Clinical and Sustainability Outcomes of Humanitarian Otolaryngology Programs: A Scoping Review
Jerome R. Lechien, Antonino Maniaci, Johannes J. FaganABSTRACT
Objective
To investigate clinical outcomes, safety, and sustainability of humanitarian otolaryngology outreach programs in low‐ and middle‐income countries (LMICs).
Data Sources
PubMed, Scopus, and Cochrane databases.
Review Methods
Following PRISMA‐ScR guidelines, two investigators searched databases for published studies reporting clinical, safety, and sustainability outcomes of otolaryngology outreach programs. Bias analysis used Methodological Index for Nonrandomized Studies (MINORS).
Results
Twenty‐six studies involving 9283 subjects met inclusion criteria, predominantly from Anglophone Africa and South America. Most programs were conducted by US multidisciplinary teams in teaching or referral hospitals, focusing on general otolaryngology, otology, airway, or head and neck surgeries. Targeted populations included surgical candidates ( N = 15), deaf populations ( N = 6), and community screening subjects. Surgical outcomes demonstrated excellent success rates with low complications. Other otolaryngological fields and disease prevalence in rural populations were poorly investigated. Sustainability outcomes were reported in 12 studies using surgical volumes and narrative evaluations rather than validated instruments; only three maintained follow‐up beyond 2 years. Key barriers included supply constraints ( N = 11), insufficient staff training ( N = 7), and inadequate infrastructure ( N = 4). Seven studies evaluated new technologies for hearing assessment, demonstrating high concordance between physicians and trained nonphysician providers. Mean MINORS score was 7.9 ± 2.3, indicating low‐to‐moderate methodological quality.
Conclusion
Most humanitarian initiatives focused on specific disease outcomes with inadequate long‐term sustainability investigation. Emerging literature on new technologies—including teleotology, digital otoscopy, and artificial intelligence‐based assessments—supports future skill transfer to nonphysician providers in regions with substantial practitioner shortages.
Level of Evidence
N/A.