Audit of Adenotonsillar surgeries in a Tertiary Facility in Uyo, South-south Nigeria

Background:Adenoid and tonsils are lymphoid tissues that occupy the nasopharynx and tonsillar fossae and serve as the initial site of immunological contact for inhaled and ingested antigens. Adenoidectomy, tonsillectomy or adenotonsillectomy is a lifesaving surgical procedure and remains a leading reason of surgical admission in general otorhinolaryngological practice both in developed and developing countries.The study aims to audit adenotonsillar surgeries in the Department of Ear, Nose and Throat in University of Uyo Teaching Hospital, and compare findings with similar studies.Method:This is a retrospective study of patients who had adenoidectomy, tonsillectomy, or adenotonsillectomy over 5 years from January 2015 to December 2019 at the Department of Ear, Nose, and Throat, University of Uyo Teaching Hospital, Uyo, Akwa Ibom state, south-south Nigeria.Results:Atotal of 526 patients were recruited, and this accounted for 38.7% of the total ENTsurgeries performed within the study period. Ages ranged from 6 months to 72 years, with a mean age of 11.89+1.03. The majority of the patients were aged between 1-5 years and the commonest presenting symptom was snoring and mouth breathing (79.5%). Sleep-disordered breathing (55.7%) was the main indication for the surgeries. Adenotonsillectomy (61.0%) was the commonest surgery performed. About 1.0% of the patients had recurrent adenoids. Conclusion: The surgeries were of immense necessity to the patients as all presenting complaints and pre-operative diagnoses became completely resolved.

Smokeless Tobacco Use in Adult Nigerian Population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population. Across-sectional survey of 1776 adults inYola; North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and data collection. Out of 1776 interviewed respondents; 133 (7.49) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8). Fifteen (0.9) chewed tobacco while only 2(0.1) both chewed and snuffed tobacco. Social acceptance (21.8) was the major reason for using smokeless tobacco. Males; 5th and 6th decades of life; poor education; lower socioeconomic class; Margi; Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Rhinosinusitis: A Retrospective Analysis of Clinical Pattern and Outcome in North Western Nigeria

Background/Objectives: Rhinosinusitis is the commonest viral infection in man and the commonest inflammatory disorder encountered by general practitioners; chest physicians; and otorhinolaryngologists all over the world. The clinical pattern and outcome of conventional management measures were assessed. Method: All new patients with the diagnosis of rhinosinusitis over a 2-year period from July 1999 to July 2001 were analyzed for clinical features; conventional radiological findings; and treatment modalities over a period of 3 years follow up. Results: There were 195 (11.7) new cases of rhinosinusitis out of a total number of 1661 patients seen over the period under review. Only 146 case notes were accessible for the study. Eighty-four (57.5) were males and 62 (42.5) were females. Their ages ranged from 7 months to 70 years. The main clinical symptoms and signs were nasal discharge or rhinorrhea (84.9); nasal obstruction (24.7); epistaxis (22.0); and sneezing (20.6). The duration of symptoms ranged from few days to about 10 years with 24 (16.4) being acute cases while 122 (83.6) were chronic cases giving a prevalence of 1.4and 7.3; respectively. Maxillary sinus (58.9) was the commonest sinus involved. More than one sinus involvement accounted for 37.7of the cases. Infective causes accounted for 67.1of cases followed by allergy (28.8). There were complications in 21 (14.4) cases with orbital involvement (33.3) being the commonest complication. Mode of treatment were medical (86.3); and conventional surgery was carried out in 13.7of the cases for either failed medical treatment or associated complications. Facial paraesthesia along the sites of surgery was the commonest complications; otherwise the outcome of treatment was excellent. Conclusion: Rhinosinusitis in this region was more of chronic (83.6) variety than acute (16.4) variety. Infective causes (67.1) and allergy (28.8) were the commonest etiological factors. About (86.3) were amendable to medical treatment while surgical treatment was carried out in 13.7of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist; conventional surgical measures may be used

Surgical Considerations in the Management of Tumours of the Nose and Paranasal Sinuses in a Northern Nigerian Teaching Hospital

BACKGROUND: Tumours of the nose and paranasal sinuses in sub-Saharan Africa are generally characterised by late presentation posing management challenges to the otorhinolaryngologists in the sub-region. OBJECTIVES: To appraise surgical considerations in the management of tumours of the nose and paranasal sinuses in a developing nation from the experiences of an Ear; Nose; and Throat Department of a Nigerian Teaching Hospital. METHODS: This was a chart review of patients with tumours of the nose and paranasal sinuses who underwent various surgical operations over a period of four and a half years.The patients were referred by other physicians or health care workers. They were assessed clinically; backed by laboratory and radiological investigations. RESULTS: A total number of 55 patients underwent 64 surgical operations. There were 31 (56.4) males and 24 (43.6) females; giving a male to female ratio of 1.3:1. They were aged between four years and 70 years. In 46(83.6) patients the tumours had extended beyond the nasal cavity or one sinus cavity to contiguous structures. The surgical operations carried out were lateral rhinotomy in 37(57.8); intranasal clearance and intranasal antrostomy in 16(25); total maxillectomy in seven(11); and anterior craniofacial resection in two (3.1) patients.The histological examination showed that 43 (78.2) cases were benign; while 12 (21.8) cases were malignant. These malignant cases needed radiotherapy and chemotherapy. CONCLUSION: Majority of the cases were characterised by late presentation; requiring surgical approaches such as lateral rhinotomy; total maxillectomy or craniofacial resection depending on the extent of the tumour. Poverty; ignorance; inadequate funding and administration challenges of health resources are factors militating against proper clinical management of tumours of the nose and paranasal sinuses in developing nations. Provision of free medical care and modern facilities for early diagnosis; treatment; and health education are needed to reverse the trend

