Adenoids and Its Management: A Review of Surgical Methods

Adenoids remained unrecognized because of their inaccessible location and the fact that most adenoidal pathology occurred in young children. Adenoidectomy is the surgical procedure in which the adenoids are removed. Removal of the adenoids is indicated when they are chronically infected or causing obstruction. Since the earliest descriptions of adenoidectomy, numerous techniques have been described and used successfully. All techniques are based on the principle of adequate visualization and removal of the adenoids without damage to the surrounding structures. The advent of endoscopic sinus surgery has popularized the use of endoscopes. The aim of this paper is to review various surgical techniques of adenoidectomy

Paediatric Otorhinolaryngological, Head and Neck Procedures in a Nigerian Tertiary Health Care Centre

Background: There is wide spectrum of paediatric otorhinolaryngology surgical conditions affecting children in developing countries. Paediatric otolaryngological surgical procedures represent a major part of all otolaryngology surgeries in developing countries. This study aimed at determining the prevalence, sociodemographic features, types of ear, nose, throat, head and neck surgical procedures, outcomes and associated complications in our center. Patients and Methods: This was a retrospective hospital based study of otorhinolaryngologic paediatric procedures. The study was carried out from August 2013 to July 2018. Data for this study was obtained from the medical record department, ENT clinic operation booking register for both minor and major surgery and theatre operation register. Data obtained were collated, documented and statistically analyzed using SPSS version 18.0. Results: Prevalence of paediatric otorhinolaryngology, head and neck procedures was 20.1%. Clinic and theatre procedures accounted for 86.7% and 13.3% respectively. Elective and emergency procedures constituted 81.8% and 18.2% respectively. There were 57.2% males with male to female ratio of 1.5:1. Otologic procedures accounted for 57.2% out of which otologic foreign body removal occurred in 20.2%. Sinonasal procedures occurred in 24.8% from which sinonasal foreign body removal occurred in 18.9%. Paediatric throat procedures occurred in 16.0% out of which adenoidectomy was performed in 6.8%. Head and neck procedures accounted for 1.9% and commonest of these was lymph nodes biopsy in 0.9%. Minor procedures in 86.7% were commoner than major procedures in 7.2%. Commonest complication from paediatric otorhinolaryngology procedures was wound infection 4.0%. Conclusion: Paediatric otolaryngology, head and neck surgical procedures are common encountered in our practice. The prevalence in this study was 20.1% with otological surgical procedures been the commonest. There are associated complications as well as greater level of our patient’s satisfaction

Red Eye: The Red Herring of Otolaryngologic Diseases

Background: Red eye of otolaryngologic origin could present a diagnostic conundrum. A clear understanding of the otolaryngologic differential diagnosis is required to clinch a diagnosis. In this paper, we describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin. Objective:To describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin with a view to facilitate early diagnosis and treatment. Methods: Records of patients with red eyes of otolaryngologic origin were reviewed. The otolaryngologic culprits and features that proved their culpability were highlighted. Results: In all, 32 patients with red eyes of otolaryngologic origin were seen. Majority had used eye drops as primary eye care. About 71.9% seen by the general practitioners were referred to ophthalmologists on account of persistent ocular symptoms. The otolaryngologic culprits were mostly nasal and paranasal diseases. Eight(25%) required conservative treatment, 24(75%) required surgical intervention and 3(9.4%) developed complete blindness. Conclusion: This study shows that red eyes of otolaryngologic origin are mostly caused by nasal and paranasal sinus diseases. However, both patients and general practioners could be misled to believe the eye is the primary source of the ocular symptoms. Such diagnostic conundrum are associated not only with increased morbidities but also cost of treatments. The need to have a clear understanding of the otolaryngologic differential diagnosis of red eyes is hereby stressed. Also, the public must desist from arbitrary use of eye drops and the slogan: “If symptoms persits after 2 days consult your doctor” should be a community watchword

THE DEARTH OF STANDARD ANATOMICAL TERMINOLOGIES IN YORÙBÁ LANGUAGE: Butchers’ terminologies to the rescue?

