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Protocol for a comparative cross-sectional study on characterisation of auditory impairment in sickle cell disease and sickle cell trait and its impact on health-related quality of life in Nigeria. BMJ Open 2024; 14:e077200. [PMID: 38286692 PMCID: PMC10826583 DOI: 10.1136/bmjopen-2023-077200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/06/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Sickle cell disease (SCD) and sickle cell traits (SCT) are genetically inherited red blood cell disorders common among people of African descent. Nigeria has a high prevalence of SCD, with a prevalence of 2.28%-3% and SCT, 25%-30%. Poorly managed SCD and SCT can lead to sensorineural hearing loss and health-related quality of life (HRQoL) issues. This research aims to assess these possible complications of SCD and SCT in Nigeria. METHODS AND ANALYSIS The study will use a comparative cross-sectional design at study power 80% to investigate the association between SCD/SCT, hearing impairment and HRQoL. Participants will be divided into two groups: a cohort and a control group. Hearing levels will be assessed through audiometric assessments and categorised by type and severity of hearing impairments using WHO classifications. HRQoL will also be assessed using WHO Disability Assessment Schedule 2.0. Statistical analyses will be performed using the SAS V.9.4, with parametric or non-parametric analysis depending on the distribution. Relationship between key variables will be determined via correlational tests, χ2, Fisher's exact test and multivariable logistic regression analyses. ETHICS AND DISSEMINATION The proposal has been fully reviewed and registered by the University of Cape Town's Faculty of Health Sciences Human Research Ethics Committee (HREC REF 228/2022) and the University of Abuja Teaching Hospital Human Research Ethics Committee (HREC/PR/2020/08/007). Information dissemination will be through conferences, peer-review publication and personal communications. The Strengthening the Reporting of Observational Studies in Epidemiology statement will be followed in writing the manuscript.
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Comparing Hearing Loss in Children with Adults Living with Sickle Cell Disease and Sickle Cell Traits. Niger J Clin Pract 2024; 27:74-81. [PMID: 38317038 DOI: 10.4103/njcp.njcp_763_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/24/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Hearing loss is a neurological sequelae associated with sickle cell disease (SCD) and probably sickle cell trait (SCT) in children and adults but remains understudied. AIM This study aimed to compare the hearing impairment among children and adults living with SCD or SCT. METHODS A comparative cross-sectional study conducted in four departments with SCD outpatient clinic in a tertiary hospital in Nigeria. Participants with Sickle cell disease (HbSS) and Sickle cell trait (HbAS) (cohort) and HbAA (control) had comprehensive ear and hearing assessments for sensorineural hearing loss. Audiometric results were categorized according to WHO classifications and data analysed with Statistical Analysis System (SAS 9.4). RESULTS A total of 212 participants (106 cohort and control, respectively), aged 6 months to 55 years, were enrolled. Of these, 35% of children with SCD and 25% with SCT had hearing impairment, while 30% of adults with SCD, 36.1% with SCT, and 11% with HbAA had hearing impairment. There was asymmetry in the hearing impairment, with the left ear more affected in children and the right ear in adults. The odds ratio (OD) of hearing impairment was higher in HbSS (2.48 (95% confidence interval (CI):1.51-4.14); P = 0.0004) and HbAS (2.28 (95% CI: 1.1-4.58); P = 0.02) participants compared with HbAA but was not statistically significant when adjusted for frequency of hospitalization, crises, blood transfusion and routine drugs in HbAS (P = 0.49) unlike HbSS (P = 0.03). CONCLUSION The prevalence of hearing loss among children and adults with SCD is higher than in those with HbA genotype. The frequency of hospitalization, crises, blood transfusion and taking routine drugs may influence hearing impairment in SCT but may not in SCD.
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The Global Otolaryngology-Head and Neck Surgery Workforce. JAMA Otolaryngol Head Neck Surg 2023; 149:904-911. [PMID: 37651133 PMCID: PMC10472262 DOI: 10.1001/jamaoto.2023.2339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/25/2023] [Indexed: 09/01/2023]
Abstract
Importance A core component of delivering care of head and neck diseases is an adequate workforce. The World Health Organization report, Multi-Country Assessment of National Capacity to Provide Hearing Care, captured primary workforce estimates from 68 member states in 2012, noting that response rates were a limitation and that updated more comprehensive data are needed. Objective To establish comprehensive workforce metrics for global otolaryngology-head and neck surgery (OHNS) with updated data from more countries/territories. Design, Setting, and Participants A cross-sectional electronic survey characterizing the OHNS workforce was disseminated from February 10 to June 22, 2022, to professional society leaders, medical licensing boards, public health officials, and practicing OHNS clinicians. Main Outcome The OHNS workforce per capita, stratified by income and region. Results Responses were collected from 121 of 195 countries/territories (62%). Survey responses specifically reported on OHNS workforce from 114 countries/territories representing 84% of the world's population. The global OHNS clinician density was 2.19 (range, 0-61.7) OHNS clinicians per 100 000 population. The OHNS clinician density varied by World Bank income group with higher-income countries associated with a higher density of clinicians. Regionally, Europe had the highest clinician density (5.70 clinicians per 100 000 population) whereas Africa (0.18 clinicians per 100 000 population) and Southeast Asia (1.12 clinicians per 100 000 population) had the lowest. The OHNS clinicians deliver most of the surgical management of ear diseases and hearing care, rhinologic and sinus diseases, laryngeal disorders, and upper aerodigestive mucosal cancer globally. Conclusion and Relevance This cross-sectional survey study provides a comprehensive assessment of the global OHNS workforce. These results can guide focused investment in training and policy development to address disparities in the availability of OHNS clinicians.
