Nigerian Journal of Otorhinolaryngology

Are there Correleations among histologic radiologic and cytopathologic findings in non-allergic Chronic rinosinusitis without nasal polyposis

A Kutluhan, Z Kaya, V Yurttas, M Kosem, M E Sakarya, I Ibiloglu — Wed, 23 Jan 2008 00:00:00 +0000

Purpose: To investigate any correlations among cytopathologic, radiologic, and historic findings in non-allergic chronic rhinosinusitis without nasal polyposis. Materials and Methods: This prospective study was done on 40 adult patients who had undergone functional endoscopic sinus surgery due to chronic rhinosinusitis. Symptom, nasal smear, paranasal computed tomography, as well as histopathologic findings of uncinate process, anterior ethmoid cells, and ethmoidal infundibulum were scored. Correlations were analysed among symptom, radiologic, and cytopathologic scores. Results: While the symptom scores of patients with chronic rhinosinusitis were positively correlated with only nasal smear scores, it was not correlated with computed tomography and histopathologic scores. On the other hand, radiologic scores were correlated with tissue eosinophils scores of uncinate process, anterior ethmoidal cells, and ethmoidal infundibulum Conclusions: The correlation of symptom score to nasal smear score in chronic sinusitis may be an evidence for the positive relationship symptoms and acute inflammation. The correlation of radiologic score to eosinophilia scores of uncinate process, anterior ethmoidal cells, and infundibulum may signify the importance of tissue eosinophils in chronic sinusitis.

Keywords: Rhinosinusitits, nasal polyposis, non-allergic rhinosinusitis.

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 45-53

Diagnosing Chronic Rhinosinusitis: a Literature update

S Lobo, R Rivron, N Najar — Wed, 23 Jan 2008 00:00:00 +0000

Diagnosing chronic rhinosinusitis has undergone significant changes since the advent of sensitive but costly diagnostic aids like endoscopy, computed tomography scanning and magnetic resonance imaging. Other new conditions like migraine without aura, mid-segment facial pain and atypical facial pain can present with similar features. Patients who have failed treatment from general practitioners or other specialists are subsequently referred to Otolaryngologists. This article reviews the current literature on the subject matter, in order to make the best use of current resources in the management of CRS.

Keywords: Rhinosinusitis, sinusitis, endoscopy, computed tomography (CT), magnetic resonance imaging (MRI)

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 54-64

Pattern Of Skin Prick Allergy Test Results In Enugu

M C Mgbor, S O Mgbor — Wed, 23 Jan 2008 00:00:00 +0000

Allergic rhinitis is a global health problem and is increasing in prebbalence up to 10 – 20% over the last half century. Both allergic rhinitis and vasomotorhinitis are the most common health problems encountered in the Ear Nose and Throat Clinic in Nigeria and they afflict all age groups in any modern society. Aim In this study we report on pattern of allergy prick skin test results found among atopic patients attending the department of otorhinolargngology of the University of Nigeria Teaching Hospital Enugu and Hansa Clinics, Enugu and propose ways of minimizing the exposure of the population to allergens. Material and method 76 patients of which 46 were males and 30 females with signs and symptoms of allergic rhinitis attending the ENT clinics were randomly recruited for the study. The patients' age ranged from > 9 – 48 years with a male to female ratio of 1.5:1. Complete medical, family and social history was obtained. The “Allergo Ganzer” Allergy test kit (Germany) was used for skin prick allergy test on each patient. Result The reactivities to test allergens were found to be in 44.4% patients positive to house dust mites I & II, 27.2% to house dust, 22% to grass, 16.6% to cereal and trees respectively and only 8.3% to mould. Conclusion House dust mites and house dust were the commonest implicated allergens, both accounting for 72.1% of all positive reactivity in our study. The need for avoidance of house rugs and carpets in our homes and offices and the development of local prick test solutions with inclusion of tropical allergens should be emphasized.

Keywords: Allergic rhinitis, allergens, house dust mites, house dust Nigeria.

