Time trend analysis of otological procedures performed in England, 1989 to 2005

Abstract

The number of major otological procedures (other than endolymphatic sac surgery) was consistent over the period examined. The generally perceived reduction in the number of procedures performed by individual surgeons may be due to a dilutional effect. This can only support the need for subspecialisation, particularly regarding the training of junior surgeons.

Cholesteatoma: a disease of the poor (socially deprived)?

“…They found that overall numbers were consistent; however, the increased provision of ENT services has led to a dilution effect and so they supported the need for subspecialization especially in training [23]. Our study has found a marginal increase in overall numbers, which may not be considered as clinically relevant with an increasing population.…”

“…Hari et al [23] performed a time trend analysis of otological procedures in England between 1989 and 2005 to investigate whether surgery for cholesteatoma is declining in developed countries. They found that overall numbers were consistent; however, the increased provision of ENT services has led to a dilution effect and so they supported the need for subspecialization especially in training [23].…”

“…However it does suggest that there is a need for additional input in deprived areas to accommodate the increased numbers of mastoid operations and chronic middle ear disease. Hari et al [23] commented that the aging population of England may be less prone to ear problems but the population has also been influenced by an influx of immigrants, often from poorer countries who may be more prone to ear problems.…”

The behavior of mastoidectomy cavities following modified radical mastoidectomy

“…Mastoidectomy for the treatment of cholesteatoma is a common surgical procedure, constituting much of the surgical volume undertaken by otologists. The goal is to eradicate disease and to achieve a dry, stable ear, necessitating little aftercare.…”

Time trend analysis of mastoidectomy procedures performed in Ontario, 1987–2007

“…An English study analyzed Government Hospital Episode Statistics (HES data) between 1985 and 2005, and reported no decline in the number of cholesteatoma operations in England over the 20-year study period [4]. However, these data were not adjusted for population increases.…”