Causes of ma xillofacial patient mortality in a Nigerian tertiary hospital

BACKGROUND: An analysis of maxillofacial mortality was done in a Nigerian tertiary health care centre to determine the major causes of mortality and identify possible predisposing factors in our environment.MATERIALS AND METHODS: A retrospective analysis of mortality in maxillofacial surgery department of Aminu Kano Teaching Hospital from January 2005 to December 2014 was done. Data were analyzed using statistical package for social sciences (SPSS) version 15.0 (SPSS Inc, Chicago, IL).RESULTS: A mortality rate of 1.8% (46 deaths from 2,540 admissions) was recorded. There were 35 males (76.1%) and 11 (23.9%) females. The mean age of the deceased patients was 40.0±13.0 years. Orofacial infections (41.3%) and advanced (stage IV) orofacial malignancies (28.3%) accounted for most deaths.CONCLUSION: Fascial space infections and orofacial malignancies contribute largely to mortality in our setting. Late presentation was a major factor predisposing to mortality.Key Words: Audit, Maxillofacial Patient, Mortalit

The forehead flap: a valuable option in resource depleted environment

Aim: Reconstruction of orofacial soft tissue defect is often challenging and this is more difficult in resource challenged environment. This retrospective study highlights our experience with the use of forehead flap to overcome some of the challenges of orofacial reconstruction in a resource depleted environment.Methods: A 23-year retrospective analysis of all patients who had orofacial defect reconstruction using forehead flap in our department was undertaken. Information was sourced from patient’s case notes and operating theatre records. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2007 (Microsoft, Redmond, WA, USA).Results: A total of 43 patients were managed within the period reviewed and consisted of 31 (72.1%) males and 12 (27.9%) females. Trauma 24 (55.8%) accounted for most defect and the lip was the commonest site of defect. Complete forehead flap was used in 31 (72.1%) of cases and when timing of defect repair is considered, delayed reconstruction was the preferred method. Postoperative complications was observed in 8 (18.6%) patients and consisted of failed flap in 2 (25.0%) patients, tumor recurrence in reconstructed site in 2 (25.0%) patients and tumor occurrence in forehead flap donor site in 1 (12.5%) patient.Conclusion: The forehead flap remains a reliable option in orofacial soft tissue defect reconstruction. It is easy to raise and can provide coverage for wide defects as far as the paramandibular and submandibular regions. Moreover, it does not require patient repositioning

A review of cleft lip and palate management: Experience of a Nigerian Teaching Hospital

Background: Cleft lip (CL) and palate (CLP) management is multidisciplinary. A cleft team was formed in a Nigerian Tertiary Hospital to address the health needs of cleft patients in the centre. Aim: This paper aims at documenting the Aminu Kano Teaching Hospital (AKTH) management protocol for orofacial clefts and also to review our experience with CLP surgeries performed at AKTH since our partnering with Smile Train. Materials and Methods: A retrospective review of all the cleft patients surgically treated from January 2006 to December 2014 under Smile Train sponsorship was undertaken. A descriptive narrative of the cleft team protocol was also given. Results: One hundred and fifty-five patients (80 males, 75 females) had surgical repairs of either the lip or palate. CL patients were 83 (53.55%), while CLP patients were 45 (29.03%) and isolated cleft palate patients were 27 (17.42%). Conclusion: The inclusion of various specialities in the cleft team is highly desirable. Poverty level amongst our patients frequently limits our management to surgical treatment sponsored by the Smile Train, despite the presence of other residual problems

Causes of maxillofacial patients mortality in a Nigerian tertiary hospital

Background. An analysis of maxillofacial mortality was done in a Nigerian tertiary health care centre to determine the major causes of mortality and identify possible predisposing factors in our environment. Materials and methods. A retrospective analysis of mortality in maxillofacial surgery department of Aminu Kano Teaching Hospital from January 2005 to December 2014 was done. Data were analyzed using statistical package for social sciences (SPSS) version 15.0 (SPSS Inc, Chicago, IL). Results. A mortality rate of 1.8% (46 deaths from 2,540 admissions) was recorded. There were 35 males (76.1%) and 11 (23.9%) females. The mean age of the deceased patients was 40.0±13.0years. Orofacial infections (41.3%) and advanced (stage IV) orofacial malignancies (28.3%) accounted for most deaths. Conclusion. Fascial space infections and orofacial malignancies contribute largely to mortality in our setting. Late presentation was a major factor predisposing to mortality