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Implementation and results of a surgical training programme for chronic suppurative otitis media in Cambodia

Published online by Cambridge University Press:  12 July 2018

A K K Smith ,
T Sokdavy ,
C Sothea ,
M K R Pastrana ,
R F Ali ,
C T Huins ,
M P A Clark ,
J G Gollogly  and
M F Bhutta
A K K Smith*
Affiliation:
ENT Department, Gold Coast University Hospital, Southport, Queensland, Australia School of Medicine, Griffith University, Gold Coast, Australia
T Sokdavy
Affiliation:
Children's Surgical Centre, Kien Khleang Rehabilitation Centre, Phnom Penh, Cambodia
C Sothea
Affiliation:
Children's Surgical Centre, Kien Khleang Rehabilitation Centre, Phnom Penh, Cambodia
M K R Pastrana
Affiliation:
St Luke's College of Medicine, Quezon City, Philippines
R F Ali
Affiliation:
School of Medicine, Imperial College London, UK
C T Huins
Affiliation:
ENT Department, University Hospitals, Birmingham NHS Foundation Trust, UK
M P A Clark
Affiliation:
ENT Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
J G Gollogly
Affiliation:
Children's Surgical Centre, Kien Khleang Rehabilitation Centre, Phnom Penh, Cambodia
M F Bhutta
Affiliation:
Children's Surgical Centre, Kien Khleang Rehabilitation Centre, Phnom Penh, Cambodia ENT Department, Brighton and Sussex University Hospitals Trust, Brighton, UK
*
Author for correspondence: Dr Aaron K K Smith, ENT Department, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, Australia E-mail: aaronkksmith@gmail.com
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Abstract

Background

Chronic suppurative otitis media is a massive public health problem in numerous low- and middle-income countries. Unfortunately, few low- and middle-income countries can offer surgical therapy.

Methods

A six-month long programme in Cambodia focused on training local surgeons in type I tympanoplasty was instigated. Qualitative educational and quantitative surgical outcomes were evaluated in the 12 months following programme completion. A four-month long training programme in mastoidectomy and homograft ossiculoplasty was subsequently implemented, and the preliminary surgical and educational outcomes were reported.

Results

A total of 124 patients underwent tympanoplasty by the locally trained surgeons. Tympanic membrane closure at six weeks post-operation was 88.5 per cent. Pure tone audiometry at three months showed that 80.9 per cent of patients had improved hearing, with a mean gain of 17.1 dB. The trained surgeons reported high confidence in performing tympanoplasty. Early outcomes suggest the local surgeons can perform mastoidectomy and ossiculoplasty as safely as overseas-trained surgeons, with reported surgeon confidence reflecting these positive outcomes.

Conclusion

The training programme has demonstrated success, as measured by surgeon confidence and operative outcomes. This approach can be emulated in other settings to help combat the global burden of chronic suppurative otitis media.

Keywords

EducationGlobal HealthOtologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 8 , August 2018 , pp. 711 - 717
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr A K K Smith takes responsibility for the integrity of the content of the paper

Presented at the Coalition for Global Hearing Health Conference, 23–25 October 2016, Manila, Philippines, and at the 19th International Symposium on Recent Advances in Otitis Media, 4–8 June 2017, Gold Coast, Australia.

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