Learning Objectives: Australia's Indigenous population has the highest rate of chronic ear disease of any Indigenous people on the planet. The World Health Organisation recognises any population with a rate of chronic ear disease greater than 4% to have a public health crisis. In remote Aboriginal & Torres Strait Islander Communities the incidence of chronic ear disease can be as high as 70%. Affected children usually have their initial suppurative infection with otorrhoea in the first six weeks of life. The impact of associated hearing loss at critical times of language development and early education has life-long individual and community adverse outcomes. The ‘tyranny of distance’ is not a significant causative factor (although it is very significant with respect to service provision), as there is a similarly high rate of disease in urban Aboriginal communities.

The disease pattern is predominantly tubo-tympanic; however, cholesteatoma does occur. Unfortunately, in this population, cholesteatoma often presents with a complication or as an incidental finding during reconstructive surgery. Outcomes are generally worse than those reported in non-Aboriginal populations. The poorer outcomes are considered to be multi-factorial in origin.

This presentation will explore the otologist's role in helping to manage the burden of this disease. It will describe the Ear Health Teams and how they function in Western Australia. It will also discuss how telemedicine has influenced management.