Implementation of the First Endoscopic Ear Surgery at a Remote Hospital in the Philippines

By June 7, 2019

Ho, Sandra1; Preis, Michal2
1 Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn NY, USA;
2 Department of Otolaryngology, Maimonides Medical Center, Brooklyn NY, USA.

This study aimed to describe the initial implementation of endoscopic ear surgery and its impact on the hospital and patient population at a remote location in an underserved country.

This prospective, descriptive study was conducted during the Compassion in Action mission trip in Ifugao, Philippines. For the past 20 missions, the Zeiss OPMI 1-H, one of the first models of operating microscopes, was used. Our goals for this mission trip in 2019 were to determine the feasibility of implementing endoscopic ear surgery at this institution and promote education of the local staff team and patients about chronic ear conditions without compromising patient safety or outcomes.

Thirty-two patients ages 3 to 67 years were included in the initial implementation of endoscopic ear surgery in this region of the Philippines. Seventeen tympanoplasties, 2 ossicular chain reconstructions/middle ear explorations, 8 bilateral myringotomy with tubes, 5 exams under anesthesia/removal of cerumen procedures were performed. Additionally, 5 awake exams were performed with patients sitting in front of the monitor. 1 scrub technician, 1 medical student, 3 nurses, 2 general surgeons and 5 patients were able to learn from the endoscopic ear images displayed on the screen. Over 1000 hours of video footage was taken to be edited and brought back next year for education and continuity of care.

We have demonstrated the first successful implementation of endoscopic ear surgery in a remote region of the Philippines. We were able to provide otologic services to thirty-two patients in four days and after 20 years, were able to show the local staff the anatomy and pathology of the ear and the steps in various otologic procedures.

Endoscopic ear surgery is feasible and safe in a remote location such as mission trips.