Training in otology and neurotology begins with didactic lectures given during the Annual Temporal Anatomy and Dissection Bone Course. This complements the otology/neurotology lectures given as part of the routine didactic conference and lecture schedule.

The annual temporal bone course (6 weeks) includes operative training on cadaveric temporal bones as well as a detailed curriculum on anatomy, common otologic diseases, and historical as well as present day medical and surgical treatments. Residents are also expected to engage in self-directed dissections in the temporal bone laboratory with a minimum of ten bones drilled each year. The complete, modern temporal bone dissection facility is available at all times for this educational opportunity. Since almost all otologic procedures can be performed in the laboratory, this is an extremely important part of the resident experience in otology. A special set of instrumentation is also available for use in stapedectomy surgery.

A complete range of clinical opportunities is available in the division. Pediatric and adult chronic ear procedures are performed regularly. In addition, middle ear exploration, stapedectomy, and ossicular reconstruction are standard at all hospitals. An ample vestibular surgery volume is available with emphasis on conservation procedures for Meniere’s disease with occasional ablative procedures. Cochlear implants and vestibular rehabilitation procedures are also performed. Lateral skull base procedures and CPA surgery are also available as part of the skull base surgical team. A team approach with members of the Department of Neurosurgery is utilized for many of these cases.

Residents are given a graded exposure to otologic clinical material commensurate with their experience, performance, and previous exposure. First-year residents perform simple operative procedures, such as myringotomy and tube insertions and myringoplasty. Although procedures such as tympanomastoidectomies, stapedectomy and various middle and posterior skull base procedures involve primarily senior residents, at Children’s Mercy Hospital, the rotating junior residents get an early exposure to various complex otologic procedures. The pre-operative clinical workup and post-operative care of these patients are also assigned to residents contingent upon their level of training. In the operating room and outpatient clinic, video and still photography monitoring of microscopes is available to assist in teaching of residents. Diagnostic and treatment efforts are supported by the Departmental audiology and vestibular rehabilitation staff. PGY-2 OTOHNS residents rotate with the Departmental audiologists and vestibular physical therapist to learn these techniques firsthand.

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