Tympanoplasty Outcomes of Inuit Populations in Nunavik, Canada

To provide an updated account of tympanoplasty success rates in Inuit patients of Northern Quebec and to explore optimal surgical techniques for this population.

Chronic otitis media and tympanic membrane perforations are highly prevalent among Inuit populations in Northern Quebec.

A retrospective chart review was conducted of Inuit patients who underwent tympanoplasty with or without ossicular chain reconstruction at the Inuulitsivik Health Center in Puvirnituq, Quebec, Canada, between January 2015 and January 2024. The primary outcome was otoscopic confirmation of an intact tympanic membrane postoperatively. Secondary outcomes included pre- and post-procedure audiometric parameters and postoperative complications.

A total of 197 patients (median age 16.4, IQR: 12.2;31.7) and 224 tympanoplasties were included (195 primary and 29 revision surgeries). Postoperative examination revealed successful closure of the tympanic membrane in 113/174 (64.9%) of patients with appropriate otoscopic follow-up, however, varied widely according to the type of graft used. Cartilage tympanoplasties had a closure rate of 86.7% (39/45 patients), compared with 63.0% (51/81) for tympanoplasties using a perichondrium or fascia as a graft, and 48.9% (23/47) for simple myringoplasties using fat and/or a hyaluronic acid scaffold (EpiDisc; P < 0.001). The median follow-up was 1.8 years (IQR: 0.9; 3.5).

While tympanoplasty may improve audiometric parameters and recurrent otorrhea, outcomes in Inuit patients are modest. This study emphasized the superior closure rates with cartilage grafts, which may help improve outcomes in this population. Further efforts should focus on addressing broader health care disparities to ensure better access to specialized surgical care and postoperative follow-up in Inuit communities.