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 65-71

Facial Nerve palsy: the Experience at a Nigerian Teaching Hospital

Wed, 23 Jan 2008 00:00:00 +0000

Background: We observed at our center that facial nerve palsy (FNP) presented in crops at a particular season of the year and was usually associated with emotional stress on the patient. Objective: The aims of this study were to evaluate the aetiology, and the management options for patient with facial nerve palsy in our institution Materials and Methods: The medical charts of all the patients that had FNP over the 16-year period (1988-2003) were retrospectively reviewed. The demographic data, aetiology and the management outcome of each patient were noted. The data were analyzed using SPSS Version 11 software and results were presented using simple frequency, percentages and charts. Results: There were 104 patients with a male: female ratio of 1.4:1. All age groups were affected with the peak prevalence in the third decade of life. Bell's palsy accounted for 50 (48.1%), inflammatory ear diseases 23(22.1%), trauma 14(13.5%), cerebral infarction 7(6.7%) malignancies 4(3.8%) and post grand-mal seizure in 2(1.9%). Unilateral FNP was seen in 93 (90%) of cases while bilateral paralysis was seen in 4 (3.8%). All the patients were treated conservatively and had physiotherapy. Full recovery occurred in 80% of the cases, 5% had partial recovery while in 15% the outcome was unsatisfactory. Corneal ulceration was seen in 5(4.8%). Conclusion: Bell's palsy was the most common cause of FNP in our center. There was need for surgical rehabilitation procedures in the management of FNP in this environment. This will ensure satisfactory outcome in all patients.

Keywords: Bell's palsy, facial nerve palsy, otitis media, corneal ulceration

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 72-76

Pattern of Head and Neck Cancer in Sokoto

K R Iseh, S A Malami

Objective: To determine the pattern of head and neck cancers in Sokoto north western Nigeria. Materials and method: This is a retrospective study of 131 histologically diagnosed head and neck cancers over a 5 year period(1999-2004) from Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria. Results: One hundred and thirty-one head and neck cancers were studied representing 21% of the total number of 623 histologically diagnosed malignancies in the centre during the 5year period (1999-2004).There were 77males(58.8%) and 54 females(41.2%).The male to female ratio was 1.43:1.The ages of the patients ranged from 9 months to 80 years. There were 69 carcinomas (52.7%), 27 lymphomas (20.6%),18 sarcomas(13.7%)and 17 blastomas (13.0%).Thirty-nine cases [30% ] were Head and neck squamous cell carcinomas. Nasopharyngeal carcinoma (13%) was the commonest Head and neck cancer in adults spanning through the 3rd ,4th ,5th,6th and 7th decades of life with the highest number in the 5th decade.. Retinoblastoma (13.0%) was the commonest childhood head and neck cancer. Conclusion: The pattern of Head and neck cancers in this region involved every site and the younger age group When compared to other parts of the country,suggests that concerted efforts should be directed towards prevention and setting up of more centres for screening, diagnosis, treatment and rehabilitation of head and neck cancers..

Keywords: Head and Neck, cancer, Sokoto, Nigeria

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 77-83

Meat bolus impactions in the oesophagus among elderly Nigerians in

K R Iseh, D J Aliyu

Background: Impacted pharyngo-esophageal foreign bodies are more common in children than adults with various types of foreign bodies reported. The elderly may also be affected with foreign body impaction. Materials and methods: This was a prospective study of elderly Nigerians who were admitted with symptoms of total dysphagia and odynophagia following ingestion of meat bolus over a 3½ year period (Jan.2002 to June 2005) from ear, nose and throat (ENT) department of usman danfodiyo university teaching hospital (uduth) sokoto, nigeiria.. They were managed ‘conservatively ‘ Results: A total number of 10 elderly patients [ 7 males (70%), 3 females (30%), 3 females (30%)] were seen whose ages ranged between 70 and 90 years. The duration of symptoms was between 1 and 2 days. All had spontaneous disimpaaction between 24-48 hours while on conservative management. One patient came back 3 months after with confirmed features of hypoharyngeal and oesophageal tumour. Conclusion: while conservative approach is advocated in all cases of meat bolus impaction for 24-48 hours to avoid possible attendant anaesthetic and surgical complications during rigid oesophagoscopy, it is imperative that contrast studies must be carried out on all patients with serial follow up to exclude any underlying malignancy after spontaneous disimpaction.

Keywords: oesophagus , meaat bolus, foreign body elderly Nigerian

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 84-88

Steak House Syndrome: Case Report And Review Of Management Options.

A Bakari, A T Anka

BACKGROUND: Oesophageal meat bolus impaction (Steakhouse Syndrome) is a common Otolaryngologic emergency. The preferred method of treatment is endoscopic removal. This paper reports on the management of an elderly man who presented at a district hospital with no facility for endoscopy. Other management options reported in the literature are reviewed. METHOD: Case report and review of relevant literature on management of Steakhouse Syndrome. RESULT: The literature is awash with various treatment options for food impaction in the oesophagus. Endoscopic removal remains the safest. Other options include the use of agents that relaxes the oesophageal sphincter, Use of proteolytic enzymes and the use of effervescent agents. CONCLUSION: Most cases of Steakhouse Syndrome resolve spontaneously at home. For those that present where there are no facilities for oesophagoscopy, the other options discussed can be employed.

Keywords: Steakhouse Syndrome, Oesophageal meat bolus impaction, oesophagoscopy.

Nigerian Journal of Otorhinolaryngology Vol. 3 (2) 2006: pp. 89-93