Pilot Hearing Screening of School-age Children in Lagos, Nigeria.

OBJECTIVES: The aim of this pilot study is to assess the prevalence of hearing disorders in school-age children in Lagos, Nigeria. METHODS: The study group consisted of 236 children aged 5 to 11 years old. Children were assessed by otoscopy, transiently evoked otoacoustic emissions, and pure-tone audiometry screening. RESULTS: Abnormal audiograms were found in 46 (19.5%) of the tested children. Otoscopy data suggest that the most frequent hearing abnormalities were related to cerumen and otitis media. Low agreement (55%) was found between otoacoustic emissions outcomes and pure-tone audiometry data. CONCLUSION: Given the high prevalence of hearing problems in this group of primary school students, there is a strong need to monitor the hearing status of children in this geographical area.

Clinicoepidemiology of benign paroxysmal positional vertigo in Nigerian.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is poorly reported in developing countries. This study aimed at determining the prevalence, aetiology, and comorbid illnesses of benign paroxysmal positional vertigo in our center. MATERIALS AND METHODS: This was a prevalence hospital-based study of all patients with the diagnosis of benign paroxysmal positional vertigo (BPPV). Pretested interviewer assisted questionnaire was administered to obtain data. Otoscopic examination, otoneurologic review, followed by mandatory Dix Hallpike maneuver and supine roll test was performed on all patients to diagnose posterior, lateral or anterior canal benign paroxysmal positional vertigo. All the data obtained were collated and analyzed by using SPSS version 16.0. RESULTS: Prevalence was 1.9%. Peak prevalence of 37.0% was at age group 41-50 years. Male accounted for 46.1% with male to female ratio of 1:1.2. Benign paroxysmal positional vertigo accounted for 62.3% urban dwellers, 33.1% postsecondary education, 39.6% Civil servant and 33.8% married. There were 99.4% unilateral and 64.3% right benign paroxysmal positional vertigo. Idiopathic was 70.1% while trauma, migraine, and inner ear disorder were 20.8%, 7.1%, and 1.9%, respectively. Benign paroxysmal positional vertigo was 66.2% posterior semicircular canal followed by 24.7% lateral semicircular canal and 0.6% anterior semicircular canal. Commonly associated comorbid illnesses were visual disorder, hypertension, arthritis, and diabetes mellitus in 27.9%, 23.4%, 22.1%, and 2.6%, respectively. CONCLUSION: Benign paroxysmal positional vertigo is common otologic disorder. It is associated with significant comorbid illnesses. Early detection will reduce morbidity and mortality. Improvement in the level of health care at primary level and health education to create awareness among the populace is to be encouraged.

Unilateral Cleft Lip Repair: Assessment of Outcome of Olokun-Olaitan Vermillion Flap Approach.

This study aimed to assess the outcome of our novel free-hand approach. Numerous cleft lip repair techniques exist, all of which involve incisions on skin and excision of tissue. Unilateral cleft lip is the result of failure of migration of orofacial tissues in-utero. Cleft lip repair should ideally involve an approach that simulates nature by avoiding skin incision and tissue excision, as these are not known to occur in the normal natural sequence of events.Without incising skin or excising any tissue, vermillion flaps were raised exposing the muscular layer and edges of skin and mucosa. Similar tissue types were advanced and sutured across the cleft, replicating what should have occurred normally.All 28 patients (100%) treated using our technique had competent lips. Acceptable symmetry of the vermillion was achieved in 24 (85.7%) of the patients. Lip symmetry was judged to be acceptable in 22 (78.6%). Symmetry of the nose was acceptable in 18 (64.3%) of patients.The Olokun-Olaitan vermillion flap approach proved effective in the repair of unilateral cleft lip, as it compared very favorably with results obtained using Millard's technique.

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.

Demography, types, outcome and relationship of surgically treated intracranial suppuration complicating chronic suppurative otitis media and bacterial rhinosinusitis.

INTRODUCTION: Surgically treated intracranial suppurations (ICS) are uncommon, life-threatening neurosurgical emergencies. They can result from complication of chronic suppurative otitis media (CSOM) and bacterial rhinosinusitis (BRS). The objective of this study was to know the frequency of BRS and CSOM and relate it to its rare complication of surgically treated ICS while also describing the demography, type and outcome of ICS that resulted from BRS and CSOM. MATERIALS AND METHODS: All patients that presented to the Otorhinolaryngological department and Neurosurgical unit of the same institution with clinical and radiological features of CSOM, BRS, and ICS were prospectively studied over a 5-year period. Patients were followed up for a minimum of 3 months. RESULTS: Two thousand, two hundred and seventy-nine patients presented during the 5-year study period. Of all these patients, 1511 had CSOM (66.3%) and 768 (33.7%) presented with features of BRS. Eleven (0.73%) had ICS complicating their CSOM while 8 (1.04%) cases of surgically treated ICS followed BRS. Bacterial rhinosinusitis was not more likely to lead to ICS (P = 0.4348). The Odds ratio (OR) of a child ≤ 18 years of age with CSOM developing ICS was 5.24 (95% Confidence interval 1.13-24.34; P = 0.0345), while it was 7.60 (95% Confidence interval 1.52-37.97; P = 0.0134) for children with BRS. CONCLUSIONS: The most common type of ICS complicating CSOM and BRS was brain abscess and subdural empyema, respectively. Children are more prone to develop surgical ICS following CSOM and BRS. The proportion of males that had ICS was higher in both CSOM and BRS patients. Optimal outcome is achieved in patients that presented with GCS of 13 and above.