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World Hearing Day - Impaired Hearing and Noise Culture. West Afr J Med 2023; 40:238-240. [PMID: 37011412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Sensorineural Hearing Loss among Hypertensives. West Afr J Med 2021; 38:125-130. [PMID: 33641146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The effect of hypertension on the vascular system leads to Target Organ Damage (TOD). The cochlea is one of the target organs affected by hypertension, giving rise to Sensorineural Hearing Loss (SNHL). OBJECTIVE To determine the prevalence and pattern of Sensorineural Hearing Loss (SNHL) among hypertensives. DESIGN Case-Control Study. SETTING Tertiary hospital. SUBJECTS Two hundred and twenty six hypertensives, aged 21 to 60 years and a corresponding number of age and sex matched control. METHODOLOGY Eligible participants were prospectively evaluated. Their blood pressures were verified, hearing thresholds assessed through Pure Tone Audiometry, Pure Tone Average were calculated and the types and degree of hearing loss were confirmed. Data was analyzed using SPSS 21 and statistical significance was set at p-value 0.05. RESULTS Each group had 127 (56.19% ) females and 99 ( 43.81 % ) males. The difference in the mean age between the cases (40.02 ± 0.70years) and the controls (37.42 ± 0.47years) was not statistically significant (p = 0.542).The difference in the mean Pure Tone Average in dBHL between the cases (15.53± 6.95) and the controls (13.98 ± 4.35) was significant (p = 0.005) with a 12.83% prevalence of SNHL among the hypertensives against 1.77% in the controls. Majority (96.6 %) of them demonstrated bilateral, symmetrical, mild SNHL with 51.7% of them being above 50 years. The odds ratio in this study was 8.17 (p = 0.0001). CONCLUSION This study demonstrated a SNHL prevalence of 12.83% with a mild, bilateral, symmetrical pattern among hypertensives; increasing with advanced age and an eight-fold risk of occurrence.
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Age-related hearing loss at Gwagwalada area council of federal capital territory, Abuja. Niger J Clin Pract 2020; 23:1494-1499. [PMID: 33221771 DOI: 10.4103/njcp.njcp_390_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Presbyacusis is a cause of hearing loss in adults worldwide. It is a type of auditory dysfunction thought to be due to a series of insults over time including agerelated degeneration, noise exposure, and diseases of the ear. It usually affects the high frequencies of hearing. Presbyacusis has a tremendous impact on the quality of life of millions of the aged and is fast becoming an increasingly prevalent disorder as the population ages. Nigerian population is becoming progressively older making it imperative to focus on this area of research. It is worth noting that the Nigerian public health system does not have an effective and sustainable hearing loss screening strategy for lateonset hearing loss in adults. Aim/Objective This study evaluated the hearing threshold and pure tone audiometric pattern/s seen in participants with agerelated hearing loss (ARHL) in Gwagwalada Area Council of the Federal capital territoryAbuja. Subjects and Methods The study was a prospective communitybased crosssectional study, and a multistage sampling technique was adopted for this study, conducted at Gwagwalada, Abuja. Individuals from 55 years and above were recruited into the study after signing an informed consent. After a thorough and detailed clinical assessment, tympanometry and diagnostic puretone audiometry were carried out in all the participants. Result One hundred and fourteen participants were recruited into the study, out of which fourteen were excluded from the analysis on account of various exclusion criteria. The age range of the participants was 55 to 79 years, with a mean age of 65.8 ± 5.6 years.Twentyfive (25.0%) participants had normal hearing threshold, while seventyfive (75.0%) participants had sensorineural hearing loss (SNHL). Conclusion The study showed that the prevalence of ARHL from age 55 years and above at Gwagwalada Area Council, of FCT, Abuja was 75.0%.
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Sudden olfactory and gustatory dysfunctions: Important red flags in COVID-19. Niger J Clin Pract 2020; 23:1030-1032. [PMID: 32620737 DOI: 10.4103/njcp.njcp_172_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
To address inequality of access to ear, nose, and throat (ENT) care, there must be significant and sustained investment in education and training of surgeons, audiologists, speech therapists, clinical officers, anesthetists, and specialized nurses engaged in ENT in sub-Saharan Africa and other developing nations. Outreach by ENT surgeons from developed countries is essential if we are to address the critical lack of access to ENT care in SSA. However, it should be based on mutual respect, shared values, aspirations, a desire to create a durable and sustainable impact, and internationally accepted best practice. In this article, we propose rules of engagement for outreach projects in SSA and other developing countries to optimize their contributions by making them useful, sustainable, productive, and developmental. These proposed rules of engagement are based on our personal experiences and observations—good and bad—of outreach activities in our countries.
