Objective: The objective of this presentation is to illustrate the learning curve of a surgeon who transitioned to Endoscopic Ear Surgery and the surgeon's creation of a teaching program in a U.S. residency program.

Methods: A 5 minutes educational video with 3 power point slides illustrating learning curve, tips, take home points and conclusions.

Results: The surgeon will illustrate the initial difficulties and challenges that can delay the transition and adoption of the primary endoscopic approach, how many cases does it take to fully transition to Endoscopic Ear Surgery, the modifications in OR set up and surgeon's position with time and skill acquisition, utilization of endoscopy in the office setting for chart documentation and patients’ education.

The surgeon will present a personal experience in teaching the residents a new surgical technique and creating a structured educational program with goals and skills to achieve according to resident's level of training.

To evaluate the surgeon's initial results in Endoscopic Ear Surgery two cohort of consecutive patients who underwent tympanoplasty with microscopic approach and endoscopic approach were evaluated for closure rate and duration of surgery. All surgeries were performed with residents’ participation. The comparison shows that in the surgeon's personal experience the endoscopic approach provided similar rate of closure and duration of surgery than the microscopic approach.

Conclusions: Transitioning to Endoscopic Ear Surgery requires an initial investment of time in attending training courses and observing live surgery performed by experienced surgeons. The surgeon's learning curve is steeper than for a resident that has familiarity with endoscopic sinus surgery. A comparison of 30 consecutive microscopic and 30 consecutive endoscopic tympanoplasty showed no difference in duration of surgery and closure rate, with a trend indicating that duration of surgery may shorten with surgeon's experience.