Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

Ask any parent about their highest priority, and they are bound to tell you it is the well-being of their child.  Doctor office waiting rooms everywhere are filled with concerned parents seeking reassurance, guidance, and treatment regarding their child’s health.  For many families, these concerns are either addressed promptly or referred for more specialized consultation. Yet if you happen to live in an area of the world where care is not so readily accessed, an initial complaint can become a chronic complaint that is never adequately investigated or treated. 

An 18-year-old girl presented to one of our partners in Ethiopia reporting white discharge draining from both of her ears, as well as hearing loss, headache, and a persistent ringing sound.  The patient’s parents recounted that the discharge, accompanied by ear pain, had been occurring on and off since early in her childhood.  The hearing loss has been gradual over time, but recently she has also been complaining of headaches, and this change caused them to seek care. The local nurse, unfamiliar with this type of complaint, turned to The Addis Clinic.  She submitted the case for consultation using our telemedicine platform asking for guidance in the evaluation and treatment of her patient.

An Ear, Nose & Throat (ENT) specialist in our volunteer network reviewed the case, communicated with the Ethiopian nurse, and recommended the patient be referred for a CT of her temporal bones to look for a cholesteatoma. A cholesteatoma is a collection of debris in the middle ear that is related to chronic ear infections. While benign, a cholesteatoma can erode the surrounding bone, causing hearing loss and allowing an infection to spread into the inner ear or further.  While waiting for the CT results, the ENT also recommended antibiotic ear drops to treat the current infection.

cholesteatoma nov. case.jpg

The local nurse referred the patient for imaging and forwarded the results to our volunteer ENT. After consulting a radiology colleague, the ENT confirmed that the patient had a bilateral cholesteatoma, the result of long-standing chronic ear infections.  Because of its destructive nature, the ENT advised that the patient would need to be seen by a surgeon to remove the cholesteatomas, or risk permanent hearing loss, nerve damage and spread of infection. 

In this story, the diagnosis is not the end of the journey, but simply another beginning.  Finding a surgeon in Ethiopia to perform this procedure will be very difficult.  Yet despite these challenges, this Addis Clinic interaction educated and empowered a patient, her family, and her local care team to understand and seek the most appropriate treatment for a long-standing and worsening complaint.  This type of high-level collaboration is what The Addis Clinic constantly seeks to promote within the global communities we serve and would be impossible without the passion and dedication of our local partners and volunteer network of physicians.