Retrospective review of soft tissue sarcoma of head and neck in a West African hospital

Background: Soft tissue sarcomas like other malignancies, impact negatively on patients and their caregivers as well as pose a challenge to the managing physician with variable treatment outcomes. A review of related studies on Medline has shown the paucity of the literature on the disease in the West African sub-region. This study was designed to determine the prevalence and highlight the clinicopathologic features of soft tissue sarcomas managed at a tertiary health institution in West Africa.Methods: A 12-year retrospective review of medical records of patients managed with head and neck sarcomas at the University College Hospital, Ibadan, Nigeria was carried out.Results: There were 18 patients [12 (66.7%) males & 6 (33.3%) females]; ages ranging from 3 to 58 years. 16.7% of patients was children. The mean duration of symptoms was 10.5 months. The clinical presentation depended on the involved anatomical location and the most common anatomical location was the sinonasal region. Fourteen (77.8%) patients presented at advanced disease stage. Eight histologic sub-types were identified and rhabdomyosarcoma accounted for 44.4%. The treatment outcome was poor.Conclusion: Head and neck sarcomas are rare in West Africa. They have heterogeneous histologic sub-types which may involve different anatomic sites. Although the prognoses of some sarcomas of the head and neck are poor due to their biological behaviours, late stage disease presentation might have contributed to the worse management outcome seen in this study.Keywords: Clinicopathology; Head–neck; Sarcomas; Soft tissue; Tumours; West Afric

Factors contributing to poor management outcome of sinonasal malignancies in south-west Nigeria

Objective: To describe the clinico-pathologic manifestations of sinonasal malignancies, identify the contributing factors to delay in presentation and recommend ways of preventing them in a resource challenged environment.Design: A questionnaire based cross sectional descriptive study of patients with sinonasal malignancies between 2006 and 2011.Setting: Hospital based study at the Otorhinolaryngology Department, University College Hospital, Ibadan.Participants: 61 patients diagnosed with sinonasal malignancies Main outcome measures: Patients demographic and essential medical data were collected with a structured, interviewer assisted questionnaire and results analysed using descriptive statistics.Results: There were 28(45.9%) males and 33(54.I %) females; mean age 37years. The common presentations were epistaxis, nasal obstruction and facial asymmetry and 96.7% patients with squamous cell carcinoma presented in advanced disease stage (Stage 3 & 4). Over 47% patients presented a year after onset of symptoms. Factors which included  self-medication, wrong advice from relations/ friends to consult traditional  herbalist or quacks for treatment and traditional & religious beliefscontributed to delay in presentation to hospitals. High cost of medical treatment, unwelcoming attitudes of some hospital staff, lack of confidence in orthodox medicine and proximity to health facilities were reasons given for not considering hospital as the first place to seek medical treatment.Conclusion: Health education to create awareness of sinonasal malignancies and provision of affordable and accessible health facilities especially in rural areas are recommended ways to encourage patients to present early in hospitals. This will improve the management outcome and quality of life of patients with sinonasal malignancies.Keywords: Delayed presentation, Health care services, Outcome, Sinonasal malignancie

Case Report Rhinosinusitis; A Potential hazard of Nasogastric tube insertion

The nasogastric tube has been used frequently for enteral feeding and as anintranasal oxygen catheter. This practice is however associated with complications. We present a case of rhinosinusitis and sepsis in a diabeticpatient following the insertion of a nasogastric tube. Physicians should be aware of sinusitis as a possible cause of sepsis in patients with nasogastric tube insertion.Key words: Rhinosinusitis, Nasogastric Tub

Synchronous congenital nasal piriform aperture stenosis and atresia : A rare accompaniment of mid-facial dystosis and cause of neonatal upper airway obstruction

Congenital nasal piriform aperture stenosis (CNPAS) is a recently distinguished clinical entity that causes airway compromise in neonate as a result of a narrowing of the nasal piriform aperture. It may be bilateral or unilateral. Often considered as a form of holoprosencaphaly. Being the narrowest part of the nasal airway, any slight reduction in its cross sectional area will profoundly increase the nasal airway resistance with the attendant clinical challenges. Readily making an accurate clinical diagnosis may be very challenging when CNPAS occurs in the setting of a craniofacial dysostosis. This communiqué is aimed at increasing awareness among clinicians involved in paediatric care of the clinical entity congenital nasal piriform aperture stenosis and atresia presenting atypically as synchronous disorder with midfacial dysostosis. Hence, it should be kept in mind as a rare mimicker of bilateral choanal atresia and requires mandatory high resolution computerized tomography to confirm the diagnosis

Foreign body in the Nasopharynx mimicking an obstructive adenoid

Foreign body in the nasopharynx is not a day-to-day experience in any Ear, Nose and Throat clinic as opposed to foreign bodies in the ear or nose. We present a case of food lodgment (piece of yam-dascorial) in the nasopharynx of a 2-year old male child. This was ignorantly dislodged into his nasopharynx by finger sweep procedure by the mother when the child chocked during feeding.Jos Journal of Medicine, Volume 7 No.

