An Audit of Malignant Oro-facial Tumors Presenting at a Tertiary Hospital in Lagos.

Oro-facial malignancies are reported to have a high mortality and morbidity, this is further worsened when patient report late. To analyze the malignant oro-facial lesions seen at a Hospital in the Lagos, Nigeria. Successive patients that presented in the hospital and met criteria of study during 15 months period were recruited into the study. Demographics, clinical variables, and treatment provided for each patient in the hospital was recorded. Data collected were presented as tables and percentages. There were 36 cases seen, their ages ranged from 10 to 72 years (median 49 years), and there were 21 males and 15 females. Time lapse before presentation to the clinic ranged from 2 to 30 months, mean (9.9 (±5.5 months and the largest dimension of lesions at presentation ranged from 2 cm to 12 cm (mean 6.4 ± 2.0 cm). Most common site of presentation was posterior tongue (16.7%; 6/36) and Squamous cell carcinoma (41.6%; 15/36) was the most common histopathologic diagnosis. Twenty-three patients (63.9%; 23/36) had primary surgeries in the hospital. Patients seen in this case series generally reported late with large lesions.

Pattern of presentation and management of lip injuries in a Nigerian hospital.

AIM: Human lip injuries, although uncommon, present major challenges in terms of reconstructive options and the outcome of surgical management. The reconstructive techniques are usually varied but the ultimate objectives of treatment are to achieve healing, function, and aesthetics. The aim of this study was to report the etiology, pattern of presentation, and surgical management of lip injuries in Lagos University Teaching Hospital (LUTH). MATERIALS AND METHODS: A prospective study of consecutive cases of lip injury was conducted at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital. Data collected included age and sex of patients, etiology, pattern of presentation, and surgical techniques of repair. RESULTS: A total of 13 patients with lip injury to the lip were included in the study (M = 6, F = 7). Human bite (11 cases) was the most common cause of injury followed by electric burns (2 cases). The most (81.8%) frequently affected site was the lower lip. Most patients presented within 72 hours after injury with infected wound. Treatment offered included thorough debridement and primary repair using various surgical techniques. A one-stage surgical technique was employed in all cases. Healing was uneventful in all cases and satisfactory. CONCLUSION: Most of the lip injuries in the present study were due to human bites with almost equal sex distribution. Lower lip was most commonly affected. All cases were successfully treated by debridement, broad spectrum antibiotic coverage, and one-stage surgical repair with a favorable outcome.

Oro-dental and maxillofacial trauma in epilepsy at a tertiary hospital in Lagos.

BACKGROUND: Seizure-related injuries are common and are a major cause of morbidity in subjects with epilepsy. OBJECTIVE: To determine the frequency and types of oro-facial injuries in epileptic patients attending a tertiary hospital. METHODS: A structured questionnaire was used to obtain information about injuries to the oral and maxillofacial region in epileptic patients at the Neurology Clinic of the Lagos University Teaching Hospital over a period of two years. Information sought included patient's sociodemographics, type of seizure, self-management of seizures, and history of injuries during seizures. RESULTS: Of the 138 epileptic patients seen, 87 (63.0%) reported the occurrence of oral and maxillofacial injuries. Mean age of these patients (29.6±12.1 years) was not significantly different from that of those who had no injuries (33.5±15.6 years). Prevalence of seizure-related injuries was not significantly different in males and females (50 [58.8%] vs 37 [71.2%]). Injuries were more likely in those who had convulsive seizures than in those who had non-convulsive seizures. Patients who had hard objects forced between their clenched teeth during seizure episodes were more likely to sustain injuries. Soft tissue injuries were more common than injuries to the facial bones and teeth. Of these, the tongue was the most commonly injured. Majority of those with soft tissue injuries did not receive treatment in hospital. Although fractures of the cheek and jaw bones were not so common, all such cases received surgical treatment in hospital. CONCLUSION: A high proportion of epileptic patients in Lagos appear to suffer seizure-related oro-facial injuries. Measures for the prevention and management of these injuries are needed to help reduce the morbidity caused by such injuries.

Clinicopathological characteristics of odontogenic myxoma in Nigerians.

