title: Extending otology services to rural settings: Value of endoscopic ear surgery.
abstract: BACKGROUND
  Few centers, mainly located in urban settings offer otological surgical services, yet majority of patients requiring these services are rural based and are generally unable to access these centers with resulting disease chronicity and complications. This paper aims to describe the access of otological surgical services by a rural population.
  
  
  METHODS
  This is a retrospective study of patients who accessed otological services at three secondary health institutions and one tertiary referral institution. All patients requiring ear surgery over a 4-year period were studied. The initial 2 years without ear endoscopic surgery was compared with the 2 years when ear endoscopic surgery was introduced. Hospital records were studied and relevant data were extracted.
  
  
  RESULTS
  Six hundred and nine ears required surgery over 4 years. Age ranged from 3 to 62 years, with a ratio of 1.4 males: 1 female. During the initial 2 years, all patients were referred from the three secondary health institutions to the urban-based tertiary institution for microscopic ear surgery, 94% failed to proceed on the referral. In the second 2 years, 34% were considered suitable for endoscopic ear surgery, of which 78% accepted and had surgery within the locality. Of the 66% referred, only 5% proceeded on the referral.
  
  
  CONCLUSIONS
  With operator training and investment in portable ear endoscopy set, bulk of ear surgery needing magnification can be treated in the rural setting. This represents a most feasible means of extending the service to the targeted population.
authors.affiliation: Department of Otolaryngology (ENT), Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Abubakar Danjuma
authors.initials: AD
authors.lastname: Salisu
authors.affiliation: Department of ENT, Aminu Kano Teaching Hospital, Kano, Nigeria.
authors.forename: Yasir Nuhu
authors.initials: YN
authors.lastname: Jibril
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004427:Ear Diseases / Q000175:diagnosis / Q000601:surgery*; D004724:Endoscopy / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D013506:Otologic Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*; D038781:Otoscopy; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012424:Rural Population; D062606:Tertiary Care Centers; D055815:Young Adult