Frey Syndrome Complicating Parotidectomy: A Case Report And Review Of Literature

The parotid gland is one of the major salivary glands located on the face. It is commonly affected by diseases necessitating its surgical removal. The facial nerve is in intimate contact with this structure and can easily be damaged during operation on this gland. Parotidectomy is the surgical operation done to remove part or the whole of the parotid gland. There are several types of parotidectomies. These may be superficial, total, total conservative, radical or extended radical. A number of complications may ensue following this procedure. Frey syndrome is one of such complications but uncommon. It is therefore the aim of this paper to present this index case with a review of literature. Key words: Frey syndrome, Parotidectomy, Complication

An Unusual Oronasal Foreign Body: Report of A Case

Background: Foreign body removal in children is very common in the daily routine of an otolaryngologist but reports of oronasal foreign bodies and their management are rare. Method: The case note of a 5 year old female child presenting with an oronasal foreign body following a domestic accident was retrieved and studied and followed up. Result: a 5 year old female child with an oronasal foreign body which created an oronasal fistula that was closed with local palatal mucoperiosteal-lined flaps. The patient defaulted following treatment, a common practice by patients in our society. Conclusion: This report highlights the occurrence of this rare condition, its management and the need to put measures in place to prevent domestic accidents especially for those most at risk. Keywords: Oronasal, Foreign body, Fistula, Domestic accident.Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 459-46

Experience in the management of the mass casualty from the January 2010 Jos Crisis

Background: On the 17 of January 2010, a sectarian crisis broke out in Jos the capital of Plateau state, Nigeria. It created a mass casualty situation in the Jos University Teaching Hospital. We present the result of the hospital management of that mass casualty incident.Objective: To share our experience in the management of the mass casualty situation arising from the sectarian crisis of Jos in January 2010.Methodology: We retrospectively reviewed the hospital records of patients who were treated in our hospital with injuries sustained in the Jos crisis of January 2010.Results: A total of 168 patients presented over a four day period. There were 108 males (64.3%) and 60 females (35.7%). The mean age was 26 ± 16 years. Injury was caused by gunshots in 68 patients (40.5%), machete in 56 (33.3%), falls in 22 (13.1%) and burning in 21 (13.1%). The body parts injured were the upper limbs in 61(36.3%) patients, lower limbs 44 (26.2%) and scalp 43 (25.6%). Majority, 125 (74.4%) did not require formal operative care. Fourteen (8.3%) patients had complications out of which 10 (6.0%) were related to infections. There were 5 (3.1%) hospital mortalities and the mean duration of hospital stay was 4.2 days. The hospital operations returned to routine 24 hours after the last patient was brought in. As a result of changes made to our protocol, management proceeded smoothly and there was no stoppage of the hospital response at any point.Conclusion: This civil crisis involved mostly young males. Injuries were mainly lacerations from machete and gunshot injuries. Majority of the victims did not require formal surgical operations beyond initial care. Maintaining continuity in the positions of the Incident commander and the mass casualty commander ensure a smooth disaster response with fewer challenges.Keywords: Conflict, disaster, hospital response, mass casualty, traum

Head/Neck Squamous Cell Carcinoma: - Prevention Strategy

Background:-Head and neck squamous cell carcinoma is the most common histological subtypes of Head and neck tumour. It consist of 4-5% of all cancer and the fourth leading cause of cancer death in developed and developing nations of America and Africa. Objective:-To describe the epidemiological pattern of Head and Neck squamous Cell Carcinoma (HNSCC) in Northern Nigeria and to review risk factors and prevention strategies. Methods:-Review of literature published from northern Nigeria from 2000 to 2010. The authors also reviewed strategy for cancer prevention with special emphasis to tobacco cigarette as the major risk factors. Search; head and neck tomours, squamous cell tomours, strategies for prevention.  Key Words:-Squamous cell carcinoma, Tobacco cigarette, Northern Nigeri

