STAGES IN THE DEVELOPMENT OF TRACHEOTOMY

Tracheostomy refers to a surgical procedure of distinguished historical evolution. It spans various periods, each having specific contributions to what obtains presently. Every resident doctor is encouraged to acquire the skill required for this live-saving procedur

Prevalence of snoring and symptoms of sleep disordered breathing among primary school pupils in Ilorin, Nigeria

Background/Aim: Snoring is the production of sound from the upper aero-digestive tract during sleep due to turbulent airflow This study is to determine the prevalence, pattern, night and daytime symptoms of snoring among nursery and primary school pupils in Ilorin, Nigeria due to its public health importance. Materials and methods: This cross sectional survey was carried out among nursery /primary school pupils in Ilorin, Kwara state between April and September, 2010. Ten schools were selected randomly from 100 schools sited within the 3LGAs of Ilorin municipality. Also private and public schools with different parental social economic status were selected. The pupils were selected from nursery 2 to primary 6 in each school using the class registers with the aid of a table of random numbers with 1500 children assessed. The parents/guardians were made to fill the questionnaires and same returned with visitations to the schools twice weekly and reminders sent via phone calls. Data were analyzed using EPIINFO 2002 version 2 software. Results: 1500 questionnaires were given out but 909 were completely filled and returned (response rate of 61%.). There were 598(65.8%) non snorers (NSn) and 311(34.2%) snorers (Sn) at different scales with 153 male snorers to 158 female snorers. The ages of the children ranges from 3 to 16 years (mean � SD, 8.3 � 4.8 years. The mean age for the Sn was 8.2 and 8.3 for NSn (range 3–6 years). No statistical difference in age, gender or socio-economic status between Sn and NSn. 598(65.8%) were non snorers (NSn) and 311(34.2%) were snorers (Sn) especially in the age groups 3–6 years, 121(38.9%) and above 6 years of age 101(32.7%) and below 3 years were 89(28%). Conclusion: Snoring is an important health problem among the pupils as a significant percentage snores and most of them are between third and sixth year of lif

The Chronic Discharging Ear in the Tropics: A useful management guide for primary care physicians

BackgroundEar discharge is a common encounter in otorhinolaryngology clinics in the tropics. It is particularly prevalent in developing countries with the under-five being mostly at risk. Primary care physician are often the first point of call and major source of referrals. Although, ear discharge is both a symptom and sign of disease but not a diagnosis; accurate diagnosis and initial management and/or promptness of referral decision by the primary care physician have a bearing on the outcome. There are many areas of controversies, insufficient evidence and limited knowledge about inflammation and infection of the ear and how they can be treated in the face of rising bacteria resistance to antimicrobial agents. Nevertheless, little has changed in the core principle of management and indications for referral to the otorhinolaryngologist. We review current literature and published peer reviewed studies in Medline, Embase, PubMed, and Cochrane Database of systematic reviews for articles in English language to highlight the clinical features and possible management of the (non-wax, non-CSF) discharging ear where resources are deficient.Keywords: ear discharge, primary care, tropics, otitis media, otitis externaSavannah Journal of Medical Research and Practice 2017;6(2):01-0

Oropharyngeal Stenosis: A Rare Complication of Tonsillectomy

Tonsillectomy is the most common major surgery done in children all over the world. Cold knife dissection under general anaesthesia is about the most popular method of surgical removal of the tonsils amongst surgeons in our setting. Although anaesthetic or surgical complications may occur with resultant morbidity and rarely mortality; oropharyngeal stenosis is an unusual complication. We report a case of a 17-year-old girl with an unusual oropharyngeal stenosis following tonsillectomy done by cold knife dissection causing prolonged hospital stay due to significant morbidity. Clinical presentation, endoscopic evaluation and surgical management of the patient were highlightedwith a review of pertinent literature. We conclude that oropharyngeal stenosis is an uncommon complication of simple tonsillectomy. Early diagnosis requires a high index of suspicion at routine follow-up clinics. A simple surgical adhesiolysis may suffice if detected early prior to progression to thick, firm scar

Descriptive analysis of salivary gland tumours in Ilorin, Nigeria

Background: Salivary gland tumors are relatively uncommon lesions accounting for about 3-6% of head and neck tumors with 60 - 80% affecting the parotid glands.Objective: The aim is to analyse descriptively the pattern of salivary gland tumor seen in Ilorin, North-Central Nigeria.Methods: A retrospective analysis of histological slides reviewed by the pathologist of patients with primary epithelial salivary gland neoplasms operated between 2001 and 2010, in Otorhinolaryngology and General Surgery. Information regarding age, gender, and anatomical location of the tumors was retrieved from the patients' hospital records. All information was entered into a SPSS computer software and result presented in tables and figures.Results: A total of 56 case notes and slides were reviewed with 24 males and 32females (M:F-1.0:1.3), with the peak age of 21-30years in males and 31-40 among the females The mean age is 38.62yrs (SD = 18.4±2.5) . There were 31 (55.4%), 17 (30.4%), 8 (14.2%), parotid, submandibular and minor salivary glands tumours respectively. Histologically pleomorphic adenoma constituted the largest with 62.5% in both the submandibular and the parotid gland specimen analysis then, mucoepidermoid tumour in 26.7%, adenoid cystic carcinoma in 5.4% and 1.8% each of acinic cell tumour (malignant), poorly differentiated carcinoma and squamous cell carcinoma.Conclusion: Salivary tumours were slightly commoner among females with pleomorphic adenoma in the third to fifth decades of life being the commonest benign tumour and mucoepidermoid the commonest malignant variants in the 5th to 6th decades of life.Keywords: Salivary gland; Parotid; Pleomorphic adenoma; mucoepidermoid, female

