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["Ear camp" for children in Namibia. A field report]
G Lehnerdt1, A van Delden, J Lautermann
1Universitäts-Hals-Nasen-Ohren-Klinik Essen, Universitätsklinikum Essen. goetz.lehnerdt@uni-essen.de
Insights
Ear surgery camps in Namibia provided tympanoplasty for children with chronic ear issues. Tragal cartilage reconstruction achieved an 80% closure rate, improving hearing by 13 dB.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Global Health
Background:
- High prevalence of chronic ear infections in Northern Namibia necessitates surgical intervention.
- Limited access to hearing aids and potential complications like cholesteatoma underscore the need for ear surgery.
Purpose of the Study:
- To assess the feasibility and outcomes of conducting ear surgery camps in underserved regions.
- To evaluate the efficacy of specific surgical techniques for tympanic membrane reconstruction in children.
Main Methods:
- Conducted two ear surgery camps in 2003 and 2004, performing 81 tympanoplasties on 61 children and one adult.
- Utilized autogenous ossicles, titanium prostheses, and tragal cartilage with perichondrium in an underlay technique for tympanic membrane reconstruction.
- Performed antrotomy or mastoidectomy in 39 cases and created open cavities in six cases due to cholesteatoma.
Main Results:
- Tympanoplasty types I and III were performed, with tragal cartilage reconstruction showing an approximate 80% closure rate after six months.
- Average improvement in air conduction thresholds was 13 dB across key frequencies (250–4,000 Hz).
- Surgical interventions addressed (sub)total tympanic membrane defects and cholesteatoma.
Conclusions:
- Ear surgery camps are viable with external support, adapting therapies to local constraints.
- Tragal cartilage with overlapping perichondrium is a safe and effective method for stable tympanic membrane reconstruction.
- Initiated training for local doctors in ear surgery to foster sustainable local expertise.
Background:
Ear surgery is urgently needed in northern Namibia as many children cannot even be provided with hearing aids due to chronically discharging ears, not to forget possible complications of untreated cholesteatoma.
Methods:
During the two "ear camps" in 2003 and 2004, 61 children (median age 12 years) and one adult were operated, mainly for (sub)total defects of the tympanic membrane (81 tympanoplasties).
Patients And Results:
We performed tympanoplasty type I in 33 cases and type III in 48 cases, mostly using autogenous ossicles and titanium prostheses. In 39 cases, an antrotomy or mastoidectomy was also performed, while in six cases an open cavity had to be created because of a cholesteatoma. The tympanic membrane was reconstructed using tragal cartilage with overlapping perichondrium in an "underlay-technique". The closure rate after 6 months was about 80%, the average improvement in air conduction thresholds in the frequencies between 250 and 4,000 Hz was 13 dB.
Conclusions:
An "ear camp" can only be realised with the financial and material help of companies and private supporters. Therapy must be adapted to the limited local possibilities. The use of tragal cartilage with overlapping perichondrium is a safe technique for the reconstruction of a stable tympanic membrane. We have started to instruct local doctors in pre- and postoperative care in ear surgery in order to develop local competence. This will be continued in the next "ear camp".
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