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The post-Ebola virus disease scourge in Nigeria: Individual levels of preparedness among physicians in the Federal Capital Territory Abuja. Ann Afr Med 2016; 15:171-178. [PMID: 27853031 PMCID: PMC5402828 DOI: 10.4103/1596-3519.194278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Ebola virus disease (EVD) is a viral hemorrhagic illness with great propensity for spread across international borders. The latest outbreak in the West African region, which involved Nigeria, was the worst among previously documented 25 outbreaks since discovery in 1976. The Nigerian response toward attaining Ebola free status was phenomenal and a case study for most nations. However, the persistence of EVD in West Africa is still a risk to recurrence, hence, the need to assess the level of consciousness of Nigerian physicians towards this. Methodology: A cross-sectional study utilizing the instrument of a pretested semi-structured questionnaire was conducted among physicians practicing within the federal capital city of Nigeria. General knowledge, treatment, prevention, and reporting of EVD were assessed and appropriate statistical analyses done using SPSS 20. Results: Of the 101 respondents, 45% and 87% showed excellent level (>80% score) of “general knowledge” and “reporting” on EVD, respectively. However, only 51% respondents had good (60–80%) knowledge on EVD treatment. Three percent correctly identified the “EVD helpline” phone-numbers for reporting suspected cases. Furthermore, 43.6% admitted the availability of personal protective equipment (PPE) in their hospitals while 35.6% had witnessed a demonstration of the use. The distribution of the PPEs appeared skewed - 74.4% (teaching-hospitals), 16% (private-hospitals), and the primary health care centers (9.6%). Conclusion: A majority of the physicians showed good level of preparedness as it relates to general knowledge on EVD, knowledge on good clinical practice, use of protocols and standard precautions and PPE. The identification of deficits in knowledge on treatment of EVD and flow path for the notification of suspected cases requires urgent redress given the risk of re-occurrence in the country.
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Evaluation of mobile smartphones app as a screening tool for environmental noise monitoring. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2016; 13:D31-D36. [PMID: 26418486 DOI: 10.1080/15459624.2015.1093134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Noise is a global occupational and environmental health hazard with considerable social and physiological impact and, therefore, there is a need for regular measurements to boost monitoring and regulations of environmental noise levels in our communities. This necessitates a readily available, inexpensive, and easy to use noise measuring device. We aimed to test the sensitivity and validity of mobile "smart" phones for this purpose. This was a comparative analysis of a cross sectional study done between January 2014 and February 2015. Noise levels were measured simultaneously at different locations within Abuja Nigeria at day and night hours in real time environments. A sound level meter (SLM) (Extech407730 Digital Soundmeter, serial no.: 2310135, calibration no: 91037) and three smartphones (Samsung Galaxy note3, Nokia S, and Techno Phantom Z running on Android "Apps" Androidboy1) were used. Statistical calculations were done with Pearson correlation, T-test and Consistency within American National Standards Institute acceptable standard errors. Noise level readings for both daytime and night with the SLM and the mobile phones showed equivalent values. All noise level meters measured were <100dB. The daytime readings were nearly identical in six locations and the maximum difference in values between the SLM and Smartphone instruments was 3db, noted in two locations. Readings in dBA showed strong correlation (r = 0.9) within acceptable error limits for Type 2 SLM devices and no significant difference in the values (p = 0.12 & 0.58) for both day and night. Sensitivity of the instrument yielded 92.9%. The androidboy1 "app" performance in this study showed a good correlation and comparative high sensitivity to the Standard SLM (type 2 SLM device). However there is the need for further studies.
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A meta-analysis and systematic review of the prevalence of mitochondrially encoded 12S RNA in the general population: Is there a role for screening neonates requiring aminoglycosides? Afr J Paediatr Surg 2015; 12:105-13. [PMID: 26168747 PMCID: PMC4955414 DOI: 10.4103/0189-6725.160342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND This was a meta-analysis and systematic review to determine the global prevalence of the mitochondrially encoded 12S RNA (MT-RNR1) genetic mutation in order to assess the need for neonatal screening prior to aminoglycoside therapy. MATERIALS AND METHODS A comprehensive search of MEDLINE, EMBASE, Ovid, Database of Abstracts of Reviews of Effect, Cochrane Library, Clinical Evidence and Cochrane Central Register of Trials was performed including cross-referencing independently by 2 assessors. Selections were restricted to human studies in English. Meta-analysis was done with MetaXL 2013. RESULTS Forty-five papers out of 295 met the criteria. Pooled prevalence in the general population for MT-RNR1 gene mutations (A1555G, C1494T, A7445G) was 2% (1-4%) at 99%. CONCLUSION Routine screening for MT-RNR1 mutations in the general population prior to treatment with aminoglycosides appear desirable but poorly supported by the weak level of evidence available in the literature. Routine screening in high-risk (Chinese and Spanish) populations appear justified.
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Abstract
BACKGROUND Foreign bodies (Fbs) in the ear, nose, and throat (ENT) are common presentations in healthcare settings worldwide. AIM This study was carried out to review the modes of presentation, management, and outcome of inserted Fbs in our setting. SUBJECTS AND METHODS A 5-year retrospective study of cases of ENT Fbs managed at two referral hospitals in Abuja Nigeria. The analysis was done with Chi-square and Pearson correlation. RESULTS Five hundred and ninety-four patients aged 0-75 years, M:F = 1.1 (295 vs. 299) were reviewed. Prevalence was predominantly among the under 5 s; 286/594 (P = 0.001). ENT Fbs were 356/594 (59.9%), 167/594 (28.1%) and 71/59 (12.0%), respectively. Cotton wool 133/356 (37.4%) and beads 75/356 (21.1%) constituted most aural Fbs. Beads 45/167 (27.0%) and grains/seed 37/167 (22.1%) were the most common nasal Fbs while fish bones 38/71 (53.5%) and piece of metals 12/71 (16.9%) were dominant in the throat. Most cases of aural and nasal Fbs were asymptomatic. Ear syringing was the most common method for removal of aural Fbs 216/594 (60.7%) and instrumentation under direct vision for nasal Fbs 153/167 (91.6%). Furthermore, 52/71 (73.2%) of throat Fbs were removed under general anesthesia. ENT complications observed included bruises, lacerations, perforations, Epistaxis, and a case of respiratory failure. Delayed presentation (beyond 24 h) was seen in 489/594 (82.3%) of cases while failed previous attempts by untrained hands constituted 353/594 (59.4%). A strong correlation between complications and duration of Fbs insertion (R (2) = 0.8759) was established. CONCLUSIONS Fbs in ENT are common especially among children below 5 years. Majority presented beyond 24 h, and there was a strong correlation between duration of Fbs insertion and associated complications. Repeated failed attempts and delayed referrals to otorhinolaryngologists from peripheral centers were also contributing factors to increased morbidity and hence the need for awareness.
