Improvised venous canula myringostomy in acute otitis media: Analysis of outcome in Nigeris

Background: This case control study was based on the hypothesis that myringostomy done on an a bulging but inflamed tympanic membrane before perforation might improve healing of the middle ear and tympanic membrane, thus reducing the probability of progression to chronic suppurative otitis media.Our objective was to compare outcome of tympanic membrane healing in acute otitis media (AOM) patients who had myringostomy and those presenting with perforation and suppuration. In this study we also examined the suitability of a venous canula as an improvisation in the absence of conventional myringostomy tube.Methods: This prospective study, carried out in the Otolaryngology Unit, Department of Surgery, Federal Medical Center, Lokoja between February 2006 and August 2008, included consecutive AOM patients who presented with excruciating otalgia and bulging, hyperaemic tympanic membrane and another group with ruptured tympanic membrane both within 2 weeks duration. The patients with bulging tympanic membrane had venous canula myringostomy done in the local anaesthesia and the canula was kept in situ until the ear became dry and until the myringostomy site closed up. While the group with tympanic membrane perforation at presentation had ear suction toileting and daily ear dressing, until ear became dry. The 2 groups were followed up daily to determine duration of stay of the improvised myringostomy tube and the closure of the myringostomy site or tympanic membrane perforation and they were compared using Pearson’s correlation test at 0. 05 significance.Results: Subjects comprised of 42 AOM (15 males and 27 females (M: F = 1.7:3) and 26 with tympanic membrane perforation (11 males and 15 females), aged between 3 years to 48 years (mean+ SD = 13+ 6 years). Relief of otalgia was seen all the subjects in the myringostomy group (100%).The mean number of days to achieve dry ear after myringostomy tube was 3 days after myringostomy while it was 3 weeks in the perforation group (P = 0.002). The mean number of days to achieve closure of the myringostomy was 3.7 days after dryness while among the perforation group, it was 3 months (P= 0.000).Conclusion: Venous canula, which is cheap and readily available, could be an improvisation for myringostomy in AOM; and this aided early relief of otalgia, resolution of disease and significant reduction in treatment durations

PAEDIATRIC OTORHINOLARYNGOLOGICAL PRESENTATION OF HALITOSIS IN A DEVELOPING COUNTRY

Background: Halitosis is a common medico social symptom among children. Aim: To determine the clinical, epidemiological patterns, aetiology and psycho-social issues of halitosis among children in a tertiary hospital in Nigeria. Methodology: This was a prospective hospital based study of children with complaints of halitosis. The study was carried out in Ear, Nose & throat Department, Ekiti State University Teaching Hospital, Ado Ekiti over a period of two years, (October 2015 to September 2017). Consent was obtained from the parents/guardian. Data was obtained by using pretested interviewer assisted questionnaire. All the data obtained were collated and analyzed by using SPSS version 16.0. Ethical clearance was obtained from the ethical committee of the institution. Results: The prevalence of halitosis in this study was 6.8% and there were 58.5% males and 41.5% females with a male to female ratio of 1.5:1. Their age ranged from 1 year – 18 years with a mean of 9.48 ± 5.84 SD years. Sources of referral for the otorhinolaryngology, head and neck care were mainly from general practitioners (52.3%) and from pediatricians (24.6%). Halitosis was noticed by family members in 50.8% and from family friends in 23.1%. Nasal and throat diseases in 49.2% and 29.2% respectively were the commonest otorhinolaryngology, head and neck disorders that were responsible for halitosis. The major causes were rhinosinusitis in 24.6%, impacted nasal foreign body in 23.1% and adenotonsillar hypertrophy in 18.5%. Associated disabilities in children and family with halitosis include social withdrawal in 35.4%, low social interaction in 32.3% and depression in 29.2%. Acute halitosis (3/12) accounted for 49.2%. In all, fifty four (83.1%) of the patients were successfully treated. Conclusion: Bad breath is a common ear, nose and throat symptom in children it is commonly due to nasal and pharyngeal diseases which are amenable to treatment

