Otological problems of the alaskan native population.

The Alaskan Otological Fellowship of the New York Eye and Ear Infirmary operates at the Alaskan Native Health Facility in Mt. Edgecumbe, Sitka, Alaska. It is a division of the Health Education and Welfare Program. The Fellowship is now in its fourth year. The area we service is approximately 35,000 square miles. All villages and schools in the area have been screened for otological care and for possible hearing aids. The incidence of otitis media and its complications is 13 percent in the Eskimo and 9.1 percent in the Indian. These percentages are those reported in the Southwest Native. There is no ready explanation of the preponderance of otologic disease in this group. In the first three years, 360 procedures were performed on 310 chronically diseased ears. Following is a breakdown of these procedures: Myringoplastys 165 Simple Mastoidectomies 25 Simple Mastoidectomy with Myringoplasty 66 Mastoidectomy with Type III Tympanoplasty 17 Modified Radical Mastoidectomy 26 Radical Mastoidectomies 36 Miscellaneous Procedures 25 It is the opinion of the authors that the choice of procedure is much more limited in this group than in an urban community. It must be remembered that aftercare and follow‐up is more difficult in these areas. It has been our policy to use conservative procedures. Elimination of the disease is the first consideration, and conservation of hearing is secondary. A dry ear is of the utmost importance, and for this reason, modified radical and classical radical mastoidectomies are more frequently performed. Types IV and V tympanoplastys are not considered feasible.