Nonmicroscopic reconstruction of subtotally amputated/torn auricles: Report of 3 cases

Otolaryngologists are increasingly expected to perform a variety of minor surgical procedures in both elective and emergency situations. Surgical repair of the subtotally amputated/torn auricle, hitherto the realm of plastic surgeons, is a procedure that can be performed both at the clinic and in the emergency room, thereby sparing patients the inconvenience and cost of referral to another subspecialist. Presented in this article are 3 cases of traumatic tearing/amputation of the external ear: 1 caused by a motorbike accident, 1 caused by a human bite, and 1 by a machete. All three ears were successfully reconstructed nonmicrovascularly

Penetrated Arrow Shot Injury in Anterior Neck

Background: Although gunshot injuries are the most common penetrating anterior neck injuries in the developed world, this finding is not the case in the developing world, where knives, spears, arrows, and machetes are the preferred weapons, particularly in tribal societies. Aim: To present the case report of a patient with arrow shot injury to the anterior neck. Method: A 48 year old cattle rearer in a village in northern part of Nigeria presented with 3 hr history of an arrow shot in anterior part of the neck which he sustained the while trying to prevent some armed robbers from stealing his cow. There was scanty bleeding from the site with the arrow in-situ sealing the wound. Result: The entrance point of the arrow, about 1 cm in diameter, was just at the anterior border of the right sternocleidomastoid muscle; about 4 cm above the medial end of the right clavicle. There was a small skin bruise with slight swelling and tenderness around the opening but no active bleeding and no crepitus. Conclusion: Penetrating neck trauma from arrow shot may lead to potentially life-threatening injuries. A prompt diagnosis, a systematic treatment protocol, and an experienced trauma team are necessary to prevent a potential catastroph. (Int J Biomed Sci 2011; 7 (1): 77-80

Cotton bud: usage, presentation, complications, and management among otorhinolaryngology patients

AIMS AND OBJECTIVES: Cotton bud usage is a common bad health practice among many patients despite associated complications. This study aimed at determining the cotton bud: usage, presentation, complications, and management among otorhinolaryngology patients in developing country. MATERIALS AND METHODS: This is a prospective hospital-based study of cotton bud usage. The study was carried out over a period 6 months between June and November 2017. Verbal consent was obtained from consented patients. Interview-assisted questionnaire was administered to obtain data. Data obtained were collated and statistically analyzed by using SPSS version 16. RESULTS: Prevalence of cotton bud usage was 83.4%. There were 45.7% male respondents and male to female ratio of 1:1. Common reasons for cotton bud usage were personal hygiene in 25.5%, itching in 23.9%, water in ear in 11.7%, and dirty/earwax in 11.3%. Cotton bud usage for ear cleaning was by self in 54.6%, parent in 32.8%, friend in 6.7%, and spouse in 5.8%. Bilateral ears were most commonly cleaned by cotton bud in 57.1%. The right ear in 25.2% was more common than left ear in 17.8%. No complications were in 37.7%. There were 28.2% injury to external ear, 23.9% impacted cotton bud, and 10.1% traumatic perforated tympanic membrane. On patients’ understanding on danger of cotton bud usage, dangerous, not dangerous, and not sure were 28.5, 60.4, and 11.1%, respectively. Common clinical features were earache, itching, hearing loss, and dirty/earwax 33.7, 19.6, 19.0, and 18.7%, respectively. Long-time (chronic) cotton bud usage accounted for 63.8% while short-time (acute) ear cleaning accounted for 36.2%. Frequency of cotton bud usage in these patients was daily in 54.9%, weekly in 20.9%, monthly in 4.9%, and occasionally in 19.3%. The most common diagnosis of cotton bud usage was personal hygiene in 25.5%. Other diagnosis of cotton bud usage was allergy in 18.7%, otitis externa in 18.1%, earwax impaction in 13.2% foreign body impaction in 11.3%, and hearing impairment in 8.3%. No information, information from family, and information from neighborhood were 31.6, 43.6, and 24.8%, respectively. Treatments offered were health education in all the patients, conservative/medical treatment in 88.7%, and cotton bud removal in 11.3%

An Impacted Denture in the Hypopharynx - A Quick Intervention Reduces Morbidity

A 32-year-old male police officer was brought to Accidents and Emergencies on account of ingestion of a denture while trying to drink his medications, 4 hours prior to presentation in our facilities. He reported immediate painful distress, a choking sensation, cough and mild difficulty in breathing. A plain radiograph showed opacification with increased prevertebral soft tissue shadow in the region of C4-C5 of the hypopharynx. The emergency examination was conducted under general anaesthesia and the foreign body was extracted from the throat. Immediate post-operative condition was satisfactory. This case is reported to demonstrate the importance of properly anchoring artificial dentures, and as a reminder to people with artificial dentures to exercise caution when taking medications. Early presentation and quick intervention, as described in this case study, are vital to prevent serious morbidity which may occur as a result of such a condition