Pattern of Tympanic Membrane Perforation in a Tertiary Hospital in Nigeria

Background/Objectives: Tympanic membrane perforation is a common otological disorder with associated hearing impairment. This study aimed at determining the clinicoepidemiological pattern, etiological factors, clinical presentation, and management of tympanic membrane perforation in a tertiary hospital in Nigeria. Materials and Methods: This was a prospective, hospital‑based study of patients with the clinical finding of perforated tympanic membrane. The study was carried out over a period of 5 years (September 2012 to August 2017). Interviewer‑assisted questionnaire was administered to obtain the detailed history and clinical findings from consenting patients. Data collected were collated and analyzed using SPSS version 16.0. Results: A total of 529 patients had tympanic membrane perforation, of which 368 (69.6%) were males and 161 (30.4%) were females with a male‑to‑female ratio of 2:1. The prevalence of tympanic membrane perforation in this study was 7.8%. The most common presenting symptom among the patients was otorrhea in 81.5%, otalgia in 72.8%, and tinnitus in 55.7%. Acute suppurative otitis media was a cause of tympanic membrane perforation in 28.4% of the patients while 55.7% of the patients proceed to chronic suppurative otitis media. Unilateral tympanic membrane perforation was 79.0%. The left ear tympanic membrane perforation was 43.9%. Grade 1 tympanic membrane perforation accounted for 39.3% while grade 2 accounted for 32.3%. The most common types of tympanic membrane perforation were central in 38.2%, anterior central in 32.3%, and posterior central in 19.3%. Conductive hearing impairment accounted for 61.6% while sensorineural hearing impairment 25.3%. The most common degrees of hearing impairment were mild and moderate and accounted for 47.1% and 25.1%, respectively. The most common complications of tympanic membrane perforation were hearing impairment in 52.6%. Majority of the patients (425) were treated conservatively, six had fat patches, while 98 were treated surgically. Tympanic membrane perforation healed at the end of 3 months in 81.5%, while 18.5% did not heal after 3 months. Conclusion: Tympanic membrane perforation arises mainly from middle ear infections and traumatic causes. At presentation, size and location of perforation vary which depend on duration of infection or the traumatic causes

SOCIODEMOGRAPHIC PROFILE AND PATTERN OF SINONASAL INJURIES AT THE EKITI STATE UNIVERSITY TEACHING HOSPITAL, ADO-EKITI, SOUTH-WEST NIGERIA

Background: Sinonasal trauma is a common otorhinolaryngology disorder worldwide. This study aimed at determining the prevalence, sociodemographic features, aetiology, clinical presentation, management and outcome of injuries to the nose and paranasal sinuses. Materials and Methods: This was a prospective study of patients with sinonasal injuries that presented at our tertiary health institution. Consented patients were studied between October 2015 and September 2017. Analysis of obtained data was done with SPSS version 16.0. Results: The prevalence of sinonasal injury was 2.7%. There were 67.1% males and 32.9% females with male to female ratio of 2:1. Foreign body was the commonest cause of injury in 35.4% followed by road traffic accidents in 24.4%. Commonest anatomical region of sinonasal injury were nasal cavity and nasal vestibule in 57.3% and 19.5%. Common clinical features among the patients were pain in 72.0%, bleeding in 53.6% and foreign bodies impaction in 35.4%. Acute sinonasal injury in 95.1% was commoner than chronic sinonasal injury (≥13 weeks) in 4.9%. Commonest associated complications of the sinonasal injuries were rhinosinusitis in 37.8% others were 22.0% epistaxis, 11.0% nasal septal abscess and 3.7% adhesion. Pre-hospital treatment in the patients was 62.2%. Major treatments offered to the patients were conservative/medical therapy in 53.7%. Commonest surgical interventions were 35.4% foreign body removal and 7.3% epistaxis control. Conclusion: Sinonasal injuries are common in the otorhinolaryngology practice. Commonest causes are self-inflicting foreign bodies impaction and road traffic accident. Pre-hospital treatment in the patients was very high

Pattern of presentation of ear , nose, throat, head and neck injury in a developing country

Objective: Ear, nose, throat, head and neck injuries are a common otorhinolaryngology disorder worldwide. This study aimed at determining the prevalence, sociodemographic features, aetiology , clinical presentation management and outcome of injuries to the ear, nose, throat, head and neck region. Methods: This was a prospective study of patients with otorhinolaryngolology , head and neck injuries that presented at our tertiary health institution. Consented patients were studied between October 2015 and September 2017. Analysis of obtained data was done with SPSS version 16.0. Results: The prevalence of ear, nose, throat, head and neck injury was 9.4%. There were 63.5% males 36.5% females with male to female ratio of 1.5:1. Foreign bodies' impaction was the commonest cause of injury in 32.3% followed by road traffic accidents in 19.8%. Commonest anatomical region were ear and nose in 49.7% and 28.5% respectively . Common clinical features among the patients were pain in 46.5%, bleeding in 37.8% and foreign bodies' impaction in 32.3%. Presentations for otorhinolaryngology care among the patients were common in 95.1% acute injury than 4.9% chronic injury (≥13 weeks). Commonest associated complications of the injuries were otitis media in 18.8% others were 14.9% otitis externa, 9.4% perforated tympanic membrane and 6.3% epistaxis. Pre-hospital treatment in the patients was 67.4%. Major treatment offered to the patients was conservative/medical therapy in 28.8%. Conclusion: Ear , nose, throat, head and neck injuries are common in the otorhinolaryngology practice. Commonest causes are self inflicting foreign bodies' impaction and road traffic accident. Pre-hospital treatment among the patients was very high

Otorhinolaryngological Manifestation of Allergy in South Western Nigerian Children