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THE EFFECT OF CD4 COUNT LEVEL ON THE MIDDLE EAR DYNAMICS OF HIV INFECTED PATIENTS. EAST AFRICAN MEDICAL JOURNAL 2014; 91:29-32. [PMID: 26862633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND HIV infection, a multi systemic disease has been identified as one of the causes of hearing loss in man. OBJECTIVES To compare the effect of HIV infection on the middle ear dynamics of HIV infected and non-HIV infected individuals using tympanometry. DESIGN A prospective cross sectional study. SETTING HIV Clinic at University of Benin Teaching Hospital (UBTH) in 2010. SUBJECTS Tympanometry was done on adults (18-45 year old) patients with confirmed retroviral disease (RVD) infection and confirmed non-HIV infected adults (18-45 year old) as the control group. All the patients certified the inclusion and exclusion criteria. MAIN OUTCOME MEASURES More women were found with HIV infection than men at a ratio of 1:3.7(men = 21% and females = 79%). There was preponderance of type "B" tympanogram among HIV-infected individuals. RESULT There was a significant correlation between CD4 cell count and type "B" tympanogram (P = 0.03). The CD4 cell count measured severity of HIV infection while the type "B" tympanogram detected middle ear effusion. CONCLUSIONS Middle ear effusion is the genesis of middle ear pathology in HIV infected population.
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The sensitivity and specificity of Lassa virus IgM by ELISA as screening tool at early phase of Lassa fever infection. Niger Med J 2013; 53:196-9. [PMID: 23661877 PMCID: PMC3640238 DOI: 10.4103/0300-1652.107552] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Early diagnosis, prompt treatment, and disease containment are vital measures in the management of Lassa fever (LF), a lethal and contagious arenaviral hemorrhagic disease prevalent in West Africa. Lassa Virus (LAV)-specific Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test, the gold standard for diagnosis, is unavailable in most centers. Serologic detection of LAV IgM is a more accessible tool and this work was to investigate its adequacy as an early marker for LF. Patients and Methods: A prospective case–control study conducted July 2007-March 2011 in a tertiary referral health center in Nigeria. Blood samples for test and control were evaluated for Lassa specific antigens and IgM using RT-PCR (primers S36+ and LVS 339) and indirect ELISA (Lassa Nucleo-protein (NP)-Antigen) respectively. RT-PCR outcome was used as standard to test for the sensitivity and specificity of IgM. Results: Of the 37 confirmed cases of LF infection by RT-PCR, 21 (57%) were IgM positive. Amongst the 35 confirmed negative cases (control group), eight were IgM positive. The diagnostic sensitivity and specificity of the IgM assay were 57% and 77% respectively. The negative and positive predictive values of the IgM serological assay were 63% and 72%, respectively, while the efficiency of the test was 67%. Conclusion: The specificity and sensitivity of IgM as a screening tool for early detection of LF appear weak and, hence, the need for a reliable LF “rapid screening kit” since RT-PCR is unavailable in most centers. In the interim, “high clinical index of suspicion,” irrespective of IgM status, requires urgent referral to confirmatory centers.
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Abstract
BACKGROUND Tonsillectomy, a common paediatric otolaryngology procedure, has undergone several evolutionary trends in the surgical techniques aimed at minimizing complications and improving patients' satisfaction. Despite the technological advancements in this respect, search for an ideal method is still ongoing, and some authorities are reverting back to the conventional methods. We wish to introduce the "Vasoconstrictive hydrolytic cold dissection" (VHCD) method. PATIENTS AND METHODS The VHCD method was described, and the outcome measures in one hundred and thirty-five patients who had the procedures were presented in . Data entrance was done with SPSS 14. RESULTS A total 135 patients comprising of 107 children aged 1-12 years and 28 adolescents/adults aged 14-52 years were operated upon using the VHCD between March 2009 and July 2012 by the same teams of Surgeons and Anaesthetists. The average surgical time and blood volume losses were 15 minutes and 5 mls for children and 12 mins and 10 mls for adults/adolescents, respectively. There was a single case (0.7%) of post-tonsillar bleed (reactionary haemorrhage). The rest (99.3%) recorded nil haemorrhage within and beyond first 2 weeks post-surgery. CONCLUSIONS Surgeons used to other techniques of tonsillectomies may not revert to the cold steel; however, those practicing CSM will benefit from VHCD. We hereby recommend this simple, cost-effective modification of the cold steel tonsillectomy, which appears to have made dissection easier and also minimizes haemorrhage, a common complication of tonsillectomy surgery. It is timely in the advent of increased advocacy towards reversal to the conventional method of tonsillectomy. A randomized control trial is required for further evaluation of this method.
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Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) is a mechanical peripheral vestibular disorder which may involve any of the three semicircular canals but principally the posterior. In as much as the literature has described theories to explain the mechanism of BPPV and also contains scholarly works that elucidate BPPV; its management remains an enigma to most clinicians. To this end, this work was aimed at outlining an evidence-based best practice for most common form of BPPV. MATERIALS AND METHODS A systematic review of the literature was conducted between 1948 and June 2011 in PubMed, Embase, Ovid, and Cochrane database through the online Library of the University of Cape Town. Seventy-nine worthy articles that addressed the study were selected on consensus of the two authors. CONCLUSION There is consensus for the use of canalith repositioning procedures as the best form of treatment for posterior canal canalolithiasis. However, successful treatment is dependent on accurate identification of the implicated canal and the form of lithiasis. Furthermore, clinicians should note that there is no place for pharmacological treatment of BPPV; unless it is to facilitate repositioning.
