Revision nasal surgery after septoplasty: trainees versus trainers
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RHINOLOGY
Revision nasal surgery after septoplasty: trainees versus trainers Therese R. Karlsson • M. Shakeel • A. Al-Adhami S. Suhailee • B. Ram • K. W. Ah-See
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Received: 19 April 2012 / Accepted: 7 August 2012 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Otolaryngology trainees are expected to be able to successfully perform septoplasty early in their career. An important parameter to assess the success of an operation is to look at the revision surgery rate. This study aimed to investigate the revision nasal surgery rate after septoplasty based on the grade of the primary surgeon. Retrospective review of hospital records of all patients who underwent septoplasty with or without inferior turbinate reduction over 12 years (1998–2010) in a tertiary referral centre in NorthEast Scotland. Patients were identified from theatre log books and were excluded if they underwent any other simultaneous nasal procedure. Data were collected on demographics, type of primary and revision surgery, grade of surgeon and duration of hospital stay. 2,168 eligible patients (70 % male, 30 % female) with a mean age of 39 years were investigated. Surgeons were divided into four categories: junior trainee (Group A), senior trainee (Group B), staff grade (Group C) and consultant (Group D). There were 753, 644, 298 and 473 patients in Groups A, B, C and D, respectively. The revision rate in Group A was 4.4 % compared to 3.2 % for Group D and this difference was not statistically significant. For their operation, patients in
Oral presentation at Scottish Otorhinolaryngology Society Meeting in Dunblane, Scotland, UK 12th of May 2011. T. R. Karlsson (&) M. Shakeel S. Suhailee B. Ram K. W. Ah-See Department of Otolaryngology-Head and Neck Surgery, Aberdeen Royal Infirmary, University of Aberdeen, Ward 45, Aberdeen AB25 2ZN, UK e-mail: [email protected] A. Al-Adhami Department of Surgery, Aberdeen Royal Infirmary, University of Aberdeen, Aberdeen AB25 2ZN, UK
Group A stayed for 1.54 nights compared to 1.47 nights in Group D, the difference being insignificant. Grade of the surgeon does not appear to strongly affect the need for revision nasal surgery and our patients do not appear to be disadvantaged if operated on by trainees. Keywords Trainer
Trainee Septoplasty Revision surgery
Introduction Septal deviation, both symptomatic and asymptomatic, is extremely prevalent and present in over half of the population [1, 2]. The mechanical blockage is corrected by septoplasty, which is the second most common procedure performed by all grades of otorhinolaryngologists in the UK [3]. All first year specialist registrars in otolaryngology should have some experience of septal surgery operative techniques [4], and should subsequently be both confident and competent to perform the operation within the first years of training [5]. However, many argue that the procedure is not so straightforward due to the varying types of septal defects as well as the range of operative techniques available [6]. In fact, a signific
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