Local physicians working to help Mongolian doctors operate safely

In Mongolia, surgeries for ear infections are typically performed with a hammer and chisel, a technique that often prolongs recovery and can result in dizziness, a loss of hearing or face paralysis.

But after the help of two local physicians and two of their colleagues, Mongolian doctors are leaning how to operate with better equipment and precision, preventing these serious side effects.

Dr. Gordon Wood of Logan returned from Mongolia on Tuesday after opening the first temporal bone learning lab in the country.

Wood was accompanied by doctors Gary Gibbons of North Logan, Delray Maughan of Boise, Idaho, and Scott Price of Billings, Mont. All four doctors are otorhinolaryngologists – ear, nose and throat doctors.

Wood, Maughan and Price are training physicians in Ulaan Bator,

Mongolia to perform mastoidectomies, a surgery on ear infections that have spread to the temporal bone. The temporal bone is the portion of the skull to which the ear is attached.

They established the learning lab at the Maternal and Children’s

Hospital, where they taught courses and demonstrated the procedure. In traveling to Mongolia, they took three microscopes, three drills, lights and cadaver bones, which doctors can use to practice performing a mastoidectomy.

Wood said they also gave lectures regarding anatomy, ear diseases and surgical and non-surgical treatments.

Karen Wood, the doctor’s wife, also traveled to Mongolia.

“There was a ribbon cutting ceremony and two news channels came. It was a big deal over there,” she said. “But success can only be measured if this one surgery can be continued and the current generation of doctors train the next generation.”

A mastoidectomy is performed in an area the size of a quarter behind

the infected ear, Wood said. In this small diameter, there is a nerve that controls facial expression and if it is cut, the face will become paralyzed. Also in this small portion of the bone is an area that controls inner-ear balance and hearing.

“If the doctor drills into that, the patient is deaf and dizzy,” Wood

said.

Doctors must also be careful to not cut the floor of the brain or the

blood vessel that draws blood from that side of the brain. If the vessel is cut, the patient can bleed to death, Wood said.

Maughan stressed the importance of training physicians to use the microscopes and drills they took to Mongolia because of the serious problems that could occur as a result of an unsuccessful surgery.

“They have very limited experience with microscopes. They use chisels without a microscope. They have limited experience using drills,” Maughan said. “They could have facial nerve paralysis and bleeding.”

Wood first traveled to Mongolia in 2002. While he was there, he said he performed surgery on 20 or 30 people and showed the doctors how to use the microscope and drill.

The next year when Wood returned, he said they could not perform mastoidectomies because of their limited education. He said doctors in Mongolia have a total of seven years of training after high school.

“In the United States, ear, nose and throat doctors have a minimum of 13 years. That is twice as much training to try and do the same thing,” Wood said. “I realized we have to try to train them the same way as in the U.S., on

cadaver bones, where if you have a complication, you don’t hurt a live patient.

“In the lab, they can learn to drain infected cells and preserve other structures,” Wood said.

Maughan said they plan to return to Mongolia in the spring or summer of next year to continue training and check on the progress of doctors.

He said they hope that at least one doctor can return every 12 months for the next few years.

Karen Wood said the people were very kind and attentive.

“They were so good to us and so appreciative of everything. They are

always giving you gifts, even until the very end,” she said. “You can’t get ahead. You give and they turn around and 10-times you back. It almost makes you feel helpless.”

Maughan agreed, saying, “They were very appreciative of it. They were very excited we could provide this for them.”

To help the temporal bone learning lab get started, donations were

made by individual physicians and medical groups, Maughan said. The Hope Alliance and the Swanson Foundation also helped the doctors in opening the lab.

Wood said microscopes are usually $35,000 each but they were able to get them for $6,000-$7,000 each from the New York Eye and Ear Institute because they were used.

This project originally started with Gibbons, who also traveled to Mongolia

this past week. Gibbons was called by The Church of Jesus Christ of

Latter-day Saints to serve a medical mission in Mongolia. During his six

months in the country, he was able to establish a trusting relationship

with Mongolian doctors. Because of their trust and confidence in him, Gibbons was able to begin plans to help the people with ear infections and the required surgery.

At this time, Gibbons received another call from the LDS Church that prevented him from continuing his work. It was then that Gibbons asked Wood to continue the project.

If interested in contributing to this learning lab, donations can be made to the Hope Alliance care of the Mongolian Temporal Bone Lab.

-ariek@cc.usu.edu