Audiometric Outcomes of Tympanoplasty With Hydroxylapatite Prosthesis: Consultant Versus Trainees

Objective: To assess and compare the audiometric outcomes and surgical complication rates of tympanoplasty with hydroxylapatite (HA) prostheses performed by a single consultant and advanced trainees. Study Design: A retrospective case review was undertaken. Setting: Tertiary referral center. Patients: One hundred eighteen cases of primary and revision tympanoplasty were included in the study performed during a 6-year period. Intervention: Tympanoplasty with HA prosthesis. Main Outcome Measures: Preoperative and postoperative audiometric data were compared for both the consultant and trainee groups. Details of the surgical procedure and operative complications were also recorded. Results: Fifty-eight procedures were performed by the consultant and 60 operations were performed by trainees. The average improvement in air-bone gap (ABG) for consultants was 14.8 dB, with a 95% confidence interval (10.4, 19.2) (paired t test; test statistic: t = 6.80, 57 df, p < 0.01), whereas for trainees, the average improvement in ABG was 7.8 dB, with a 95% confidence interval (4.1, 11.6) (paired t test; test statistic: t = 4.19, 59 df, p < 0.01). The difference of 7.0 dB in mean ABG between the 2 groups was significant (two-sample t test; test statistic: t = 2.44, 116 df, p = 0.02). There was no significant difference in the surgical procedure or in the number of revision operations performed by the consultant or trainees. Surgical complication rates were comparable for the two groups. Conclusion: In this series, the consultant achieved a significantly better closure in ABG than trainees for tympanoplasty with HA prostheses.