• Nicholas C Van Buren, Reinou S Groen, Adam L Kushner, Mohamed Samai, Thaim B Kamara, Jian Ying, and Jeremy D Meier.
• Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
• Otolaryngol Head Neck Surg. 2014 Oct 1;151(4):638-45.

ObjectivesDemonstrate how the Surgeons OverSeas Assessment of Surgical Need (SOSAS) can be used to determine the burden of head and neck (H&N) surgical disease in developing countries and identify reasons for untreated disease.Study DesignCluster randomized, cross-sectional, countrywide survey.SettingSierra Leone.Subjects And MethodsThe survey was administered to 75 of 9671 enumeration areas in Sierra Leone between January 9 and February 3, 2012, with 25 households in each cluster randomly selected for the survey. A household representative and 2 randomly selected household members were interviewed. Need for surgical care was based on participants' responses to whether they had an H&N condition that they believed needed surgical care.ResultsOf 1875 households, data were analyzed for 1843 (98%), with 3645 total respondents. Seven hundred and one H&N surgical conditions were reported as occurring during the lifetime of the 3645 respondents (19.2%).The current prevalence of H&N conditions in need of a surgical consultation was 11.8%. No money (60.1%) was the most common reason respondents reported for not receiving medical care. A bivariate analysis demonstrated that age, village type, education, and type of condition may be predictors for seeking health care and/or receiving surgical care.ConclusionsThese results show limited access for patients to be evaluated for a potential H&N surgical condition in Sierra Leone. The true incidence of untreated surgical disease is unknown as most respondents were not evaluated by a surgeon. This survey could be used in other countries as health care professionals assess surgical needs throughout the world.© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

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