Facial cleft with Amelia: a Nigerian case report.

Clefts of the lip and palate are the most common serious congenital anomalies in orofacial region. However, the occurrence of associated defects in the limbs is quite rare. This report presents a 12-week-old male child born with unilateral left cleft lip and palate, absence of the upper left arm and forearm, and fusion of both big and middle toes and absence of the entire small toe on the left foot. The repairs of lip and palate defects were done at 6 and 19 months of age while parents were referred for rehabilitation to ameliorate absence of upper left arm. We discuss the challenges of management of defects in a developing economy, issues of acceptance of children born with defects amenable to surgery and the benefit of parental education on the care of the child.

Delayed soft tissue recurrence after treatment of ameloblastoma in a black African: case report and review of the literature.

INTRODUCTION: Ameloblastoma is rare worldwide. Delayed treatment can result in significant morbidity from facial deformity and infiltration of adjacent tissues. Mortality can occur from invasion of vital structures in the head and neck, super infection, recurrent and even distant metastases. Recurrence after radical treatment is not common. CASE REPORT: This paper presents a case of soft issue recurrence in the chin 21 years after radical resection of the mandible for ameloblastoma. The iliac crest bone grafted to the site was not involved in the tumour recurrence. Conclusion. Radical surgical resection is accepted treatment for solid/multicystic ameloblastoma. However, the surgical review should be for life as recurrence can occur after a long interval.

A review of 318 odontogenic tumors in Kaduna, Nigeria.

PURPOSE: To analyze 318 odontogenic tumors seen at a tertiary oral care center in Kaduna, Nigeria for comparison with findings in previous Nigerian and world records. MATERIALS AND METHODS: A retrospective survey of odontogenic tumors based on the classification of Kramer et al was undertaken at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria, from all histopathologically proven cases of tumors and tumor-like lesions of the oral and perioral structures. Data were retrieved from case notes, radiographs, histopathology results, and follow-up records. Information collected were used to complete a questionnaire and subjected to analysis. RESULTS: There were 990 tumor and tumor-like lesions of the oral and perioral structures, of which 318 were odontogenic tumors (32%). Twelve histopathologic types of odontogenic tumors were found with more benign (n=314; 99%) than malignant (n=4; 1%). Ameloblastoma made up 233 (73%) of the tumors, followed by odontogenic myxoma (n=38; 12%), ameloblastic fibroma (n=9; 3%), and the adenomatoid odontogenic tumor (2%). Three cases of calcifying odontogenic cyst were co-existent with ameloblastoma (2) and ameloblastic fibro-odontoma (1). Among 275 surgically treated odontogenic tumors, enucleation was performed in 64 cases (23%), dentoalveolar segment resection with preservation of lower border of the mandible (n=33; 12%), segmental resection (n=168; 61%), and composite resection (n=9; 3%); 1 case was deemed inoperable. At least 8 cases of ameloblastoma (13%) recurred out of 60 followed up. CONCLUSION: Ameloblastoma is a fairly common tumor of Nigerian Africans accounting for 73% of odontogenic tumors and 24% of all tumors and tumor-like lesions of the oral and perioral structures. Various forms of resection are practiced to eradicate the tumor in view of the late presentation in our environment. Patients in Nigeria do not often return for follow-up reviews. A minimum of 5 years of follow-up reviews are necessary after treatment of ameloblastoma.

Odontogenic tumours in children and adolescents: a study of 78 Nigerian cases.

BACKGROUND: There is paucity of literature on odontogenic tumours in children and adolescents. Available records are difficult to compare due to differences in study criteria. To contribute to the records, a 20-year study of odontogenic tumours on the basis of the WHO classification (Kramer et al., 1992) in Nigerian African children and adolescents < or =18 years of age was undertaken. MATERIAL: A retrospective survey of oral/jaw tumours and allied lesions in children and adolescents < or =18 years of age seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria between 1979 and 1998. Data collected were histopathologic type, age, clinical features, radiologic appearance, treatment and record of recurrence. METHOD: Odontogenic tumours selected using the WHO classification were used for further study. Data were collected from case notes, radiographs, histopathologic reports and follow-up records. Information retrieved was used to complete a questionnaire and subjected to analysis. RESULTS: Two hundred and fifty-two (252) subjects < or =18 years were recorded, from which 78 (31%) had odontogenic tumours. Among seven types of odontogenic tumours seen, ameloblastoma (54%), odontogenic myxoma (19%) and adenomatoid odontogenic tumour (9%) were predominant. All patients seen were from 6 to 18 years with more than half (53%) between 15 and 18 years of age. A patient with multiple, bilateral odontomas of the maxilla and mandible resembling Herrmann's syndrome was recorded. Seventy-three patients were treated using enucleation (37%), dentoalveolar resection with preservation of lower border (15%) and segmental resection (48%). Five patients absconded after tumour diagnosis. No tumour recurrence was recorded in 65 treated cases followed-up for between 2 months and 10 years. CONCLUSION: This report shows that while ameloblastoma was the predominant odontogenic tumour, its frequency in Nigerian African children was lower than in the adult population. A case resembling Herrmann's syndrome is also presented.