Characteristics and Management of Childhood Tinnitus in a Developing Country.

OBJECTIVES: Tinnitus is a commonly neglected otologic symptom among children in developing country. This study aimed at determining the prevalence, clinical characteristics, diagnosis and management of childhood tinnitus in a developing country. METHOD: This prospective hospital based study of patients' age 18 years and below with complaints of tinnitus was conducted in Ear, Nose and Throat Department of Ekiti state UniversityTeaching Hospital,Ado Ekiti,Nigeria between April 2016 to March 2018. The parents/guardians/patients were briefed about the scope of the study. After getting oral consent, pretested interviewers assisted questionnaire was administered to collect data. Data obtained were collated and analyzed using SPSS software version 18.0 and was expressed in simple tables and charts. RESULTS: Prevalence of tinnitus in this study was 6.2%. There were 56.1% males and male to female ratio was 1.5:1. Majority 55.3% had single episode of tinnitus and long duration (>3 months) was commonest form of tinnitus in 59.1%. Bilateral tinnitus was recorded in 68.9% while subjective tinnitus constituted 93.9%. Discrete tinnitus was commoner in 67.4%. Major causes of tinnitus were febrile illnesses, otitis media, noise exposure, unknown (idiopathic), earwax impaction and ototoxicity in 19.7%, 16.7%, 15.9%, 14.4%, 12.9% and 9.8% respectively. A commonest tympanometric finding was type A in 72.7% of patients. Commonly affected quality of life were anxiety, depression and attention problem in 51.5%, 43.2% and 40.2% respectively. Associated comorbid illnesses in this study were 50.8% sleeping disorders, 42.4% concentration disorders and 31.1% headache. Referrals were mainly from paediatrician in 44.7%. Prehospital treatment was mainly medication in 62.1%. All the patients were counselled (assured). Other treatments given were conservative treatment, surgery, ear syringing and hearing aids in 56.1%, 15.9%, 12.9% and 9.1% patients respectively. CONCLUSION: Childhood tinnitus is caused by preventable diseases. At presentation there were associated hearing impairment, comorbid illnesses and affectation of quality of life.

Preschool Children Hearing Impairment: Prevalence, Diagnosis and Management in a Developing Country.

OBJECTIVES: Preschool children hearing impairment is a common otologic diseases worldwide. The burdens of this preventable condition can be reduced in developing country. This study was carried out to determine the prevalence, diagnosis and management of hearing impairment among children less than 5 years seen in our center. METHOD: This was a prospective hospital based study of preschool children with complaints of hearing impairment in Ekiti state university teaching hospital, Nigeria. This study was conducted over a period of two years (February 2016 to January 2018). Data was obtained from consented patients by using pretested interviewers assisted questionnaire. Data obtained was collated and analyzed by using SPSS software version 18.0. D escriptive statistics was used to present and expressed the data as simple tables and charts. RESULTS: The prevalence of hearing impairment in this study was 5.9% with peak value of 37.6% at preschool age 3 years. There were 42.6% males and 57.4% females. Majority (51.5%) of the patients were urban dwellers. The aetiologic factors of hearing impairment include; 15.8% neonatal jaundice, 13.9% febrile illness, 12.9% otitis media and 11.9% birth asphyxia. Prelingual presentation was commonest in 57.4%. Common clinical features includes yet to speak, restlessness/stubborn and not responding to command in 60.4%, 48.5% and 46.5% respectively. Commonest type of hearing impairment was sensorineural hearing loss is 61.4%. Type A tympanometry (normal) was the commonest findings in 82.2%. CONCLUSION: Preschool children hearing impairment with late presentation is a common otologic diseases burden to parent and otorhinolaryngologist in our center. The common causes were preventable with resulting permanent auditory damage.

Pattern of allergic rhinitis among children in Ekiti, Nigeria.

BACKGROUND: Allergic rhinitis is a chronic and recurrent nasal condition. It is often neglected in children with late presentation. This study aimed at determining the prevalence, sociodemographic features, comorbid illnesses, complications and quality of life in children with allergic rhinitis in the study institution. MATERIALS AND METHODS: This is a prospective hospital based study of children with allergic rhinitis in Ekiti state university teaching hospital, Ado Ekiti. The study was carried out in ENT department over a period of two years (between June 2015 to May 2017). Informed consent was obtained from the parents/guardian/patients and consented patients were enrolled into the study. Data were obtained by pretested interviewers assisted questionnaire. Details of their history, physical examination and investigations were carried out and findings were documented. All data obtained were descriptively analysed using SPSS version 18.0 and presented in simple tables and charts. Ethical clearance was sought for and obtained from the ethical committee of the hospital. RESULTS: A total of 4341 patients were seen out of which 265 were children with allergic rhinitis. Prevalence of allergic rhinitis in children in this study was 6.1%. There were 63.0% males with male to female ratio of 2:1. Allergic rhinitis was peaked at preschool age group (1-5 years) accounted for 47.9%. A total of 42.3% participants were living in urban setting while 57.7% were from rural setting. Majorities (40.4%) of the patients were in nursery and parent's major occupation was mainly farming in 27.2%. There was positive family history of allergy in 54.7% patients. Perennial allergic rhinitis were noted in 63.8% patients while seasonal allergic rhinitis were noted in 36.2% patients. Major form of allergens was inhalant 81.8% and the least form of allergen was ingestant 5.7%. The commonest identified trigger factors among the study population were as follows: dust, cold weather and smoke which were accounted for 59.6%, 37.4% and 18.9% of the study patients respectively. Other noted triggering factors were soap and perfume which accounted for 4.2% and 1.1% respectively. Major associated comorbid illnesses among the patients were tonsils hypertrophy, adenoid hypertrophy and inferior turbinate hypertrophy which accounted for 55.5%, 46.4% and 40.4% respectively. Clinical presentations of allergic rhinitis in this study were mainly 75.8% nasal blockage, 65.3% runny nose and 8.5% recurrent sneezing. Commonest complications of allergic rhinitis were 35.1% pharyngitis, 32.1% otitis media and 28.3% headache. Treatment of allergic rhinitis leads to improvement on the clinical features in 90.1% patients. No significant improvement in clinical features were noticed in 9.8% patients. None of the studied patients reported worse clinical condition after treatment of allergic rhinitis. No mortality was recorded from allergic rhinitis in this study. CONCLUSION: Allergic rhinitis affect all paediatric age group and there were delayed presentation in the participants. There were associated comorbid illnesses, complications and affectation of quality of life at presentation in majority of the patients.