Nasal Rhinosporidiosis: A Case Report And Outcome Of Therapy With Fluconazole

Background: Rhinosporidiosis is a rare disease in Nigeria. Its is widely believed to be caused by a fungus but this is disputed by many. Recent proof suggests that Rhinosporidiosis is caused by a cyanobacterium Study design: This is a clinical case report. Results: A 27-year old Nigerian male presented with an endonasal mass that mimicked neoplastic tumour. This mass showed significant good clinical response to therapy with oral fluconazole — an antifungal agent. Conclusion: This supports the likelihood of Rhinosporidiosis being of fungal aetiology or that cynobacterium is sensitive to fluconazole. Key Words: Rhinosporidiosis, fungus, cyanobacterium, fluconazole, Nigeria. Nig. J. Otorhinolaryngology Vol.1(1) 2004: 22-2

Update on the pattern of tracheostomies at a tertiary health institution after 27 years

Objective: To determine any change in the incidence, indications and complications of tracheostomy in the University of Nigeria Teaching Hospital after 27 years.Method: All tracheostomies performed in the five-year period ending December 2004 were identified from our theater records. The age and sex of the patients, rank of the surgeon, indications and complications were ascertained by retrospective case note review. The results were compared with the results of a similar work done between 1973 and 1978.Results: In the 5- year under review, 52 tracheostomies were performed, with an average of 10.4 tracheostomies per year. The age range was 11 months – 90 years. The highest incidence was in the age group of 0-20 years. Male to female ratio was 1.4:1. The commonest indication was for the relief of upper airway obstruction. The common causes of upper airway obstruction were laryngeal carcinoma and laryngeal foreign bodies. Complications occurred in 38.2% of the patients. Commonest complication was surgical emphysema. Mortality rate was 3.8%.Conclusion: There was a reduction in the frequency of tracheostomy operations (P< 0.001). Upper airway obstruction still remains the commonest indication for tracheostomy. However, acute laryngeal infection as an indication for tracheostomy in children diminished. There was no significant change in the mortality rate. Keywords: tracheostomy, incidence, indications, complications Nigerian Journal of Otorhinolaryngology Vol. 3(1) 2006: 8-1

Pattern of Otorhinolaryngology Disorders seen in Geriatric patients at a private Otorhinolaryngologic clinic in Enugu

Aims: Life expectancy among Nigerians is improving and they are living longer now than previously. This paper is about a study of the peculiar Otorhinolaryngology disorders seen among geriatric patients at Balsam Clinics, Enugu, Nigeria. Method: This is a hospital based, retrospective study for the four years 2000-2003. Result: A total of 5096 new patients attended Balsam Clinics during the study period, January 2000 to December 2003. Of these, 294 were aged 65 years and above. Ten of the 294 patients were excluded from the study because of incomplete data leaving 284 geriatric patients for the study. There were 151 males and 133 females. The most prevalent Otological disorders were presbyacusis (71), otitis media (41) impacted cerumen in external auditory canal (30) and chronic suppurative otitis media (29). The most prevalent rhinological disorders were chronic sinusitis (14), epistaxis (8), while chronic pharyngitis (7) and carcinoma larynx (6) led laryngological disorders . Conclusions: We conclude that demand for hearing rehabilitation programmes will be on the increase to improve the quality of life of these senior citizens. Key words: presbyacusis, geriatric Nigerians, Otorhinolarngology. Nigerian Journal of Otorhinolaryngology Vol.2(1) 2005: 13-1

A clinico-pathologic analysis of children with foreign bodies in the larynx in nnewi, south-east Nigeria

Objective: To share our experience with laryngeal foreign bodies in this evolving ENT unit over the past four years. To highlight the mode of clinical presentation of children with foreign bodies in the larynx and the nature of the foreign bodies encountered in our environment. To make case for high index of suspicion and prompt referral.Methodology: This was a descriptive analysis of all patients diagnosed and treated for foreign body in the larynx in our centre between May 2007 and April 2011.The medical records of the patients treated for this condition and the unit&rsquo;s operating register were analyzed retrospectively.Results: A total of sixteen (16) patients were seen with laryngeal foreign bodies over the period comprising thirteen males and three females M:F (4.3:1). Ten of the patients (87.5%) were 3 years or below, non was above 6 years. Less than half of the patients (44%) presented within the first 24 hours. Two actually presented after two months. Food items constituted (75%) of foreign bodies inhaled while the rest were various forms of non food items. Fish bones were the majority among the food items. It accounted for 58.3% of the food items and 44% of the entire foreign bodies in our series. Most of the patients presented with the triad of breathlessness, cough and hoarseness.Conclusion: A foreign body in the larynx is not an uncommon childhood condition. A high index of suspicion is advocated to encourage early referral and prompt treatment to avoid complications which could be very fatal

Treatment of pharyngocutaneous fistula acquired from incisions and drainage of deep neck space abscess in a patient with occult third branchial anomaly

Aim: To report the treatment of an extremely rare case of pharyngocutaneous fistula that resulted from incisions of deep neck space abscess in a patient with occult 3rd branchial anomaly.Methodology: clinical case report.Case report: OC is a 19-year old female who presented with 18-month history of a discharging opening in her anterior neck. This started after she had incisions and drainage of recurrent deep neck abscess three times at another health facility. We did surgical exploration to excise and close the fistula but only succeeded at the second attempt.Conclusion: We conclude that branchial apparatus anomaly whether manifest or occult should be suspected in the aetiological factor of deep neck abscess. Caution should be exercised in incising and draining recurrent deep neck space abscess to avoid facilitating formation of fistula.Keywords: brachial anomaly, deep neck space abscess, pharyngocutaneous fistula Nigerian Journal of Otorhinolaryngology Vol. 2(2) 2005: 86-8

Infantile fibrosarcoma of the parotid gland in a 6-year old female: case report and management challenges

Infantile fibrosarcoma is a rare soft tissue sarcoma that may present at any time from birth to early childhood. The parotid gland is not a common site for malignancies especially in children, and there has been no report of this disease in our environment.The aim of this publication is to report a case of this rare tumour, managed recently in our Centre, and to highlight some of the attendant challenges during the management.We present the case of a 6-year old female child with infantile fibrosarcoma of the left parotid gland and subtle left facial palsy &ndash; probably the first in Nigeria; emphasizing the rarity of this tumour, and the need for a high index of suspicion in making the diagnosis.Keywords: Chemotherapy, facial palsy, infantile fibrosarcoma, parotidectom