Adolescent otolaryngology

OBJECTIVE: To determine the pattern of disease amongst ambulatory adolescents referred to a pediatric otolaryngology outpatient department. METHODS: Retrospective chart review of adolescents newly referred to a tertiary pediatric otolaryngology outpatient department over a 12-month period. RESULTS: One hundred and fifteen patients were included (male 56, female 59) mean age 14.9 years. There were 36 (31%) patients who had previously required otolaryngology management for another condition, and 29 patients with complex medical conditions. Investigations, including audiology and medical imaging, were performed in 35 patients. The patients were managed surgically 34 (30%), medically 28 (24%), referred to other departments 10 (9%) had no intervention 21 (18%), while 22 (19%) failed to attend for follow up. CONCLUSION: Ambulatory adolescent patients present with a comparable spectrum of otolaryngological problems to other pediatric age groups. These patients appear to be well managed by pediatric otolaryngologists, and there does not seem to be a need to develop a free standing adolescent otolaryngology subspecialty within tertiary pediatric otolaryngology at this time.     

Practice of pediatric otolaryngology: results of the future of pediatric education II project

OBJECTIVES: To define the practice of pediatric otolaryngology compared with general otolaryngology and to estimate pediatric otolaryngology workforce utilization and needs. METHODS: Survey of members of the American Academy of Pediatrics Section on Otolaryngology and Bronchoesophagology and the American Society of Pediatric Otolaryngology and of a random sample of the membership of the American Academy of Otolaryngology-Head and Neck Surgery. RESULTS: Pediatric otolaryngologists were more likely to practice in urban and/or academic settings than were general otolaryngologists. Children (age <18 years) comprised over 88% of the patients of pediatric otolaryngologists and 30% to 35% of the patients of general otolaryngologists. Pediatric otolaryngologists were more likely to see children with complicated diseases such as airway disorders or congenital anomalies than were general otolaryngologists. Pediatric otolaryngologists, unlike general otolaryngologists, reported an increasing volume of pediatric referrals, as well as increased complexity in the patients referred. The surveyed physicians estimated the present number of pediatric otolaryngologists in their communities as approximately 0.2 to 0.3 per 100 000 people. CONCLUSIONS: Most children receiving otolaryngologic care in the United States receive such care from general otolaryngologists. The patient profile and practice setting of the subspecialty of pediatric otolaryngology differ from those of general otolaryngology. The demand for pediatric otolaryngologists appears to be increasing, but many general otolaryngologists do not believe there is an increased need.     

Análisis del género en las autorías de las publicaciones científicas del acta otorrinolaringológica española en la última década

IntroductionIn recent decades, progress has been made in tackling inequality between men and women, encouraging publications that analyse and provide recommendations to eliminate this issue. The aim of this study is to analyse the gender differences in the authorship of the studies published in the journal Acta Otorrinolaringológica Española.MethodsA cross-sectional study of issues published between January 2010 and December 2019, including number of authors (total, men and women), type and year of publication, institution and country (first, second and last author), and area of specialisation. Women's participation was calculated based on female/male ratio, trend and associated factors.ResultsA total of 615 articles with 2,841 authors (1,017 women and 1,824 men) from Spain were collected. A total of 244 (39.7%) women and 371 (60.3%) men were listed as first authors (P = .879), 245 (39.84%) women and 370 (60.16%) men as second authors (P = .919), and 137 (22.28%) women and 478 (77.72%) men as final signatories (P < .000). All the ratios calculated were below the recommended figures.DiscussionThe participation of female authors in the scientific production of Acta Otorrinolaringológica Española is acceptable, following a similar distribution to the current number of female ENT specialists. Further efforts are needed to increase the number of final signatories and to change the decreasing trend recorded over the last decade.     