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Efficacy of utilising patient self-report of auditory complaints to monitor aminoglycoside ototoxicity [Correspondence]. Int J Tuberc Lung Dis 2012; 16:283. [DOI: 10.5588/ijtld.11.0712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cochleo-vestibular clinical findings among drug resistant Tuberculosis Patients on therapy-a pilot study. Int Arch Med 2012; 5:3. [PMID: 22293572 PMCID: PMC3284867 DOI: 10.1186/1755-7682-5-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 01/31/2012] [Indexed: 11/24/2022] Open
Abstract
Abstracts
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Classification and management challenges of otitis media in a resource-poor country. Niger J Clin Pract 2011; 14:262-9. [DOI: 10.4103/1119-3077.86764] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Neonatal hearing screening in Benin City. Int J Pediatr Otorhinolaryngol 2010; 74:1323-6. [PMID: 20863576 DOI: 10.1016/j.ijporl.2010.08.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Revised: 08/15/2010] [Accepted: 08/20/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Congenital hearing loss is a major health care problem that tends to retard the developmental milestones of children. It takes early detection and intervention to avoid a permanent loss in acquisition of speech and cognitive functions. Hence, the importance of hearing screening in all newborns especially in the developing world for accurate statistics and early intervention. Therefore, this work was aimed at detecting the crude prevalence of congenital hearing loss among the newborns in Benin City. METHODOLOGY Consecutive neonates at designated immunization centers in Benin City metropolis were screened for hearing loss via the detection and analysis of distortion product otoacoustic emissions from both ears. The handheld otoacoustic machine model MAICO 8172 was employed and the outcome results presented in tables. Statistical analysis was performed using SPSS 11. RESULTS A total of 400 neonates (218 males and 182 females) were screened for the presence of otoacoustic emission in both ears. Ninety neonates (22.5%) p<0.05 were referred. Bilateral hearing loss was seen in 26 (6.5%) whereas 64 (16%) had unilateral loss. CONCLUSIONS The screening tests suggest a high crude prevalence (6.5%) of bilateral neonatal hearing impairment in Benin City necessitating confirmation and intervention. The study fortifies the need for hearing screening among all new born in developing countries.
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Early-onset sensorineural hearing loss in Lassa fever. Eur Arch Otorhinolaryngol 2010; 268:197-201. [PMID: 20809263 DOI: 10.1007/s00405-010-1370-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Accepted: 08/19/2010] [Indexed: 11/25/2022]
Abstract
Lassa fever (LF) is a viral hemorrhagic disease which affects one-fourth to two million people annually with the fatality rate of about 10,000. It is associated with sensorineural hearing loss (SNHL) usually at the convalescent stage. Recently, cases of SNHL at the acute phase have been reported. This study was done to further investigate the incidence and features of SNHL in acute phase of LF. It is a prospective case-control study of LF patients seen with acute SNHL conducted between July 2007 and April 2009 at Irrua Specialist Teaching Hospital Nigeria. The diagnosis of acute LF was based on the clinical features and detection of IgM antibodies and/or positive Lassa virus-specific reverse transcriptase-polymerase chain reaction using primers S36+ and LVS 339 while SNHL was diagnosed clinically and confirmed with PTA and speech discrimination tests. Patients with other acute febrile illnesses were used as control. Statistical analysis was done using SPSS version 11 and Fisher's exact test while level of significance was set at p < 0.05. Out of the 37 confirmed cases of LF, 5 (13.5%) and none (0%) of the control developed early-onset SNHL (p = 0.03). Forty percent of the cases studied had negative IgM. The audiograms showed involvement at all frequency groups with pure tone average 65-85 dB and the speech discrimination 20-40%. The overall case fatality rate was 27.0%, and for early SNHL cases 60.0% (p > 0.05). The incidence of SNHL in LF infection is about 13.5% and could be a reflection of a worse disease process. There is possibility of direct viral invasion aside immunological reaction as a causative mechanism.
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Correlating the site of tympanic membrane perforation with Hearing loss. BMC EAR, NOSE, AND THROAT DISORDERS 2009; 9:1. [PMID: 19121227 PMCID: PMC2631525 DOI: 10.1186/1472-6815-9-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Accepted: 01/04/2009] [Indexed: 11/10/2022]
Abstract
Background It is recognized that the size of tympanic membrane(TM) perforation is proportional to the magnitude of hearing loss, however, there is no clear consensus on the effect of the location (site) of the perforation on the hearing loss. Hence the study is set to investigate the relationship between the location of perforation on TM and hearing loss. Methods A cross-sectional prospective study of consecutive adult patients with perforated TM conducted in the ENT clinic of University College Hospital Ibadan between January 1st 2005 and July 31st 2006. Instruments used for data collection/processing include questionnaires, video and micro-otoscopy, Pure tone audiometer, image J and SPSS packages. Results Sixty-two patients (22-males, 40-females), aged 16–75 years (mean = 35.4 +/- 4) with 77 perforated ear drums were studied and 15(24.2%) had bilateral TM perforations, 21 (33.9%) right unilateral and 26(41.9%) left unilateral. The locations of the TM perforations were 60(77.9%) central, 6(9.6%) antero-inferior, 4(5.2%) postero-inferior, 4(5.2%) antero-superior and 3(3.9%) postero-superior respectively with sizes ranging from 1.51%–89.05%, and corresponding hearing levels 30 dB – 80 dB (59% conductive and 41% mixed). Fifty-nine percent had pure conductive hearing loss and the rest mixed. Hearing losses (dBHL) increased with the size of perforations (P = 0.01, r = 0.05). Correlation of location of perforations with magnitude of hearing loss in acute TM perorations was (P = 0.244, r = 0.273) and for chronic perforations (p = 0.047 & r = 0.31). Conclusion The location of perforation on the tympanic membrane (TM) has no effect on the magnitude of hearing loss in acute TM perforations while it is significant in chronic ones.
