Outcomes of an Ear Camp Conducted in Bhutan by Thai Rural ENT Foundation—A Descriptive Study

Background: The Thai Rural ENT foundation has been conducting ear camps in Bhutan for many years to address the shortage of ENT specialists in the kingdom where patients are examined and treated for various ear illnesses. However, there has been no study conducted to assess the outcomes of such camps. This is the first study of its kind to be carried out in Bhutan. Objective: To study the spectrum of ear cases seen during the mobile ear camp, the intervention done and treatment outcomes. Materials and Methods: The study enrolled patients with ear disorders who presented to the mobile ear camp at Monggar Regional Referral Hospital, Bhutan, from January 6, 2020, to January 8, 2020. The following data were recorded: demographic details, preoperative clinical symptoms and otoscopic findings, preoperative audiogram, treatment or surgery done, postoperative middle ear and mastoid infection, wound infection, graft condition, any complications, and postoperative audiogram of operated cases. Patients who underwent surgery were followed up at 1 day, 6 weeks, and 2 months postoperatively. Results: Two hundred ten patients presented with otologic conditions and 43 underwent surgeries. Otitis media was the commonest disease detected, and tympanoplasty was the commonest surgery performed. The tympanic membrane closure rate was 92.1%, and the rate of hearing improvement was 63.2%. Conclusion: The ear camp had beneficial effect and showed good results.

Endoscopic ear surgery in the ear camp setting; forward thinking or folly?

Background:Endoscopic ear surgery is becoming an accepted technique in otological surgery, in the management of chronic otitis media.Methods:The technique was introduced to the humanitarian care setting of an ear camp in Nepal to consider the appropriateness of the technique in this type of clinical setting.Results:Fifteen cases of myringoplasty were successfully completed.Conclusion:The apparent advantages of the endoscopic approach over the traditional microscopic one were the ease of transporting the equipment and the optimal view obtained of the tympanic membrane. The ability for pathology and operative technique to be observed equally well by the surgeon and local staff was helpful for teaching, and enables a move towards self-sufficiency of care. Easy image capture also has potential for remote telemedicine applications.

Microsurgery in Nepal: a week on 'ear camp' with the Britain Nepal Otology Service

In December 2012, I was privileged to be given the opportunity to assist on the 49th Britain Nepal Otology Service (BRINOS) 'ear camp' in Nepal, a country where 40 per cent of the population are estimated to live in poverty. In the BRINOS initiative, a collaboration of ENT specialists, nurses and community ear assistants (CEAs) apply their skills in thrice-yearly ear surgery camps to the enormous task of reducing morbidity from ear disease.

Diagnostic otoscopy skills of community ear assistants in Western Nepal

Introduction:Deafness is a major problem in developing countries. Rural communities tend to be affected more than urban ones, and chronic otitis media is common. The World Health Organization has proposed primary ear care as a method of providing otological services in developing countries. This study aimed to assess the diagnostic otoscopy skills of community ear assistants in rural Western Nepal.Materials and methods:Community ear assistants undertook the pre-operative evaluation of 92 patients selected for middle-ear surgery in an ‘ear camp’ setting. The otoscopy skills of community ear assistants were also assessed by means of an otoscopy quiz. Consultant otologists and trainee otolaryngologists underwent an identical assessment.Results:The community ear assistants' selection of patients for middle-ear surgery concurred with the consultant otologists' opinion in 87 of 92 patients (94.5 per cent). The level of community ear assistants' otoscopy skills was between that of junior and senior otolaryngology trainees.Conclusions:With intensive training, medically unqualified community ear assistants can develop otoscopy skills comparable to those of medically qualified otolaryngology trainees. These results support the development of primary ear care in poorer countries where access to specialist otological services is difficult or impossible.