Article Abstract

Myringoplasty outcomes of Indigenous Australians in the West Kimberley region of Western Australia

Authors: Soumya Soumya, Anton Hinton-Bayre, Harvey Coates, Eng H. Ooi, Jafri Kuthubutheen

Abstract

Background: Chronic suppurative otitis media (CSOM) is a significant cause of hearing loss in remote Aboriginal communities of Australia. Myringoplasty aims to prevent otorrhoea and improve hearing loss associated with CSOM by closing tympanic membrane perforations. This study aims to review myringoplasty outcomes for Indigenous Australians in the West Kimberley region.
Methods: Retrospective chart review of clinical, operative, and audiometric data at Broome and Derby hospitals from 2004 to 2014 found 419 myringoplasty operations were performed on 327 patients. The primary outcome “success” was defined as closure of the perforation with an air-bone gap of less than 25 dB at 6 months or greater post-surgery.
Results: Of the 419 ears undergoing myringoplasty, only 90 (21.5%) had complete follow-up. Simple closure was seen in 39% of ears with complete follow-up, with higher rates seen in female patients, small to medium perforations, and ears with normal pre-operative hearing. Closure of the tympanic membrane with normal hearing was seen in 29% of ears with complete follow-up, with higher success rates seen in those with dry ears pre-operatively.
Conclusions: Follow-up and outcomes for myringoplasty remain poor for Indigenous people in the West Kimberley region. Standardised prospective data recording and integration will minimise data attrition. Patient attrition will remain a challenge requiring ongoing investment and education. Improvements in ear and hearing outcome are more likely to arise from health care system improvements over patient selection and operative technique.