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