Vagal reflex stimulation complicating retrieval of an unusual foreign body from the laryngotracheal lumen: Case report

Foreign body impaction in the aero digestive tract is a life-threatening emergency, particularly in the paediatric age group. Removal under general anaesthesia poses both surgical and anaesthetic challenges and this may rarely result in mortality. We report a case of a 4 year old boy with an unusual foreign body (FB) impacted in the laryngotracheal causing difficult intubation and precluding tracheostomy with attendant vasovagal reflex stimulation and cardiac arrest. Clinical presentation and radiological evaluation of the patient were highlighted with a review of pertinent literature. We conclude that dis-impacting a foreign body in the trachea could potentiate bradycardia and cardiac arrest; co-existing hypercarbia and/or sepsis increase the risk and worsen the prognosis

Five year review of oropharyngeal cancer patients at University of Ilorin Teaching Hospital, north central Nigeria

Oropharyngeal tumours constitutes 10 to 12% of all head and neck malignancies, and Squamous cell carcinoma (SCC) is the most common histological variant seen in 90% of cases. Studies have confirmed the high prevalence of the disease among males, and the roles of alcohol intake and cigarette smoking as risk factors are well documented. This is a retrospective  review of  socio-demographic and risk factors of oropharyngeal cancers in our practice. All cases of orophyryngeal cancer seen at Ear, Nose and Throat Department of University of Ilorin Teaching  Hospital (U.I.T.H) between July 2008 and June 2013 were reviewed. UITH has over 600 beds and is a tertiary institution for the University Medical Scohool.There were 27 cases, 15 (54.6%) were within 40-60 years, 7 (27.3%) were below 40 years, and 5 (18.2%) above 60 years. Seventeen (63.6%) were females and 10 (36.4%) males with male to female ratio of 1:1.7.  Twenty (72.7%) were non-smokers while 7 (27.3%) were smokers. Ten cases (36.4%) had history of alcohol intake while 17 (63.4%) did not take alcohol. Lateral wall and tonsil tumours constituted 55.6% (15) of the total, closely followed by base of the tongue tumours 7 (27.3%), then soft palatal tumours 5 (18.2%). There was none in the posterior pharyngeal wall. Seven patients (26.0%) had surgery followed by chemoradiation, 3 (11.1%) had chemoradiation only, while 17 (63.4%) either declined surgery or defaulted clinic follow-up. Two of the patients (7.4%) had associated HIV infection. This study showed relative high incidence of oropharyngeal tumours in young and middle aged females; who are non-alcohol drinking and non-smokers. Incidental finding of HIV infection in some of the patients is a pointer to the possible role of sexually transmitted viral infections in the epidemiology of oropharyngeal cancers and a focus for preventive measures.Keywords: Oropharyngeal cancer, risk factor, sexually transmitted viral infectio

Otorhinolaryngological manifestations of pregnancy in a Nigerian tertiary health center

The objective of our study is to assess the frequency and distribution of ENT symptoms according to trimesters of pregnancy and the effect of these symptoms on the quality of life of pregnant women.This was an observational prospective case control study performed in the department of Otorhinolaryngology, Family Medicine and Obstetrics and Gynaecology in a specialist health institution in Nigeria. A total of 220 women were recruited from the ENT, Family Medicine and Antenatal Clinic for the study, consisting of 110 subject and another 110 age matched  controls following ethical approval. Assessment of ENT complaint and Examinations were carried out using a structured proforma for both subject and controls and compared the values and results presented in tables and figuresAge range for the subject was 17 - 43 years with a mean age of 28.4±5.4 years and age range for the controls is 19 – 43 years with a mean age of 28.1 ±5.3 years. Thirty seven of the subject were in the first trimester another 37 in the second trimester and 36 in the third trimester. The commonest aural manifestations were otalgia and ear fullness, the commonest nasal manifestations were snoring, epistaxis and facial hyperpigmentation while the commonest throat symptoms were Gastro-oesophageal reflux disease, sore-throat and dysphagia.We conclude that snoring and epistaxis were the most common symptoms in the third trimester, followed by gastro-oesophageal reflux disease which was also found to be predominant in the first and second trimester. All the symptoms were found to increase with advancement in age of pregnancy except for hearing loss, hoarseness and facial weakness which are not statistically significant in our study.Keywords: Pregnancy; Trimester; Otorhinolaryngology; Manifestation; Snorin