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

Pattern of Ocular Involvement in Midface Injuries Seen at a Tertiary Care Hospital in Northern Nigeria

Aim: The aim of the study was to report the etiology, pattern, and spectrum of ocular injuries in patients with maxillofacial injuries seen at a tertiary care hospital in northern Nigeria.  Patients and Methods: This is a retrospective evaluation of the etiology, spectrum, and treatment of ocular injures seen in patients with midfacial fractures, who presented at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria, a tertiary care hospital in northern Nigeria. Cases were seen at the oral and maxillofacial clinic for those presenting with midfacial fractures, whereas those presenting with ocular injuries due to midfacial injuries were referred from the ophthalmology department. Data were collected on their demographics, etiology of injuries, body part(s) involved, and treatment. Results: A total of 256 patients had midfacial injuries during the period, of which 219 patients had 357 associated ocular injuries. The age range was between 3 and 76 years. There were more males (83.8%) than females (16.2%), giving a male-to-female ratio of 5.2:1; the 21–30 years' age bracket was most frequently affected (38.4%). The predominant etiology of injuries was road traffic accidents (RTAs) (90.1%), followed by assault (4.9%). Zygomatic complex fractures (38.6%) and orbital wall fractures (24.7%) were the common midfacial injuries. There were 357 ocular injuries, giving a patient: injury ratio of 1:1.6, with subconjunctival hemorrhage (32.5%) and ruptured globe (20.0%) being common. Treatments performed were reduction and immobilization of midfacial fractures plus evisceration (32.0%), followed by reduction and immobilization of fractures alone (23.9%) and reduction and immobilization plus grafting of soft tissues (21.2%). Conclusion: Ocular injuries are quite common in patients with midfacial injuries, with a ratio of 1.6:1. RTA was the most common etiology, with zygomatic complex fractures as the most common midfacial injury. Subconjunctival hemorrhage was the most common ocular injury manifestation, with young adults (21–30 years of age) being most affected. Treatment often involved reduction and immobilization of midface fractures with evisceration and grafting of ocular tissues

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

Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients

Background: The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV‑related oral lesions in paediatric Nigerian patients on HAART with those not on HAART. Materials and Methods: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross‑sectional study over a 2‑year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P‑value of <0.05 was considered significant. Results: A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm3, 913 cells/mm3 and 629 cells/mm3 for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56‑1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54‑0.94; P=0.024) and HIV‑gingivitis (OR=0.59; 95% CI=0.46‑0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV‑periodonttitis (OR=0.60; 95% CI=0.51‑0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31‑5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62‑2.06). Conclusion: HIV‑related Oral lesions are frequently seen in HIV‑infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV‑gingivitis.Keywords: HIV/AIDS, Nigeria, oral manifestations, paediatricsNigerian Medical Journal | Vol. 53 | Issue 3 | July-September | 201

Paediatric jaw tumours: experiences and findings from a resource limited tertiary health care center

Introduction: primary maxillofacial tumors are uncommon in pediatric patients. When they do occur, the tissue damage caused directly alters facial growth, development as well as psycho-social evolution. This study was carried out to determine the pattern, sociodemographic characteristics and histologic peculiarities of paediatric jaw tumors in our environment. Methods: a retrospective hospital-based study where the case notes of children below the age of 14 years who presented with jaw tumors and tumor-like lesions from January 2014 to December 2018 were studied. Results: eighty-two patients were studied; patients aged 10-14 years had the highest representation. Mean time of presentation was 8 months with jaw swelling being the commonest presentation (84.1%). Majority of the fathers were in their 4th decade of life while most of the mothers were in their third decade of life and both parents possessed primary school certificate as their highest level of educational attainment. Fathers were mostly traders, while mothers were mostly full-time housewives. The maxilla and mandible were most commonly affected with the left side showing higher preponderance. Burkitt lymphoma (19 (23.2%)) and adenomatoid odontogenic tumor (14 (17.1%)) were the commonest lesions. When the tumor involved both the maxilla and the mandible, the tumor was most likely malignant. Conclusion: in our center, paediatric jaw tumors are commonest in male children with the 10-14 years´ age group most commonly affected. Burkitt lymphoma and adenomatoid odontogenic tumors were the commonest tumors. Early presentation must be encouraged since these tumors if presented early can be successfully treated