Branchial cleft anomaly of external auditory canal: a case report

A 15 year old male with a first branchial cleft anomaly seen at the Usmanu Danfodiyo University Teaching Hospital Sokoto is presented. He had recurrent preauricular swelling, which was continuous with three fistulous openings in the left external auditory meatus confirmed by sinogram. It may be mistaken for chronic suppurative otitis media or lymphadenitis, hence the need for a detailed clinical assessment. Surgical excision of the tract is the treatment of choice. Keywords: Branchial cleft anomaly, external auditory canal, sinogram, surgery Annals of African Medicine Vol.2(2) 2003: 83-8

Surgical Management of Cystic Lesions of the Upper Jaw

Objective: Tumors of the nose and paranasal sinuses are of various aetiology. They originate from different sites and cause facial asymmetry. Cystic lesions are rare but may mimic tumours. This study reports surgical excision of cystic upper jaw lesions. Materials and methods : A prospective recruitment of all cases of cystic lesions of the upper jaw seen in two tertiary health centres and analysis of surgical management were carried out over a nine and a half year period (Sept1999-feb 2009). Results:Ten cases of cystic lesions were seen 6 in females and 4 males aged between 13 and 45years.They accounted for 9% of 111cases of tumours of the nose and paranasal sinuses seen during the period. Five cases were naso-alveolar or nasolabial cysts, 3 were dentigerous cysts, while 2 were mucoceles of the maxillary sinus.These were excised without recurrences after a minimum period of one year follow up for nine cases while one case is still being followed up. Causes and management of cystic swellings of the maxilla are discussed and compared with world literature. Conclusion: Cystic lesions of the maxilla causing facial asymmetry constituted 9% of cases of tumours of the nose and paranasal sinuses seen in north western Nigeria. Although cystic lesions of the upper jaw are rare, they are amendable to surgical excision if the root or sources are completely extirpated. Keywords: Nasoalveolar cysts, Dentigerous cyst, Mucocoele Maxilla, Excision

Smokeless tobacco use in adult Nigerian population

The study aim was to establish the prevalence and determinants of smokeless tobacco use in Nigerian adults' population.Across-sectional survey of 1776 adults inYola, North-East Nigeria was carried out in June 2007.A modified World Health Organization (WHO) tobacco survey questionnaire was used for interview and datacollection. Out of 1776 interviewed respondents, 133 (7.49%) were user of smokeless tobacco. Snuffing of tobacco powder was the most common method of using smokeless tobacco (6.8%). Fifteen (0.9%) chewedtobacco while only 2(0.1%) both chewed and snuffed tobacco. Social acceptance (21.8%) was the major reason for using smokeless tobacco. Males, 5th and 6th decades of life, poor education, lower socioeconomic class, Margi, Hausa and Fulani tribes were the determinants of smokeless tobacco use.About 89.5% of the smokeless tobacco users believed that smokeless tobacco was not harmful to their health. : Although the prevalence of smokeless tobacco use was low among Nigerian adult population in this study. Ignorance of the potential health dangers of smokeless tobacco was rampant therefore; concerted efforts should be made to discourage the use of all forms of tobacco rather than concentrating on cigarette smoking

Nasopharyngeal cancer mimicking otitic barotrauma in a resource-challenged center: a case report

<p>Abstract</p> <p>Introduction</p> <p>Nasopharyngeal cancer commonly manifests with cervical lymphadenopathy, recurrent epistaxis and progressive nasal obstruction. Neuro-ophthalmic and otologic manifestations can also occur. Isolated otologic presentations of nasopharyngeal cancer are rare and the diagnosis of nasopharyngeal cancer may not be foremost in the list of differentials.</p> <p>Case presentation</p> <p>We present the case of a 29-year-old Nigerian woman with bilateral conductive hearing loss and tinnitus after air travel. There were no other symptoms. The persistence of the symptoms after adequate treatment for otitic barotrauma necessitated re-evaluation, which led to a diagnosis of nasopharyngeal cancer.</p> <p>Conclusion</p> <p>Isolated otologic manifestations of nasopharyngeal cancer are rare in regions with low incidence of the disease. There is a need for it to be considered as a possible differential in patients presenting with bilateral serous otitis media.</p

Etiological Profile and Treatment Outcome of Epistaxis at a Tertiary Care Hospital in Northwestern Tanzania: A Prospective Review of 104 Cases.

