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Tympanoplasty Outcomes of Inuit Populations in Nunavik, Canada.

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Τίτλος: Tympanoplasty Outcomes of Inuit Populations in Nunavik, Canada.
Συγγραφείς: Roy CF; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center., Yeung JC; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.; Department of Pediatric Surgery, Montreal Children's Hospital., Himdi L; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center., Correa JA; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada., Mijovic T; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.
Πηγή: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2026 Feb 01; Vol. 47 (2), pp. e306-e311. Date of Electronic Publication: 2026 Jan 09.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 100961504 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-4505 (Electronic) Linking ISSN: 15317129 NLM ISO Abbreviation: Otol Neurotol Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2001-
Ιατρικοί όροι (MeSH): Tympanoplasty*/methods , Tympanic Membrane Perforation*/surgery , Otitis Media*/surgery , Inuit*, Postoperative Complications/epidemiology ; Humans ; Male ; Female ; Retrospective Studies ; Adolescent ; Treatment Outcome ; Adult ; Young Adult ; Child ; Quebec ; Middle Aged
Περίληψη: Objective: To provide an updated account of tympanoplasty success rates in Inuit patients of Northern Quebec and to explore optimal surgical techniques for this population.
Background: Chronic otitis media and tympanic membrane perforations are highly prevalent among Inuit populations in Northern Quebec.
Materials and Methods: A retrospective chart review was conducted of Inuit patients who underwent tympanoplasty with or without ossicular chain reconstruction at the Inuulitsivik Health Center in Puvirnituq, Quebec, Canada, between January 2015 and January 2024. The primary outcome was otoscopic confirmation of an intact tympanic membrane postoperatively. Secondary outcomes included pre- and post-procedure audiometric parameters and postoperative complications.
Results: A total of 197 patients (median age 16.4, IQR: 12.2;31.7) and 224 tympanoplasties were included (195 primary and 29 revision surgeries). Postoperative examination revealed successful closure of the tympanic membrane in 113/174 (64.9%) of patients with appropriate otoscopic follow-up, however, varied widely according to the type of graft used. Cartilage tympanoplasties had a closure rate of 86.7% (39/45 patients), compared with 63.0% (51/81) for tympanoplasties using a perichondrium or fascia as a graft, and 48.9% (23/47) for simple myringoplasties using fat and/or a hyaluronic acid scaffold (EpiDisc; P < 0.001). The median follow-up was 1.8 years (IQR: 0.9; 3.5).
Conclusion: While tympanoplasty may improve audiometric parameters and recurrent otorrhea, outcomes in Inuit patients are modest. This study emphasized the superior closure rates with cartilage grafts, which may help improve outcomes in this population. Further efforts should focus on addressing broader health care disparities to ensure better access to specialized surgical care and postoperative follow-up in Inuit communities.
(Copyright © 2025, Otology & Neurotology, Inc.)
Competing Interests: The authors disclose no conflicts of interest.
References: Coleman A, Wood A, Bialasiewicz S, Ware RS, Marsh RL, Cervin A. The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media. Microbiome 2018;6:199.
Ayukawa H, Bruneau S, Proulx JF, Macarthur J, Baxter J. Otitis media and hearing loss among 12-16-year-old Inuit of Inukjuak, Quebec, Canada. Int J Circumpolar Health 2004;63(suppl 2):312–4.
Mak D, MacKendrick A, Bulsara M, et al. Outcomes of myringoplasty in Australian Aboriginal children and factors associated with success: a prospective case series. Clin Otolaryngol Allied Sci 2004;29:606–11.
Bowd AD. Otitis media: health and social consequences for aboriginal youth in Canada’s north. Int J Circumpolar Health 2005;64:5–15.
Baxter JD. Otitis media in Inuit children in the Eastern Canadian Arctic--an overview--1968 to date. Int J Pediatr Otorhinolaryngol 1999;49(suppl 1):S165–8.
Baxter JD. Chronic otitis media and hearing loss in the Eskimo population of Canada. Laryngoscope 1977;87(9 pt 1):1528–42.
Konishi M, Sivalingam S, Shin SH, Vitullo F, Falcioni M. Effects of early commercial air travel on graft healing rates after tympanoplasty. Ann Otol Rhinol Laryngol 2012;121:110–2.
Akhal T, Bassim M. Flight after stapes surgery: an evidence-based recommendation. OTO Open 2023;7:e65.
