RECURRENT PLEOMORPHIC ADENOMA OF THE UPPER LIP: CASE REPORT AND REVIEW OF THE LITERATURE.

INTRODUCTION: Pleomorphic adenoma or mixed tumour is a benign salivary gland tumour, presenting usually in the parotid or submandibular glands. This tumour contains elements of both epithelial and mesenchymal origin. They are the most common tumours (50%), (60-65%) of the major and minor salivary glands. The palate is considered as the most common intraoral site (42.8-68.8%), followed by the upper lip (10.1%) and cheek (5.5%). CASE REPORT: A 37 year old female Nigerian house wife was seen with a four year history of painless slowly progressive upper lip swelling. Prior to her presentation, she had surgery for same swelling in a peripheral hospital. All other histories were not significant. CONCLUSION: PA remains the commonest benign minor salivary gland neoplasm and excision with safe margins the treatment of choice.

Chondromyxoid fibroma of the mandible: Case report and review of the literature.

INTRODUCTION: Chondromyxofibroma (CMF) is exceedingly rare, accounting for 0.5% of the 10,065 bone tumors categorized by Unni and Inwards and 1.6% of their catalog of benign bone tumors. Only 2 of the 50 chondromyxoid fibromas included in their study occurred in the skull. Chondromyxoid fibroma of the maxillofacial region is typically seen in patients in the 2nd-3rd decade of life with slight female predominance. It is more commonly seen in the maxilla and is unusual in the sphenoid and ethmoid sinuses. The tumor is composed of hypocellular chondroid or myxochondroid tissue with multinucleated giant cells. CASE REPORT: A 30 year old Nigerian house wife was seen at the Oral and Maxillofacial clinic of the Dental and Maxillofacial Department of the Federal Medical Centre Lokoja with a 4 year history of Rt mandibular swelling which was initially slow growing and painless and difficulty in eating. The whole lesion was removed and result confirmed the previous biopsy of chondromyxofbroma of the jaw. CONCLUSION: Patients with CMF need close monitoring due to high rate of recurrence with cases of malignant transformation at rate of 1-2%, and this seems to have occurred following irradiation.

Prevalence of orofacial clefts in Nigeria.

Orofacial clefts are the most common malformations of the head and neck. In Africa, orofacial clefts are underascertained, with little or no surveillance system in most parts for clefts and other birth defects. A Nigerian craniofacial anomalies study, NigeriaCRAN, was established in 2006 to support cleft research specifically for epidemiological studies, treatment outcomes, and studies into etiology and prevention. We pooled data from seven of the largest Smile Train treatment centers in the six geopolitical zones in Nigeria. Data from September 2006 to June 2011 were analyzed and clefts compared between sides and genders using the Fisher exact test. A total of 2197 cases were identified during the study period, with an estimated prevalence rate of 0.5 per 1000. Of the total number of orofacial clefts, 54.4% occur in males and 45.6% in females. There was a significant difference (P = .0001) between unilateral left clefts and unilateral right clefts, and there was a significant difference (P = .0001) between bilateral clefts and clefts on either the left or right side. A significant gender difference (P = .03) was also observed for cleft palate, with more females than males. A total of 103 (4.7%) associated anomalies were identified. There were nine syndromic cleft cases, and 10.4% of the total number of individuals with clefts have an affected relative. The significant difference between unilateral clefts and the gender differences in the proportion of cleft palate only are consistent with the literature. The present study emphasizes the need for birth defects registries in developing countries in order to estimate the exact prevalence of birth defects including orofacial clefts.

Cleft lip and palate surgery in children: anaesthetic considerations.

BACKGROUND: The Care of cleft patients is very challenging. Team cleft care is usually lacking in many developing countries due to shortage of qualified manpower. This study is aimed at highlighting anaesthetic challenges in the management of cleft in children. PATIENTS AND METHODS: This was a study of cleft lip and palate patients who were managed during team cleft care activities at University of Maiduguri Teaching Hospital and Federal Medical Centre Nguru both in north eastern Nigeria from January to June 2009. RESULTS: One hundred and six cleft patients presented for surgical repair under general or local anaesthesia. Fifteen (14%) patients all of whom children were unfit for general anaesthesia due to various medical reasons. Ninety-one (86%) cleft patients comprising 53(50%) children and 38(36%) adults had cleft repair under halothane general endotracheal anaesthesia and local anaesthesia, respectively. There was no anaesthetic complications recorded under local anaesthesia. Fifteen percent of children who received general endotracheal anaesthesia suffered various anaesthetic complications which included hypoxia (3.8%), laryngospasm (1.9%), kinking of endotracheal tube (5.7%), inadvertent extubation (1.9%) and pulmonary aspiration (1.9%). There was no mortality or anaesthesia-related morbidity at the time of discharge in all the cases. CONCLUSION: We conclude that anaesthesia for cleft lip and palate repair in hospital based team-cleft care activities in our environment is relatively safe. We recommend general anaesthesia with controlled ventilation for children and local anaesthesia for adult and older children who can cooperate.

Congenital bilateral fusion of the maxillomandibular alveolar processes with craniosynostosis: report of a rare case.

A rare congenital anomaly of maxillomandibular fusion with pectus excavatum and craniosynostosis in a neonate is presented. The child was kept alive by nasogastric tube feeding. A modification of classification of syngnathia is proposed. The aetiopathogenesis and difficulty in management in our environment are discussed.

Delayed repair of lip avulsion following gun-shot injury--a case report.

A case of delayed repair of lower lip repair tissue avulsion following gun shot injury in a 35 year old commercial driver is presented. The report illustrates the need for adequate wound debridement over a period of time to demarcate viable tissues before surgical reconstruction. It also serves as a reminder of the problems that may be faced in managing facial gun shot injuries in the civilian population in our environment.

African oral histoplasmosis mimicking lip carcinoma: case report.

A case of localised African histoplasmosis with an unusual presentation in a 56 year old Nigerian farmer is reported. The lesion presented as an ulcer clinically mimicking squamous cell carcinoma of the lower lip. An incisional biopsy and culture studies confirmed African histoplasmosis and the ulcer healed spontaneously without treatment. This case is reported to highlight the unusual location and clinical course of African histoplasmosis.