Hearing outcomes after mobile ear surgery for chronic otitis media in Greenland

Abstract

Objectives. Chronic otitis media (COM) with hearing loss (HL) occurs frequently in many populations with limited access to specialized treatment. This article reports on the hearing outcomes following mobile ear surgery in Greenland. Study design. The study was longitudinal and prospective with pre-and post-operative followup data compiled at 1-and 2-year intervals. Methods. Selection criterion included individuals with COM with or without suppuration (CSOM) and with associated HL. Hearing tests were obtained by using a simple air-conduction (AC) audiometry. The median age of the 274 participants was 27 years (8-60 years), and 45% were males. Sixty-one percent had COM and 34% had CSOM. Myringoplasty or tympanoplasty type I was performed in 88% of the cases. Results. The median pre-operative AC pure-tone average was 38 dB. The follow-up rate was 75% and 61% at 1-and 2-years. Hearing gain was found in 78% at both follow-ups and was ≥10 dB in 62% and 56%, respectively. The median hearing gain was 15 dB and 12 dB, respectively. Independent predictors of hearing gain were pre-operative tympanic membrane atrophy and closure of perforations. Conclusions. Long-term hearing gain can be achieved with mobile ear surgery and this, in addition to tympanic membrane closure, is important for hearing rehabilitation in populations with poor access to health care.

Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

“…The study showed a long-term ‘take rate’ (i.e. the percentage of total ears with closed perforations) of 76 per cent and a long-term median air conduction PTA hearing gain of 12 dB 9 , 16 …”

“…Our group published recently the results of 274 cases of unilateral ear surgery for chronic otitis media and CSOM carried out in a mobile setting in Greenland 9 , 16 . Two or (at most) three patients (i.e.…”

“…the percentage of total ears with closed perforations) of 76 per cent and a long-term median air conduction PTA hearing gain of 12 dB. 9,16 In the present study, which we believe is the first to report results for one stage, bilateral ear surgery conducted by a mobile surgical unit in remote areas, we operated upon a minimum of two patients (i.e. four ears) per day, thus increasing the number of ears operated upon by 25 -50 per cent.…”

Factors affecting hearing improvement following successful repair of the tympanic membrane

“…Those that do include them report the results in different ways (Table I). [1][2][3][4][5][6][7][8][9][10] Hearing improvement is reported in a variable proportion of patients, but this is partly because of the different ways in which the results are presented. The degree of audiometric hearing improvement correlates with improved quality of life, as measured by the Glasgow Benefit Inventory, and is therefore a useful outcome measure.…”

Health care and health care delivery in Greenland

“…These studies have been designed to accommodate the specific need for culturally sensitive research in Greenland and across the Arctic, as described in the present research strategy (51). To a lesser degree, health research has included projects on quality, encompassing large, international collaborative projects such as the International Polar Year project on infectious disease surveillance covering the whole Arctic region (52), but also Nordic (53), national (48,54,55) and local (56,57) projects on aspects of quality in care. To improve the health care system, more research is needed on health care management, including topics such as culturally sensitive implementation of health care, evaluation of best practice, cost-benefit analysis of resource allocation, as well as clinical quality and how it can be facilitated.…”