Impacted dentures in the pharynx and esophagus - Implication for advocacy.

Background: Impaction of dentures has potentially significant morbidity and management challenges. This study sought to leverage on the occurrence of swallowed dentures to advance discussions on its management and prevention. Methods: A 5-year retrospective review of patients seen on account of impacted dentures at the Ear, Nose, and Throat Department of the Korle-Bu Teaching Hospital was done. Variables obtained included age, sex, location of impacted denture, treatment done, denture type, number of teeth, and complications. Variables were analyzed, and descriptive summaries were reported. Results: There was a record of 898 cases of impacted foreign bodies which presented to the department. Fifty-five (6.1%) records were on account of impacted dentures. These consisted of 25 (45%) males and 30 (55%) females. Ranging from 23 to 98 years, the mean and median ages were 55.7 (±18.1) years and 56.5 years respectively. There were no complications, and no identifiable predisposing patient conditions. All prostheses were removable acrylic dentures, and some observations included worn-out and loose dentures, while several had their prostheses dislodging in the process of swallowing tablet medications with water. Conclusion: Swallowed dentures are not rare occurrences in Ghana. Denture wearers should, therefore, be encouraged to get professional reviews, especially when prostheses get unretentive, while dental professionals are urged to incorporate measures in their fabrication to reduce the occurrence of swallowed dentures.

Résumé Contexte: L'impaction des prothèses dentaires présente des problèmes de morbidité et de gestion potentiellement importants. Cette étude visait à tirer parti de la survenue de prothèses avalées pour faire avancer les discussions sur sa prise en charge et sa prévention. Méthodes: Une étude rétrospective sur 5 ans des patients vus en raison de prothèses impactées au service des oreilles, du nez et de la gorge de l'hôpital universitaire de Korle Bu a été réalisée. Les variables obtenues comprenaient l'âge, le sexe, l'emplacement de la prothèse incluse, le traitement effectué, le type de prothèse, le nombre de dents et les complications. Les variables ont été analysées et des résumés descriptifs ont été rapportés. Résultats: On dénombre 898 cas de corps étrangers impactés qui se sont présentés au service. Cinquante-cinq (6,1 %) dossiers concernaient des dentiers impactés. Il s'agissait de 25 (45 %) hommes et 30 (55 %) femmes. Allant de 23 à 98 ans, les âges moyen et médian étaient respectivement de 55,7 (±18,1) ans et 56,5 ans. Il n'y a eu aucune complication et aucun état prédisposant identifiable du patient. Toutes les prothèses étaient des prothèses amovibles en acrylique, et certaines observations incluaient des prothèses usées et desserrées, tandis que plusieurs avaient leurs prothèses se délogant en avalant des médicaments en comprimés avec de l'eau. Conclusion: Les dentiers avalés ne sont pas rares au Ghana. Les porteurs de prothèses dentaires devraient donc être encouragés à obtenir des examens professionnels, en particulier lorsque les prothèses deviennent non rétentives, tandis que les professionnels dentaires sont invités à intégrer des mesures dans leur fabrication pour réduire l'apparition de prothèses avalées. Mots-clés: Dentier, Œsophage, Ghana, impacté, avalé.

Genotypic Characterization of Epstein Barr Virus in Blood of Patients with Suspected Nasopharyngeal Carcinoma in Ghana.

Nasopharyngeal cancer (NPC) is associated with Epstein Barr virus (EBV) infection. However different viral strains have been implicated in NPC worldwide. This study aimed to detect and characterize EBV in patients diagnosed with NPC in Ghana. A total of 55 patients diagnosed with NPC by CT scan and endoscopy were age-matched with 53 controls without a known oncological disease. Venous blood was collected from the study participants and DNA extracted from the blood samples. Detection of EBV and genotyping were done by amplifying Epstein Barr nuclear antigen 1 (EBNA-1) and Epstein Barr nuclear antigen 2 (EBNA-2), respectively, using specific primers. Viral load in patients and controls was determined using real-time polymerase chain reaction. EBV positivity in controls (92%) was significantly greater than that of NPC patients (67%) (χ2 = 19.17, p < 0.0001), and viral infection was independent of gender (χ2 = 1.770, p = 0.1834). The predominant EBV genotypes in patients and controls were genotype 2 (52%) and genotype 1 (62%), respectively. Median EBV load was significantly higher in NPC patients than the control group (p < 0.01). In summary, prevalence of EBV genotype 2 infection was higher in NPC patients than the control group. Assessment of EBV load may be used as a biomarker for the diagnosis of NPC.

Complicated sinusitis in developing countries: an African perspective.

PURPOSE OF REVIEW: Complicated rhinosinusitis continues to be a diagnosis not to be missed because of the potential life-threatening and life-changing outcomes. This is true for clinicians in both developed and developing countries. Advances in diagnostic imaging, appropriate antibiotic use and timely surgical intervention have resulted in better outcomes particularly in the developed world. This review focuses on the current management of complicated sinusitis in resource-limited settings. RECENT FINDINGS: Recent publications indicate leaning toward endoscopic sinus surgery as a standalone procedure or in combination with traditional external approaches in the management of complicated rhinosinusitis with less morbidity and shorter recovery time. It is becoming increasingly evident that multidisciplinary specialties should be involved in the effective management of patients with complicated sinusitis. SUMMARY: Early recognition, prompt surgical intervention and antibiotic therapy remain keys in the management of complicated rhinosinusitis. In many African countries and other developing countries, the absence of specialized imaging and endoscopic diagnostic equipment and endoscopic surgical facilities and expertise means that reliance must be placed on clinical acumen both for diagnosis and monitoring of treatment response of complicated sinus infections.