The need to replace foreign-language medical terms with indigenous terms has prompted researchers to search for indigenous equivalents of the foreign medical terms. This study which focused on the dearth of standard anatomical terminologies in Yorùbá language was an attempt to examine the adoptability of butchers’ terminologies as descriptive anatomical terms for human abdomino-thoracic organs. Practising butchers in the South West Nigeria were interviewed on their terminologies for cow’s abdomino-thoracic organs and the basis for each terminology. The butchers’ terminologies, in Yorùbá language were critically appraised for adoptability as anatomical terms for human abdomino-thoracic organs. The study observed that cow’s abdomino-thoracic organs were grossly similar to those of humans. Majority (65%) of the cow’s abdomino-thoracic organs are named by the butchers’ in traditional Yorùbá terminologies. The butchers’ terminologies were etymologically derived based on pre-existing concepts similar to the modern terminologies derived from the ancient Greek and Latin words. About 25% of the butchers’ terminologies were the same with some human anatomical terminologies which were in use by the health care professionals. The terminologies concur with the cultural attitudes of the Yorùbá with reference to the private parts of the human body and majority (80%) of the butchers’ terminologies is simple and familiar to the people. Given these characteristic features, we concluded that the butchers’ terminologies are strongly adoptable as descriptive anatomical terms for human abdomino-thoracic organs and may resolve the dearth of standard anatomical terminologies in Yorùbá language. The findings may form a baseline for future studies on the translation of anatomical terminologies to Yorùbá language

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

Knowledge and Practice of Sneeze and Cough Etiquettes among Participants in A Randomized Study in Ekiti-State, South-Western Nigeria

Background: Indiscriminate sneezing and coughing with infectious runny nose pose threats to public health. In this study, we investigate knowledge and practice of sneeze and cough etiquettes among residents in Ekiti-State, South- Western Nigeria. Objective: To sensitize the public on the roles of sneeze and cough etiquettes in the prevention the spread of infectious respiratory diseases. Methodology: A prospective, cross-sectional, randomized study of respondents in Ekiti State was conducted. Results: In all, 395 participants were studied. Of this number, 228 (57.7%) sneeze or cough into air without a cover on their nose or mouth, 82 (20.7%) into handkerchiefs, 20 (5.1%) into tissue, 22 (5.6%) into bare hand, 5 (1.3%) into sleeve or crook of elbow and 38 (9.6%) use a combination of methods. The proportion of respondents that wash hands or handkerchief soon after clean-up of the runny nose was only 38%. There was an inverse relationship between education attainment and hospital care of runny nose. Conclusion: This study shows that the majority (57.7%) of the respondents sneeze or cough into air without a cover on the nose or mouth. Only 1.3% of the respondents sneezes or coughs into sleeve or crook of the elbow which is the most acceptable form of hygiene etiquette. The proportion of respondents that wash hands or handkerchief soon after a clean-up of runny nose was quite small. Education has no comparative advantage over illiteracy in the uptake of treatment of runny nose. We, therefore, recommend that the public must be educated on the best sneeze, cough and respiratory hygiene etiquettes irrespective of their educational attainment

Patterns of Otolaryngologic Sequelae of Suicide Attempts Seen in Nigerian Tertiary Hospitals

Background: Otolaryngologic sequelae of suicide attempts are rarely reported as an entity. In this report, we describe the patterns otolaryngologic sequelae of suicide attempts seen in Nigerian tertiary hospitals. Objective: To improve among clinicians, knowledge of the patterns of otolaryngologic sequelae of suicide attempts with a view to promote their management at the three tiers of health care delivery. Methodology: A retrospective analysis of clinical records of survivors of suicide attempts seen in Nigerian tertiary hospitals. Results: In all, 52 patients were seen. Of this, 34 were cases of otolaryngologic sequelae. Majority, (56.0%) of the sequelae were corrosive oesophagitis. Other sequelae were: corrosive oropharyngoesophagitis (14.7%), corrosive oropharyngitis (8.8%), and corrosive laryngitis (5.9%), hypertrophy scar on the neck (5.9%), laryngeal stenosis (2.9%), pharyngocutaneous fistula (2.9%) and sudden hearing loss (2.9%). The sudden hearing loss was caused by overdose of diazepam. There was discordance in the prevalence of isolated corrosive oesophagitis and oropharyngitis as noted by the 56.0% vs. 8.8% respectively in a pathologic continuum. Conclusion: Corrosive oesophagitis is the most common otolaryngologic sequelae of suicide attempts accounting for 56.0% of cases in this study. There was discordance in the patterns of corrosive injuries of the oesophagus and oropharynx as noted by the 56.0% and 8.8% prevalence respectively, in a pathologic continuum. This stresses the need to avoid using the clinical state of the oropharynx to gauge the condition of the oesophagus. It also emphasizes the importance of diagnostic endoscopy in all symptomatic cases of corrosive ingestion. The occurrence of sudden hearing loss post-ingestion of diazepam remains enigmatic. We therefore suggest empirical studies on this unique finding using laboratory animals

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Choice of specialty among Medical Practitioners in Ekiti State, South-Western Nigeria

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