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Introduction: Cortical mastoidectomy is a common otolaryngology procedure and represents a compulsory part of otolaryngology training. As such, a specific validated assessment score is needed for the progression of competency-based training in this procedure. Although multiple temporal bone dissection scales have been developed, they have all been validated for advanced temporal bone dissection including posterior tympanotomy, rather than the task of cortical mastoidectomy.
Methods: The Melbourne Mastoidectomy Scale, a 20-item end-product dissection scale to assess cortical mastoidectomy, was developed. The scale was validated using dissections by 30 participants (10 novice, 10 intermediate and 10 expert) on a virtual reality temporal bone simulator. All dissections were assessed independently by three blinded graders. Additionally, all procedures were graded with an abbreviated Welling Scale by one grader.
Results: There was high inter-rater reliability between the three graders (r = .9210, P < .0001). There was a significant difference in scores between the three groups (P < .0001). Additionally, there was a large effect size between all three groups: the differences between the novice group and both the intermediate group (P = .0119, η = 0.2482) and expert group (P < .001, η = 0.6356) were significant. The difference between the intermediate group and expert group again had a large effect size (η = 0.3217), but was not significant. The Melbourne Mastoidectomy Scale correlated well with an abbreviated Welling Scale (r = .8485, P < .0001).
Conclusion: The Melbourne Mastoidectomy Scale offers a validated score for use in the assessment of cortical mastoidectomy.
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http://dx.doi.org/10.1111/coa.13569 | DOI Listing |
Laryngoscope Investig Otolaryngol
August 2025
University of Manitoba, Max Rady College of Medicine Winnipeg Manitoba Canada.
Objective: Simulation-based surgical training is now standard in residency education - aided by tools such as printed, virtual, and augmented reality environments. Autonomous education with use of machine learning is an emerging necessity owing to resident work-hour limitations and staff availability. An essential first step to providing automated feedback during simulated surgery is the development of a tool to classify surgical technique.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
July 2025
Department of Surgery (Otolaryngology), University of Melbourne, Melbourne, Victoria, Australia.
Introduction: A clear understanding of the difficulty levels of different aspects of a surgery is required to effectively guide and assess trainees. This study investigated which steps of cortical mastoidectomy are most challenging for novice and intermediate surgeons, and how these performances align with expert opinions.
Methods: Thirty participants were divided into three groups: 10 novices (medical students), 10 intermediates (surgical trainees), and 10 experts (consulting ENT surgeons).
Laryngoscope Investig Otolaryngol
June 2025
Division of Otorhinolaryngology, Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden.
Objective: An indolent form of mastoiditis has gained increased attention lately, challenging clinicians both regarding diagnosis as well as treatment. The etiology behind this assumed infection herein named subacute mastoiditis (SAM) is unknown; however, a link to nontuberculous mycobacteria (NTM) infections has been seen. A survey on pediatric cases with SAM over 20 years was performed to investigate the typical clinical features and to identify optimal treatment strategies for this condition, causing aggressive temporal bone destructions along with intratemporal and intracranial complications.
View Article and Find Full Text PDFJ Int Adv Otol
March 2025
Department of Otolaryngology-Head and Neck Surgery, Soroka University Medical Center, Ben-Gurion University Faculty of Health Sciences, Beer-Sheva, Israel.
Background: Acute mastoiditis (AM), a complication of acute otitis media, remains a concern despite medical advancements and often leads to severe complications such as cerebral sinus vein thrombosis (CSVT). This study aimed to characterize the clinical, microbiological, and hematological aspects of CSVT secondary to AM in children while assessing the necessity of thrombophilia evaluation in these patients.
Methods: A retrospective analysis was conducted on pediatric patients with CSVT secondary to AM between January 2015 and December 2022.
Otol Neurotol
June 2025
Department of Surgery (Otolaryngology), University of Melbourne, Victoria, Australia.
Hypothesis: Virtual reality (VR) simulation has been established as an effective method of supplementing traditional surgical training. Learning curves can analyze skill acquisition over time in VR settings. Although previous studies explored learning curves of mastoidectomy performances on single specimen, this study analyzed learning curves on anatomically different virtual temporal bones across three expertise levels (novice, intermediate, and expert).
View Article and Find Full Text PDF