Clinico-pathological profile of sinonasal masses: an experience in national ear care center Kaduna, Nigeria

<p>Abstract</p> <p>Background</p> <p>The presence of a mass in the nose and paranasal sinuses may seem to be a simple problem; however it raises many questions about the differential diagnosis. The aim of this study is to evaluate the clinico-pathological profile of sinonasal masses in our environment</p> <p>This is a retrospective analytical review of all the patients with sinonasal masses that presented to the national ear care center, Kaduna over a six year (2003-2008) period. Their biodata, clinical profile and histological diagnoses were analyzed.</p> <p>Findings</p> <p>A total of 76 patients were analyzed, age range 5 to 64 yrs with a mean age of 33.3 yr median and modal age of 35.00 (SD = 13.1 ± 1.5). Majority of the patients were in the age groups 21-50 yrs. There were 34 male and 42 female with M: F ratio of 1:1.2. The main presenting symptoms are nasal blockage 97.4% and rhinorrhea 94.7%. It was bilateral in 34 (44.7%), left side in 24(31.6%) and right side in 18(23.7%) patients. The commonest clinical diagnoses were simple nasal polyp 47(61.8%) and antrochoanal polyp 10(13.2%). About 59 (77.6%) were benign, 2 (2.6%) were malignant and 15 (19.7%) were lost to follow up. The commonest histological diagnosis is simple inflammatory nasal polyp in 28 (36.8%) patients and the least was nasal capillary hemangioma 2 (2.6%). About 55(72.4%) patients had surgical treatment.</p> <p>Conclusions</p> <p>Nasal obstruction and rhinorrhea are the commonest symptoms of presentation, simple inflammatory nasal polyp is still the commonest histological pattern seen in our environment, and surgery is still the best modality of treatment for benign tumor thus the need for advocacy for early recognition and referral to the ENT surgeon.</p

The value of spreader grafts in rhinoplasty: a critical review

The value of spreader grafts in rhinoplasty cannot be underestimated. Various studies have demonstrated that they play a valuable role in the restoration of nasal dorsum aesthetics, provide support for the nasal valve and maintain the straightened position of the corrected deviated cartilaginous septal dorsum. However, there is still controversy on the extent of its value in nasal patency. This study reviews the literature and describes the values and limitations of spreader grafts in rhinoplasty and the alternatives to classic spreader grafts

Nasal polyps - clinical profile and management in Ibadan, Nigeria

Background: Nasal polyps are benign mucosal protrusions into the nasal cavity of multifactorial origin and are characterized by chronic mucosal inflammation. They result from the prolapsed lining of the ethmoid sinuses and block the nose to a variable degree depending on their sizes. This study aims to evaluate the clinical profile and management of nasal polyposis as seen in Ibadan, Nigeria. Method: A 5-year (1998-2002) prospective study of 63 nasal polyposis patients depicting the clinical profile and implications was done at the department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria. Results: There were 38(60%) males and 25(40%) females with M: F of 1.5:1 and with an average age of 34 years. The duration of symptoms ranged from 2months –14years with an average occurrence of 12 new cases a year. The main clinical presentations were nasal obstruction 95%, nasal discharge 81%, sneezing 59% and observed nasal polyps 78%. The polyps were found in the right nasal 16%, left nasal 25% while bilateral 37%. The rest were of antro-choanal polyps 22%. Polyps from ethmoidal region constituted 88% while from lateral nasal wall 12%. Treatment is a combination of surgery and medical therapy with topical corticosteroids. Eighty-Seven percent (87%) of the cases had surgical treatment; simple polypectomies 67%, Caldwell-Luc's operations 15%, and external ethmoidectomies 13% while internal ethmoidectomies 5%. The hospital stay ranged from 1- 6 weeks with recurrence rate of 13% and onset of recurrence ranged from 2 weeks – 4 years. Conclusion: Whatever therapeutic regimen is used nasal polyps are a chronic common condition in which their cause remain unknown, are prone to recurrence and in some cases with embarrassing frequencies. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 164-16