Oesophageal denture impaction producing Horner's syndrome: a case report

Otitis media in indonesian urban and rural school children

BACKGROUND

Although the epidemiology of otitis media is well-known in industrialized countries, the extent of otitis media in developing Asian countries, especially in south East Asia is not well studied.

METHODS

To define the burden of otitis media and its sequelae in children 6-15 years of age, we enrolled elementary and junior high school children in 6 areas in rural and urban Indonesia. Randomly selected schools and classrooms were selected. All children were administered a questionnaire and had ear examinations, pneumatic otoscopy and screening audiometry. Children with any abnormality on examination or with a relevant history underwent diagnostic audiometry and tympanometry, if indicated.

RESULTS

Of the 7005 children studied, 116 had chronic suppurative otitis media (CSOM), 30 had acute otitis media and 26 had otitis media with effusion. 2.7% of rural children had CSOM compared with 0.7% of urban children (P < 0.0001). The rates per 1000 of CSOM in rural Bali and Bandung were significantly higher (75 and 25, respectively) than in the rest of Indonesia (P < 0.05). In rural Bali, the rate per 1000 children of inactive CSOM was 63 in 6- to 9-year-old children, compared with 37 in children aged 13-15 years. Concomitantly, the rates of tympanosclerosis were 7 and 26/1000, respectively, in these age groups.

CONCLUSIONS

In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.

Denture impaction in the oesophagus experience of a young ENT practice in Nigeria

Introduction

The effect of dental loss and associated desire to restore its function and aesthesis has led to an increase in the number of people wearing dentures. This study therefore reviews the cases of impacted acrylic dentures in the oesophagus.

Methods

A retrospective review of patients that were managed for oesophageal denture impaction at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over an eight year period from 2005 to 2012.

Results

A total of 14 patients (M: F 2.5: 1). The age ranged from 32 - 75 years. Majority 64.3%) were 51 years and above. Over 70% presented early. Major presenting symptoms were throat pain (100%), odynophageal (92.9%) and dysphageal (78.6%). The radiographic findings were air entrapment (64.3%) and increase in prevertebral soft tissue shadow (78.6%). Majority (87.5%) were impacted at the upper (cervical) oesophagus. Over 78% had successful extraction with rigid oesophagoscopy. Two (14.3%) had spontaneous expulsion of the denture and 1 (7.1%) discharged himself against medical advice. Complications were mucosa tear (28.6%), laryngeal spasm/ airway obstruction (14.3%), mucosa oedema/ erythema (57.1%), neck abscess (7.1%).

Conclusion

Impaction of esophageal dentures is relatively common in our locality; most patients present early for medical attention and associated with successful rigid oesophagoscopies and denture extraction under GA, and generally good outcome. Education of the wearers of dentures was emphasized as a way of preventing dentures impaction.