A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Post irradiation hearing loss in head/neck patients in Lagos; Nigeria

A prospective study was conducted at Lagos University Teaching Hospital on patients with malignancies of the head and neck region treated with external beam irradiation type and severity of hearing loss. Each patient had a preirradiation and post irradiation pure tone audiogram at 3 weeks; 8 weeks and 6 months. Following completion of radiotherapy serial post irradiation audiogram threshold was compared with pre-treatment threshold. An increase of 10 dB HL (decibel hearing level) or greater was considered significant. Radiation dose ranged from 45-55Gy in twenty to twenty-five fractions per weeks over four to five weeks treatment. Patients that received chemotherapy as adjunctive to therapy during the period of the study were excluded. A total of 40 patients (80 ears) completed the audiological follow up out of ninety four patients seen during the study period .Age ranged between 4-79 years. The tumor site distribution showed 20