Task performance in stapedotomy: Comparison between surgeons of different experience levels

OBJECTIVES: Two steps in stapedotomy are particularly challenging: (1) micropick fenestration of the stapes footplate (SF) and (2) crimping of the stapes prosthesis (SP) to the incus. We conducted trials to determine if experience correlates with differences in performance for these tasks. METHODS: In a surgical model of stapedotomy, performance was measured for 3 experienced and 3 novice surgeons. For fenestration, we measured ability to target the fenestration and force applied to the SF. For crimping, we measured crimp quality, movement of the SP during crimping, and force applied to the SF. RESULTS: Experienced surgeons demonstrated significantly better ability to target the fenestration and, during crimping, caused less SP movement and a significantly lower rate of SP dislodgment. CONCLUSIONS: Clear differences in task performance are measurable between more and less experienced surgeons during critical steps of stapedotomy. CLINICAL SIGNIFICANCE: The observed differences in task performance may contribute to an understanding of maneuvers that increase the risk of inadequate prosthesis placement and cochlear trauma - factors likely responsible for variable hearing results with strapedotomy.