[Middle ear surgery in Mongolia--first results with middle ear prostheses]

Area of Science:

• Otorhinolaryngology
• Medical device technology
• Global health

Background:

• Mongolia faces significant challenges in otorhinolaryngology care, with limited access to advanced diagnostic and surgical equipment.
• Ear microsurgery and tympanoplastic procedures are nascent, necessitating international collaboration for skill and equipment transfer.
• A joint program between Wuerzburg and Ulan Bator universities aims to integrate standard tympanoplasty into routine surgical practice.

Purpose of the Study:

• To evaluate the audiological outcomes of tympanoplastic procedures performed in Ulan Bator, Mongolia.
• To compare the effectiveness of different ossicular reconstruction materials, including autologous ossicles and various prostheses.
• To assess the feasibility and success of implementing advanced ear surgery techniques in a low-resource environment.

Main Methods:

• Ninety tympanoplastic procedures were conducted between 2005 and 2006 at the Ulan Bator ORL center.
• Reconstruction involved autologous ossicles, polyethylene, Teflon, and titanium prostheses.
• Postoperative audiological outcomes were evaluated six months after surgery.

Main Results:

• Titanium prostheses yielded the most significant hearing improvement, averaging 26 dB.
• Polyethylene and Teflon prostheses resulted in mean hearing gains of 7 dB and 18 dB, respectively.
• Autologous ossicle reconstruction provided a mean hearing improvement of 8.6 dB.

Conclusions:

• Standard tympanoplasty techniques are reliable even in settings with limited medical resources.
• Titanium prostheses offer superior and reliable middle ear reconstruction outcomes.
• Biocompatible alloplastic materials, particularly titanium, are highly suitable for ear reconstruction in challenging environments.