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Myringoplasty Outcomes for Aboriginal and Torres Strait Islander Children Treated Via the Deadly Ears Program: A
Lara Gahan1, James Nightingale1,2, Trent Lyon3
1Queensland Children's Hospital, South Brisbane, Queensland, Australia.
Background:
Australian Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media with tympanic membrane (TM) perforation in the world. Deadly Ears is a statewide, Indigenous-led outreach service providing on-Country ear health care across Queensland. We evaluated myringoplasty surgery outcomes delivered through this program.
Methods:
A retrospective cohort study of Aboriginal and Torres Strait Islander children undergoing myringoplasty surgery by Deadly Ears between January 2015 and February 2025 was performed. Demographic, clinical, surgical, and audiological data were extracted from medical records. Primary outcomes were TM closure and improvement between pre- and post-operative audiological categories. Associations between primary outcomes and patient, ear, and surgical variables were analysed.
Results:
One hundred and four children underwent 135 myringoplasties (median age 10 years, IQR 8-12) across nine communities. Surgical and audiological follow-up was complete for 123 (91%) cases (median follow-up 707 days, IQR 358-1156). Complete TM closure achieved in 60.2% of cases and perforation size improved in 74.8%. Hearing improved by at least one category in 64.2% of ears. The proportion of children with normal hearing increased from 3.7% to 44.7%. Cartilage-based grafts, consultant surgeon operating, and shorter time to initial follow-up were associated with improved TM closure rates. Hearing improvement was associated with age < 12 years.
Conclusion:
Strong community engagement facilitated by Deadly Ears was reflected by high and complete follow-up rates. Surgical and audiological outcomes were consistent with other Aboriginal and Torres Strait Islander outreach programs but remain lower than metropolitan centres. Ongoing investment in culturally responsive, community-designed outreach models is essential.
