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Ghana Medical Journal

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Factors contributing to poor management outcome of sinonasal malignancies in south-west Nigeria

AJ Fasunla, SA Ogunkeyede

Abstract


Objective: To describe the clinico-pathologic manifestations of sinonasal malignancies, identify the contributing factors to delay in presentation and recommend ways of preventing them in a resource challenged environment.
Design: A questionnaire based cross sectional descriptive study of patients with sinonasal malignancies between 2006 and 2011.
Setting: Hospital based study at the Otorhinolaryngology Department, University College Hospital, Ibadan.
Participants: 61 patients diagnosed with sinonasal malignancies Main outcome measures: Patients demographic and essential medical data were collected with a structured, interviewer assisted questionnaire and results analysed using descriptive statistics.
Results: There were 28(45.9%) males and 33(54.I %) females; mean age 37years. The common presentations were epistaxis, nasal obstruction and facial asymmetry and 96.7% patients with squamous cell carcinoma presented in advanced disease stage (Stage 3 & 4). Over 47% patients presented a year after onset of symptoms. Factors which included  self-medication, wrong advice from relations/ friends to consult traditional  herbalist or quacks for treatment and traditional & religious beliefs
contributed to delay in presentation to hospitals. High cost of medical treatment, unwelcoming attitudes of some hospital staff, lack of confidence in orthodox medicine and proximity to health facilities were reasons given for not considering hospital as the first place to seek medical treatment.
Conclusion: Health education to create awareness of sinonasal malignancies and provision of affordable and accessible health facilities especially in rural areas are recommended ways to encourage patients to present early in hospitals. This will improve the management outcome and quality of life of patients with sinonasal malignancies.

Keywords: Delayed presentation, Health care services, Outcome, Sinonasal malignancies




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