t half to the second half of the experience. These findings show that, with rigorous training of the physician, the learning curve can largely be comp leted during residency training, allowing the new practitioner to perform e ndoscopic sinus surgery safely and with good results.