Clinical Application of the SAMEO‐ATO Classification and Analysis of the Correlation Between Individual Subgroups and Surgery Duration

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Introduction: Tympanomastoid surgery, encompassing intricate middle ear and mastoid procedures, necessitates a standardized classification system to ensure consistent documentation, enhance comparability, and improve outcome analysis across different clinical settings. The SAMEO-ATO classification, established by the International Otology Outcome Group (IOOG), provides a comprehensive framework that categorizes surgical interventions into key components, covering both mastoid operations (SAMEO) and middle ear surgeries (ATO). Methods: We analyzed correlations between specific subgroups within the SAMEO-ATO framework and the duration of surgery. Data were retrospectively collected from 300 patients at a university hospital, categorized according to the SAMEO-ATO classification, and statistically analyzed to determine associations between subgroups and operative time. Results: retroauricular), as well as the specific components of mastoidectomy, external auditory canal reconstruction, mastoid cavity obliteration, middle ear access, tympanic membrane reconstruction, and ossicular chain reconstruction, significantly influenced surgery duration. Conclusions: The results suggest that the SAMEO-ATO classification can serve as a valuable predictive tool for estimating procedural complexity in tympanomastoid surgery. These findings contribute to the growing body of evidence supporting the utility of the SAMEO-ATO classification in otological practice and underscore its potential as a framework for outcome-oriented research in middle ear and mastoid surgery.

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