Table of Contents
Ear Nose And Throat problems are the foremost common reason for a visit to a doctor in both rural and concrete communities. In many developing countries, there’s a scarcity of Ear Nose And Throat and overburdened hospital facilities. To date, there’s no comprehensive study that has evaluated the spectrum of Ear Nose And Throat disorders during a rural community. Methods. A prospective study was finished a period of three years to profile the cases presenting to the outpatient clinic during a secondary care hospital and within the camps conducted in tribal areas in the Vellore District of Tamil Nadu, India. Trained community volunteers were wont to identify Ear Nose And Throat conditions and refer patients. Results. a complete of 2600 patients were evaluated and treated. Otological symptoms were the foremost commonly reported with rhinitis being the second most ordinarily reported. Presbycusis was the foremost common disability reported within the rural community. the opposite symptoms presented are largely associated with hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe Ear Nose And Throat practices, rehabilitation of deafness through the provision of hearing aids, and therefore the evaluation and surgical management by Ear Nose And Throat specialist helped the agricultural community to access the service.
Ear Nose and Throat Introduction
The most common problems warranting a visit to a doctor or a health care provider in developing countries are associated with Ear, Nose, and Throat [1, 2].
problems are the foremost common problems that there are home remedies to medical treatments which are available, and most people manage their problem within the community without seeking help. additionally, thanks to the shortage of specialist professionals during this field, these problems are treated by community practices. The studies done have checked out the prevalence of Ear Nose And Throat diseases in children [3, 4] and have shown that the disease burden is thanks to otitis and its sequelae which are the foremost common causes of preventable deafness in children in developing countries [5, 6]. The prevalence of traditional practices increased the disease morbidity requiring surgical management. A postal survey using questionnaire methods was wont to assess the prevalence of Ear, Nose, and Throat -related disorders during a community. there’s no data on the prevalence of otorhinolaryngological diseases during a rural community in India. this study was undertaken to work out the prevalence of Ear Nose And Throat disorders in a population presenting to a secondary care hospital with emphasis on medical care in rural communities and tribal areas. this is often the primary study that wiped out a developing country as the proper understanding of the magnitude of Ear Nose And Throat diseases and therefore the factors related to their occurrence within the community are vital to enable the formulation of health care services aimed at toward early detection and treatment.
A prospective study was finished a period of three years (2009–2012) to profile the cases presenting to the Ear Nose And Throat clinic which was conducted once every week during a secondary care hospital, and once a month in tribal areas of Vellore District. The Ear Nose And Throat team comprised of Ear Nose and Throat Doctors, audiologists, and community workers. The population covered was four lakhs, and therefore the tribal population consisted of thirty thousand. These communities are predominantly farming community. 40% live below the poverty level. The literacy of girls is 40% and of men is 60%. 25% are under 15 years. The elderly form 6% of the population. The male: female ratio is 1000: 980. Being farmers, they’re hooked into the rainfall for agriculture, and work is seasonal.
The Clinic In Secondary Care Hospital
The clinic in secondary care hospital was well equipped with a binocular microscope and Ear Nose And Throat instruments. An initial program of coaching community volunteers was conducted in rural and tribal villages. These community volunteers were taught about safe ear care practices, the harmful effects of prevalent traditional practices, and therefore the treatment options available. They were taught to spot the symptoms of Ear Nose and Throat diseases, namely, ear pain with/without discharge, recurrent upper tract infections, throat pain difficulty swallowing, related to fever within the community and refer them to the camps conducted periodically. Community hearing workers preferably graduates with science subjects were trained to try to hearing assessment employing a portable audiometer for adults and fit hearing aids (semi-digital, trimmer model) within the community. Children with learning disabilities and delays or lack of speech were identified within the community with the assistance of faculty teachers and community hearing workers and were mentioned tertiary hospitals for detailed evaluation to rule out other disabilities and for rehabilitation. The questionnaire method of knowledge collection was wont to know the prevalence of Ear, Nose, and Throat -related conditions within the tribal community, and referred patients received treatment within the camps; surgical cases were mentioned secondary and tertiary hospital for further management.
Patients were seen by community health physicians within the secondary care hospital and were mentioned the Ear Nose and Throat clinic which was conducted once every week. Emergency cases that were mentioned in the tertiary hospital weren’t taken for analysis.
Ear Nose and Throat Statistical Methods
All the info was entered into Microsoft Excel format and SPSS software. The mean number of patients, both adults, and youngsters calculated, and therefore the ratio of prevalence among both the groups was received. Pearson’s chi-square test was done to match the connection of otitis in children with various factors resulting in chronic conditions. the extent of significance was set at but 0.05.
In our study, a complete of 2600 patients-both adults and youngsters were seen during the years 2009–2011, including a complete number of 20 camps that were conducted in tribal areas.
Otological symptoms were the foremost commonly reported (60%), with pain and ear discharge being reported in pediatric and adult populations followed by acute rhinitis thanks to allergy and infectious causes (Figure 1). deafness was most ordinarily reported in patients over 50 years aged with moderately severe to severe deafness needing rehabilitation.
