Day case adenotonsiletomy: experience of two private clinics in Nigeria.

BACKGROUND: adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy. METHODOLOGY: All pediatrics cases requiring adenoidectomy, tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery-ASA grade I or II for general anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others. RESULTS: A total number of 144 patients requiring adenoidectomy Tonsillectomy or both were seen at the study centers with only sixty six (45.8%) meeting the inclusion criteria. Adenoidectomy constituted 47% of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5%) of the patient, the other complications were non-persistent vomiting 13 (19.7%), low grade fever 5 (7.6%) and pain at time of discharge 23 (34.8%). There were no fatalities. CONCLUSION: The complication rates were low. Day-case Adenoidectomy/tonsillectomy or adenotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/post recovery as this as this had a soothing/calming effect on the patient/s.

Day case adenotonsiletomy: experience of two private clinics in Nigeria

Background: adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy. Methodology: All pediatrics cases requiring adenoidectomy; tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery- ASA grade I or II for general Anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others. Results: A total number of 144 patients requiring adenoidectomy; Tonsillectomy or both were seen at the study centers with only sixty six (45.8) meeting the inclusion criteria. Adenoidectomy constituted 47of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5) of the patient. the other complications Were non-persistent vomiting 13 (19.7); low grade fever 5 (7.6) and pain at time of discharge 23 (34.8). There were no fatalities. Conclusion: The complication rates were low. Day-case Adenoidectomy/tonsillectomy or denotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/ post recovery as this as this had a soothing/calming effect on the patient/s

Otoscopy compared with tympanometry: an evaluation of the accuracy of simple otoscopy.

BACKGROUND: Although otoscopy has been shown to compare favourably with results of tympanometry the actual diagnostic value of otoscopy for otitis media with effusion (OME) has not been evaluated in Nigeria. The study was aimed at evaluating the sensitivity, specificity and predictive value of otoscopy in the diagnosis of OME as compared with tympanometry. METHOD: It was a prospective hospital-based, descriptive cross-sectional study in which the results of simple otoscopy were compared with results of the tympanometry of 82 ears of children aged between 6 months and 12 years, who presented to the Otolaryngology clinics of the UNTH Enugu with symptoms of obstructive adenoid enlargement. RESULTS: Simple otoscopy produced 84.4% agreement with tympanometry in detecting OME. The agreement was better in older children than the younger ones (P < 0.05). Simple otoscopy was more specific in detecting ears considered normal than abnormal ears. Among the abnormal ears, otoscopy was more sensitive in its detection of OME than negative middle ear pressure. Retraction of the tympanic membrane was the most specific otologic finding in detection of OME. CONCLUSION: Simple otoscopy is comparable to the accuracy of tympanometry in the diagnosis of OME.

Otoscopy Compared with Tympanometry: An Evaluation of the Accuracy of Simple Otoscopy

Background: Although otoscopy has been shown to compare favourably with results of tympanometry; the actual diagnostic value of otoscopy for otitis media with effusion (OME) has not been evaluated in Nigeria. The study was aimed at evaluating the sensitivity; specificity and predictive value of otoscopy in the diagnosis of OME as compared with tympanometry. Method: It was a prospective hospital-based; descriptive cross-sectional study in which the results of simple otoscopy were compared with results of the tympanometry of 82 ears of children aged between 6 months and 12 years; who presented to the Otolaryngology clinics of the UNTH Enugu with symptoms of obstructive adenoid enlargement. Results: Simple otoscopy produced 84.4agreement with tympanometry in detecting OME. The agreement was better in older children than the younger ones (P

Otoscopy Compared With Tympanometry: An Evalluation of the Accuracy of Simple Otoscopy

Background:Although otoscopy has been shown to compare favourably with results of tympanometry; the actual diagnostic value of otoscopy for otitis media with effusion (OME) has not been evaluated in Nigeria. The study was aimed at evaluating the sensitivity; specificity and predictive value of otoscopy in the diagnosis of OME as compared with tympanometry. Method: It was a prospective hospital-based; descriptive cross-sectional study in which the results of simple otoscopy were compared with results of the tympanometry of 82 ears of children aged between 6 months and 12 years; who presented to the Otolaryngology clinics of the UNTH Enugu with symptoms of obstructive adenoid enlargement. Results: Simple otoscopy produced 84.4agreement with tympanometry in detecting OME. The agreement was better in older children than the younger ones (P

Tobacco-pouch suture technique for the treatment of vascular lesions of the lip in Enugu, Nigeria.

We present the clinical findings and treatment of haemangiomas and arteriovenous malformations only, although many other vascular lesions affect the lip. We used simple clinical findings for our diagnosis and treated our patients by applying the Tabaksbeutelnaht (tobacco-pouch suture) technique to encircle the tumour and strangle it. Subsequently 10% saline (2-3 ml), which acted as a sclerosant, was injected into the tumour. Despite the absence of advanced imaging techniques and limited options for treatment, we achieved total success and good cosmetic results in 13 patients. This may be an effective therapeutic alternative to expensive methods used in developed countries and may be emulated by maxillofacial surgeons in poorer countries.

A blind parallel comparative study of the efficacy and safety of rovamycin versus augmentin in the treatment of acute otitis media.

A single blind randontised controlled parallel clinical trial of Rovamycin was conducted in which (Rovamycin Rhone-Poulenc Rorer) was compared with Augmentin in patients with acute otitis media. Forty patients were randomised to treatment with either Rovamycin or Augmentin and the drugs were evaluated for efficacy and safety. The efficacy parameters used were fever clearance, symptom clearance and cure rate after 8 days of treatment Our study showed that fever regressed in 19 (95%) of the 20 patients in both groups; otalgia in 19 (95) patients for the Augmentin and 18 (90%) for Rovamycin after 8 days of application of the trial drugs in these parameters. There was also no significant difference between them in their safety and tolerability profiles. These results showed that Rovamycin is a useful addition to our armamentarium in the fight against bacterial otitis media. Operationally, Rovamycin has an advantage over Augmentin for the reason that is given only twice a day as against thrice-daily dosage f orAugmentin. Compliance and consequently effectiveness in practices should therefore be better for Rovamycin.

Otomycosis in Nigeria: treatment with mercurochrome.

Seventy-two mycologically proven cases of otomycosis (38 males, 34 females) aged 8-80 years were investigated. Aspergillus niger was the commonest aetiological agent (43.1%) followed by Candida spp. (22.2%), A. flavus (19.4%) and A. fumigatus (15.3%). Three topical drugs, namely mercurochrome, clotrimazole and locacorten-vioform, were evaluated for otomycosis therapy in separate groups of 24 patients each. Mercurochrome was found to be the most efficacious in terms of healing, relief from symptoms of the disease and production of negative fungal cultures. Mercurochrome is recommended as a safe and economical drug for the topical treatment of otomycosis in developing countries like Nigeria.