DR AN AUDIT AND OUTCOME OF EAR PROCEDURES IN A RESOURCE LIMITED TERTIARY HEALTH CENTER

Abstract

Background: Ear Procedures are common and determined by different factors in otorhinolaryngology, head and neck practice. This study aimed at determining the clinical profile and outcome of ear procedures in a tertiary health care. Materials and Methods: This was a retrospective study of all patients who had ear procedures done in Ekiti State University Teaching Hospital, Ado Ekiti , a sub Saharan African country. The data collected were collated and analyzed using Statistical Package for Social Sciences (SPSS) version 18.0. Results: Rate of ear procedure in this study was 20.8%. Peak age groups of ear surgery were at the extreme ages of (1-10) and (≥ 61) years in 29.6% and 26.2% respectively. Main presenting symptoms were earache in 54.4% and object in the ear in 35.7%. Unilateral ear procedure is more common in 93.5% and occurred in the 52.5% right ear. Clinic procedures accounted for 93.8%. Emergency procedures accounted for 35.2%. Main indications for ear procedures were 47.8% ear wax impaction, 16.5% otitis externa and 16.1% foreign body impaction. Major ear procedures in this study were 50.5% ear syringing, 30.0% aural toileting/dressing and 13.6% foreign body removal. Major complication recorded was trauma in 1.9%. Referred patients accounted for 3.9% and main limitation and indication for referral were surgical facilities, diagnostic equipment and patient financial constraints in 3.1%, 2.7% and 1.9% respectively. Main indications for referral were 2.7% auditory brainstem response, 1.9% tympanoplasty and 0.7% cochlear implants. Majority 63.4% of the patients were satisfied with the ear procedures. There were 3.6% losses to follow up. About 3.3% of patients were referred for ear surgery in other center. Conclusion: Surgical ear procedures are still not fully practiced especially where there are limited resources. This study showed a prevalence of 20.8%. Ear syringing was a major ear procedures performed in 50.0% of patients. There is need to provide adequate surgical facilities which will tremendously reduce referral cases and encourage surgical tourism in developing country.