Clinical Application of the SAMEO‐ATO Classification and Analysis of the Correlation Between Individual Subgroups and Surgery Duration

ABSTRACT Introduction Tympanomastoid surgery, encompassing intricate middle ear and mastoid procedures, necessitates a standardized classification system to ensure consistent documentation, enhance comparability, and improve outcome analysis across different clinical settings. The SAMEO‐ATO classification, established by the International Otology Outcome Group (IOOG), provides a comprehensive framework that categorizes surgical interventions into key components, covering both mastoid operations (SAMEO) and middle ear surgeries (ATO). Methods We analyzed correlations between specific subgroups within the SAMEO‐ATO framework and the duration of surgery. Data were retrospectively collected from 300 patients at a university hospital, categorized according to the SAMEO‐ATO classification, and statistically analyzed to determine associations between subgroups and operative time. Results Our findings indicated that the type of surgical approach (e.g., endaural vs . retroauricular), as well as the specific components of mastoidectomy, external auditory canal reconstruction, mastoid cavity obliteration, middle ear access, tympanic membrane reconstruction, and ossicular chain reconstruction, significantly influenced surgery duration. Conclusions The results suggest that the SAMEO‐ATO classification can serve as a valuable predictive tool for estimating procedural complexity in tympanomastoid surgery. These findings contribute to the growing body of evidence supporting the utility of the SAMEO‐ATO classification in otological practice and underscore its potential as a framework for outcome‐oriented research in middle ear and mastoid surgery.