Outcome of surgical management of chronic otitis media in the community through mobile ear surgery camps in Nepal

Shrivastav, Rakesh Prakash; Prasad, Lakshmi; Sinha, Bharati; Bhattarai, Hari Datta; Guragain, Rajendra; Shah, N; Pradhan, Ben B.; Bhusal, C L; Banskota, D K; Karki, T; Thapa, Neeraj; Amatya, Ram Chhaya Man

doi:10.1016/s0531-5131(03)00872-0

Cited by 2 publications

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“…This paper describes the elements that we have found necessary to make the centres successful, including appropriate surgical techniques. Others have recorded their experiences in different places, [41][42][43][44] emphasising the need for repeat visits 45 and longer-term follow up of surgical outcomes. 46 Some have pointed out that volunteers are often relatively inexperienced residents or junior trainees, and that they are not tied in with local training programmes.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of chronic ear disease in remote or resource-constrained environments

2018

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BackgroundSurgery for chronic suppurative otitis media performed in low- and middle-income countries creates specific challenges. This paper describes the equipment and a variety of techniques that we find best suited to these conditions. These have been used over many years in remote areas of Nepal.Results and conclusionExtensive chronic suppurative otitis media is frequently encountered, with limited pre-operative investigation or treatment possible. Techniques learnt in better-resourced settings with good follow up need to be modified. The paper describes surgical methods suitable for resource-poor conditions, with rationales. These include methods of tympanoplasty for subtotal wet perforations, hearing reconstruction in wet ears and open cavities, large aural polyps, and canal wall down mastoidectomy with cavity obliteration. Various types of autologous ossiculoplasty are described in detail for use in the absence of prostheses. The following topics are discussed: decision-making for surgery on wet or best hearing ears, children, bilateral surgery, working with local anaesthesia, and obtaining adequate consent in this environment.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of chronic ear disease in remote or resource-constrained environments

2018

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

2010

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CitationR Triolo, S O'Leary. Hearing outcomes following myringoplasty for patients from developing countries with chronic otitis media. AbstractObjective: The purpose of this study is to compare hearing outcomes following myringoplasty for chronic otitis media for patients from developing counties with those of urban Australian patients. Subjects & Methods: This study is a retrospective review of 110 patients (118 ears) with non-cholesteatomatous chronic suppurative otitis media who underwent myringoplasty at The Royal Victorian Eye & Ear Hospital from 2003 to 2007. Patients who had emigrated from a developing country were analysed as one group and Australian born patients were analysed as another. Patients were excluded from the study if their hearing was normal or only mildly impaired in the affected ear pre-operatively. Outcomes are expressed in terms of tympanic membrane closure, improvement in air conduction (AC) pure tone average (PTA) and achievement of AC PTA ≤ 40 dB HL post-operatively. Results: Patients from developing countries demonstrated greater improvements in hearing following myringoplasty, mean gain in AC PTA 16.6 dB, than urban Australian patients, 9.6 dB. This difference was statistically significant (unpaired t-test; t = 2.66, p < 0.05). Conclusion: Patients from developing countries with hearing impairment secondary to chronic otitis media can achieve hearing outcomes following myringoplasty at least comparable to urban Australian patients.

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Outcome of surgical management of chronic otitis media in the community through mobile ear surgery camps in Nepal

Cited by 2 publications

References 0 publications

Surgical treatment of chronic ear disease in remote or resource-constrained environments

Surgical treatment of chronic ear disease in remote or resource-constrained environments

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

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