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Abstract
BACKGROUND Tympanic membrane perforations vary in size, shape and position. The degree of conductive deafness varies with the size and position of the tympanic membrane perforation. OBJECTIVE This study is to determine the pattern and causes of tympanic membrane perforation. METHOD Hospital based study at the ENT Clinic, UCH, Ibadan. Consecutive patients seen during the period of study with ear symptoms were interviewed and examined by ENT surgeons. This information was entered into computer and analyzed using SPSS v 11. RESULT Thirty-three (13.5%) of the 244 patients were found to have tympanic membrane perforation. Fifteen (45.5%) patients were new while 18 (54.5%) were follow up patients. There were 13 (39.4%) males and 20 (60.6%) females. The type of perforation seen were central 57.6%, subtotal 33.3%, total 6.1%, marginal 3.0%. The sides affected were left ear 45.5%, right ear 15.2%, and both ears 39.4%. The causes found were chronic suppurative otitis media (CSOM) 90.9%, acute suppurative otitis media (ASOM) 6.1%, and trauma to the affected ear 3.0%. CSOM was the cause of tympanic membrane perforation seen in children. CONCLUSION There is need for early diagnosis and treatment of all cases of tympanic membrane perforation and proper education of parents and guardians on proper method of ear care and early referral. There is also need to train all healthcare workers especially primary health care providers on how to manage these cases.
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Assessments of the Size of Tympanic Membrane Perforations: A Comparison of Clinical Estimations with Video-Otoscopic Calculations. EAR, NOSE & THROAT JOURNAL 2008. [DOI: 10.1177/014556130808701009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted a study to determine how accurate various ENT specialists were in estimating the size of 100 tympanic membrane (TM) perforations with standard otoscopy. The specialists included, in descending order of rank, 2 Consultant Surgeons, 2 Senior Registrars, and 2 Registrars, all of whom had confirmed good vision. We compared their estimates, which were made independently and expressed as a percentage of the total area of the TM, with exact measurements calculated with computer-based video-otoscopy. We found that the video-otoscopic calculations were far superior to the estimates of the specialists, even the most experienced Consultants (p < 0.01). We recommend that video-otoscopy he used whenever possible.
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Assessments of the size of tympanic membrane perforations: a comparison of clinical estimations with video-otoscopic calculations. EAR, NOSE & THROAT JOURNAL 2008; 87:567-569. [PMID: 18833533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
We conducted a study to determine how accurate various ENT specialists were in estimating the size of 100 tympanic membrane (TM) perforations with standard otoscopy. The specialists included, in descending order of rank, 2 Consultant Surgeons, 2 Senior Registrars, and 2 Registrars, all of whom had confirmed good vision. We compared their estimates, which were made independently and expressed as a percentage of the total area of the TM, with exact measurements calculated with computer-based video-otoscopy. We found that the video-otoscopic calculations were far superior to the estimates of the specialists, even the most experienced Consultants (p < 0.01). We recommend that video-otoscopy be used whenever possible.
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Impacted radio-opaque glass in the oesophagus of a child. THE NEW ZEALAND MEDICAL JOURNAL 2008; 121:86-88. [PMID: 18425158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Most ingested foreign bodies in the aero-digestive tracts in both children and adults are not radio-opaque, and as a result, a preoperative plain radiograph may not be helpful. However, incorporating radio-opaque markers into such potential foreign bodies like toys, beads, and dentures during manufacture (as illustrated in this case of a 6-year-old boy who ingested a piece of glass mirror which was easily seen on X-ray) would obviate this problem. While this may constitute some financial burden on manufacturers, the cost effectiveness on health management is non-negotiable. We suggest that appropriate authorities and regulatory bodies should enforce this through legislation.
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Migraine and Meniere's disease: two different phenomena with frequently observed concomitant occurrences. J Natl Med Assoc 2008; 100:334-338. [PMID: 18390027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Some variants of migraine could be indistinguishable from Meniere's disease, and this has prompted suggestions of possible association between the two disease entities. AIM AND OBJECTIVES This study aims at determining the prevalence of migraine among Meniere's patients and a possible linkage between the two diseases in our environment. METHODOLOGY A 10-year retrospective study of patients diagnosed with Meniere's disease using American Academy of Otorhinolaryngology criteria, including those that had associated migranous symptoms in accordance with the International Headache Society (IHS) diagnostic criteria for migraine, between 1996 and 2005. The prevalence of migraine in the Meniere's patients was also compared with lifetime prevalence recorded from a previous population-based study within the same setting. The statistical difference was tested with a Z nonparametric test (significance at P < 0.05). Epicalc2000 and SPSS 11 were used for the statistical analysis. RESULT A total of 25 patients representing 0.22% of the 11,463 ear, nose and throat outpatients seen within the study period met the diagnostic criteria for Meniere's disease. There were nine (36%) males and 16 (94%) females. Their ages ranged 27-65 years, mean 45.25 years +/- 11.05. Eight (32%) met IHS criteria for migraine. There is a statistically significant difference between the prevalence of migraine in Meniere's patients and migraine in the overall population (32% vs. 5.3%, P = 0.000). CONCLUSION The significant preponderance in the prevalence of migraine in Meniere's disease suggests a link between the two diseases. However, more molecular or genetic studies are needed to unveil this phenomenon.
