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Creating a cross-institutional grading scale for temporal bone dissection


  • Presented in part as a poster at the 32nd Annual Association for Research in Otolaryngology Midwinter Meeting, Baltimore, Maryland, U.S.A., February 14–19, 2009.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.



There is increasing interest in objective assessment of surgeon competence. In the field of otolaryngology, several surgical training programs, including The Ohio State University, the University of Toronto, and Stanford University, have pursued standardized criteria to rate their trainees' performance in the initial steps of temporal bone dissection (complete mastoidectomy with facial recess approach). Although these assessment metrics require the completion of similar basic components integral to successful temporal bone dissection, certain listed criteria are unique to each institution. Our aim was to establish a more standardized set of criteria that can be used across different institutions to objectively assess temporal bone dissection. We translated these new criteria into automated metrics in our temporal bone dissection simulator to achieve even more objective grading of temporal bone dissections.

Study Design:

Cross-sectional study/survey.


The temporal bone assessment criteria developed by each of the three aforementioned institutions were compiled into an all-encompassing scale. This compilation was sent out as an online survey to members of the American Neurotology Society and American Otological Society with instructions to rate the importance of each criterion.


Criteria that were ranked by >70% of respondents as either “very important” or “important” were used to create the new, cross-institutional scale for the objective assessment of temporal bone dissection.


The new assessment scale and its eventual incorporation into the temporal bone surgical simulator will enhance the objectivity of currently existing methods to evaluate surgical performance across different institutions. Laryngoscope, 2010