Surgical Management of Chronic Suppurative Otitis Media: A 3-year Experience

Background/Objective: To determine the outcome of surgery for chronic suppurative otitis media at our department over 3 years, between 2001 and 2003. The outcome measures were; achievement of dry ear, closure of tympanic membrane perforation and improvement in hearing for patients who had myringoplasty. Methods: A retrospective review of case notes of patients with chronic suppurative otitis media (cholesteatoma and non-cholesteatomatous disease) operated upon by 2 consultant ENT surgeons in our department over a 3 year period. The operations performed were mastoidectomy and type I tympanoplasty or myringoplasty. The results were analysed and presented. Results: Seventy three patients were operated upon for cholesteatoma and non-cholesteatomatous chronic otitis media during this period, there were 41 males and 32 females with a sex ratio of 1:1.3. Age range was 9 to 84 years with the mean age of 37 years. 17 of them were children aged 9 to 15 years (24%). 25 patients (34.2%) had cholesteatoma and 48 (65.8%) had non-cholesteatomatous disease 41 (56.2%) had myringoplasty and 29 (39.7%) had mastoidectomy, and 3 (4.1%) patients had tympanomastoidectomy. 62.5% (n=20) mastoid cavities were dry at 12 months follow up. Perforation closure was achieved in 89% (n=34). Binaural hearing was achieved in 6 patients and in 4 patients the operated ear became the better hearing ear; air-bone gap was closed completely in 8 patients (19.5%), and in 36.6% (n=15) the gap was closed to within 10dB. There was no deterioration in hearing in the operated ears. One patient presented with House Brachman grade 2 facial palsy pre-operatively which worsened to grade 4 post operatively but improved to pre-operative grade at 12month follow up. Conclusion: Chronic suppurative otitis media is a disease that is still with us, and at our department, the surgery has a high success rate, which is also comparable in adults and children.Fond/Objectif: Pour d\ue9terminer les r\ue9sultats de la chirurgie pour l'otite moyenne chronique suppurative \ue0 notre d\ue9partement pendand une p\ue9riode de 3 ans, entre 2001 et 2003. Les mesures de r\ue9sultats \ue9taient; accomplissement d'oreille s\ue8che, fermeture de perforation de tympan secondaire et am\ue9lioration d'audition pour les malades qui ont eu la myringoplastie. M\ue9thodes : Un examen r\ue9trospectif des notes de cas des malades pr\ue9sentant l'otite moyenne chronique suppurative ( maladie cholest\ue9atome et non-cholest\ue9atome) qui ont \ue9t\ue9 op\ue9r\ue9s par 2 chirurgiens consultants ORL dans notre d\ue9partement pendant une p\ue9riode de 3 ans. Les op\ue9rations \ue9taient la masto\uefdectomie et le type I de la tympanoplastie ou de la myringoplastie. Les r\ue9sultats ont \ue9t\ue9 analys\ue9s et pr\ue9sent\ue9s. R\ue9sultats: Soixante-treize malades ont \ue9t\ue9 op\ue9r\ue9s pour l'otite moyenne chronique cholest\ue9atome et non cholest\ue9atome pendant cette p\ue9riode. Il y avait 41 m\ue2les et 32 femelles avec un sex ratio de 1:1,3. La cha\ueene d'\ue2ge \ue9tait de 9 \ue0 84 ans avec l'\ue2ge moyen de 37 ans. 17 d'entre eux \ue9taient des enfants \ue2g\ue9s 9 \ue0 15 ans (24%). 25 malades (34,2%) ont eu le cholest\ue9atome et 48 (65,8%) ont eu la maladie non-cholest\ue9atome. 41 (56,2%) ont eu la myringoplastie et 29 (39,7%) ont eu la masto\uefdectomie, et 3 (4,1%) malades ont eu tympanomasto\uefdectomie. 62,5% (n=20) cavit\ue9s du mastoide \ue9taient s\ue8ches \ue0 12 mois continuent. La fermeture de perforation a \ue9t\ue9 r\ue9alis\ue9e dans 89% (n=34). L'audition binaurale \ue9tait accomplie dans 6 malades et dans 4 malades, l'oreille op\ue9r\ue9e est devenue l'oreille de meilleure audition ; l'\ue9nergie r\ue9serve de l'oreille interne a \ue9t\ue9 combl\ue9e compl\ue8tement dans 8 malades (19,5%), et dans 36,6% (n=15) l'\ue9cart a \ue9t\ue9 r\ue9duit au sein de 10dB. Il n'y avait aucune d\ue9t\ue9rioration d'audition dans les oreilles op\ue9r\ue9es. Un malade a \ue9t\ue9 pr\ue9sent\ue9 avec la paralysie du nerf facial de la cat\ue9gorie 2 de la Chambre Brachman pr\ue9-perop\ue9ratoirement qui a empir\ue9 \ue0 la cat\ue9gorie 4 post-perop\ue9ratoirement mais a am\ue9lior\ue9 \ue0 la cat\ue9gorie pr\ue9-perop\ue9ratoire \ue0 12 mois ult\ue9rieurs. Conclusion: L'otite moyenne chronique suppurative est une maladie qui est toujours avec nous, et \ue0 notre d\ue9partement, la chirurgie a un taux \ue9lev\ue9 de succ\ue8s, qui est \ue9galement comparable dans les adultes et les enfants

Descriptive epidemiology of salivary gland neoplasms in Nigeria: An AOPRC multicenter tertiary hospital study

Objectives: Accurate diagnosis of salivary gland neoplasms (SGN) in many centers in Africa is limited by poor diagnostic resources and ancillary services. Hence, we have carried out a multicenter epidemiological study to understand the true burden of SGN in Nigeria. Method: In this descriptive cross‐sectional study, we have deployed resources available to members of the African Oral Pathology Consortium (AOPRC) to examine the burden of salivary gland lesions in Nigeria, using a multicenter approach. Data from seven major tertiary health institutions in northern, western, and southern Nigeria were generated using a standardized data extraction format and analyzed using the Epi‐info software (Version 7.0, Atlanta, USA). Result: Of the 497 cases examined across the seven centers, we observed that SGN occurred more in females than males. Overall, pleomorphic salivary adenoma (PA) was found to be the most common. PA was found to be the commonest benign SGN while adenocystic carcinoma (ADCC) was the commonest malignant SGN. Regional variations were observed for age group, diagnosis, and gender distribution. Significant statistical differences were found between males and females for malignant SGNs (p‐value=0.037). Conclusion: We found regional variation in the pattern of distribution of SGN in Nigeria. This is the largest multicenter study of SGN in Nigeria, and our findings are robust and representative of the epidemiology of this neoplasm in Nigeria