Temporal bone computed tomography checklist-TeSLANO: introduction of a standardized preoperative imaging evaluation for middle ear surgery

Purpose: Aim of the study was to evaluate if the introduction of the imaging checklist TeSLANO would improve the identification of crucial anatomical findings from temporal bone computed tomography (TBCT) scans among a cohort of Otolaryngology residents. Study design: Single-blinded prospective cohort study. Setting: Tertiary care university hospital and referral center for otology and skull base surgery. Methods: The cohort was composed by eight Otorhinolaryngology residents (four junior and four senior) that were individually asked to identify all relevant anatomic findings from preoperative TBCT scans. Supervising surgeon showed to each resident four TBCT scans before and four after the introduction of a systematic checklist evaluation system based on the TeSLANO acronym. Statistical analysis was performed using McNemar's test and results were considered significant with a P value < 0.05. Results: Introduction of the checklist improved global identification of critical anatomical structures from 48.75 to 89.17% (P < 0.05). The postimplementation identification percentage improved for both the senior and junior groups (P < 0.05). Conclusions: The imaging checklist TeSLANO allows a systematic approach to review TBCT scans and significantly improves identification of critical anatomical structures in Otorhinolaryngology residents.