Hearing Loss among Elderly Patients in an Ear Clinic in Nigeria

Background - Hearing Loss is a very common disabling condition among the elderly. It is estimated that above the age of 60, one in four people have some degree of hearing loss and over the age of 70, to one in two. Approximately one-third of persons above 65 years have disabling hearing loss. This study was to investigate the pattern of hearing among the elderly patients in an ear clinic in Nigeria. Methods - Eighty-eight elderly patients were studied ex-post facto. These were the patients aged over 65 among 586 patients who had presented for hearing loss and had been sent for Pure Tone Audiometry over a period of three years. Results - The eighty eight patients studied comprised 15% of the 586 patients who had been seen for Pure Tone Audiometry. Mean age was 72.4 years (SD= 6.58). The Male: Female ratio was 1.9:1. There was normal hearing in 18%. More than eight out of ten (82%) had hearing loss. Among those with hearing loss, more than eight out of ten (82%) had disabling hearing loss. Although a mixed hearing loss pattern predominated, there where almost as many with only sensorineural hearing loss. Thus more than seven out of ten had some sensorineural hearing loss. And although the majority of those with hearing loss had the classical sloping presbyacisis pattern, other patterns were also found. Conclusion - Disabling hearing loss is very common among the elderly. It is usually due to presbyacusis but can also be from other causes. Since there is a risk of subsequent psychological problems and social isolation, all caregivers of elderly people should be aware of this and provide care or guidance appropriately. In addition, strategic initiatives directed to the elderly, the general public, health workers, professionals working with the elderly, ear and hearing specialists, government entities and Non Governmental Organizations are needed to address the issue. Keywords: Hearing Loss, Elderly, Rehabilitation, Nigeri

Hoarseness: Management challenges in Osogbo, Osun State, Nigeria.

Background: Hoarseness is a symptom of utmost significance and calls for a separate consideration because of the frequency of its occurrence.Objective: This study highlighted some challengesmilitating against effective management of the condition in resource poor environmentMethods: A retrospective descriptive study between December 2006 and November 2012Results: A total of 151 patients consisting of 99 males and 52 female. The age of the patients ranged from 9 months to 85 years with a mean± SD of 41.13 ± 18.45 years. Inflammation 63 (41.7%) andtumour47 (31.1%) were the leading causes. Sixty three (41.7%) presented within the first six months, 112 (74.2%) presented within the first year and 39 (25.9%) presented after the first year of onset. Large proportion 10/14 (71.4%)of patients with laryngeal papillomatosis presented late, they presented due to airway obstruction that necessitated emergency tracheostomy at presentation. Most 27 (81.8%) cases of laryngeal cancer presented late and in advanced stage. Only 6 (18.8%) patients with laryngeal cancer consented to total laryngectomy and 13(39.4%) opted for chemoradiation therapy. Three (9%) defaulted after emergency tracheostomy and direct laryngoscopy and biopsy. Nine patients (27.3%) defaulted after emergency tracheostomy before histological diagnosis.Conclusion: There are challenges associated with management of patients with hoarseness in our locality. Most patients presented late and in critical situations. Suggestions for better management and strategies for better outcome were discussedKeywords: Hoarseness, management challenges, laryngoscopy, laryngeal cancer, resource poor environmen

Knowledge of physicians about sleep disorders in Osogbo, South West Nigeria

Background: Sleep disorders are common and global problem that affects a larger proportion of the population. The condition is significantly under diagnosed and most cases are left untreated.Objective: The presents study aims to study the knowledge of physicians about sleep disorders in suburban town in south-west NigeriaMethods: This is a cross-sectional, descriptive study that was conducted in Osogbo, South-West Nigeria. The target population was Physicians that work in LAUTECH Teaching Hospital and State Hospital Asubiaro, both in Osogbo, Nigeria. An adjusted 26 response question version of sleep disorders was used to collect data.Results: There were 96 respondents consisting of 62 males and 34 females. Majority (74%) work in the Teaching Hospital and 71.9% had worked for ≤ 10years. Most respondents agreed sleep disorder is not common in Nigeria,40.6% had never seen patients with sleep disorders. Larger proportion (65 – 79%) was familiar with most symptoms of sleep disorders but only 29.2%will ask question on apnea. Only5.2% were familiar with Epworth sleepiness scale. Over 93% were not familiar with any diagnostic test required to confirm sleep disorders. Majority(59.4 – 85.4%) believed that sleep disorders predispose to complications but only 38.5% knew sleep disorder can predispose to pulmonary hypertension. Over 63% could not manage sleep disorders effectively, 30.2% will refer to specialist, 15.6% did not know to whom they should referConclusion: Many Physicians in our environment have little knowledge on sleep disorders. Bearing in mind the long term health effects of sleep disorders, there is a need for Physicians to update their knowledge on this condition. This will lead to better management and improvement in quality of life of patientsKeywords: Sleep disorders; Physicians' knowledge; Polysomnography; Complications; Nigeri

Profile of Childhood Hearing Loss in A Nigerian Teaching Hospital

Background: Childhood hearing loss in the developing world is associated with late diagnosis and rehabilitation challenges. Methods: A retrospective review of all the cases of childhood hearing loss from January 2007 to December 2011 in a tertiary health institution. Results: A total of 53 patients, with the majority (92.5%) resulted from acquired causes of which 88.7% were due to birth asphyxia. Over 73% presented with moderately severe to profound hearing loss. Only 15% had a hearing aid fitted, 22.6% will require cochlear implant, while 43.3% could not afford a hearing aid. Conclusion: Developing countries are noted for a higher prevalence of acquired and preventable causes of childhood hearing loss. Primary prevention through effective obstetric care, public enlightenment, incorporation of universal hearing screening programs into the national policies, and readily available and affordable rehabilitative facilities are advised. [Arch Clin Exp Surg 2014; 3(4.000): 226-232