Current State of Temporal Bone Education: National Survey of U.S. Otolaryngology Residency Programs

OBJECTIVES: To characterize the structure, resources, and educational practices of temporal bone laboratory training across ACGME-accredited U.S. otolaryngology residency programs. METHODS: A national cross-sectional survey was distributed to program directors and faculty responsible for temporal bone education. Survey domains included curriculum structure, training frequency, faculty involvement, assessment practices, and access to laboratory resources. Descriptive statistics and univariable regression analyses were performed to explore associations between program characteristics and neurotology fellowship pursuit. RESULTS: Thirty-seven programs responded (28.2%). Laboratory structure varied widely, including longitudinal (monthly or weekly) and condensed (annual or 2-3 courses/year) formats. Programs with longitudinal sessions reported more annual lab hours than condensed formats (median 42 vs. 16 h/year, p = 0.003). All programs had access to cadaveric temporal bones (mean 2.25 ± 1.13 bones per resident/year), though five reported fewer bones than residents. The mean drill-to-resident ratio was 0.59, with 10.8% reporting a 1:1 ratio. Formal performance evaluation was used by 43.2% of programs. On exploratory univariable analysis, longer otology rotation duration was associated with having at least one neurotology fellow within five years (p = 0.025). Larger resident cohort size (p = 0.048) and older laboratory instruments (p = 0.043) were associated with producing more than one fellow. CONCLUSION: There is substantial variability in temporal bone education across U.S. otolaryngology training programs. Programs differ in curricula, resources, and access to cadaveric and simulation-based training. Standardization of core components may improve educational equity and training consistency. LEVEL OF EVIDENCE: N/A.