Outcome of mobile ear surgery for chronic otitis media in remote areas.

Abstract

The Inuit of Greenland, Canada and Alaska suffer from chronic otitis media (COM). In Greenland these patients used to be referred to Denmark for ear surgery. This was expensive and unsatisfactory, and the results were poor. A mobile ear surgery project was developed. The study is longitudinal and prospective with follow-up. The 274 patients were selected according to severity of COM and hearing loss. Only air conduction (AC) audiometry was obtained. Median age was 27 years and 55% were females. Closure rates at three weeks, one year, and two years were 67 percent, 72 percent, and 76 percent, respectively. Median AC pure tone average improvement was 15 dB and 12 dB after one year and two years, and 73 percent and 67 percent were satisfied. Outcome was associated with quality of the surgical skills (P < 0.002). We found marked spontaneous fluctuations between the follow-ups. The results of mobile ear surgery in Greenland are acceptable. Mobile ear surgery may be implemented in areas with limited access to health care, eg, in developing countries.