The residency experience in pediatric otolaryngology

OBJECTIVES: To assess the residency experience in pediatric otolaryngology, determine the impact of pediatric fellowship programs on residency training, and evaluate the need for fellowship training in pediatric otolaryngology. DESIGN: An anonymous, web-based survey of chief residents in otolaryngology. METHODS: Respondents described their experience in pediatric otolaryngology using a 5-point Likert scale and reported their comfort levels (yes/no) with various medical and surgical issues in pediatric otolaryngology. RESULTS: The survey was successfully completed by 70 respondents, representing a response rate of 26%. The majority of the respondents reported positive experiences with regard to the following aspects of pediatric otolaryngology training: didactics (81%), clinical research opportunities (78%), positive faculty role models (87%), career mentorship (74%), independent medical (84%) and surgical (81%) decision-making, and overall comprehensive residency experience (87%). Basic science research opportunities (50%) were reported as less available than clinical research opportunities (78%) (P = .002). Compared with other surveyed issues, a lower comfort level was reported for management of craniofacial anomalies (P < .001), excision of large lymphatic malformations (P < .001), cochlear implantation (P < .001), laryngotracheal reconstruction (P < .001), and surgical correction of velopharyngeal insufficiency (P < .001). No statistically significant difference was noted in responses based on the presence of a fellowship program at the institution. CONCLUSIONS: The residency experience in pediatric otolaryngology is perceived as comprehensive by graduating chief residents participating in this survey. The presence of a fellowship program does not appear to negatively impact the residency experience. Based on the reported comfort levels, the management of complex issues in pediatric otolaryngology may require additional training.     

Factors predictive of an academic otolaryngologist’s scholarly impact

ObjectivesDescribe the h index as a bibliometric that can be utilized to objectively evaluate scholarly impact. Identify which otolaryngology subspecialties are the most scholarly. Describe if NIH funding to one’s choice of medical school, residency, or fellowship has any impact on one’s scholarly output. Determine other factors predictive of an academic otolaryngologist’s productivity.Study designAnalysis of bibliometric data of academic otolaryngologists.MethodsActive grants from the National Institutes of Health (NIH) to otolaryngology departments were ascertained via the NIH Research Portfolio Online Reporting Tools Expenditures and Reports database. Faculty listings from these departments were gleaned from departmental websites. H index was calculated using the Scopus database.ResultsForty-seven otolaryngology programs were actively receiving NIH funding. There were 838 faculty members from those departments who had a mean h index of 9.61. Otology (h index 12.50) and head and neck (h index 11.96) were significantly (P < 0.0001) more scholarly than the rest of subspecialists. H index was significantly correlative (P < 0.0001) with degree of NIH funding at a given institution. H index was not significantly higher for those that attended medical school (P < 0.18), residency (P < 0.16), and fellowship (P < 0.16) at institutions with NIH funding to otolaryngology departments.ConclusionsH index is a bibliometric that can be used to assess scholarly impact. Otology and head and neck are the most scholarly subspecialists within otolaryngology. NIH funding to an individual’s medical school, residency, or fellowship of origin is not correlative with one’s scholarly impact, but current institutional affiliation and choice of subspecialty are.     

Publication rates of scientific papers presented at the Otorhinolarygological Research Society meetings

The aim of this study was to determine the publication rate of scientific papers in peer review journals presented at the Otorhinolarygological Research Society (ORS) meetings from 1978 to 1995 inclusive. The abstracts of the presentations at ORS meetings are published in Clinical Otolaryngology. A MEDLINE search was performed on abstracts presented at ORS meetings from 1978 to 1995 using both authors and key words within the text of the abstract. The publication rate, journal of publication, time to publication, change in contents, change in authors and change in conclusions of abstracts were tabulated. The publication rate for papers presented at ORS meetings from 1978 to 1995 was 69.09%. The average time to publication was 22.5 months. Papers derived from the ORS abstracts were most commonly published in Clinical Otolaryngology (34%) and Journal of Laryngology and Otology (18.64%). The results indicate that nearly 69% of presented material at the biannual ORS meetings eventually get published in peer reviewed journals. This compares favourably with publication rate of other specialities.     

Health provider determinants of nonattendance in pediatric otolaryngology patients

INTRODUCTION: Nonattendance for otolaryngology appointments disrupts the management of medical care and leads to ineffective use of resources. The determinants of nonattendance in pediatric otolaryngology patients have not been well documented. OBJECTIVES: To investigate health provider determinants of nonattendance in pediatric otolaryngology patients. STUDY DESIGN: We assessed the effects of waiting time for an appointment and the timing of the appointment (during the day, week, and year) on nonattendance proportions during a 1 year period. Chi square tests were used to analyze statistically significant differences of categorical variables. Logistic regression was used for multivariate analyses. RESULTS: A total of 2,628 pediatric visits were included in the study. The overall proportion of nonattendance at the pediatric otolaryngology clinic was 33.0%. Nonattendance proportions were 32.7% between 7 AM and 9 AM; 28.3% between 9 AM and 2 PM, and 36.5% between 2 PM and 8 PM (P < .001). The proportion of nonattendance was 24.1% when there was a short waiting time for an appointment (0-7 days), and 36.3% when there was an intermediate waiting time (7-15 days), and 36.6% when there was a long waiting time (15 days and above)(P < .001, P < .012, respectively). CONCLUSIVE: Health provider determinants of nonattendance in pediatric otolaryngology clinic appointments include the waiting time for an appointment and the hour of the appointment within the day.     