Traumatic Tympanic Membrane perforation: An aetiological profile

<p>Abstract</p> <p>Background</p> <p>Traumatic perforation of the tympanic membrane may be due to direct or indirect source. The aim of the study is to profile the various aetiologies of traumatic tympanic membrane perforation in Ilorin, north central Nigeria.</p> <p>A retrospective review of 64 patients seen at the University of Ilorin Teaching hospital, Ilorin, Nigeria over a ten year period (January 1998 to Dec 2007) with history of traumatic tympanic membrane perforation from various causes, these also included multiply injured patients with bleeding from middle ear as part of their presentations. The data retrieved included the biodata, the clinical presentations, source of injury, the clinical findings and the treatment outcome. The data were entered into an SPSS version 11 computer soft ware and analyzed descriptively.</p> <p>Findings</p> <p>Sixty four (64) ears were analysed, Age range 6 months to 50 yrs, mean age of 29.2 yrs 7.9% of them were ≤5 years, 29.7% between 21-34 years, and 37.7% were 35 years and above. The male to female ratio was 2.5:1.0. Commonest aetiology was from slaps, then road traffic injury (RTI) in 35.9% and 23.5%, Majority of the slap injury were from fights (30.5%), security agents, senior students and cultists at schools (17.4% each). Sudden hearing loss was a typical presentation (95.3%), majority of the patient defaulted from follow up once the symptoms of bleeding and pain subsided. Only 7.8% had neomembrane formation on follow up</p> <p>Conclusion</p> <p>Traumatic perforation of the tympanic membrane is an uncommon injury that is under-reported, there is the need to educate on alternative punitive measure among students and security agents, unskilled removal of foreign body, early identification, evaluation and referral of patients reduces the attendant morbidity.</p

Immunotherapy for head and neck cancers

Head and neck squamous cell carcinoma (HNSCC) is a frequent tumour which arises from various anatomical areas in the head and neck region. HNSCC has multiple resistance mechanisms through which it evades the immune responses. It is particularly characterized by an immunosuppressive environment which includes the release of immunosuppressive factors, expansion, and expansion of immune cells which have inhibitory activity reduction of tumour immunogenicity. Human papillomavirus positive (HPV+) HNSCC tumours have one of the higher levels of T cells infiltration. Studies which explore this relationship to the prognosis of patients vary, with some showing benefit only with high CD8/Treg ratio as seen with HPV+ disease and others showing improved prognosis with a higher number of TIL Treg. High CD8+ TIL seen in HPV + disease has been shown in several studies to confer improved disease-free survival. The most successful vaccination strategy is preventive vaccination for HPV. Investigations using different approaches have been carried out on therapeutic vaccines for HPV-associated HNSCC. Despite immune responses being seen in a number of studies, these vaccines are still not effective for clinical use as of ye

Oro-cranial penetrating pencil injury

Oro-cranial penetrating injuries are often seen in ear, nose and throat practices. Cases of penetrated pencil injuries are rarely reported despite being common in the developing world. A 7-year-old boy referred from a neighboring hospital was playing at school with the sharp end of a pencil in his mouth when he was pushed from behind by another child. He fell on his face and the sharp end of the pencil penetrated his throat with the distal end hanging out. There was no bleeding at presentation, as the pencil completely sealed the entrance point. The entrance point was at the posterior wall of the oropharynx corresponding to the uvulo-palatine junction. It penetrated posterosuperiorly through the soft tissue to reach the anterior part of the posterior cranial fossa. Since sharp and pointed objects in the upper aerodigestive tract can result in potentially fatal complications, prompt diagnosis, a systematic treatment protocol, and an experienced trauma team are necessary to prevent a potential catastroph

Epidemilogical Profile of Speech and Language Disorder in North Central Nigeria

Background: Speech-language pathologists/Otolaryngologists recognize high prevalence of speech and language disorder among children. The aim of the study is to find out the epidemiological profile of speech and language disorder in north central Nigeria. Method: A five year retrospective review of all referral to speech and language therapy unit ENT Department between January 2005 and December 2009. Information retrieved and analysed included bio-data, clinical presentation and diagnosis of the patients.Descriptive analysis of these data were done. Results: A total of 146 patients were seen out of which 89 (61%) were under five, 32 (21.9%) were between 5-10 years, 20 (13.7%) in the range of 11-20 yrs and 2 (1.4%) were between 21-34 yrs. None was observed in the elderly. Male preponderance was noted with male to female ratio of 1.9:1.0. The commonest diagnosis was deaf-mutism in 84 (57.5%) followed by delayed speech development in 31(21.2%) patients. The least diagnosis was aphasia in 2 (1.4%) patients. Conclusion: Speech and language disorder was commonest among the under five’s with non in the elderly, There was a higher prevalence amongst males and deaf-mutism was the commonest observed

Traumatic Tympanic Membrane perforation: An aetiological profile

Background: Traumatic perforation of the tympanic membrane may be due to direct or indirect source. The aim of the study is to profile the various aetiologies of traumatic tympanic membrane perforation in Ilorin, north central Nigeria. A retrospective review of 64 patients seen at the University of Ilorin Teaching hospital, Ilorin, Nigeria over a ten year period (January 1998 to Dec 2007) with history of traumatic tympanic membrane perforation from various causes, these also included multiply injured patients with bleeding from middle ear as part of their presentations. The data retrieved included the biodata, the clinical presentations, source of injury, the clinical findings and the treatment outcome. The data were entered into an SPSS version 11 computer soft ware and analyzed descriptively. Findings: Sixty four (64) ears were analysed, Age range 6 months to 50 yrs, mean age of 29.2 yrs 7.9% of them were ≤5 years, 29.7% between 21-34 years, and 37.7% were 35 years and above. The male to female ratio was 2.5:1.0. Commonest aetiology was from slaps, then road traffic injury (RTI) in 35.9% and 23.5%, Majority of the slap injury were from fights (30.5%), security agents, senior students and cultists at schools (17.4% each). Sudden hearing loss was a typical presentation (95.3%), majority of the patient defaulted from follow up once the symptoms of bleeding and pain subsided. Only 7.8% had neomembrane formation on follow up Conclusion: Traumatic perforation of the tympanic membrane is an uncommon injury that is under-reported, there is the need to educate on alternative punitive measure among students and security agents, unskilled removal of foreign body, early identification, evaluation and referral of patients reduces the attendant morbidit