Resident soft-tissue training
Makanisa School for the Deaf.
Healing the Children, a Philadelphia-based organization that provides healthcare globally, sponsored two ear, nose and throat (ENT) doctors to travel to Ethiopia last winter to perform tympanoplasties and myringoplasties on poor children.
“They have an enormous need,” says Dr. Margaretha Casselbrant, Director, Department of Pediatric Otolaryngology, Children’s Hospital of Pittsburgh, “due to poverty, lots of diseases, malnutrition, ear impaction and fluid behind the eardrums.” Dr. Casselbrant, along with long-time colleague, Dr. Glenn Isaacson, Director, Pediatric Otolaryngology at Temple University School of Medicine, spent six days in November and December 2014, in Addis Ababa treating perforated eardrums and other sequelae of suppurative otitis media.
In addition to treating children and performing surgeries, the two ENT specialists trained resident doctors. “There were only ten ENT doctors in the whole of Addis Ababa,” says Dr. Casselbrant about the capitol with over 3 million people. “They were very well-educated, but the equipment was simple and old. We had to work with less, but we had what we needed.”
The two ENT doctors also brought hearing aids to children attending Makanisa School for the Deaf in Addis Ababa. Dr. Casselbrant is planning another outreach trip to Egypt in December 2015. Read more about the Ethiopia trip in the upcoming SMED newsletter.
A new technique for healing the tympanic membrane is being employed at the University of Western Australia, Fremantle Hospital, located in Perth. Performed in early January, this type of myringoplasty involves regenerative tissue-engineering and uses a scaffold and growth factor combination that is an alternative to invasive surgery. A basic fibroblast grown factor (b-FGF) to gel foam sealed with tissue glue (Tisseel) requires only local anesthesia and about eight minutes operating time. Dr. Harvey Coates, UWA Professor and Paediatric Otolaryngologist, has been performing this technique and reports the hospital has an 83 percent success rate in adults, with similar success rates in children. Read more: of this article written by Dr. Coates, SMED advisor.
“This important and timely article pleads for access to surgery in developing nations. The two Harvard authors make a case that doing this would be cost-effective,” says Dr. Charles Bluestone about an article published today in “The New York Times.”
The article states that “Most of the world lacks access to safe, affordable and timely surgical care. Every year over 80 million people worldwide face financial catastrophe if they get surgery. And while the individual cost of getting surgery is great, the societal cost of inaction is staggering. If nothing is done to increase surgical access, developing nations are projected to lose $12.3 trillion from their gross domestic products between now and 2030.”
“One of the stated missions of SMED is to provide teaching of surgeons in these countries to treat and prevent the complications of otitis media; approximately 20,000 deaths from complications of otitis media occur each year, which most likely results from lack of or inadequate medical and surgical health care,” says Dr. Bluestone. “Although not implemented to date, we need to find donors to accomplish this task, either by training these surgeons in the US or traveling to the affected nations.”
Read The New York Times Article:
This database is the largest of its kind and is generating data that examines procedures associated with significant improvement in patient quality of life in outcome-driven investigations assessing the surgical management of OM (otitis media). This data has the potential to be important in treatment of algorithms, procedure justification, and risk factor modification. read more:
Breastfeeding protects against AOM (acute otitis media) until 2 years of age, but protection is greater for exclusive breastfeeding and breastfeeding of longer duration, according to a systematic review and meta-analysis. Exclusive breastfeeding during the first 6 months was associated with around a 43% reduction in ever having AOM in the first 2 years of life. read more:
PCV7 was associated with a 22% significant reduction in OM (otitis media) in children under ten with an additional 19% reduction after being vaccination with PCV13. These declines are equivalent to 592,000 and 15,700 fewer consultations and OM-related hospitalizations, respectively, in England and Wales every year. read more:
A developmentally delayed three-year-old suffered a cerebral artery infarction as a rare complication of acute otitis media. Meningeal inflammation spread to the walls of intracranial vessels, causing rupture with hemorrhage. The child had a history of global developmental delay.