Workforce Issues for the Academic Otolaryngologist

Background The current medico‐economic environment has led to profound changes in our health care system and questions of physician surplus. These issues have particularly affected the academic health care system, as research funding and departmental support have decreased, and many young otolaryngologists are questioning academic careers because of these uncertainties. The current study was undertaken to assess the workforce environment for the academic otolaryngologist, particularly the young physician. Methods Surveys were sent to the academic chairmen of all accredited otolaryngology residency programs in the United States, requesting information on faculty appointments—actual and projected—as well as subspecialty appointments and expectations of young faculty. Results The response rate was 60% (59/98). Faculty additions have been relatively stable from 1994 to 1998, with approximately 37 assistant professor and 5 associate professor positions filled yearly. Faculty additions were the result of departmental expansion in 83% of cases and spanned many subspecialties. The subspecialty positions most frequently added from 1994 to 1998 were generalists (57), head and neck oncologists (53), pediatric otolaryngologists (48), and otologists (39), with generalists filling 15 positions in 1998. Ninety‐three percent of programs anticipate faculty additions in the next 5 years; most will be at the assistant professor level (77%), with 30% of positions for generalists, 20% for head and neck oncologists, and 18% for pediatric otolaryngologists. Faculty expectations are primarily clinical, with research being least important. Conclusions Academic positions are available for the young otolaryngologist, particularly in the fields of general otolaryngology, head and neck oncology, and pediatric otolaryngology.     

Otolaryngology-related Google Search trends during the COVID-19 pandemic

ObjectiveTo assess trends of Google Search queries for symptoms and complaints encountered commonly in otolaryngology practices during the coronavirus disease 2019 (COVID-19) pandemic when in-person care has been limited.Materials and methodsIn this cross-sectional study, data on Google Search queries in the United States for 30 otolaryngology-related terms were obtained from Google Trends. The means of relative search volume from the COVID-19 period (March 29, 2020 through May 16, 2020) were compared to similar periods from 2016 to 2019 using a t-test of two independent samples.ResultsIn total, 16.6% of search terms had significant increases in relative search volume during the COVID-19 period, with the largest percentage increase for “can't smell” (124.4%, p = .006), followed by “allergies” (30.3%, p = .03), “voice pain” (26.1%, p = .008), and “ears ringing” (19.0%, p < .001). Of all search terms, 26.7% had significant decreases in relative search volume, including the largest percentage decrease for “laryngitis” (59.8%, p < .001), followed by “thyroid nodule” (54.4%, p < .001), “thyroid cancer” (45.6%, p < .001), and “ENT” (34.9%, p < .001).ConclusionThis study demonstrates that Google search activity for many otolaryngology-related terms during the COVID-19 pandemic has increased or decreased significantly as compared to previous years. With reduced access to in-office otolaryngology care in the United States during the COVID-19 pandemic, these are important considerations for otolaryngology practices to meet the needs of patients who lack access to care.     

A survey of postoperative nasal packing among UK ENT surgeons

Packing of the nasal cavity following routine nasal surgery is a common but controversial practice. We aimed to evaluate nasal packing practices among UK ENT consultants for common nasal operations. A questionnaire was sent to 648 consultant ENT surgeons regarding their packing practice in patients undergoing nasal surgery. Data were collected regarding rhinology subspecialty interest, number of nasal operations performed per year, likelihood of packing for six common nasal procedures, and types of pack used. In all, 282 (43.5%) replies were received. Fifty-four (78.3%) rhinologists claimed to perform >100 nasal operations per year versus 64 (31.8%) non-rhinologists (P < 0.005). For specific operations, there was a universal trend towards less routine packing (>70% frequency) in the rhinologist group (P < 0.005). Surgeons who specified a subspecialty interest in rhinology packed significantly less often than the non-rhinologists for common nasal operations. There was great variation in the type of pack favoured by different surgeons.     

