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

An Unusual Oronasal Foreign Body: Report of A Case

Background: Foreign body removal in children is very common in the daily routine of an otolaryngologist but reports of oronasal foreign bodies and their management are rare. Method: The case note of a 5 year old female child presenting with an oronasal foreign body following a domestic accident was retrieved and studied and followed up. Result: a 5 year old female child with an oronasal foreign body which created an oronasal fistula that was closed with local palatal mucoperiosteal-lined flaps. The patient defaulted following treatment, a common practice by patients in our society. Conclusion: This report highlights the occurrence of this rare condition, its management and the need to put measures in place to prevent domestic accidents especially for those most at risk. Keywords: Oronasal, Foreign body, Fistula, Domestic accident.Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 459-46

An audit of endoscopic otorhinolaryngological practice in Jos, Nigeria

Background: Endoscopic otorhinolaryngological procedure is quicker, safer and cheaper than open surgery because of its less invasive nature. It is constantly being practiced in the developed nations and the Middle East. The indications abound in our environment. However, very few hospitals have the facilities for these procedures. The aim of this paper is to highlight the state and scope of our endoscopic practice.Method: All the case records of patients who had endoscopic otorhinolaryngological procedures within the 18 months in two teaching hospitals were retrieved and biodata, endoscopic findings and management were extracted.Result: A total of 100 cases made up of 79 (79%) adults were seen within the study period. Their ages ranged from 9 months to 76 years with average age of 42.3 years. Diagnostic endoscopic procedures were 76 (76%) while therapeutic cases were 24 (24%). Laryngoscopy was the most common endoscopic procedure constituting 62 (62%) cases. Others included oesophagoscopy (20%), bronchoscopy (10%)Conclusion: Endoscopic procedure is safe. Dearth of endoscopic equipments is a major impediment to the practice of this procedure in our environment. Collaboration between centers is a quick way to circumvent this problem and helps to keep the specialist proficient.Keywords: Otorhinolaryngology, Endoscopy, Indications, Jos Otene

Day Case Adenotonsiletomy: Experience of Two Private Clinics in Nigeria

Background: adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy. Methodology: All pediatrics cases requiring adenoidectomy, tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery- ASA grade I or II for general Anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others. Results: A total number of 144 patients requiring adenoidectomy, Tonsillectomy or both were seen at the study centers with only sixty six (45.8%) meeting the inclusion criteria. Adenoidectomy constituted 47% of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5%) of the patient. the other complications Were non-persistent vomiting 13 (19.7%), low grade fever 5 (7.6%) and pain at time of discharge 23 (34.8%). There were no fatalities. Conclusion: The complication rates were low. Day-case Adenoidectomy/tonsillectomy or denotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/ post recovery as this as this had a soothing/calming effect on the patient/s. Keywords: Day-case, Adenoidectomy, Tonsillectomy, Nigeria. Nigerian Journal of Medicine Vol. 17 (3) 2008: pp. 296-29