Assessment of microvascular anastomosis training in otolaryngology residencies: Survey of United States program directors

Abstract

OBJECTIVE To assess current microvascular training strategies in otolaryngology residency programs. STUDY DESIGN Cross-sectional study. SETTING U.S. otolaryngology residency programs. SUBJECTS AND METHODS A total of 104 U.S. otolaryngology program directors received surveys inquiring about program size, the presence of fellowship training in microvascular surgery, the number of microvascular cases per month, the use of microvascular animal laboratory, and whether residents, fellows, or co-attendings assist in the anastomoses. RESULTS A 51 percent response rate was achieved, and of the 54 programs that responded, 78 percent reported no microvascular fellowship positions in plastics or head and neck reconstruction. A total of 52 percent reported performing three or fewer microvascular surgeries per month. Of the programs that did not have a microvascular fellow, only five (12%) performed eight or more surgeries per month. A total of 65 percent of the programs reported that residents assist during the anastomosis at least 75 percent of the time. Of the programs where residents assist 75 percent or more of the time, 70 percent have a formal training in microvascular technique ranging from demonstrating laboratory competencies to multiday courses. A total of 48 percent of the responding programs report having an animal laboratory for microvascular surgery. All animal laboratories used the rat as the model. CONCLUSION Many programs find value in providing residents with microvascular training, both in the operating room and in the laboratory. Only a small minority of programs without fellowship positions responded that they perform microvascular surgery on a regular basis (4 or more surgeries per month).