Ear Nose and Throat Ear Disorders
A total of 1526 patients were evaluated with various otological problems. Ear pain related to ear discharge was the foremost common complaint (49.7%). Acute otitis was seen in 413 (27%) with children being 3 times more affected than adults (3: 1 ratio). Chronic otitis mucosal disease was seen in 186 (12.1%) with an adult child: the ratio of 5: 1; squamosal disease was seen in 52 patients with adults having a greater prevalence, adult: child ratio of two: 1 (Figure 2). 2 patients presented with complications of acute mastoiditis were mentioned tertiary hospital. otitis with otomycosis and associated perichondritis was seen in 274 (17.9%) patients, which was mostly thanks to self-cleaning with sticks and pins
Of the varied causes of vertigo evaluated, only 7 (0.4%) had classical BPPV. Followup of patients mentioned tertiary hospital for symptoms of vertigo showed vestibular neuronitis in 72, Ménière’s disease in 9 and acute labyrinthitis in 3 patients (Figure 3).
Ear Nose and Throat Acute Otitis
161 children but 16 years presenting with acute otitis were followed up. Both boys and girls were equally affected. 33.8% had dry ears, and 67% proceeded to chronic otitis. Chi-square (0.17) showed that the age of onset is indirectly proportional to the chronicity of the disease; that’s, early onset of acute otitis predisposes to chronic otitis. However, there was no correlation between episodes of AOM and chronicity of the disease
Ear Nose and Throat Treatment
The patients with ear discharge were suction cleaned to spot the pathology whether bacterial/fungal and appropriate treatment was given within the sort of antibiotic ear drops/antifungal ear drops. additionally, if there was associated otitis, oral antibiotics to hide staphylococcus and pseudomonas were prescribed. In children, additionally to oral antibiotics, prophylactic antibiotic ear drops got. Parents were counseled in healthy ear care practices via hand washing, protecting the ear while bathing/swimming. Surgical management of chronic suppurative otitis was done at secondary care and tertiary hospital.
Acute rhinitis was the foremost common complaint reported by 209 (50%); it’s a seasonal predisposition with most of the patients having problems during winter months with equal predisposition among adults and youngsters. 34 (8%) of the patients had recurrent sinusitis which proceeded to features of chronic sinusitis over a period of three years. 2 of the patients were children. Nasal polyposis was seen in 43 (10%) of patients who were surgically treated at a tertiary center. rhinitis was seen in 35% with peak incidence noted within the months of June, July, and August. This was most ordinarily seen in adults instead of children. Vestibulitis along epistaxis was seen in 10% of patients mostly in children which were mostly thanks to nose-picking (Figure 6).
Ear Nose and Throat Treatment
Rhinitis of allergic etiology was treated with antihistamines, nasal steroid sprays; the patient was counseled on the necessity of identifying the trigger factors as far as possible to avoid them; however, since most of the patients had symptoms associated with their occupation (painting, masonry, and dealing in dust), medical treatment was needed.
Various causes of throat pain were evaluated. Recurrent tonsillitis was the foremost common complaint seen in 140 (49%) of the patients with quite 85% of cases being positive of culture. This was most ordinarily seen in children with a child ratio of three: 1.
Among the varied patients () evaluated for change of voice and difficulty swallowing. vocal fold pathology starting from acute and chronic laryngitis 14 (19%) to polyps/nodules 12 (16%) was seen within the patients. Difficulty swallowing was evaluated with blood investigations, and barium swallow and 17 (23%) had all the features of Plummer Vinson syndrome which was secondary to chronic iron deficiency anemia which was seen in females (age 40 years).
An approach to making awareness, health education, and treatment availability might be the rationale for the massive number of disease prevalence reported during this study.
In our study, otological symptoms were the foremost commonly reported with the main burden being chronic suppurative otitis as also reported by WHO . there’s an indirect relationship between age of onset and chronicity of the disease, and hence risk factors that will be targeted should be identified. Overcrowding and exposure to wood and cigarette smoke should be reduced , and poor hygiene should be improved, including access to wash water. Health education messages in reference to personal hygiene might be developed to focus on known risk factors. Universal immunization practice should be emphasized insight of increased risk with multiple sorts of H. influenzae and S. pneumonia  and a beneficial effect in reducing the amount of recurrent attacks 10
Allergic rhinitis may be a disorder that is showing an upward trend in rural communities thanks to a rise in pollution. rhinitis is related to significant comorbidities and health care costs [11, 12] and has been identified together of the highest ten reasons for visits to medical care clinics.
In our study, it as seen that 8% of the patients had progressed to chronic sinusitis; nasal polyposis was also seen in 10% of the patients which was associated with chronic rhinitis. this is often in agreement with the study done by Ahmadiafshar et al.  which showed a correlation between nasal polyposis and duration of symptoms of rhinitis.
Ear Nose and Throat Conclusion
Creating awareness of the common, Nose and Throat conditions and the way they’re caused and treatment options available help decrease the burden of the disease within the community. Using trained community workers to spread the message of safe Ear Nose and Throat practices, provides rehabilitation of deafness through the provision of hearing aids, and therefore the evaluation and surgical management by the specialist (once a week) helped the agricultural community to access the service.
This model of Ear, Nose, and Throat health healthcare delivery is effective and alongside medical care health personal helps in alleviating the disease burden within the rural and tribal communities. This model of providing Ear Nose and Throat services could have an impression across the whole nation especially in developing countries where there’s a lack of awareness and rehabilitation options thanks to limited resources.