Minor salivary gland tumors of the palate: Clinical and pathologic correlates of outcome

Minor salivary gland tumors of the palate are rare and may pose a diagnostic and therapeutic dilemma for the head and neck surgeon. The authors reviewed their 46 years of experience with minor salivary gland tumors of the palate to determine the factors that influence outcome and their implications for treatment. Malignant tumors were seen in 116 patients (78%) and benign tumors were found in 33 patients (22%). Adenoid cystic carcinoma was the most common malignant tumor, occurring in 43 patients, and pleomorphic adenoma was the most common benign tumor, occurring in 30 patients. Univariate analysis on the malignant lesions showed that grade 3 tumor histology (P<.001), tumor size greater than 3 cm (P<.001), perineural invasion (P=.031), bone invasion (P=.012), positive surgical margins (P<.001), and positive initial but negative final margins (P=.004) were all associated with decreased survival. With multivariate analysis, tumor size, margin status, and grade were shown to be independently associated with decreased survival (P<.05). The recurrence rate at the primary site was significantly higher for adenoid cystic carcinoma than for other histologies (P=.0059). The 2-, 5-, and 10-year disease-specific survival rates for patients with malignant disease were 96%, 87%, and 80%, respectively. Wide surgical excision with adequate margins is essential for a favorable outcome in patients with malignant minor salivary gland tumors. Postoperative radiotherapy is reserved for patients with grade 3 tumor histology, large primary lesions, perineural invasion, bone invasion, cervical lymph node metastasis, and positive margins, although a clear-cut survival advantage has not been proven. Recurrence, especially regional and distant metastasis, portends an extremely poor prognosis. Laryngoscope, 105:1155-1160, 1995     

Peer review: studying the major otolaryngology journals

OBJECTIVE: To determine if the otolaryngology literature is comparable to other surgical specialty journals with respect to quality and types of articles published. METHODS: The four major otolaryngology journals--Annals of Otology, Rhinology and Laryngology, Archives of Otolaryngology--Head and Neck Surgery, Laryngoscope, and Otolaryngology--Head and Neck Surgery--were studied for 6-months and examined for the following variables: 1) proportion of clinical or basic science research, 2) proportion of prospective or retrospective studies, 3) types of statistics used, 4) sample sizes of the studies, and 5) proportion of single case reports. A composite group of surgical specialty journals consisting of Journal of Bone and Joint Surgery, Neurosurgery, and Ophthalmology was also studied for the same time period. The otolaryngology journals and other specialty journals were compared with respect to each of these variables, after which the comparison was conducted within the group of otolaryngology journals. RESULTS: Analysis of 905 articles, comprising 508 articles from the four major otolaryngology journals and 397 articles from the composite of the other specialty journals, was conducted. No significant difference in the proportion of single case reports between the otolaryngology journals (15.0%) and the other specialty journals (12.8%) was noted (P = .364). The otolaryngology journals had a significantly higher proportion of basic research than the other specialty journals (27.4% vs. 14.5%, P<.001) as well as a higher percentage of prospective studies (62.1% vs. 49.0%, P = .001). The studies in the otolaryngology journals had a much lower mean sample size than those in the other specialty journals (70.2 vs. 373.8, P = .010). No difference between the two groups was found in the use of statistics (P = .228). Among the otolaryngology journals, Laryngoscope was found to publish fewer single case reports than the other three journals, and Annals of Otology, Rhinology and Laryngology had the highest proportion of prospective studies (P = .031 and .012, respectively). No differences were found for sample sizes and use of statistical analysis (P = .266 and P = .710, respectively) among the otolaryngology journals. CONCLUSIONS: The otolaryngology literature compares quite favorably with the literature of other surgical specialties, excelling in prospective studies and basic science research. It only lags with respect to sample size. The study composition among the different major otolaryngology journals is largely similar with respect to basic study parameters, suggesting comparable quality among the journals.     

Duplicate publications in the otolaryngology literature

OBJECTIVE/HYPOTHESIS: A duplicate publication duplicates other published work by the same author(s). The purpose of the study was to define the extent of this problem within the otolaryngology literature.STUDY DESIGN: Retrospective review of the literature. METHODS: Original articles published in Archives of Otolaryngology-Head and Neck Surgery and Laryngoscope in 1999 were reviewed using the OVID search engine. Titles and abstracts from English articles written by the same first, second, or last author were analyzed, and suspected publications were evaluated. Duplicate publications were classified as dual (identical data set and conclusions) or suspected dual (nearly identical data set and conclusions) publications. RESULTS: Of the 492 articles evaluated, 40 index articles were identified. These led to a total of 42 (8.5%) duplicate articles of which 27 were classified as dual and 15 as suspected dual publications. Approximately half of the duplicate publications were published by authors in the United States (55%). Duplicate articles usually appeared within 12 months of the each other (74%) and failed to cross-reference the earlier publication (83%). CONCLUSIONS: Journal editors have become aware of an increase in the number of duplicate publications in the medical literature. The incidence of duplicate publications in the otolaryngology literature appears to be similar to that in other specialties.     

