Intraoperative and postoperative management in endoscopic ear surgery: Perspectives from a worldwide survey

PURPOSE: To examine intraoperative and postoperative practices (antibiotic and antithrombotic prophylaxis, ear packing, behavioural recommendations, follow-up strategies) in exclusive endoscopic ear surgery management, based on a global survey of experienced surgeons. METHODS: The setting is an international survey distributed via personal mailing lists and the International Working Group on endoscopic ear surgery. Anonymous responses were collected through Google Forms and analyzed using descriptive statistics, logistic regression models, and Kruskal-Wallis tests with post-hoc analyses to explore associations between geographic origin, surgical practices, and postoperative protocols. The result is a cross-sectional descriptive study. RESULTS: We collected responses from 44 surgeons across 21 different countries. Significant variability in surgical management practices was observed, often diverging from the current literature. Geographic origin and surgeon experience showed a limited association with specific practices. Notably, North American surgeons reported longer follow-up durations and more consistent use of cefazolin, whereas European surgeons demonstrated greater variability in antibiotic regimens. CONCLUSION: The survey reveals wide variability in the intraoperative and postoperative management of exclusive endoscopic ear surgery, driven more by individual preferences than by scientific evidence. The absence of consistent patterns based on geography or expertise highlights the lack of standardized, evidence-based protocols.