Epistaxis is the commonest otolaryngological emergency affecting up to 60% of the population in their lifetime, with 6% requiring medical attention. There is paucity of published data regarding the management of epistaxis in Tanzania, especially the study area. This study was conducted to describe the etiological profile and treatment outcome of epistaxis at Bugando Medical Centre, a tertiary care hospital in Northwestern Tanzania. This was a prospective descriptive study of the cases of epistaxis managed at Bugando Medical Centre from January 2008 to December 2010. Data collected were analyzed using SPSS computer software version 15. A total of 104 patients with epistaxis were studied. Males were affected twice more than the females (2.7:1). Their mean age was 32.24 ± 12.54 years (range 4 to 82 years). The modal age group was 31-40 years. The commonest cause of epistaxis was trauma (30.8%) followed by idiopathic (26.9%) and hypertension (17.3%). Anterior nasal bleeding was noted in majority of the patients (88.7%). Non surgical measures such as observation alone (40.4%) and anterior nasal packing (38.5%) were the main intervention methods in 98.1% of cases. Surgical measures mainly intranasal tumor resection was carried out in 1.9% of cases. Arterial ligation and endovascular embolization were not performed. Complication rate was 3.8%. The overall mean of hospital stay was 7.2 ± 1.6 days (range 1 to 24 days). Five patients died giving a mortality rate of 4.8%. Trauma resulting from road traffic crush (RTC) remains the most common etiological factor for epistaxis in our setting. Most cases were successfully managed with conservative (non-surgical) treatment alone and surgical intervention with its potential complications may not be necessary in most cases and should be the last resort. Reducing the incidence of trauma from RTC will reduce the incidence of emergency epistaxis in our centre

Lateral rhinotomy-a review of 38 operations from Sokoto Nigeria

Aims And Objectives: Intranasal tumours are likely to be incompletely excised if pernasal excisional biopsy alone is used. There are several other approaches for the removal of intranasal tumours one of which is lateral rhinotomy. This paper reviews 38 lateral rhinotomies performed in 30 patients in Sokoto Nigeria, over a 41/2 year period.Patients And Method: The record of 30 patients who underwent 38 lateral rhinotomies in Sokoto were reviewed. The indications for lateral rhinotomy, operative findings and histology results were analysed over a 41/2 year period.Results: 38 lateral rhinotomies were performed in 30 patients. There were 19 males (63.3%) and 11 females (36.7%) with a male to female ratio of 1.7:1. Their ages ranged between 6yrs and 65yrs. 29 patients (96.7%)had 37 lateral rhinotomies performed on them as a result of intranasal neoplasm while one (3.3%) had lateral rhinotomy performed for removal of local Arrow foreign body in the orbit and infratemporal fossa. Operative findings indicated that in only 8 surgeries (21.1%) were intranasal tumours confined to the nasal cavities, whilein 27 surgeries (76.3%) intranasal tumour had extended beyond the nasal cavity.Conclusion: Lateral rhinotomy provides excellent exposure to intranasal tumours more than all other approaches in achieving tumour free margin during excisional biopsy pending the outcome of histology report with acceptable cosmetic results

CASE REPORT: Histoplasmosis of Paranasal Sinuses and Orbit: A Case Report

Fungal sinusitis is a known cause of persistent or chronic sinusitis. Various authors have reported various fungal organisms such as aspergillus species, candida species and phycomycetes but not histoplasma duboisii as the cause of fungal sinusitis. A rare case of facial deformity secondary to invasive fungal infection by histoplasma duboisii of the left paranasal sinuses and left orbit associated with proptosis and loss of vision is presented in a 44 year old female trader from Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto. This had defied all antifungal agents. Following computerized tomographic (CT) scan of the brain and paranasal sinuses to ascertain the extent of invasion, radical surgical clearance, through anterior craniofacial resection with removal of all orbital contents except the eyelid and optic nerve stump was carried out with no recurrence 11/2 years after surgery. There is no place for conservative medical or surgical treatment in invasive sinus mycosis of the paranasal sinuses and orbit. (Key words: Fungal sinusitis, Histoplasma duboisii, Radical surgery). Sahel Med. J. Vol.6(3) 2003: 87-9

Chronic Suppurative Otitis Media: A Clinical Profile in Sokoto, Nigeria

This is a retrospective study of sixty eight cases of chronic suppurative otitis media seen in the Ear, Nose and Throat (ENT) Department of Usmanu Danfodiyo University Teaching Hospital Sokoto from June 1998 to May 1999. It was commonest in the paediatric age group (68.82%). The commonest symptom at presentation was ear discharge (100%), ear ache (26.47%), hearing loss (22.46%) and itchiness (10.29%). The commonest signs were ear discharge (100%) and tympanic membrane perforation (100%). All patients had the tubotympanic type of chronic suppurative otitis media. Pseudomonas aeruginosa and staphylococcus aureus were the most commonly cultured organisms (28.5% each). Cultures were sensitive to gentamicin and peflacine in most cases. Chronic suppurative otitis media is a public health problem affecting mainly the paediatrics age group with attendant learning impairment, caused by some degree of hearing loss and frequent hospital visitation for treatment. Therefore, prevention is stressed to reduce the morbidity of the disease. Key words: Chronic suppurative otitis media, pseudomonas aerugi nosa, hearing loss. Sahel Med. J. Vol.6(3) 2003: 75-7