Investigate of the learning curve of cochlear implantation

Objective To investigate the learning curve of cochlear implantation and its guiding significance for clinical surgery. Methods A retrospective analysis of the clinical data of two otologists in early cochlear implant surgeries,including 98 cases of Dr.A and 54 cases of Dr.B.Statistics of the two doctors incidence of complications and operating time.Operation time as index were drawing a,b two groups of cases of scatter plot,the oscillating sine curve model Y =sin（X）-P/2 and logarithmic curve model Y=b1 ln（X）＋b0 curve fit were analyzed.Then,extract the early 90 cases of surgery by Dr.A which was divided into a,b,c three groups with 30 cases a group.The operating time and complications were further compared and analyzed （SPSS 16.0）. Results From the operation sequence,A and B physicians,early operation cases cost more operating time,and more complications.Learning curve before and after about 30 cases appeared inflection point,showing a rapid decline in period （learning phase） and slow decline period （consolidation phase） in two stages.Group contrast to Dr.A's early 90 consecutive cases,the operating time of Phase b and Phase c decreased significantly than Phase a （Pa-b ＜0.01,Pa-c ＜0.01）,while there was no significant difference between group Phase b and Phase c （Pb-c =0.68）,the complication rate of Phase b and Phase c decreased significantly than Phase a （Pa-b ＜ 0.01,Pa-c ＜ 0.01）,while there was no significant difference between group Phase b and Phase c （Pb-c =0.15）. Conclusions Our department of cochlear implantation followed the learning curve rule.The minimum number of cases that should accumulate in the learning phase needs about 30 cases. Key words: Cochlear implantation; Learning curve