Clinico-Pathological Analysis of Osteomyelitis in Cancrum Oris (Noma) Patients Seen in Noma Children Hospital, Northwest Nigeria

Background: Cancrum oris is a rapid and devastating infectious disease of the orofacial region, which can be life threatening in its fulminant stage. Infection of bone (osteomyelitis) is a possible sequelae of Noma (cancrum oris) and is more likely due to late presentation especially in our environment. A literature search revealed scanty research describing osteomyelitis in Noma patients. Objective: To analyze the clinico–pathology of osteomyelitis in Noma patients diagnosed and treated at Noma Children Hospital, Sokoto. Methods: The design was a 2-year retrospective study of records of Thirty–two patients who had sequestrectomy secondary to osteomyelitis in Noma (Cancrum oris). Age, gender, jaws affected and side of involvement were analyzed Results: The age ranged from 2–11 years with mean ±standard deviation 5.47 ± 2.68 years was recorded. Osteomyelitis in Noma patients was found among 17 (53.10%) males compared to 15 (46.90%) females. In 20 (62. 50%) of the cases, anterior maxillary involvement was observed and the remaining 12 (37. 50%) was found at the mandibular posterior region and it is more common on the left side. Result of histopathology showed both acute and chronic inflammatory cells. Necrosis and bone hyperactivity was observed in most of the slides. Conclusion: Osteomyelitis is a common complication of Noma and its treatment is of paramount importance for adequate management of Noma patients. &nbsp

A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians

Introduction: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria.Methods: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran’s I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance.Results: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblas- toma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within.Conclusion: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following:  the country’s tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes.Keywords: Ameloblastoma, ethnicity, spatial analysis, Nigeria

A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians

Introduction: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria. Methods: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran\u2019s I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance. Results: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblastoma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within. Conclusion: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following: the country\u2019s tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes. DOI: https://dx.doi.org/10.4314/ahs.v19i1.44 Cite as: Adisa AO, Osayomi T, Effiom OA, Kolude B, Lawal AO, Soyele OO, et al. A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians. Afri Health Sci. 2019;19(1). 1677-1686. https://dx.doi.org/10.4314/ ahs. v19i1.4

Oral health-related quality of life following third molar surgery in an African population

Introduction: Surgical extraction of impacted mandibular third molars is often associated with sequelae such as postoperative pain, facial edema, and limitation in mouth opening ability. These sequelae may result in changes in the patients' lifestyle and quality of life (QoL). Aim: The aim of this study was to evaluate the effect of surgical extraction of impacted mandibular third molars on patients' QoL in the immediate postoperative period (7 days). Materials and Methods: Ethical approval for this study was obtained from the Health Research and Ethics committee of the Lagos University Teaching Hospital. A total of 124 individuals with impacted mandibular third molars, who satisfied the inclusion criteria and consented to participate in this study, were included. The Oral Health Impact Profile-14 (OHIP-14) QoL questionnaire was used to assess QoL. QoL was assessed preoperatively (baseline) and on postoperative days (PODs) 1, 3, and 7. Maximal interincisal mouth opening, facial width, and pain were also reviewed at all evaluation points. Data analysis was done using the Statistical Package for Social Sciences (SPSS) for Windows (version 16.0, Chicago, IL, USA). Results: A total of 124 individuals were included in the final analysis. An age range of 18–51 years with a mean (±standard deviation) of 28.5 (7.4) years was observed. A male to female ratio of 1:1.5 was observed. The most frequently encountered type of impaction was the mesioangular impaction 51 (41.1%) and recurrent pericoronitis was the principal reason for extraction 53 (42.7%). The severity of the sequelae (pain, trismus, and facial edema) was maximal on the first POD. Patients' overall QoL deteriorated sharply on the first POD and subsequently improved. Conclusion: Surgical extraction of mandibular third molars is associated with worsening of patients' postoperative QoL in the immediate postoperative period. Prospective patients should be informed about this, and ways of reducing this untoward effect should be explored

A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria

Abstract Background There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery. Methods A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software. Results One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)]. Conclusion Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted

