Factors affecting the learning curve in endoscopic ear surgery: experience, training and case selection

Abstract Introduction Hundreds of studies have been conducted on the overall success of endoscopic ear surgery over the traditional microscopic technique, prompting further usage of the endoscope. Endoscopic technique gives a wider scene and simple investigation of concealed areas surrounding the angles in the middle ear, minimizing recurrence rates compared to approaches using only microscopes. Furthermore, no needs for the postauricular or endaural incisions with the endoscopic tool. On the other hand, those newly introduced tools have a number of drawbacks can be summarized in the inability to use the two hands, possibility of mechanical and thermal damages, and the difficulty of handling bleeding within the narrow middle ear field. Those difficulties can be overlooked by adequate learning programs and gaining experiences. Objectives This study of the literature focuses on all the disadvantages concerned with the use of endoscopes in ear surgery by freshly educated physicians and provides solutions described in the literature to enhance the learning curve ensuring patient safety and improving clinical outcomes. Data synthesis I performed a literature search of medical databases, including MEDLINE, PubMed and Google Scholar, and was expanded to other search engines including Springer link, Science Direct and Wiley Online Library to find out relevant articles. The search terms used were as follows: endoscopic ear surgery, microscopic ear surgery, advantages, handicaps, learning curve, otology and middle ear surgery. I evaluated the results of these searches and excluded articles and documents that were not pertinent or were redundant. I focused my review on studies involving difficulties associated with the exclusive endoscopic ear surgeries for the newly trained physicians and how to overcome those difficulties and enhances their learning curve. Conclusion Endoscopic Ear Surgery has a steep learning curve and several disadvantages. However, with skilled and well-trained hands, all of the mentioned handicaps may be easily overcome.