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Safety of tympanoplasty and ossiculoplasty performed by otorhinolaryngology trainees

  • F Alzhrani (a1), R Aldueb (a2), K Alosaimi (a3), T Islam (a4), F Almuhawas (a1) and A Alsanosi (a1)...



This study aimed to examine the impact of trainee involvement in performing tympanoplasty or tympano-ossiculoplasty on outcomes.


A retrospective analysis was performed of a prospective database of all patients undergoing tympanoplasty and tympano-ossiculoplasty in a single centre during a three-year period. Patients were divided into three primary surgeon groups: consultants, fellows and residents. The outcomes of operative time, surgical complications, length of hospital stay, and air–bone gap improvement were compared among the groups.


The study included 398 tympanoplasty and tympano-ossiculoplasty surgical procedures, 71 per cent of which were performed by junior trainees (residents). The junior trainee group was associated with a significantly longer surgical time, without adverse impact on outcomes.


Trainee participation in tympanoplasty and tympano-ossiculoplasty surgery was associated with longer surgical time, but did not negatively affect the peri-operative course or hearing outcome. Therefore, resident involvement in these types of surgery is safe.


Corresponding author

Author for correspondence: Dr Farid Alzhrani, King Abdullah Ear Specialist Center, College of Medicine, King Saud University, PO Box 245, Riyadh11411, Saudi Arabia E-mail: Fax: +966 11 477 5524


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Dr F Alzhrani takes responsibility for the integrity of the content of the paper



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1Liu, CY, Yu, EC-H, Shiao, AS, Wang, MC. Learning curve of tympanoplasty type I. Auris Nasus Larynx 2009;36:26–9
2Naderpour, M, Jabbari Moghadam, Y, Ghanbarpour, E, Shahidi, N. Evaluation of factors affecting the surgical outcome in tympanoplasty. Iran J Otorhinolaryngol 2016;28:99104
3Anzola, JF, Nogueira, JF. Endoscopic techniques in tympanoplasty. Otolaryngol Clin North Am 2016;49:1253–64
4Owa, AO, Gbejuade, HO, Giddings, C. A middle-ear simulator for practicing prosthesis placement for otosclerosis surgery using ward-based materials. J Laryngol Otol 2003;117:490–2
5Piromchai, P, Ioannou, I, Wijewickrema, S, Kasemsiri, P, Lodge, J, Kennedy, G et al. Effects of anatomical variation on trainee performance in a virtual reality temporal bone surgery simulator. J Laryngol Otol 2017;131:S2935
6Emir, H, Ceylan, K, Kizilkaya, Z, Gocmen, H, Uzunkulaoglu, H, Samim, E. Success is a matter of experience: type 1 tympanoplasty: influencing factors on type 1 tympanoplasty. Eur Arch Otorhinolaryngol 2007;264:595–9
7Wexner, T, Rosales-Velderrain, A, Wexner, SD, Rosenthal, RJ. Does implementing a general surgery residency program and resident involvement affect patient outcomes and increase care-associated charges? Am J Surg 2017;214:147–51
8Feeney, T, Price, LL, Chen, L, Graham, R, Chatterjee, A. Resident and fellow participation in thyroid and parathyroid surgery: an ACS-NSQIP clinical outcomes analysis. J Surg Res 2017;220:346–52
9Virk, SA, Bowman, SRA, Chan, L, Bannon, PG, Aty, W, French, BG et al. Equivalent outcomes after coronary artery bypass graft surgery performed by consultant versus trainee surgeons: a systematic review and meta-analysis. J Thorac Cardiovasc Surg 2016;151:647–54
10DiDato, S, Farber, A, Rybin, D, Kalish, JA, Eslami, MH, Moreira, CC et al. The effect of trainee involvement on perioperative outcomes of abdominal aortic aneurysm repair. J Vasc Surg 2016;63:1622
11Cvetanovich, GL, Schairer, WW, Haughom, BD, Nicholson, GP, Romeo, AA. Does resident involvement have an impact on postoperative complications after total shoulder arthroplasty? An analysis of 1382 cases. J Shoulder Elbow Surg 2015;24:1567–73
12Saliba, AN, Taher, AT, Tamim, H, Harb, AR, Mailhac, A, Radwan, A et al. Impact of resident involvement in surgery (IRIS-NSQIP): looking at the bigger picture based on the American College of Surgeons-NSQIP Database. J Am Coll Surg 2016;222:3040
13Uecker, J, Luftman, K, Ali, S, Brown, C. Comparable operative times with and without surgery resident participation. J Surg Educ 2013;70:696–9
14Cobb, AN, Eguia, E, Janjua, H, Kuo, PC. Put me in the game coach! Resident participation in high-risk surgery in the era of big data. J Surg Res 2018;232:308–17
15Pollei, TR, Barrs, DM, Hinni, ML, Bansberg, SF, Walter, LC. Operative time and cost of resident surgical experience: effect of instituting an otolaryngology residency program. Otolaryngol Head Neck Surg 2013;148:912–18
16Vieira, BL, Hernandez, DJ, Qin, C, Smith, SS, Kim, JY, Dutra, JC. The impact of resident involvement on otolaryngology surgical outcomes. Laryngoscope 2016;126:602–7
17Baker, AB, Ong, AA, O'Connell, BP, Sokohl, AD, Clinkscales, WB, Meyer, TA. Impact of resident involvement in outpatient otolaryngology procedures: an analysis of 17,647 cases. Laryngoscope 2017;127:2026–32
18Jackson, TD, Wannares, JJ, Lancaster, RT, Rattner, DW, Hutter, MM. Does speed matter? The impact of operative time on outcome in laparoscopic surgery. Surg Endosc 2011;25:2288–95
19Fiorini, FR, Santoro, R, Deganello, A, Mannelli, G, Meccariello, G, Gallo, O. Is open tracheotomy performed by residents in otorhinolaryngology a safe procedure? A retrospective cohort study. Eur Arch Otorhinolaryngol 2015;272:1483–9
20Dasani, SS, Simmons, KD, Wirtalla, CJ, Hoffman, RL, Kelz, RR. Understanding the clinical implications of resident involvement in uncommon operations. J Surg Educ 2019;76:1319–28
21Goldberg, I, Yang, J, Park, J, Pryor, AD, Docimo, S Jr, Bates, AT et al. Surgical trainee impact on bariatric surgery safety. Surg Endosc 2019;33:3014–25
22Wong, A, Filimonov, A, Lee, YJ, Hsueh, WD, Baredes, S, Liu, JK et al. The impact of resident and fellow participation in transsphenoidal pituitary surgery. Laryngoscope 2018;128:2707–13
23Macki, M, Fakih, M, Rubinfeld, I, Chang, V, Walters, BC. The impact of different postgraduate year training in neurosurgery residency on 30-day postoperative outcomes. Neurosurgery 2019;84:778–87
24Schrand, KV, Hussain, LR, Dunki-Jacobs, EM, Grannan, KJ. Outcomes associated with resident involvement in ventral hernia repair: a population based study using the NSQIP database. Am J Surg 2018;216:923–5
25Scheer, A, Martel, G, Moloo, H, Sabri, E, Poulin, EC, Mamazza, J et al. Laparoscopic colon surgery: does operative time matter? Dis Colon Rectum 2009;52:1746–52


Safety of tympanoplasty and ossiculoplasty performed by otorhinolaryngology trainees

  • F Alzhrani (a1), R Aldueb (a2), K Alosaimi (a3), T Islam (a4), F Almuhawas (a1) and A Alsanosi (a1)...


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