Oral and maxillofacial malignancies: An analysis of 77 cases seen at an academic medical hospital

Introduction: Oral and maxillofacial malignancies (OMMs) consist of a wide range of lesions, which constitute varying proportions of the total incidence of malignancies in the human population. Available epidemiological data vary across racial, geographical, gender, and occupational divides. They are often associated with significant impairment of patients' quality of life. Materials and Methods: A review of hospital records of patients with histologically diagnosed primary OMM, who presented to the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, over a 5-year period, was done. Data including age, gender, site, and type of tumor, and histological grade of tumor were retrieved and analyzed with the SPSS version 20.0. Results: A total of 77 cases of OMMs were identified with a male/female ratio of 1:1.03. The mean (±standard deviation) age was 50.1 (17.8) years. Squamous cell carcinoma was the most frequently seen epithelial malignancy constituting 35.1% of all malignancies, with most patients in advanced stages of the disease. Osteosarcoma was the most frequently diagnosed sarcoma, constituting 11.7% of all malignancies seen. Salivary gland malignancies constituted 29 (37.7%). Other malignancies seen include, malignant peripheral nerve sheath tumor, leiomyosarcoma, and malignant melanoma. Conclusion: OMMs constitute a significant health burden in our region. Thus, adequate resources should be allocated toward improving awareness among the populace. Policy shifts and regular dental visits which may increase the likelihood of early intervention should be instituted

Rare etiological factor of maxillofacial injury: Case series seen and managed in a tertiary referral centre

Entanglement injury from local milling/grinding machine with a conveyor belt is a rare etiology of maxillofacial injuries. While there is abundant literature on industrial cause of trauma, entanglement injury as a mechanism has not been reported in the literature. We present two cases of maxillofacial injury secondary to entanglement of the loose apparel into the conveyor belt of the local grinding machine. The community should be aware of this rare cause of trauma, and adequate protection of children using these facilities should be enforced. One of such measure is to provide physical barriers to guard against these machines

Maxillectomy defects - to reconstruct or not? Pilot survey of Nigerian oral and maxillofacial surgeons

Background: The choice of reconstruction options for maxillectomy defects varies significantly. Factors affecting it range from the type of defect to the surgeon's expertise. This study aims to evaluate the practice of Nigerian Oral and Maxillofacial surgeons in the reconstruction of post-maxillectomy defects. Materials and Methods: The survey was conducted by use of questionnaires administered at the annual scientific meeting of the oral and maxillofacial surgeons of Nigeria in Ibadan 2012. Results: A response rate of 66.7% was achieved. All of our respondents are consultant oral and maxillofacial surgeons, 80% of whom practice in a teaching hospital. All but one of them perform maxillectomies, however only 25% of them offer surgical reconstruction of the resulting defects to patients. Flaps have been used by 25% of the respondents, while none of them has employed microvascular reconstruction. Prosthetic rehabilitation of patients is pervasive among the respondents. Conclusion: Maxillectomy defects have far-reaching consequences on patients' quality of life and attempts should be made to reconstruct such defects. Although maxillectomy is a commonly performed procedure among oral and maxillofacial surgeons in Nigeria, especially for malignancies of the oral and paranasal sinuses, surgical reconstruction of resulting defects is not so frequently done. Microvascular surgery, which is becoming a frequently utilized option among surgeons in developed nations, is still infrequently used in our environment. There is a need for oral and maxillofacial surgeons in our climes to improve their skills so as to increase the range of reconstructive options offered

Pleomorphic adenoma of the upper lip: A case report

Pleomorphic adenoma is the most frequently encountered benign mixed tumor of the minor salivary gland and usually presents in the parotid; however, in the minor salivary gland, it is more common in the palate. Tumors of the minor salivary glands are uncommon, with the most common intraoral site reported being the hard and soft palate owing to the preponderance of minor salivary glands in this region followed by the lips. Pleomorphic adenoma arising from minor salivary glands of the lips tends to occur at an earlier age than it does at other sites. Pleomorphic adenoma of the lip is a rare neoplasm, and thus its diagnosis requires a high index of suspicion and a long-term follow-up. Here, the authors present a case of pleomorphic adenoma of the upper lip