An audit of endoscopic otorhinolaryngological practice in Jos, Nigeria

Background: Endoscopic otorhinolaryngological procedure is quicker, safer and cheaper than open surgery because of its less invasive nature. It is constantly being practiced in the developed nations and the Middle East. The indications abound in our environment. However, very few hospitals have the facilities for these procedures. The aim of this paper is to highlight the state and scope of our endoscopic practice.Method: All the case records of patients who had endoscopic otorhinolaryngological procedures within the 18 months in two teaching hospitals were retrieved and biodata, endoscopic findings and management were extracted.Result: A total of 100 cases made up of 79 (79%) adults were seen within the study period. Their ages ranged from 9 months to 76 years with average age of 42.3 years. Diagnostic endoscopic procedures were 76 (76%) while therapeutic cases were 24 (24%). Laryngoscopy was the most common endoscopic procedure constituting 62 (62%) cases. Others included oesophagoscopy (20%), bronchoscopy (10%)Conclusion: Endoscopic procedure is safe. Dearth of endoscopic equipments is a major impediment to the practice of this procedure in our environment. Collaboration between centers is a quick way to circumvent this problem and helps to keep the specialist proficient.Keywords: Otorhinolaryngology, Endoscopy, Indications, Jos Otene

Is routine histopathology of tonsil specimen necessary?

Background: Tonsillar diseases are common in paediatric and adult otolaryngological practice. These diseases require tonsillectomy.  Specimens are subjected to histopathology routinely in my institution for fear of infections and tumour without consideration for risk factors. The financial burden is on the patients and waste of histopathologist’s man hour because other specimens are left un-attended. This study aims to find out the necessity of routine histopathology of tonsil specimens. Materials and Methods: A 2 year retrospective review of the  histopathological results of two (paediatric and adult) groups of 61 patientsmanaged for tonsillar diseases at the ENT UNIT of Jos University Teaching Hospital from July 2005 to June, 2007. Data extracted included biodata,clinical features and histopathological diagnosis.Result: The 61 patients comprise 35 children and 26 adults. The youngest and oldest paediatric patients were 1 year and 3 months and 16 yearsrespectively, a range of 1 year 3 months to 16 years. The youngest and oldest adults were 17 and 50 years with a range of 17-50 years. Groups mean ages were 5.1 and 28.5 years. The gender ratios were 1:2.7 and 1:1.9 respectively. One adult was HIV positive. The histopathological diagnosis were chronic nonspecific tonsillitis in 10(16.6%), follicular tonsillitis in 23(38.3%), chronic suppurative tonsillitis in 10(16.6%), lymphoid hyperplasia in 18(30.0%) and lymphoma in 1(1.0%)  respectively.Conclusion: Histopathologic request for tonsillectomy specimens should be based on certain risk factors with consideration of the cost to patients and to spare the histopathologist’s man hour

Safe Day Case Adenotonsillectomy: Experience from a Private Hospital in Jos

Background: Adenoidectomy, tonsillectomy or adenotonsillectomy are very common day case operations in childhood otolaryngologic practice. The complications are few, short lived, with minimal disruptions of both parental and patients' activities. The aim of this paper is to report the complications of day case adenotonsillectomy in a private hospital setting in a developing country. Methodology: This is a 30-month (January 2008 April, 2010) retrospective review of adenoid and tonsillar operations carried out in a private Ear, Nose and Throat (ENT) surgical centre, in Jos, Nigeria. Results: A total of 117 patients were seen during the study period. Forty (34.2%) patients had benign tonsillar diseases. Thirty three (82.5%) were tonsillar hypertrophies with obstructive symptoms while the remaining seven (17.5%) were cases of recurrent tonsillitis. There were 16 males and 24 females giving an overall male to female ratio of 1:1.5.The youngest patient was 15 months while the oldest was 8 years. All the patients had tonsillectomy by cold dissection. The duration of hospital stay was between 12 and 16 hours. The most common complications were nausea and vomiting and dysphagia. There was a case of aspiration of breast milk, while two patients had arrhythmias. All the histologic reports were consistent with tonsillitis and tonsillar hypertrophy. Conclusion: Day case tonsillectomies in private hospitals settings are safe with few complications that are often not life threatening. It should be encouraged in our environment in private hospitals where the facilities are available.Key Words Day case tonsillectomy, adenotonsillectomy, otolaryngolog

