Optimizing outcomes in ear surgery: A dynamic framework for assessing postoperative complications and quality of care.

PURPOSE: To ensure continuous, standardized documentation of postoperative courses after ear surgery. This partial analysis focuses on quantifying the occurrence and frequency of specific complications. A complication registry was implemented to provide quality indicators, facilitating early detection and dynamic assessment.

METHODS

In this prospective, single-centre cohort study, 2,120 patients who underwent primary or revision middle ear surgery (Jan 2019 - Jun 2022) were entered in the registry and evaluated. Complications were assessed during regular follow-up visits and analysed dynamically using the Kaplan-Meier estimator, introducing the Complication Persistence Function (CPF) as a novel metric.

RESULTS

A total of 528 (24.9%) complication-related cases involving 570 distinct complications were documented. The introduction of the CPF allowed for the first time the characterisation of the regression time of complications by extracting parameters such as the median persistence time (MPT), the plateau onset time (POT) and the persistence rate (PR). Bone conduction (BC) threshold shift and facial nerve palsy (FNP) were analysed in detail. Immediate and late-onset subgroups of BC threshold shift and FNP showed significantly different recovery dynamics (p < 0.05).

CONCLUSION

This study introduces a standardised, dynamic approach to the documentation and analysis of otosurgical complications. The CPF provides robust metrics for assessing surgical outcome quality and should be considered a complementary method alongside traditional outcome measures. These findings can help establish mandatory documentation parameters and improve comparability across clinical centres.