Global Health and Otolaryngology

Background. Humanitarian medical missions may be an effective way to temporarily overcome limitations and promote long-term solutions in the local health care system. Operation Smile, an international medical not-for-profit organization that provides surgery for patients with cleft lip and palate, not only provides surgery through short-term international missions but also focuses on developing local capacity. Methods. The history of Operation Smile was evaluated globally, and then on a local level in 3 countries: Colombia, Bolivia, and Ethiopia...

OBJECT: Frontoethmoidal mengingoencephaloceles (fMECs) are frequently observed in Cambodia, especially in poor families. The authors describe issues related to the surgical treatment of fMECs in Cambodia at the end of a humanitarian program that provided surgery free of charge to patients and their families. METHODS: The authors reviewed 257 cases of fMEC involving patients who presented to their institution, the Children's Surgical Center in Phnom Penh, between 2004 and 2009...

Providing long-term multidisciplinary care for cleft lip/palate is a challenge for international humanitarian organizations that perform surgery across borders. The use of telemedicine as a means of evaluating speech in patients with cleft lip/palate has not been studied previously. We looked at determining whether a speech evaluation performed by a speech-language pathologist (SLP) using telemedicine would be equivalent to a speech evaluation performed in-person, in an international setting between Tijuana, Mexico and San Diego, CA...

The USNS Comfort (T-AH-20) is 1 of 2 United States Navy hospital ships. In 2011, she deployed to 9 countries in Central and South America including Jamaica, Peru, Colombia, Ecuador, Nicaragua, Guatemala, El Salvador, Costa Rica, and Haiti. Eight surgical specialties including otolaryngology were involved, for a combined total of about 150 cases per country. An advance team coordinated patients with the Host Nation to be seen for presurgical screening. Selected patients were then taken aboard the ship for surgery and recovered in either the ship's intensive care unit or ward...

Patients suffering from conditions requiring specialist intervention cannot obtain treatment when facilities do not exist locally. Specialist visiting teams in a number of surgical disciplines have attempted to address these issues in collaboration with local clinicians. These interventions require careful planning and communication to achieve optimum results. Several teams have been successful in building long-term relationships that have lead to important clinical developments in the local country.

OBJECTIVES/HYPOTHESIS: Determine trends in global health-related publication in otolaryngology. STUDY DESIGN: A review of research databases. METHODS: A search of publications available on PubMed and nine additional databases was undertaken reviewing two time periods 10 years apart for the timeframes 1998 to 2002 (early time period) and 2008 to 2012 (recent time period) using specific search terms to identify global health-related publications in otolaryngology...

PURPOSE OF REVIEW: Deafness is indeed a silent disability in many parts of the world, and the majority of people who have hearing impairment live in developing countries. With rising economy and developing nations becoming hub of industrialization, hearing loss may increase in these countries. In this review, the authors have elected to focus the discussion on India to frame the challenges of cochlear implants in a developing country. This article reviews the common causes of hearing loss, the challenges faced by those with hearing impairment and why the penetration of these devices is low and also reviews some reasons for the inability of the government to support the implant programme in India...

The American Academy of Otolaryngology--Head and Neck Surgery and its members have shown continuing commitment to improving global otolaryngology care through humanitarian and international outreach programs. These efforts, based on a surgical mission model, have produced only modest improvements in otolaryngologic care in Ethiopia. In cooperation with the Ethiopian Ministry of Health and 2 Ethiopian medical schools, we present a framework for otolaryngology education for the next decade. It recognizes the limitations of the current didactic paradigm and aims to use available domestic and international resources to improve the quality and availability of head and neck surgical and medical services...

OBJECTIVE: This study aimed to describe the development and implementation of the first sustainable, multidisciplinary, pediatric airway surgical mission in an underserved country. METHODS: This prospective, qualitative study was conducted for the first 4 Operation Airway missions in Quito, Ecuador. The major goals of the missions were to assist children with aerodigestive abnormalities, create a sustainable program where the local team could independently provide for their own patient population, develop an educational curriculum and training program for the local team, and cultivate a collaborative approach to provide successful multidisciplinary care...

OBJECTIVE: To report the commencement of cochlear implantation (CI) in children in Northern Nigeria and review the challenges encountered with a view to establishing CI programme. CASES: Two children with post-meningitic sensorineural hearing loss had standard pre-implantation assessment and cochlear implantation surgery in Nigeria in conjunction with surgeons from another developing country. Post-implantation meningitis was encountered and managed in one of the patients...