R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2024. Accessed April 13, 2025: https://www.R-project.org/.
Dunn PK, Smyth GK. Randomized quantile residuals. J Comput Graph Stat 1996;5:236–44.
Hartig F DHARMa: Residual Diagnostics for Hierarchical (Multi-Level / Mixed) Regression Models. R package version 0.4.7; 2024. Accessed April 13, 2025: https://CRAN.R-project.org/package=DHARMa.
Morey RD. Confidence intervals from normalized data: a correction to Cousineau (2005). Tutor Quant Methods Psychol 2008;4:61–4.
Tan HE, Santa Maria PL, Eikelboom RH, Anandacoomaraswamy KS, Atlas MD. Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol 2016;37:838–46.
Smith MCF, Huins C, Bhutta M. Surgical treatment of chronic ear disease in remote or resource-constrained environments. J Laryngol Otol 2019;133:49–58.
Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 2017;127:2139–48.
Jeffery CC, Shillington C, Andrews C, Ho A. The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis. J Otolaryngol Head Neck Surg 2017;46:48.
Brudgell R Op-ed: An Inuit perspective on health and healthcare in Canada. McGill University Department of Family Medicine. August 28, 2023. Accessed April 13, 2025: https://www.mcgill.ca/familymed/article/inuit-perspective-health-and-healthcare-canada.
De Wals P, Lemeur JB, Ayukawa H, Proulx JF. Middle ear abnormalities at age 5 years in relation with early onset otitis media and number of episodes, in the Inuit population of Nunavik, Quebec, Canada. Int J Circumpolar Health 2019;78:1599269.
Contributed Indexing: Keywords: Inuit patients; Outcomes; Quality improvement; Tympanoplasty
Entry Date(s): Date Created: 20260109 Date Completed: 20260109 Latest Revision: 20260109
Update Code: 20260130
DOI: 10.1097/MAO.0000000000004696
PMID: 41508355
Βάση Δεδομένων: MEDLINE
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  Data: Tympanoplasty Outcomes of Inuit Populations in Nunavik, Canada.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Roy+CF%22&quot;&gt;Roy CF&lt;/searchLink&gt;; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Yeung+JC%22&quot;&gt;Yeung JC&lt;/searchLink&gt;; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.; Department of Pediatric Surgery, Montreal Children&#39;s Hospital.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Himdi+L%22&quot;&gt;Himdi L&lt;/searchLink&gt;; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Correa+JA%22&quot;&gt;Correa JA&lt;/searchLink&gt;; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Mijovic+T%22&quot;&gt;Mijovic T&lt;/searchLink&gt;; Department of Otolaryngology Head and Neck Surgery, McGill University Health Center.
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– Name: Abstract
  Label: Abstract
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  Data: Objective: To provide an updated account of tympanoplasty success rates in Inuit patients of Northern Quebec and to explore optimal surgical techniques for this population.&lt;br /&gt;Background: Chronic otitis media and tympanic membrane perforations are highly prevalent among Inuit populations in Northern Quebec.&lt;br /&gt;Materials and Methods: A retrospective chart review was conducted of Inuit patients who underwent tympanoplasty with or without ossicular chain reconstruction at the Inuulitsivik Health Center in Puvirnituq, Quebec, Canada, between January 2015 and January 2024. The primary outcome was otoscopic confirmation of an intact tympanic membrane postoperatively. Secondary outcomes included pre- and post-procedure audiometric parameters and postoperative complications.&lt;br /&gt;Results: A total of 197 patients (median age 16.4, IQR: 12.2;31.7) and 224 tympanoplasties were included (195 primary and 29 revision surgeries). Postoperative examination revealed successful closure of the tympanic membrane in 113/174 (64.9%) of patients with appropriate otoscopic follow-up, however, varied widely according to the type of graft used. Cartilage tympanoplasties had a closure rate of 86.7% (39/45 patients), compared with 63.0% (51/81) for tympanoplasties using a perichondrium or fascia as a graft, and 48.9% (23/47) for simple myringoplasties using fat and/or a hyaluronic acid scaffold (EpiDisc; P &amp;lt; 0.001). The median follow-up was 1.8 years (IQR: 0.9; 3.5).&lt;br /&gt;Conclusion: While tympanoplasty may improve audiometric parameters and recurrent otorrhea, outcomes in Inuit patients are modest. This study emphasized the superior closure rates with cartilage grafts, which may help improve outcomes in this population. Further efforts should focus on addressing broader health care disparities to ensure better access to specialized surgical care and postoperative follow-up in Inuit communities.&lt;br /&gt; (Copyright &#169; 2025, Otology &amp; Neurotology, Inc.)