BACKGROUND: Odontogenic myxoma (OM) is a locally aggressive neoplasm whose clinicopathological characteristics have not been extensively reported in Nigerians. OBJECTIVE: To describe the clinicopathological characteristics of cases of OM seen at the Lagos University Teaching Hospital in Nigeria. METHODS: A review of both clinical and histopathological records of sixty-three cases of OM diagnosed over a period of thirty-seven years was undertaken. The cases were analyzed for age, sex, site, size, duration and histological contents of collagenization, odontogenic epithelium and calcification. RESULTS: Odontogenic myxoma represented 63(11.2%) cases of odontogenic tumours, was commonest in the second to forth decades and rare below age 10 and above 70 years. It was more common in females. Maxillary lesions were more common with respect to both central and peripheral histologic types, but occurred in equal frequencies in mandible and maxilla with respect to the central histologic type. Forty-seven (74.6%) cases were fibromyxoma and sixteen (25.4%) myxoma. Odontogenic epithelium was rare and observed in 5 (9.5%) cases while calcific material was present in sixteen (25.4%) cases. Late presentation was a common feature and surgical excision was the treatment of choice. CONCLUSION: Odontogenic myxoma is un-common among Nigerians when compared with ameloblastoma. Clinicopathological characteristics in this series are similar to information in the scientific literature.

Public and professional perception of oral and maxillofacial surgery (a pilot study).

BACKGROUND: In the advanced countries, the awareness of Oral and maxillofacial surgery by both the public and medical specialties has led to rapid development and expansion of Oral and Maxillofacial surgery specialty with management of diverse and complex problems within a well defined anatomical region. In the developing countries like Nigeria, the trends are slow and this explains why majority of our patients present at very late stage when only palliative measures are the option. OBJECTIVE: The study aims to assess the level of public and professional (GMP and GDP) knowledge and awareness of oral and Maxillofacial surgery specialty. DESIGN: A questionnaire was devised to assess the knowledge and awareness about the specialty of oral and maxillofacial surgery . Ninety one members of the public who were office workers, civil servants, hospital worker in Yaba local government area of Lagos state were the public respondents. The inclusion criteria was that all respondents had attained at least secondary school educational level. They were randomly chosen and had the questionnaires applied to them. Additionally, 40 General medical practitioners and 40 General dental practitioners were picked randomly from 7 local government areas of Lagos state (Yaba, Ebutte Meta, Surulere, Lagos Island, Shomolu, Kosofe and Ikeja) and the questionnaire was applied to them. RESULTS: Only 5.4% of the public had heard of oral and maxillofacial surgeon before. By comparison, the corresponding figures for ENT and plastic surgeons were 40.0% and 23.1% respectively. Only 4.4% of the public had a prior treatment by an oral and maxillofacial surgeon while 86.2% did not know what a maxillofacial surgeon does. The professionals (GMP and GDP) are quite aware of who a maxillofacial surgeon is, but are less knowledgeable of new areas/subspecialties of maxillofacial surgery such as cleft lip and palate surgery, cosmetic and orthognathic surgery, implantology, craniofacial surgery. Also general Medical Practitioners (60%) views of maxillofacial surgeons work are mainly dento-alveolar in horizon. CONCLUSION: These figures are low and it is an indication of low awareness of the specialty by the public and the professionals. While regular auditing ,publications, flow of information, leaflets about oral and maxillofacial surgery to the public, health service personnel, providers and government will improve the trends, continuous professional development Programmes (CPDP) for GDP and GMP will keep them abreast of developments in the specialty.

Alcohol, smoking and oral cancer. A 10-year retrospective study at Base Hospital, Yaba.

This paper is an attempt to document alcohol and smoking habits as risk factors in the aetiology of oral cancer. A retrospective survey of patients who presented with oral cancer at Base Hospital, Yaba (BHY) for 10 years (1987 - 1996) was carried out. Fifty eight patients were surveyed excluding those with incomplete data. There were 40 male (66%) and 18 female (33 1/3%) giving a M:F ratio of 2:1. There were 50% of the patients who were referred by hospitals and clinics, while the remaining 50% were self-referred. The maximum number of male patients with oral cancer occurred at 65-70 year age range while the corresponding figures for female was 50-60 years. A significant number of our patients, 40%, lived in rural areas and most of them presented with poor oral hygiene, oral sepsis, decayed and( missing teeth. It was noted that most of these were relations of military personnel. In the biopsy report, the most frequently diagnosed was squamos cell carcinoma, 84.6% of the total, however 7.1% of lymphoma, and 3.5% each of adenocystic carcinoma and odontogenic carcinoma were made. A case of melanoma was also recorded. From the study, alcohol consumption is a more implicated factor in the aetiology of oral cancer than tobacco, especially in patients with highest cancer incidence in floor of mouth, tongue and buccal mucosa (52.5% of cases). This perhaps shows that alcohol and tobacco has site specificity in the aetiology of oral cancer.