Background: Allergy is a systemic, chronic and recurrent disorder of otorhinolaryngological importance. This disorder is often neglected with late presentation in paediatric age group. This study aimed at determining the prevalence, sociodemographic features, trigger factors, clinical features, complications, quality of life, associated comorbid illnesses and treatment outcome among children. Materials and Methods: This was a prospective hospital based study of children with allergy in our center. The study was carried out over a period of one year from May 2017 to April 2018. Data were obtained by using pretested self-administered questionnaire. Data obtained were documented, collated and analyzed by using SPSS version 18.0 Results: Prevalence of allergy in this study was 8.6%. There were 60.2% male with male to female ratio of 1.5:1. There was positive family history of allergy in 55.9% patients. Perennial allergy was the commonest in 68.3% of the children. Major forms of allergens were 71.5% inhalant and 9.7% ingestant. The common self-reported trigger factors were dust, cold weather and smoke in 58.1%, 41.9% and 22.0% respectively. Major associated comorbid illnesses in this study were 43.5% adenotonsillar hypertrophy. Commonest allergic symptoms were runny nose in 38.7%. The commonest affected organ was nose in 46.8%. Commonly affected quality of life was 22.6% irritability, 20.4% absenteeism, 19.9% sleep disruption and 12.9% impaired social life. Common complications were 48.9% secondary infection, 46.2% otitis media/externa, 44.1% injury, 42.5% foreign body impaction and 40.3% pharyngitis. Treatment of allergy leads to improvement and recovery from the clinical features in 52.2%. No significant improvement in 47.8%. Conclusion: Allergy is a systemic disease affecting ear, nose and throat. It affects all paediatric age group with associated comorbid illnesses, complications and affectation of quality of life at presentation in majority of the patients

Effects of Seed Fractions of Buchholzia coriacea on Reproductive Functions of Male Wistar Rats

Buchholzia coriacea seeds have been reported to induce reproductive toxicity. In this study, the possible mechanism(s) by which these seeds induce male reproductive toxicity were examined. Methanol fraction (MFBC-50 and 100 mg/kg), hexane fraction (HFBC-50 mg/kg) or ethylacetate fraction (EFBC-50 mg/kg) of B. coriacea seeds were administered daily (p.o) for 6 weeks to rats and thereafter sacrificed. Sperm profile was examined microscopically while sex hormones were assayed using ELISA technique. Oxidative stress biomarkers were assayed spectrophotometrically in serum and testis. All treatment significantly decreased sperm motility and sperm count while sperm with defective morphology increased when compared with control. The MFBC (50 mg/kg) decreased luteinizing hormone (LH) and follicle stimulating hormone (FSH). The HFBC decreased testosterone, LH and FSH while EFBC decreased testosterone and FSH. Serum and testicular malondialdehyde (MDA) increased while serum and testicular superoxide (SOD), and testicular catalase decreased in HFBC and EFBC groups. MFBC (100 mg/kg) decreased serum SOD, testicular SOD and testicular catalase. Marked derangement of the testicular epithelium was observed in treated rats. Buchholzia coriacea seeds mediate male reproductive toxicity by precipitation of oxidative stress and suppression of the pituitary-testicular axi

Improvised Venous Canula Myringostomy in Acute Otitis Media: Analysis of outcome in Nigeris

Background : This case control study was based on the hypothesis that myringostomy done on an a bulging but inflamed tympanic membrane before perforation might improve healing of the middle ear and tympanic membrane, thus reducing the probability of progression to chronic suppurative otitis media. Our objective was to compare outcome of tympanic membrane healing in acute otitis media (AOM) patients who had myringostomy and those presenting with perforation and suppuration. In this study we also examined the suitability of a venous canula as an improvisation in the absence of conventional myringostomy tube. Methods :This prospective study, carried out in the Otolaryngology Unit, Department of Surgery, Federal Medical Center, Lokoja between February 2006 and August 2008, included consecutive AOM patients who presented with excruciating otalgia and bulging, hyperaemic tympanic membrane and another group with ruptured tympanic membrane both within 2 weeks duration. The patients with bulging tympanic membrane had venous canula myringostomy done in the local anaesthesia and the canula was kept in situ until the ear became dry and until the myringostomy site closed up. While the group with tympanic membrane perforation at presentation had ear suction toileting and daily ear dressing, until ear became dry. The 2 groups were followed up daily to determine duration of stay of the improvised myringostomy tube and the closure of the myringostomy site or tympanic membrane perforation and they were compared using Pearson’s correlation test at 0. 05 significance. Results : Subjects comprised of 42 AOM (15 males and 27 females (M: F = 1.7:3) and 26 with tympanic membrane perforation (11 males and 15 females), aged between 3 years to 48 years (mean+ SD = 13+ 6 years). Relief of otalgia was seen all the subjects in the myringostomy group (100%). The mean number of days to achieve dry ear after myringostomy tube was 3 days after myringostomy while it was 3 weeks in the perforation group (P = 0.002). The mean number of days to achieve closure of the myringostomy was 3.7 days after dryness while among the perforation group, it was 3 months (P= 0.000). Conclusion : Venous canula, which is cheap and readily available, could be an improvisation for myringostomy in AOM; and this aided early relief of otalgia, resolution of disease and significant reduction in treatment durations

Case Report: Open Mastoidectomy and temporalis flap in the control of chronic otorrhoea

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