|Year : 2010 | Volume
| Issue : 4 | Page : 199
Otology practice in Nigeria: The way forward
Department of Otolaryngology, Postgraduate Medical Institute, University of Hull Hull, United Kingdom
|Date of Web Publication||8-Oct-2010|
Department of Otolaryngology, Postgraduate Medical Institute, University of Hull
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Agada F. Otology practice in Nigeria: The way forward. Ann Afr Med 2010;9:199
In current otological practice, advancement in effective immunization and hearing screening has led to a decline in chronic otological diseases. Cochlear implants have had a significant impact on patients with profound hearing loss. Advancement in middle ear implants, hybrid cochlear implant hearing aid system and brain stem implants are in the forefront of the next generation of changes.
However, while the above might be true for developed countries, the authors in their article have shown that otological practice in developing countries has remained unsatisfactory. While over 50% of patients seen in their practice in Kano had otological disease, it is disheartening that they could offer very little to most patients, as a result of lack of resources. The majority of their patients had preventable cause for their otological disease.
This finding is similar to those of several authors. Fagan et al in their survey of ENT practices in Africa have demonstrated the paucity of specialized services and training facilities in Africa.
Lasisi et al in their article on discharging ear highlighted the deplorable state of otolaryngological practice in West Africa sub region. However, in their conclusion, they suggested the following: "A structured short-term clinical fellowship in otology for young otolaryngologists in the West African sub region may be ideal." While this is important, it is my view that centers in developing countries should invite skilled otologists from the developed countries to be involved in training.
Centers in the UK invite top otologists and ENT surgeons from all over the world to come and be involved in training, courses and conferences, therefore raising the bar for trainees in the UK. We can seek to apply such an approach to our training programs in Nigeria.
The way forward is for a strong campaign to improve immunization, introduce universal hearing screening for children, and to consider centralizing otological practice in a few centers that are well equipped. Having many poorly equipped centres does not effectively meet the patient's needs.
The recommendations made by Fagan et al should be considered. Their recommendations include need for "a comprehensive, multipronged, multinational program to improve the quality of, and access to, ENT, audiology, and speech therapy services in Africa."
Temporal bone courses, ear courses and workshops need to be organized either at a local or national level. Only when we continue to re-educate ourselves, can we begin to take small, but important steps in meeting the challenges we face in our centers.
The authors in their conclusion advised, "Concerted effort should be geared towards strengthening preventive ear health, training and re-training, procurement of relevant diagnostic and operative equipment."
I do agree with the authors but such efforts can only be made if ENT surgeons in Nigeria arrange a meeting to seek ways in which some of the suggestions can be taken forward.
| References|| |
|1.||Fagan JJ, Jacobs M. Survey of ENT services in Africa: Need for a comprehensive intervention. Global Health Action 2009; 2. |
|2.||Lasisi AO. The chronic discharging ear in the Sub Saharan Africa: Need for improved management. Int J Otorhinolaryngol 2008;7:2. |