OBJECTIVES/HYPOTHESIS: The objectives of this work were to quantify the involvement of US otolaryngology residency programs in global health endeavors, identify goals and services provided, and determine the participation of residents and fellows. STUDY DESIGN: Cross-sectional survey of US otolaryngology faculty. METHODS: A 10-point online questionnaire was distributed to 103 US otolaryngology residency program directors; all faculty involved in global health volunteerism were invited to participate...

BACKGROUND: Hearing impairment is a leading cause of disease burden, yet population-based studies that measure hearing impairment are rare. We estimate regional and global hearing impairment prevalence from sparse data and calculate corresponding uncertainty intervals. METHODS: We accessed papers from a published literature review and obtained additional detailed data tabulations from investigators. We estimated the prevalence of hearing impairment by region, sex, age and hearing level using a Bayesian hierarchical model, a method that is effective for sparse data...

OBJECTIVE: To make recommendations concerning cochlear implantation during humanitarian medical trips by exploring the attitudes of US cochlear implant surgeons. STUDY DESIGN: Cross-sectional survey. SETTING: Academic. SUBJECTS AND METHODS: Questionnaires were sent to 405 members of the William House Cochlear Implant Study Group. The 198 respondents (49%), all active cochlear implant surgeons, were divided into 3 groups depending on their level of experience working in a developing country...

Hearing impairment has far-reaching consequences for affected individuals, in terms of quality of life indicators. In the public health care sector of South Africa the hearing-impaired population is faced with limited aural rehabilitation services. This study evaluated self-reported outcomes of aural rehabilitation in a group of adults in the public health care sector with a standardised outcomes measurement tool (IOI-HA). Sixty-one participants were included (44% male; sample mean age 69.7 years) through face-to-face or telephonic interviews...

OBJECTIVE: The purpose of this study was to determine the efficacy of treating chronic ear disease by performing a single surgical intervention in the austere environment of a developing nation. SUBJECTS AND METHODS: Data were collected from retrospective chart reviews on 121 patients who underwent surgical treatment of chronic ear disease during humanitarian surgical missions in South and Central America. Surgical outcomes and clinical course were assessed at 10 to 12 months after the initial surgery...

INTRODUCTION: This paper attempts to review changes in the lives of hearing-impaired patients within the developing world, brought about by globalisation and development. The paper also explores limitations to improved care and addresses the collective moral responsibility of developed nations. METHODS: Analysis of literature. RESULTS: Within developing nations, large populations have emerged with a similar pattern of problems, access to information and aspirations as those living in developed nations...

A simplified cochlear implant (CI) system would be appropriate for widespread use in developing countries. Here, we describe a CI that we have designed to realize such a concept. The system implements 8 channels of processing and stimulation using the continuous interleaved sampling (CIS) strategy. A generic digital signal processing (DSP) chip is used for the processing, and the filtering functions are performed with a fast Fourier transform (FFT) of a microphone or other input. Data derived from the processing are transmitted through an inductive link using pulse width modulation (PWM) encoding and amplitude shift keying (ASK) modulation...

BACKGROUND: The goals of the present study were to explore the presentation of multinodular goiter (MNG) and solitary thyroid nodules (STN) in the sub-Himalayan belt, including the risk of malignancy, and to evaluate whether specialized surgeon training in endocrine surgery has an effect on reducing complications. METHODS: This retrospective study (1998-2003) analyzed 624 patients with thyroid disorders seen in the thyroid clinic of a tertiary care hospital in western Nepal...

BACKGROUND: Excessive noise is a global occupational health hazard with considerable social and physiological impacts, including noise-induced hearing loss (NIHL). This paper describes the worldwide morbidity of occupational NIHL in the year 2000. METHODS: The proportion of the population exposed to occupational noise was estimated using noise exposure data from the US National Institute for Occupational Safety and Health (NIOSH), adjusted by data on the distribution of the work force by occupational category and economic sector, and economic activity rates in each WHO subregion...

The aim of this study was to evaluate self-reported outcomes among hearing aid users (age 16-89 years; mean 45.8 years) to determine the effectiveness of aural rehabilitation in Nigeria based on the International Outcome Inventory for Hearing Aids (IOI-HA). The responses were evaluated with descriptive statistics, factor analysis of the principal components and multiple regressions. Most respondents reported favorable outcomes in all domains of the inventory, comprising: daily use (mean 4.1; SD 1.2), benefits (mean 3...