Day Case Adenotonsiletomy: Experience of Two Private Clinics in Nigeria

Background: adenoidectomy and tonsillectomy are among the common surgeries perform in children in otorhinoryngological practice. It was the aim of this study to evaluate the post operative mobility in patients undergoing day-case adenoidedtomy/tonsillectomy or adenotonsillectomy. Methodology: All pediatrics cases requiring adenoidectomy, tonsillectomy or both who presented at HANSA clinics Enugu (January 1990 to June 2004) and GENIKS specialist clinics Ibadan (January 2000 to June 2004) were counseled for day case surgery. The inclusion criteria were: Patients certified fit for surgery- ASA grade I or II for general Anaesthesia and had no intercurrent CVS disease or bleeding diathesis among others. Results: A total number of 144 patients requiring adenoidectomy, Tonsillectomy or both were seen at the study centers with only sixty six (45.8%) meeting the inclusion criteria. Adenoidectomy constituted 47% of the surgeries with over 80 of the patient age less than 7 years reactionary haemorrhage was noted in 3 (4.5%) of the patient. the other complications Were non-persistent vomiting 13 (19.7%), low grade fever 5 (7.6%) and pain at time of discharge 23 (34.8%). There were no fatalities. Conclusion: The complication rates were low. Day-case Adenoidectomy/tonsillectomy or denotonsillectomy is safe and the presence or closeness of the family members contributed greatly to patients/ post recovery as this as this had a soothing/calming effect on the patient/s. Keywords: Day-case, Adenoidectomy, Tonsillectomy, Nigeria. Nigerian Journal of Medicine Vol. 17 (3) 2008: pp. 296-29

cervical necrotizing fasciitis: Case series and review of literature

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Swab and aspiration specimen collection methods and antibiogram in chronic suppurative otitis media at Jos University Teaching Hospital: Which is superior?

Background: Chronic suppurative otitis media is a very common otologic problem in our environment. Appropriate methods for obtaining sample specimens for specific bacteria isolation has generated a lot of controversy. The simplest method available in our environment is the traditional swab method which, however, has been condemned on the basis of introducing contaminants. The objectives of this study were to compare the bacterial yield and the antibiogram of two specimen collection methods: the traditional swab method and aspiration method.Method: This was a 3-month prospective study involving outpatients seen at both the emergency and outpatients’ clinics of the Jos University Teaching Hospital in the period between May 2008 and July 2008. The biodata, duration of discharge and sites of samples were recorded in the study data form after obtaining consent from the patients or the parents of child.Results: Eighty patients were studied comprising 40 each for aspiration and swab technique. This consists of 30 males (37.5%) and 50 females (62.5%) with a male to female ratio of 1:1.7. There were 24 (30%) children (14 males, 10 females). Six (4 males, 2 females) and 74 (26 males, 48 females) patients had bilateral and unilateral ear discharges,respectively. A total of 86 specimens were obtained in all, consisting of 42 left and 44 right ears. There were 68 bacteria isolates comprising Pseudomonas (30), Staphylococcus (18), Proteus (12), and (8) Klebsiella species. Two were incidental fungal isolates of (Candida species), (8) cultures grew contaminants and (10) specimens had no growth at all. Each of the swab and aspiration techniques had (44) specimens.Conclusions: Despite the controversy surrounding the sampling technique in literature, swab technique has been found to be as good as the aspiration technique in our study. The organisms isolated are the same as those obtained in other places. Contaminants found were few and occurred in equal amount in the same patients in the two methods