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: The authors disclose no conflicts of interest.
– Name: Ref
  Label: References
  Group: RefInfo
  Data: Coleman A, Wood A, Bialasiewicz S, Ware RS, Marsh RL, Cervin A. The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media. Microbiome 2018;6:199.&lt;br /&gt;Ayukawa H, Bruneau S, Proulx JF, Macarthur J, Baxter J. Otitis media and hearing loss among 12-16-year-old Inuit of Inukjuak, Quebec, Canada. Int J Circumpolar Health 2004;63(suppl 2):312–4.&lt;br /&gt;Mak D, MacKendrick A, Bulsara M, et al. Outcomes of myringoplasty in Australian Aboriginal children and factors associated with success: a prospective case series. Clin Otolaryngol Allied Sci 2004;29:606–11.&lt;br /&gt;Bowd AD. Otitis media: health and social consequences for aboriginal youth in Canada’s north. Int J Circumpolar Health 2005;64:5–15.&lt;br /&gt;Baxter JD. Otitis media in Inuit children in the Eastern Canadian Arctic--an overview--1968 to date. Int J Pediatr Otorhinolaryngol 1999;49(suppl 1):S165–8.&lt;br /&gt;Baxter JD. Chronic otitis media and hearing loss in the Eskimo population of Canada. Laryngoscope 1977;87(9 pt 1):1528–42.&lt;br /&gt;Konishi M, Sivalingam S, Shin SH, Vitullo F, Falcioni M. Effects of early commercial air travel on graft healing rates after tympanoplasty. Ann Otol Rhinol Laryngol 2012;121:110–2.&lt;br /&gt;Akhal T, Bassim M. Flight after stapes surgery: an evidence-based recommendation. OTO Open 2023;7:e65.&lt;br /&gt;R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; 2024. Accessed April 13, 2025: https://www.R-project.org/.&lt;br /&gt;Dunn PK, Smyth GK. Randomized quantile residuals. J Comput Graph Stat 1996;5:236–44.&lt;br /&gt;Hartig F DHARMa: Residual Diagnostics for Hierarchical (Multi-Level / Mixed) Regression Models. R package version 0.4.7; 2024. Accessed April 13, 2025: https://CRAN.R-project.org/package=DHARMa.&lt;br /&gt;Morey RD. Confidence intervals from normalized data: a correction to Cousineau (2005). Tutor Quant Methods Psychol 2008;4:61–4.&lt;br /&gt;Tan HE, Santa Maria PL, Eikelboom RH, Anandacoomaraswamy KS, Atlas MD. Type I tympanoplasty meta-analysis: a single variable analysis. Otol Neurotol 2016;37:838–46.&lt;br /&gt;Smith MCF, Huins C, Bhutta M. Surgical treatment of chronic ear disease in remote or resource-constrained environments. J Laryngol Otol 2019;133:49–58.&lt;br /&gt;Jalali MM, Motasaddi M, Kouhi A, Dabiri S, Soleimani R. Comparison of cartilage with temporalis fascia tympanoplasty: a meta-analysis of comparative studies. Laryngoscope 2017;127:2139–48.&lt;br /&gt;Jeffery CC, Shillington C, Andrews C, Ho A. The palisade cartilage tympanoplasty technique: a systematic review and meta-analysis. J Otolaryngol Head Neck Surg 2017;46:48.&lt;br /&gt;Brudgell R Op-ed: An Inuit perspective on health and healthcare in Canada. McGill University Department of Family Medicine. August 28, 2023. Accessed April 13, 2025: https://www.mcgill.ca/familymed/article/inuit-perspective-health-and-healthcare-canada.&lt;br /&gt;De Wals P, Lemeur JB, Ayukawa H, Proulx JF. Middle ear abnormalities at age 5 years in relation with early onset otitis media and number of episodes, in the Inuit population of Nunavik, Quebec, Canada. Int J Circumpolar Health 2019;78:1599269.
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        Type: general
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              Text: 2026 Feb 01
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