Ear Foreign Bodies: Observations on the Clinical Profile in Sokoto; Nigeria

Background/objectives: Ear foreign bodies are common otorhinolaryngological emergencies which must be removed otherwise they may present with various complications. This paper reviews cases of ear foreign bodies seen over a seven year period from January 1995 to December 2001 in the Ear; Nose and Throat (ENT) department of Usmanu Danfodiyo University Teaching Hospital Sokoto; Nigeria. Method: This is a retrospective study of all case folders of patients who presented with ear foreign bodies whose clinical features and management modalities were analyzed . Results: The total number of patients reviewed were 207.There were 126 males (60) and 81 females (40) with a male to female ratio of 1.5:1. Their ages ranged from 1 to 65 years with 61.8being children under 10 years old. Agricultural seed was the commonest documented foreign body (15). Deliberate insertion by patients accounted for 70of the cases while accidental insertion accounted for 30. Ear foreign bodies became complicated in 41 patients (19.8) at presentation one of them requiring a major surgical operation (posterior tympanotomy) to remove the foreign body. About 99.5of the foreign bodies were removed through the per meatal approach with 79.8being carried out by the nurses and doctors who had received basic training to do so. Conclusion: Ear foreign bodies may become complicated and so needs to be removed using standard methods which should be carried out by those specially trained to do so

Ear Foreign Bodies: : Observations on the Clinical Profile in Sokoto; Nigeria

Background/objectives: Ear foreign bodies are common otorhinolaryngological emergencies which must be removed otherwise they may present with various complications. This paper reviews cases of ear foreign bodies seen over a seven year period from January 1995 to December 2001 in the Ear; Nose and Throat (ENT) department of Usmanu Danfodiyo University Teaching Hospital Sokoto; Nigeria. Method: This is a retrospective study of all case folders of patients who presented with ear foreign bodies whose clinical features and management modalities were analyzed . Results: The total number of patients reviewed were 207.There were 126 males (60) and 81 females (40) with a male to female ratio of 1.5:1. Their ages ranged from 1 to 65 years with 61.8being children under 10 years old. Agricultural seed was the commonest documented foreign body (15). Deliberate insertion by patients accounted for 70of the cases while accidental insertion accounted for 30. Ear foreign bodies became complicated in 41 patients (19.8) at presentation one of them requiring a major surgical operation (posterior tympanotomy) to remove the foreign body. About 99.5of the foreign bodies were removed through the per meatal approach with 79.8being carried out by the nurses and doctors who had received basic training to do so. Conclusion: Ear foreign bodies may become complicated and so needs to be removed using standard methods which should be carried out by those specially trained to do so

Pattern of Epistaxis in Sokoto; Nigeria: a Review of 72 Cases

Background: Epistaxis remains a common otorhinolaryngological emergency in most hospital emergency departments with varied manifestations. The pattern as seen in a tertiary health institution in sokoto; Nigeria is the subject of this paper. Method: This is a 5 year retrospective study (January 1995-December 1999) of all cases of epistaxis presenting at or referred to the Ear; Nose and Throat (ENT) Department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto; Nigeria whose data were analyzed. Results: A total number of 72 cases were seen with epistaxis out of 3;706 new cases seen at the ENT clinic. The incidence of epistaxis amongst UDUTH ENT patients was 19/1000.There were 45 males (62.5) and 27 Females (37.5) with a male to female ratio of 1.7:1.Their ages ranged between 1and 70 years with the 0-10 age range recording the highest number (26.4).The commonest cause of epistaxis was idiopathic (29.2); followed by trauma (27.8) and hypertension (18.0).Non surgical methods (97.2) such as observation alone (34.7) without active intervention to arrest bleeding; and nasal packing (34.7);being the commonest intervention measures used to actively arrest bleeding followed by cauterization of the bleeding points (11.1) were the frequent treatment measures. Surgical extirpation was carried out in 2 cases (2.8) to arrest the epistaxis Conclusion: Although epistaxis is a common otorhinolaryngological emergency and varied in its manifestation; it affects mainly the young peoplein this environment with idiopathic; trauma; and hypertension being the common causes which are amendable to treatment with excellent results