Introduction
Otologists performing middle ear surgery have traditionally focused on
eradicating disease, obtaining a safe/dry ear, and improving hearing.
However, patients may additionally value other outcomes such as
postoperative pain, incision size, and length of surgery (i.e., time
spent under anesthesia). Given that patient-centered care has emerged as
a crucial element of providing quality healthcare, it is important to
identify and be conscious of values, preferences, and expressed needs of
patients undergoing ear surgery. While many studies have addressed
traditional outcomes (e.g., hearing outcomes) of ear surgery, there is
little data analyzing so-called alternative outcomes that patients may
value when they undergo ear surgery.
Middle ear surgery can be performed with either a traditional microscope
or an endoscope. Transcanal endoscopic ear surgery (TEES) allows access
to the middle ear through a minimally invasive incision that in some
cases that would previously have required a postauricular approach with
the microscope. Partly because of this advantage, TEES has become
increasingly popular in recent years. TEES has certain additional
advantages over microscopic ear surgery. Studies have shown that TEES
may have decreased operative time (e.g., for tympanoplasty) [1],
increased educational value [2,3], and similar or better outcomes
[4] for some procedures (despite the limitations of one-handed
dissection [5]) when compared microscopic ear surgery. Moreover,
TEES avoids a postauricular incision, which has been shown to minimize
pain and numbness [6,7]; this may contribute to an increased
patient-driven interest in TEES. However, previous studies have not
confirmed this hypothesis by quantitatively examining which outcomes
patient value most when undergoing ear surgery.
Our objective is to assess how much patients value minimizing pain and
numbness relative to other postoperative otologic outcomes using a
cross-sectional survey. We hypothesize that patients will highly value
alternative outcomes comparably to hearing, including postoperative
pain/numbness, incision size, and length of surgery