Endoscopic Ear Surgery in an Under-Equipped Context: The Case of Mali

Objective: The aim of this work is to expose the advantages of the endoscope in otologic and neurotological surgery in an under-equipped context and its realization using an unusual tool. Methods: This is a prospective study extended over 2 years on the medical observations of twenty (20) patients operated endoscopically using a type tool (1080P HD Otoscope with LED light and Built-in Camera). The tool is connected to a mobile androïd phone (Samsung galaxy S24 ultra et S21 ultra) with a wifi diffuser placed in front of the surgeon. The standards relating to ethics have been well respected since the writing of medical files, in particular respect for anonymity, private life, the information of patients and their informed consent in relation to the use of their file in the scientific research framework. Respect for the principles of integrity; independence of work, absence of conflict of interest and assessment of risks to patient health. Results: During our study period, we collected 20 patients operated on by our tool. The average age of our patients was 36.65 years with extremes ranging from 12 to 70 years. The female sex was the most represented with a sex ratio of 0.81. The preoperative assessment included tone audiometry in all cases. A CT scan of the rock was performed in eight (8) patients (40%). The indications were mainly represented by type I tympanoplasties in 16 cases (80%), cholesteatoma treatments in four cases (20%). The approaches were: the duct in four patients (20%), the endaural route in ten patients (50%) and the retroauricular route in six patients (30%). The results of the audiological control tests showed a closure of the rinne to less than 20db in 18 patients (or 90%). The first follow-up CT scan at 12 months was normal. A clinical check-up is carried out every 6 months. A questionnaire on post-surgical quality of life noted significant hearing comfort in all patients.