Endoscopic Middle Ear and Mastoid Surgery in Developing Country: Our Experience at Kathmandu ENT Hospital

By June 8, 2019

Acharya, Sailesh1; Thapa, Prakash Bahadur1; Bhattarai Bebek2
1 Department of ENT, Kathmandu ENT Hospital, Kathmandu, Nepal;
2 Department of Audiology and Speech therapy, Kathmandu ENT Hospital, Kathmandu, Nepal.

Microscope has been the standard tool for ear surgery since decades. The use of endoscopes for ear surgery is relatively new concept and is gaining popularity in recent time. The use of endoscope results in better visualization of the Middle Ear cavity in contrast to microscope, which can result in better outcome. In context of Nepal, a developing country, where incidence and prevalence of middle ear disease is relatively high owing to poor hygiene and lack of proper healthcare facility in all geographical locations.

A prospective study was designed to assess the outcome of endoscopic ear surgery in context of Nepal. This study was carried from August 2017 to July 2018 for a total duration of one year. Total of 106 individuals were selected based on the inclusion criteria who willingly consented to be part of the study. The surgery performed was Tympanoplasty and/or Canal Wall Down procedure depending upon the pathology. Outcomes was measured at three and six months post operatively using visual inspection of tympanic membrane healing and audiological evaluation to assess hearing status.

In our study, we found that the tympanic membrane  healing was 90.6%, which is better immediate outcome post operatively. It was also noted that there was satisfactory improvement in hearing status following surgery. The finding of this study opens door to endoscopic ear surgery in developing countries like Nepal.