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Amyloid angiopathy of the floor of the mouth: a case report and review of the literature. J Med Case Rep 2007; 1:117. [PMID: 17967184 PMCID: PMC2147018 DOI: 10.1186/1752-1947-1-117] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 10/29/2007] [Indexed: 11/20/2022] Open
Abstract
Amyloidosis is a rare disease characterised by the deposition of insoluble extracellular fibrillar proteins in various tissues of the body. The pattern of manifestation is organ dependent and also on whether the disease is localised or systemic, primary or secondary. Though the disease is usually fatal with a 5-year survival rate of 20%, there is still paucity of literature on this disease entity worldwide. Diagnosis has remained mostly at autopsy. A case of amyloid angiopathy involving the submandibular gland and floor of the mouth with an associated fatal bleed is reported. The purpose of this case report is to reiterate the importance of a high index of suspicion in the approach to the management of head and neck swellings.
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Meniere’s disease: rare or underdiagnosed among Africans. Eur Arch Otorhinolaryngol 2007; 264:1399-403. [PMID: 17610076 DOI: 10.1007/s00405-007-0377-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Accepted: 06/12/2007] [Indexed: 11/26/2022]
Abstract
Meniere's disease can easily be misdiagnosed because several otological disorders mimic the disease. Conflicting reports on the incidence of this disease among the Africans had been documented. The goal of our study was to verify the prevalence and clinical features of Meniere's disease in WA sub-region. A 10 year (1996-2005) retrospective study carried out in our hospital. The diagnostic criteria for the disease were outlined and Oyedeji's social classification instrument was adapted for socio-economic stratification of patients. The method of treatment and prognostic out-come were discussed. Out of 11,463 patients seen within the period, 25 (16 females and 9 males) met the diagnostic criteria for Meniere's disease. The age ranged from 27 to 75 years (mean=47.2 SD13.2) and the most predominant age group was 41-50 years. Sixty-eight percent were of low socio-economic class and the rest high. About 84% had unilateral and 16% bilateral Meniere's disease. All the patients presented with tinnitus, vertigo and audiologically confirmed sensorineural hearing loss. CT-scan and MRI were used to rule out some differentials, while caloric and recruitment tests were used to strengthen the diagnosis. Treatment regimen (conservative) outcome: 72% had good improvement, 8% fair, while 20% absconded from follow-up. The prevalence of Meniere's disease in West African sub-region is 0.22%. This prevalence among Africans may not differ from the Caucasians. Under- or over-diagnosis of the disease previously must have been responsible for the contrasting results. Appropriate diagnostic tools are necessary for accurate diagnosis of the disease.
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Abstract
CONTEXT The knowledge of variations of the tympanic membrane (TM) perforations with the climatic changes in the West African subregion would help clinicians in its prevention and management. OBJECTIVE To analyze the pattern of clinical presentations and associated features of TM perforation in adults in West Africa. DESIGN A prospective study. SETTING Tertiary referral centre, University hospital. PATIENTS OR OTHER PARTICIPANTS Thirty-five (35) consecutive adults with TM perforations during a 1-year period had clinical evaluation of each TM using head mirror, video otoscopy, and micro-otoscopy. MAIN OUTCOME MEASURES Clinical presentations and associated features of TM perforations. RESULTS Thirty-five patients, 20 (57%) men and 15 (43%) women, with 42 perforated TMs were examined. Twenty-eight (80%) patients had unilateral perforations. Infection was responsible for 90.5% of cases, and trauma was responsible for the rest. Locations of perforations were central (29; 69.1%), anteroinferior (4; 9.5%), posteroinferior (4; 9.5%), anterosuperior (3; 7.1%), and posterosuperior (2; 4.8%). The sizes of the perforations ranged from 1.2 to 83.2%. Large sizes of 25% and more were found to occur in humid and wet seasons, and also, clinical presentations of otorrhea (65.6%), otalgia (51.5%), tinnitus (37.1%), and ear itching (34.4%) seemed to worsen. CONCLUSION Most TM perforations result from infection and are preventable via appropriate health education. Posterosuperior perforation is rare, and this is probably one of the factors making choleasteatoma uncommon in West Africa. Approximately 83.3% of TM perforations measure more than 25% in size and appear during the wet humid season of the year. These findings are important for both local and foreign otolaryngologists who may be practicing in this subregion of the world.
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Abstract
Background Teratoma is a rare developmental neoplasm that arises from totipotential tumor stem cells. Head and neck teratomas constitute about 10% of all cases. Only two cases of mature teratoma of the nasal septum have previously been documented in the world literature. Case presentation We present a case of histologically confirmed mature teratoma arising from the nasal septum in an eighteen month old Nigerian female who presented with a history of noisy breathing associated with recurrent rhinorrhea since birth. Physical examination revealed obstruction of the right nasal cavity by a pale fleshy mass. She underwent a total surgical excision and to date, after thirty one months follow-up, she is free from recurrence. Conclusion The prognosis for benign teratoma of the nasal septum is good following total surgical excision.