Keys for successful publication in Eur Ann Otorhinolaryngol Head Neck Dis: A STROBE analysis of peer reviews of articles submitted in 2020–2021

ObjectiveTo evaluate reviewing and editorial decision for articles submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases.Materials and methodsA retrospective analysis was made of reviewers’ comments on 1,133 scientific articles (700 original articles, 96 literature reviews, and 337 case reports), originating from 69 countries, consecutively submitted on-line between January 1st, 2020 and December 31st, 2021. The main objective was to document the acceptance rate and decision time. Accessory objectives were to synthesize the main comments and to screen for correlations between acceptance and the main characteristics of first authors, articles and reviewers’ comments.ResultsIn total, 4.1% of submitted articles were accepted. Median decision time differed significantly (P < 0.0001), at 1 month in case of refusal and 4 months in case of acceptance. Reviewers mentioned failure to adhere to the journal's authors’ guide, to use the appropriate EQUATOR guidelines and to adopt the recommended P < 0.005 significance threshold in 94.8%, 54.2%, and 39.9% of cases, respectively. On multivariate analysis, 3 variables significantly impacted acceptance, which increased from 1.3% to 44.6% (P < 0.0001) when an appropriate EQUATOR guideline was used and from 0.3% to 57.4% (P < 0.0001) when the significance threshold was set at P < 0.005, and decreased from 10.5% to 1.1% (P = 0.0001) when the article did not originate from a French-speaking country (member of the Francophonie organization).ConclusionAdhesion to modern scientific medical writing rules increased acceptance rates for articles in the European Annals of Otorhinolaryngology Head & Neck Diseases. Teaching modern scientific medical writing needs to be enhanced in otorhinolaryngology.     

Thyroid surgery: changing patterns of practice

Objective: The practice of thyroidectomy has evolved over the past 10 years with the introduction of minimally invasive surgery, laryngeal nerve monitoring, and outpatient surgery. We sought to investigate corresponding trends in the disciplines performing thyroid surgery. Methods and Materials: The authors conducted a nonrandomized, case‐controlled comparison of surgical volumes and systematic analysis of publication volumes. Two surrogates for the proportion of thyroidectomies being performed by otolaryngologists–head and neck surgeons (OHNS) and general surgeons (GS) were chosen: 1) the operative case logs of graduates from American training programs in OHNS and GS from 1995 through 2004 were compared; and 2) the number of scientific articles published relating to thyroid surgery were systematically queried for two timeframes (1990–1994 and 2000–2004). Results: There was a gradual increase in the mean number of thyroidectomies performed by GS residents from 13.2 in 1995 to 18.2 in 2004. During the same timeframe, the mean number of thyroidectomies performed by OHNS residents more than doubled from 15.0 to 33.5. The number of American GS thyroid publications from 1990 to 1994 was 79, compared with 98 in the period 2000 to 2004, representing a 24% increase. During the same timeframe, the number of American OHNS articles increased from 14 to 49 (a 250% increase). The relative proportion of thyroid publications authored by American otolaryngologists more than doubled from 15.1% to 33.3% (P = .0017). Conclusions: A clear trend is emerging in the pattern of thyroid surgery in that a growing proportion of publications are being authored by otolaryngologists compared with general surgeons, and the average number of procedures performed by graduating chief residents is now 84% higher in otolaryngology compared with general surgery.     

Incidence of and risk factors for additional tympanostomy tube insertion in children

