Abstract：
OBJECTIVE: Placing a middle ear prosthesis is considered a key competency for the general otolaryngologist, but surgeons struggle to obtain and maintain this skill. The current study aims to characterize pre-coronavirus disease 2019 trends in stapedectomy and ossiculoplasty.
METHODS: Database review.
METHODS: Tricare beneficiaries are treated at civilian and military facilities.
METHODS: The Department of Defense beneficiary population of more than nine million persons per year was reviewed for patients undergoing either stapedectomy or ossiculoplasty between 2010 and 2019, identified by the current procedural terminology code.
RESULTS: A total of 3052 stapedectomies and 7197 ossiculoplasties were performed. Over the 10-year study period, stapedectomy decreased by 23%, with an average annual rate of -2.7% per year (Pearson r = -.91, P = .0003). Ossiculoplasties declined by 18%, an average annual rate of -1.9% (r = -.8, P = .006). In combination, cases declined by 20%, an average annual rate of -2.2% (r = -.87, P = .001).
CONCLUSIONS: While declines in stapedectomy surgery have been well reported, here we show steady declines in ossiculoplasty as well. If these trends continue, more cochlear implantations may be performed annually than stapedectomy and ossiculoplasty combined, with cochlear implantation likely to overtake ossicular chain surgery in the near future. These changes in surgical volume have a direct implication on resident education and general otolaryngology expectations after graduation. Strong consideration should be made to replace \"Stapedectomy/Ossiculoplasty\" as resident key indicator with \"Cochlear Implantation,\" a more professionally meaningful skill.
METHODS: Database review.
METHODS: Tricare beneficiaries are treated at civilian and military facilities.
METHODS: The Department of Defense beneficiary population of more than nine million persons per year was reviewed for patients undergoing either stapedectomy or ossiculoplasty between 2010 and 2019, identified by the current procedural terminology code.
RESULTS: A total of 3052 stapedectomies and 7197 ossiculoplasties were performed. Over the 10-year study period, stapedectomy decreased by 23%, with an average annual rate of -2.7% per year (Pearson r = -.91, P = .0003). Ossiculoplasties declined by 18%, an average annual rate of -1.9% (r = -.8, P = .006). In combination, cases declined by 20%, an average annual rate of -2.2% (r = -.87, P = .001).
CONCLUSIONS: While declines in stapedectomy surgery have been well reported, here we show steady declines in ossiculoplasty as well. If these trends continue, more cochlear implantations may be performed annually than stapedectomy and ossiculoplasty combined, with cochlear implantation likely to overtake ossicular chain surgery in the near future. These changes in surgical volume have a direct implication on resident education and general otolaryngology expectations after graduation. Strong consideration should be made to replace \"Stapedectomy/Ossiculoplasty\" as resident key indicator with \"Cochlear Implantation,\" a more professionally meaningful skill.
摘要：
目的：放置中耳假体被认为是普通耳鼻喉科医师的关键能力，但是外科医生很难获得和保持这种技能。目前的研究旨在描述2019年冠状病毒病前期在骨切除术和骨成形术中的趋势。
方法：数据库审查。
方法：Tricare受益人在民用和军事设施接受治疗。
方法：在2010年至2019年期间，国防部每年有超过900万人受益人口接受了stapede切除术或骨成形术的患者，根据当前的程序术语代码进行了审查。
结果：共进行了3052例结扎切除术和7197例骨成形术。在10年的研究期间，stapede切除术减少了23%，年平均增长率为-2.7%(皮尔逊r=-.91，P=.0003)。单周成形术下降了18%,年平均增长率为-1.9%(r=-.8，P=.006)。在组合中，病例下降了20%，年平均增长率为-2.2%(r=-.87，P=.001)。
结论：虽然已经很好地报道了stapedomination手术的下降，在这里，我们也显示了骨成形术的稳步下降。如果这些趋势继续下去，每年可以进行更多的人工耳蜗植入手术，而不是钉骨切除术和骨成形术。在不久的将来，人工耳蜗植入可能会超过听骨链手术。手术量的这些变化对毕业后的住院医师教育和一般耳鼻喉科的期望有直接的影响。应强烈考虑将“stapedometration/Ossulotemplating”作为住院医师的关键指标替换为“人工耳蜗植入”,“一项更具专业意义的技能。
方法：数据库审查。
方法：Tricare受益人在民用和军事设施接受治疗。
方法：在2010年至2019年期间，国防部每年有超过900万人受益人口接受了stapede切除术或骨成形术的患者，根据当前的程序术语代码进行了审查。
结果：共进行了3052例结扎切除术和7197例骨成形术。在10年的研究期间，stapede切除术减少了23%，年平均增长率为-2.7%(皮尔逊r=-.91，P=.0003)。单周成形术下降了18%,年平均增长率为-1.9%(r=-.8，P=.006)。在组合中，病例下降了20%，年平均增长率为-2.2%(r=-.87，P=.001)。
结论：虽然已经很好地报道了stapedomination手术的下降，在这里，我们也显示了骨成形术的稳步下降。如果这些趋势继续下去，每年可以进行更多的人工耳蜗植入手术，而不是钉骨切除术和骨成形术。在不久的将来，人工耳蜗植入可能会超过听骨链手术。手术量的这些变化对毕业后的住院医师教育和一般耳鼻喉科的期望有直接的影响。应强烈考虑将“stapedometration/Ossulotemplating”作为住院医师的关键指标替换为“人工耳蜗植入”,“一项更具专业意义的技能。
