Management strategies of peritonsillar abscess in the tropics: a survey of surgeons' preference.

Peritonsillar abscess (PTA) or Quinsy is one of the common abscesses of the head and neck that requires urgent attention. Its treatment may often require hospital admission. Needle aspiration, incision & drainage and tonsillectomy have been the various treatment policies available depending on surgeon's preference. We present a survey of current practices in the management of PTA of practicing ENT surgeons in Nigeria. Questionnaires were mailed to members of the Otorhinolaryngological Society of Nigeria (ORLSON). Of the 60 surgeons surveyed, 56.7 % advise tonsillectomy in patients with history of recurrence, 20 % when there is previous history of tonsillitis and 23.3 % in patients with single attack of PTA. Overall 96.7 % of surgeons advises interval tonsillectomy and only 3.3 % advice abscess/quinsy tonsillectomy. There is paucity of literature on PTA in the tropical region, the survey therefore serves as a baseline information for further research especially outcome based in order to establish a standard criteria for choice of a treatment policy in our region. We suggest maintaining the policy of interval tonsillectomy in the appropriate patients for the time being.

Nasopharyngeal cancer in North--Eastern Nigeria: clinical trends.

BACKGROUND: Nasopharyngeal cancer is the malignancy of the posterior aspect of the nose called Nasopharynx. It is one of the most difficult diseases to diagnose at an early stage. AIM: To determine prevalence, clinical trends and histopathological types of Nasopharyngeal cancer in Maiduguri, North Eastern Nigeria. PATIENTS AND METHOD: Fifteen year retrospective evaluation of patient's case notes and cancer registry records of 40 patients with histologically confirmed nasopharyngeal cancer between 1991-2005. RESULTS: Nasopharyngeal cancers constituted 35.1% of all malignancies of ear, nose, throat during the study period. The M:F was 2.1-1, the mean age was 39(+/- 16.5) years and a peak age group and its occurrence of 40-49 years. The commonest symptom at presentation were cervical lymphadenopathy (72.5%), rhinorrhoea (55%), epistaxis(45%). The commonest histological type was squamous cell carcinoma(92.5%). Patients who received chemotherapy in addition to radiotherapy and higher symptom free period. CONCLUSION: Cancer is a difficult disease to diagnose at an stage. A meticulous ear, nose and throat examination and thorough evaluation of nasal symptoms with associated cervical lymphadenopathy may lead to an early diagnosis of nasopharyngeal cancer's.

AIDS-associated Kaposi's sarcoma in Northeastern Nigeria.

INTRODUCTION: Kaposi's sarcoma is an acquired immunodeficiency syndrome (AIDS)-defining illness, and with the size of the human immunodeficiency virus (HIV)/AIDS pandemic in sub-Saharan Africa, AIDS-related Kaposi's sarcoma (KS) are now being diagnosed more frequently, although the true incidence of HIV-associated KS is not known. The clinical presentations of AIDS-related KS varied markedly across the African continent. This article reports a series of unusual clinical presentations of the tumour in Northeastern Nigeria. METHODS: This is a prospective study carried out from September 2003 to August 2005, at the University of Maiduguri Teaching Hospital, Borno State, Northeastern Nigeria. RESULTS: 20 cases of histologically-confirmed KS were prospectively studied. There were 17 (85 percent) men and three (15 percent) women, giving a male to female ratio of 5.7:1. Their ages ranged from 21-45 (median 37) years. 18 (90 percent) of the patients were anaemic. Mean haematocrit value, CD4+ cell count and duration of symptoms for all the patients were 29.5 +/- 7.5 percent, 119.0 +/- 91.4 cells per microlitre and 3.5 +/-1.7 months, respectively. Multiple lesions were a common presentation affecting sites such as lower limbs, trunk, conjunctiva, upper limbs and rectum as well as penis, lymph node, scrotum and oropharynx. CONCLUSION: Contrary to other reports that KS is not associated with HIV infection, our study has demonstrated otherwise. This study also showed that both sexes are affected but with a male preponderance. KS is also a late presentation of the HIV/AIDS disease spectrum in our environment and has varied clinical manifestations. There is an urgent need to develop health education programmes to enhance the understanding of this disease and how it spreads, particularly among the young generation.