OBJECTIVE: To determine the incidence and risk factors that account for additional tympanostomy tube placement among children who have undergone an initial placement of ventilation tubes. DESIGN: Retrospective case review of consecutive patients. SETTING: A tertiary care pediatric hospital. PATIENTS: Five-year consecutive series of 2121 children cared for in a hospital-based, tertiary care pediatric otolaryngology practice. INTERVENTION: Subsequent need for additional ventilation tube surgery. RESULTS: Four hundred twenty-three (19.9%) of the 2121 children who underwent initial placement of bilateral myringotomy tubes (BMTs) between April 20, 1995, and May 25, 1998, subsequently had a second set of tubes placed by May 25, 2000. Children 18 months or younger at the time of initial BMT placement were nearly twice as likely (26.3% vs 15.9%) to undergo a second BMT procedure when compared with children who were older than 18 months at initial surgery (P<.005). The probability of having a second BMT procedure was reduced if adenoidectomy was performed at the first BMT procedure (0.08 vs 0.24, P<.001). Adenoidectomy status, craniofacial deformities, and a family history of adenoidectomy or tonsillectomy with or without BMTs were independent risk factors for multiple BMTs. CONCLUSIONS: Epidemiologic analysis of this consecutive series of patients who underwent BMT placement in a tertiary care pediatric otolaryngology practice suggests that 1 in 5 patients will subsequently require a second set of ventilation tubes. Age younger than 18 months at the time of the initial BMT procedure is associated with an increased risk for additional surgery but is not an independent risk factor. Adenoidectomy reduces the incidence of subsequent BMTs following initial surgery.     

Letters of recommendation to an otolaryngology/head and neck surgery residency program: their function and the role of gender

Objectives/Hypothesis: To ascertain common features and gender differences in letters of recommendation (LORs) for applicants to an otolaryngology/head and neck surgery (OHNS) residency program. Study Design: Retrospective review. Methods: Seven hundred sixty‐three LORs submitted to one OHNS residency program in 2006 were reviewed. Results: All 763 letters “recommended” the applicant for OHNS residency. Ninety‐one percent of letters were written by men, 68.4% by male otolaryngologists (OTOs), 4.2% by female OTOs, and 33% by OHNS department chairs or division chiefs (100% men). A comparison of female and male letter writers revealed five categories with significant differences: female letter writers were more likely to call an applicant a “team player” (P = .000), “compassionate,” (P = .001) and use strings of adjectives (P = .024). In contrast, they were less likely when compared with male letter writers, to mention an applicant's personal life (P = .003), or write “letters of minimal assurance” (P = .035). Evaluation of the letters by applicant gender revealed two findings: letter writers were more likely to use a gender term in letters for male applicants (P = .004), and male letter writers were more likely to make reference to a female candidate's physical appearance (P = .040). Conclusions: LORs for OHNS residency universally advocate for the applicant. The letters are writtenpredominately by the highest‐ranking male OTOs in academic medicine. In the LORs, male and female applicants are described similarly. Male and female letter writers, however, often describe applicants in different ways regardless of applicant gender.     

Development of proficiency-based knot-tying and suturing curriculum for otolaryngology residents: A pilot study

ObjectiveBasic surgical skills such as knot-tying and suturing are important for all otolaryngologists, regardless of subspecialty. The present study was undertaken in order to assess basic surgical techniques such as knot-tying and suturing required for novice otolaryngology residents with taking the variety of subspecialties into consideration, and evaluate the impact of a proficiency-based training curriculum based on these techniques.MethodsA prospective study was performed for developing of proficiency-based knot-tying and suturing curriculum for otolaryngology residents in the third post-graduate year (PGY-3). The proficiency-based training curriculum was developed based on the tasks selected by RAND/UCLA method with expert panel, which is an iterative and anonymous survey used to establish consensus among participants. Expert panelists were selected from various divisions to reflect variety of their subspecialties. PGY-3 residents trained with the developed curriculum that included proctored pre-test, self-training to proficiency, and proctored post-test. Visual analogue scale (VAS) of trainees’ overall competence in the operating room was self-assessed by each resident, before and after completing the training curriculum.ResultsNine PGY-3 residents were enrolled as trainees. Eleven experts chosen as panelists had various subspecialty, including 2 from otology, 2 from rhinology, 2 from laryngology, 2 from head and neck surgery, and 3 from general otolaryngology. Seven tasks were selected from RAND/UCLA method and used to develop the curriculum. Trainee scores at pre-test were significantly lower than expert scores for all 7 tasks (p < 0.01) and each coefficient of variation of trainee score was larger than that of expert score (p < 0.05), supporting construct validity. The mean of composite scores between pre-test and post-test had statistical significance (68.6 ± 11.6 vs 95.9 ± 3.6, p < 0.01), documenting substantial improvement after training. Self-assessment VAS was also improved pre- to post-training (1.2 ± 0.9 vs 4.5 ± 1.4, p < 0.01). A follow-up questionnaire showed that trainees felt the educational curriculum to be beneficial.ConclusionIn the present study, seven basic technical skills were selected using the RAND/UCLA method and used to create a proficiency-based training curriculum. Our results indicate that this curriculum significantly improves proficiency of basic surgical skills of junior otolaryngology residents.