Postoperative Pain and Numbness in Endoscopic Ear Surgery: Patient
Values and Outcomes
Purpose: Transcanal endoscopic ear surgery (TEES) avoids a postauricular
incision, which has been shown to minimize pain and numbness. Our
objective is to assess how much patients value minimizing pain and
numbness relative to other postoperative otologic outcomes. Methods:
Cross-sectional anonymous surveys were distributed to otolaryngology
clinic patients in a tertiary care center. Patients were instructed to
rate how much they value various outcomes when undergoing hypothetical
ear surgery on a scale of 0 (not important) to 10 (very important).
Linear regression was used to analyze demographic predictors of valued
outcomes. Results: 102 patients responded (response rate 75%, 50%
male). 51% presented for otologic complaints; other represented
subspecialties included head & neck surgery, facial plastic surgery and
rhinology. 10% of survey respondents were Spanish-speaking. Outcomes of
highest importance included hearing (mean 9.3; SD 1.9), staff
friendliness (8.9; 1.8), numbness (8.3; 2.4), and pain (8.1; 2.5).
Outcomes of moderate importance included time spent under anesthesia
(7.0; 3.2), scar visibility (6.3; 3.5), incision size (5.5; 3.4),
incision hidden in the ear canal (5.4, 3.9), and surgery cost to the
hospital (5.1; 3.9). In linear regression analysis, increasing age was
associated with decreased value placed on size of incision (β=-0.06,
p<0.001) and visibility of scar (β=-0.07, p<0.001).
Conclusion: Patients placed very high value on minimizing pain and
numbness after ear surgery, nearly as much as a good hearing outcome.
This has implications for patient-driven interest in TEES, which has
been previously shown to reduce pain and numbness compared to the