Management of an "Ear Camp" for children in Namibia.

OBJECTIVE

In this publication, we present our experiences with managing an "Ear Camp" in northern Namibia, where the population is predominantly black. Medical coverage for ear problems is poor in this part of the country.

METHODS

Within 10 days, 38 children (median age 12 years) were operated mainly for (sub) total defects of the tympanic membrane. In two cases, an open cavity had to be created because of a cholesteatoma. We performed a tympanoplasty type I in 18 cases and a tympanoplasty type III in 20 cases. Additionally, in 8 cases an antrotomy and in another 8 cases a mastoidectomy was performed. The ossicular chain was reconstructed with a titanium-PORP (14 cases), a titanium-TORP, interposition of the head of the malleus or a cartilage columella (one case each) or by placing the reconstructed tympanic membrane directly onto the head of the stapes (three cases). The tympanic membrane was reconstructed by the use of tragal cartilage with overlapping perichondrium in underlay-technique.

RESULTS

Thirty-one children could be followed up. A defect of the tympanic membrane was found in five cases because of continuous purulent discharge. The average improvement of air conduction thresholds in the frequencies between 250 and 4000 Hz was 15 dB.

CONCLUSIONS

Surgical techniques, antibiotic treatment and perioperative management have to be adapted to limited possibilities of pre-treatment and aftercare. As development aid should support people to look after themselves, we started to instruct local doctors with regard to pre- and postoperative care in ear surgery. Training of the local doctors will be continued in our next "Ear Camp" in 2004.