Middle-ear disease in remote Aboriginal Australia: a field assessment of surgical outcomes

Abstract

Chronic middle-ear disease is highly prevalent among Australian Aboriginal people, and many undergo surgical treatment. However, the outcomes of surgery in this group have not been fully evaluated. This is a descriptive study of operations for middle-ear disease (excluding grommets) on Aboriginal patients in Kimberley hospitals between 1 October 1986 and 31 December 1995. Logistic regression was used to model predictors of surgical outcome. Success was defined by an intact tympanic membrane and air-bone gap of < or = 25 dB at review at, or later than, six months post-operation. A success rate of 53 per cent was observed; increasing age was the only variable predictive of success. Successful outcomes were more likely in adults and children aged > 10 years, however, this does not take into account the necessity of hearing for language acquisition and learning. Dedicated resources must be allocated for post-operative follow-up of Aboriginal patients so that much-needed, rigorous evaluations of ENT surgery can be conducted.

Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community‐based, multicentre, double‐blind randomised controlled trial

“…In Aboriginal children, CSOM usually commences in infancy, is evident within a few weeks of birth, 4 causes conductive and sensorineural hearing loss, 5 , 6 and has adverse effects on child development 7 . It is recurrent, 8 can persist into adulthood, 9 may result in a need for hospitalisation 10 and may have other neurological and life‐threatening sequelae 11 …”

Hearing outcomes following myringoplasty for patients from developing countries with chronic otitis media

“…Several studies have reported outcomes of myringoplasty performed in district hospitals and by surgical outreach teams to developing countries and remote indigenous communities. A few have demonstrated promising results [1][2][3][4][5][6][7] , however some of these have not included audiological outcomes 4,5 or were limited by small sample sizes 6,7 , while others have reported disappointing outcomes that are significantly poorer than those achieved at tertiary centres in developed nations [8][9][10] . The reasons why outcomes of surgery for CSOM remain poor in some developing country and remote indigenous settings are not well understood.…”

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

“…Ear surgery is highly specialized and despite the high prevalence of chronic otitis media (COM) and associated hearing loss (HL) among Indigenous populations -such as the Inuit in the Arctic, the Aboriginals of Australia and the American Indian and Alaska Native peoples -ear surgery is almost unattainable (1)(2)(3). This also is the case for populations in less developed countries (4).…”

“…In the international literature we found only 3 studies dealing with the outcomes of mobile ear surgery (3,9,10). We have conducted mobile ear surgery since 1998 in Greenland in an effort to lower the costs by bringing the surgery teams to Greenlanders.…”