9 research outputs found
Reasons for late presentation of cleft deformity in northeastern Nigeria
Cleft lip and palate is the commonest congenital deformity of the orofacial region. It is generally accepted that the surgical operations of cleft lip and palate should be done early in life. Indeveloping countries, a significant number of these patients present for treatment in late childhood and in some instances as adults. The precise reasons for this will most certainly vary from culture to culture, but the common reasons may be quite similar in many countries Method: Fifty-two patients with facial clefts who presented late at the University of Maiduguri Teaching Hospital within a 2-year period were assessed by interviewing either the parents, relations or even the patients themselves. Result: The reasons for late presentation were financial constraint (46%), lack of knowledge of availability of cleft services (40%), far distance from cleft centre (8%), cultural beliefs (4%) and fear of surgery(2%). Conclusion: The result of this study revealed financial constraint and lack of knowledge of availability of cleft services as prominent reasons why majority of patients with cleft deformity presents late. Adequate funding of cleft care from both government and non-governmental organisations, providing primary health care workers with information regarding the availability of cleft services and improved public enlightenment programme would reduce the rate of late presentation in Nigeria and other developing countries
Oral mucosa grafts for urethral reconstruction
Background: Urethral reconstruction has continued to present formidable
and enormous challenges for urologic, paediatric and plastic surgeons
as diverse opinions have been expressed on the quality and type of
ideal substitution material. This literature review is aimed at drawing
attention of surgeons to the versatile nature of oral mucosal grafts.
Methods: A review of the utilization of oral mucosa in urethral
reconstruction was made. Structured Medline search was performed
looking at all aspects of utilization of oral mucosa including mucosal
harvest, donor site morbidity and outcome. Results: The unique
demands of the urethra set a high standard for autogenous graft
substitutes; hence literature reports reveal that split and full
thickness skin grafts from the scrotum, penis, extragenital sites
(ureter, saphenous vein, appendix, colon, medial upper arm, neck,
lateral chest, abdomen, bladder mucosa) and more recently oral mucosa
have been used. Unlike other tissues, oral mucosa grafts are flexible,
easy to harvest and trim and have an excellent microvasculature
favorable for graft-taking. Furthermore, the natural moist location of
the oral mucosa in the oral environment favours its easy adaptability
in the urethral passage thus giving good long-term results. However,
there are reports of complications at the donor site with the commonest
being anaesthesia or paraesthesia of the cheek or lips. Regional
variations of the oral mucosa, length of the graft required, the
decision to close or leave donor site open and harvesting technique are
some of the factors suggested to account for differences in donor site
morbidity. Conclusion: Oral mucosal graft is a versatile urethral
substitute with excellent outcome. It is becoming the gold standard for
urethral substitution
Hybrid clear cell odontogenic carcinoma and ameloblastic carcinoma-report of a case
Ameloblastic carcinoma (AC) produces extensive local destruction, perforation of the cortical plate, extension into surrounding soft tissues, numerous recurrent lesions, and metastasis, usually to cervical lymph nodes. Clear cell odontogenic carcinoma (CCOC) which was previously designated clear cell odontogenic tumor also exhibits an aggressive biologic behavior and a tendency to metastasize to distant locations. Both lesions are rare. We report an odontogenic carcinoma with a dual histomorphologic feature of CCOC and AC coexisting in a single lesion. To the best of our knowledge, this is the first report of its kind in the literature
Oral mucosa grafts for urethral reconstruction
Background: Urethral reconstruction has continued to present formidable
and enormous challenges for urologic, paediatric and plastic surgeons
as diverse opinions have been expressed on the quality and type of
ideal substitution material. This literature review is aimed at drawing
attention of surgeons to the versatile nature of oral mucosal grafts.
Methods: A review of the utilization of oral mucosa in urethral
reconstruction was made. Structured Medline search was performed
looking at all aspects of utilization of oral mucosa including mucosal
harvest, donor site morbidity and outcome. Results: The unique
demands of the urethra set a high standard for autogenous graft
substitutes; hence literature reports reveal that split and full
thickness skin grafts from the scrotum, penis, extragenital sites
(ureter, saphenous vein, appendix, colon, medial upper arm, neck,
lateral chest, abdomen, bladder mucosa) and more recently oral mucosa
have been used. Unlike other tissues, oral mucosa grafts are flexible,
easy to harvest and trim and have an excellent microvasculature
favorable for graft-taking. Furthermore, the natural moist location of
the oral mucosa in the oral environment favours its easy adaptability
in the urethral passage thus giving good long-term results. However,
there are reports of complications at the donor site with the commonest
being anaesthesia or paraesthesia of the cheek or lips. Regional
variations of the oral mucosa, length of the graft required, the
decision to close or leave donor site open and harvesting technique are
some of the factors suggested to account for differences in donor site
morbidity. Conclusion: Oral mucosal graft is a versatile urethral
substitute with excellent outcome. It is becoming the gold standard for
urethral substitution
A clinicopathological study of lipomas of the head and neck
Background: Lipoma of the head and neck region are fairly common.
Methods: This twelve year retrospective study evaluated thirty-nine cases of head and neck lipomas in Nigerians.
Results: They constituted 14.4% of benign tumours of the head and neck region and 17.6% of total body lipomas seen within the study period. There were two peaks in the age distribution with patients in the fifth and seventh decades of life recording the highest number of cases. More males were affected with a male-female ratio of 2:1. Most cases (33.3%) were seen in the neck, followed by the scalp (23.1%). Only one intra oral case presenting on the tongue was recorded. The two patients with multiple lipomas were negative for associated systemic disease. Two histological variants were seen (conventional and fibrolipoma).
Conclusion: Tumours of adipose tissue are common head and neck neoplasms. While conventional lipomas are the commonest histological variants, the diagnosis of these lesions may be arrived at from clinical presentations supplemented with histological examinations. Treatment by surgical excision (lipectomy) produces satisfactory results.
(Nig J Surg Res 2003; 5; 12 – 17)
Key words: Head and neck, lipoma
Orofacial Injuries in Eclamptic Nigerians
A retrospective review of one hundred and seventy three cases of
eclampsia seen between 1994 and 2002 was conducted. Twenty one patients
(12.1%) whose ages ranged from 18 to 35 years sustained orofacial
injuries during the course of their eclamptic fits. Lacerations and
bruises on the tongue, gingivae and lips accounted for injuries in all
the patients. Temporomandibular joint dislocation was also recorded in
one patient. Tongue lacerations were mainly due to tongue biting.
Forceful insertion of objects during convulsive episodes was
responsible for the bruises and deep lacerations at the ventral surface
of the tongue in two patients. Two patients died from severe and
uncontrolled bleeding complicated by renal failure and aspiration
pneumonia from lacerations on the tongue and gingivae. Vigorous
campaign should be carried out to encourage antenatal care attendance
by pregnant mothers so that potential cases of eclampsia could be
nipped in the bud before progressing to frank eclampsia. Furthermore,
additional injuries usually inflicted on pregnant women by anxious
relatives from forceful insertion of unpadded objects as mouth props
should be discouraged through public health promotional campaigns.
Obstetricians should be aware of the possibility of these injuries in
an unconscious eclamptic patient and their life-threatening
consequences if not promptly diagnosed and managed. The need to seek
appropriate and early dental or maxillofacial consultation where such
injuries are suspected and where services are available is imperative.
(Afr J Reprod Health 2004; 8[3]:147-151