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

Abstract

Objectives: We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas.Materials and methods: The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing was assessed using median air conduction pure tone average gain, and the 'take rate' (i.e. the percentage of total ears with a closed perforation) was evaluated.Results: All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of 25 dB in at least one ear. In total, 71 per cent of the patients were satisfied. There were no hearing hazards.Conclusions: The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared with unilateral ear surgery.

Comparative Study on Bilateral Single Sitting Endoscopic Myringoplasty Conchal Cartilage Versus Temporalis Fascia Graft

“…Most of the patients in this series had medium-sized perforation, followed by large perforation as was also observed in most other studies. 10,15 This is also comparable to most other studies. Advantages of conchal cartilage from single ear include the following-…”

Success rates in restoring hearing loss in patients with chronic otitis media: A systematic review

“…On examining the full texts, 92 articles were assessed as unsuitable where COM was not the primary disease (7), tympanoplasty subtypes were not the primary intervention (11), the article was not published in English (5), the article did not contain long‐term hearing outcomes (68) or the presented data were too limited (1). Thirty‐nine studies 14‐52 reporting long‐term hearing outcomes and/or complications following middle ear interventions were included for synthesis.…”

“…Regarding complications, 31 14,15,17,19‐27,29‐32,34‐39,41‐44,46,47,49‐51 studies presented complications data, however, three of these studies 30,41,54 presented complications data in terms of ears and could not be included in the data synthesis calculation, which is based on complication per patient. The mean complication rate, calculated for a total of 3162 patients from the remaining studies, was 14.0% (Figure 4).…”

Panel 7: Treatment and Comparative Effectiveness Research

“…Knowledge of these risk factors can assist with preparation and the consent process. Homoe et al 107 described a program of 1‐stage bilateral CSOM/COM ear surgery in 17 Greenlandic children and young adults. At 3 weeks and 2 years postsurgery, 50% to 60% of tympanic membrane perforations were intact.…”

“…Knowledge of these risk factors can assist with preparation and the consent process. Homoe et al 107…”