A five year audit of cases admitted in maxillofacial surgery wards in a Nigerian teaching hospital

Objective: Admissions of Maxillofacial surgery patient's are on the rise. However, search of English literature shows that there has not been any audit on pattern of maxillofacial admission done in any Nigerian hospital. The objective of the study was to review the indications and pattern of maxillofacial surgery admission in a Nigerian Teaching hospital over a 5-year period. Methods: A retrospective review of the pattern of maxillofacial admissions in a Teaching Hospital in North-West Nigeria from January 2011 to December 2015. Sources of information included maxillofacial ward admission records; patients' case files, accident and emergency records and patients discharge registers. Results: One thousand one hundred and thirty (1,130) patients were admitted into the maxillofacial ward during the study period with an overall gender ratio of 1:1.25. 260 patients were admitted as emergencies while 870 patients were admitted on elective basis. Review of treatment given showed that reduction and immobilization/ arthroplasties had the highest frequency (29.38%) while sequestrectomies had the lowest frequency of 0.80%. Conclusion: A progressive increase in the number of admission of patients into maxillofacial surgery wards shows that there is need for advocacy to improve the practice of the specialty in this region in terms of resources allocation and manpower development

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

OBJECTIVES: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. MATERIALS AND METHODS: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. RESULTS: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean 26.0+/-10.6 years). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. CONCLUSION: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.