Outcome Of Chronic Suppurative Otitis Media Surgery In Two Teaching Hospitals In Kenya.

Abstract

Background Chronic suppurative otitis media (CSOM) is among the most common childhood infections. CSOM is the main cause of hearing loss among children in developing countries including Kenya. Operation Ear drop (OED) is an international charity that has been focused on improving care for Kenyan patients with CSOM by sponsoring surgeries and providing the necessary training for Otolaryngologists. Aim To determine the outcome of chronic suppurative otitis media surgeries in a training programme in Kenya. Methods Study period: September 2016 to September 2017 Study site: ENT departments of Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH). Study design and procedure: This is a prospective descriptive study. Patients who underwent tympanoplasty and/or mastoidectomy for chronic suppurative otitis media sponsored by OED, and consented to being included in the study were subjected to preoperative history taking, preoperative and postoperative physical examination, video-otoscopy and pure tone audiometry (PTA) at 250, 500, 1000, 2000, 4000 and 8000 Hz. The Demographic, clinical and PTA data was then collected on a preformatted questionnaire. The outcome measures were Tympanic membrane graft take rate, dry middle ear cavity and change in Pure Tone Audiometry (PTA). Data was analysed using SPSS version 20. Descriptive statistics was used for the population sociodemographic characteristics. Results In 50.8% and 61.5% of the cases the tympanic membrane was intact at 3 months and 6 months postoperative period respectively. The graft take rate was not significantly affected by the period of last discharge, perforation size, age of the patient, the expertise of the surgeon or the hospital where the surgery was performed. There was progressive improvement in hearing. Conclusion Chronic suppurative otitis media surgery is beneficial in correcting anatomical defect in the tympanic membrane, achieving a dry non-discharging ear and reducing the effect of hearing loss.