["Ear camp" for children in Namibia. A field report].
Maneno muhimu
Kikemikali
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).
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".