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Quality of life in patients with head and neck cancers. J Natl Med Assoc 2006; 98:765-70. [PMID: 16749653 PMCID: PMC2569276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE The aim was to assess the psychosocial effects on the quality of life (QOL) of adults with head and neck cancer (HNC) and any gender variations with predictive factors that may influence QOL. PATIENTS AND METHODS This was a three-month descriptive and prospective evaluation of QOL in 50 adult patients with HNC who were still on treatment but had spent a period of at least four weeks from commencement in a tertiary hospital. MAIN OUTCOME RESULTS There were 32 males and 18 females with a mean age of 47.74 years. Females had higher mean scores than males in all domains except pain domain, global and general questions. There was no significant difference in the mean score between the genders in all the domains: overall bother, overall satisfaction, response to treatment, site with QOL and health-related QOL (HRQOL). Pain domain correlated significantly with eating and emotion but weakly with stage of the disease. The predictive factor for overall bother was mainly emotion domain, while site of lesion with QOL was for overall satisfaction, response to treatment and HRQOL. CONCLUSIONS Pain, which is a major problem experienced by these patients with HNC, requires more attention by the caregiver in order to improve their QOL.
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Spectrum of otorhinolaryngology emergencies in the elderly in Ibadan, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2006; 14:411-4. [PMID: 16353703 DOI: 10.4314/njm.v14i4.37199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The elderly (65 years and above) are a special group of patients whose illnesses and management are modified by the process of aging. It is thus the aim of this study to evaluate the spectrum of ear, nose, throat, head and neck emergencies among the elderly in Ibadan, Nigeria. METHOD This is an eight-year (April 1996-March 2004) retrospective study of 87 geriatric patients who presented with otorhinolaryngological emergencies at our centre. RESULTS Eighty-seven emergency cases studied constituted about 20% of the total geriatric cases seen within this period. There were 55 (63.2 per cent) males and 32 (36.8 per cent) females. The pharyngolaryngeal emergencies with upper airway obstruction constituted 55 per cent of the cases, a majority being a result of malignant lesions of the larynx and pharynx. Others were nasal 20.7 per cent, otological 11.5 per cent, oesophageal 9.7 per cent and head and neck 3.1 per cent. Most of the patients had emergency tracheostomy (54 per cent), as a prelude to their definitive management while 24 per cent were managed medically. CONCLUSION Prevalence of emergency otorhinolaryngology cases among the elderly appears high. Most of the throat diseases with upper airway obstruction were due to malignancy. There is thus the need for increased awareness of the people through social campaigns and health education on the merits of early detection and seeking appropriate treatment for these tumours.
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Retropharyngeal abscess: a clinical experience at the University College Hospital Ibadan. NIGERIAN JOURNAL OF MEDICINE 2006; 14:415-8. [PMID: 16353704 DOI: 10.4314/njm.v14i4.37200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Infection within the retropharyngeal space could progress on to an abscess formation resulting into retropharyngeal abscess (RPA), which can either be acute or chronic. RPA can be a life-threatening emergency, with potential for airway compromise and other catastrophic complications. This review is aimed at highlighting our experience with patients with a diagnosis of retropharyngeal abscess. METHODS Retrospective review of thirty patients with a confirmed diagnosis of retropharyngeal abscess, who were admitted and managed within an eleven-year period (1993 to 2003) in the Otolaryngology department of the University College Hospital Ibadan. RESULTS There were fifteen males and females each with M:F ratio of 1:1, consisting of twenty-five children and five adults and their median age was 21 months and twenty three (77%) were younger than 5 years. It was observed that while the adult patients presented early for specialist treatment, the paediatric patients presented late. The major complaints were fever (87%), respiratory distress or stridor (57%), cough (53%), neck pain/swelling (43%), and refusal of feeds (30%). Other minor complaints were throat pain, difficulty in swallowing, anorexia, and weight loss. The commonest associated symptoms seen especially among the younger age group were nasal discharge, nasal blockage, tooth-ache, snoring and limitation of neck movement. CONCLUSION The treatment of retropharyngeal space infections in children and adults should include accurate clinical diagnosis, empirical usage of broad-spectrum antibiotics, and timely surgical drainage.
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Hoarseness in adult Nigerians: a University College Hospital Ibadan experience. NIGERIAN JOURNAL OF MEDICINE 2004; 13:152-5. [PMID: 15293835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Hoarseness is a major symptom of laryngeal disease. Persistent hoarseness may be an early warning of such sinister lesions as cancer of the larynx and nasopharynx, hence the need for increased awareness of this symptom and its causes. METHODS This is a retrospective study of all hoarse adult patients seen in the Otorhinolaryngology clinics of the University College Hospital Ibadan over an 8-year period (1995-2002). RESULTS The total study population of 124 patients consisted of 72 (58.06%) males and 52 (41.94%) females with an overall mean age of 46.98 years and age range 16-84 years. The mean duration of hoarseness before presentation was 23.29 months; 56 (45.2%) patients presented within 6 months of onset of hoarseness. Chronic non-specific laryngitis including vocal cord nodules was the most common cause of hoarseness (55.6%). Chronic non-specific laryngitis patients had a mean age of 45.05 years. Fourteen point forty-nine percent (14.49%) of patients with chronic non-specific laryngitis smoked cigarette and drank alcohol, 60.88% were professional voice users. The other causes of hoarseness included laryngeal cancer (24.2%), recurrent laryngeal nerve palsy (8.1%) and laryngeal papilloma (6.5%). The patients with laryngeal cancer had a mean age of 57.63 years. The two male patients with laryngeal tuberculosis were all secondary to pulmonary phthisis. CONCLUSION The causes of hoarseness are varied and late presentation may worsen the prognosis. Persistent hoarseness of more than three weeks should have detailed Otolaryngological evaluation.
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