Utilization and Findings of Flexible Naso-Pharyngo-Laryngoscopy in Upper Airway Disorders: A Clinic Audit.

Background: Flexible naso-pharyngo-laryngoscopy (NPL) has become an essential clinic tool for evaluating patients with upper airway disorders in otorhinolaryngology. It has been established to be a simple, cost-effective, and minimally invasive technique with good diagnostic yields. This study aimed to audit the procedure of flexible NPL done in our clinic over 2 years and analyse the technique, indications, and findings of the procedure. Methodology: A retrospective cross-sectional study among all the patients who presented to our ENT clinic in ABUTH Zaria, from July 2021 to June 2023 with upper airway symptoms or neck swelling who had flexible NPL done in the clinic. The records of these patients were reviewed, and information extracted including age, sex, use of anaesthesia, indications and findings of the procedure were entered in SPSS and analysed. Results: Flexible NPL was done in 266 patients aged 4 months to 85 years. Only 3% of the patients required local anaesthesia. The commonest indications were for preoperative evaluation of goitre (26.7%), suspected adenoid hypertrophy (18.4%), complaints of hoarseness (18.8%), and foreign body sensation (12%). The commonest diagnoses made were adenoid hypertrophy (19.9%), laryngeal tumour (5.3%), nasopharyngeal tumour (4.9%), vocal cord palsy (4.9%), rhinitis (4.5%) and pharyngitis (4.1%), laryngitis (3.0%), laryngopharyngeal reflux disease (3.0%) and vocal cord nodule (2.3%). Conclusions: Office flexible NPL was done commonly for preoperative evaluation of goitre, suspected adenoid hypertrophy, hoarseness, and foreign body sensation. The commonest pathologies were adenoid hypertrophy, laryngeal tumour, nasopharyngeal tumour, vocal cord palsy, rhinitis, pharyngitis, and laryngitis.

Adenoid and Tonsil Hypertrophy in Zaria, North Western Nigeria: Review of Clinical Presentation and Surgical Outcome.

Background: Adenotonsillar hypertrophy is one of the most common childhood disorder that necessitates presentation to the ear nose and throat specialist. The disorder may be managed conservatively or by surgery. Aim: To highlight the clinical presentation and surgical treatment outcome of patients managed for adenoid and tonsillar hypertrophy at Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Materials and Methods: The case records of patients managed for adenoid and tonsil hypertrophy were reviewed from January 2013 to December 2017 at the Division of Otorhinolaryngology, Department of Surgery Ahmadu Bello University Teaching hospital Zaria, - Northwestern Nigeria. Case notes with incomplete information and /or missing pages were excluded. The data were analyzed using IBM SPSS (for windows, version 23). Results: There were 56 (55.4%) males and 45 (44.6%) females with male to female ratio of 1.2:1. Their ages ranged from 2-16 years with a mean and standard deviation of 4.0 and 3.2 respectively. The most common symptom at presentation was snoring 85 (84.2%) followed by rhinorrhea 81(80.2%). Findings from the radiologic investigations revealed that majority of the patients had severely narrowed nasopharyngeal air column 83(82,2%) Adenotonsillectomy was the most common surgery performed on most of the patients 63(62.4%) who presented with adenotonsillar hypertrophy. Majority of the patients 95(94.1%) had resolution of symptoms within the period of follow up. Four (4.0%) of them had recurrent adenoidal growth. Conclusion: Snoring, rhinorrhea and mouth breathing were the most common symptoms of adenotonsillar hypertrophy. The outcome of adenotonsillar surgeries in our patients is good, with the majority having resolution of symptoms.

Audiologic Evaluation of Patients with Head and Neck Cancers Treated with Cisplatin Based Chemotherapy: A Longitudinal Study.

Background: Recently, the incidence of head and neck cancers are on the increase globally and particularly in our environment. In addition, concurrent platinum-based chemoradiotherapy has become widely used in the treatment of head and neck malignancies. The objective of this study was to determine the effect of cisplatin-based chemotherapy on hearing in patients with head and neck cancers at our University Teaching Hospital. Methodology: This was a hospital-based longitudinal case-control study that involved 54 participants attending the oncology treatment centre of the University Teaching Hospital Zaria. The study investigated the hearing threshold and degree of hearing loss pre and post cisplatin-based chemotherapy at intervals of 3 months and 6 months. The data obtained were analyzed using Statistical Product and Service Solutions (SPSS)version 20. Results: Seventy-two participants were recruited into the study, but 54 (75%) participants met the inclusion criteria and were enrolled and as well as same age and sex match controls. Thirty-one31(57.4%) of the participants had a nasopharyngeal tumour, 14(25.9%) had Sinonasal tumour and 9(16.7%) had Laryngeal tumour. Among the study group, there were 39 males (72.2%) and 15 females (27.8%) with an M: F ratio of 2.6:1. The age of the participants ranged from 13-68 years. (Mean =40.3years. SD=13.6). Assessment of hearing in the better ear showed 22 (40.7%) of subjects and 6 (11.1%) of controls had hearing loss before the onset of the study. The majority of these patients had mild hearing loss either mixed or SNHL. In the study group, 32(29.6%) ears showed changes in hearing threshold after 3 months of cisplatin therapy while68(62.9%) ears showed changes at 6 months of therapy. The overall incidence of ototoxicity after 6 months of therapy was 62.9%. Conclusion: This study found a significant number of head and neck cancers patients with hearing impairment pre-chemotherapy. Cisplatin treatment-based chemotherapy was associated with significant short term hearing impairment in patients with head and neck cancers.