Incidental histopathological diagnosis of tonsilar actinomycosis: A report of four cases.

Actinomycosis of the tonsils is uncommon even though the causative organisms are normal commensal of the oropharyngeal tract that may colonise the tonsillar crypts with resultant infection in apparently healthy individuals. Diagnosis is often incidental in tonsillectomy specimens sent to the pathology laboratory for varied diseases. This is a 10-year study of tonsillectomy specimens diagnosed with actinomycosis. Specimens were formalin-fixed and paraffin processed and stained with haematoxylin and eosin, gromott methenamine silver and periodic acid-Schiff. Four cases of tonsillar actinomycosis were diagnosed from a total of 772 tonsillectomy specimens. Histologically, characteristic oeosinophilic granules with peripheral radial protuberances surrounded by microabscesses were seen. Tonsillar actinomycosis is often an incidental diagnosis; however, a high index of suspicion should be entertained in patients with recurrent tonsillitis and/or tonsillar hypertrophy of unknown cause.

Hearing Thresholds among Individuals with Dependence on Psychoactive Substances: A Comparative Cross Sectional Pilot Study.

Background: Globally, the use of multiple psychoactive substances (MPS), either together or at different times, is on the rise. It is associated with a significant public health burden, including an increased risk for hearing impairment. This study aimed to determine the hearing thresholds among individuals with dependence on multiple psychoactive substances. Methodology: It was a comparative cross-sectional study of 41 subjects with dependence on multiple substances and an equal number of age and sex-matched comparison groups. The test group further had three subgroups, based on their predominant substances of dependence; Group I: Cigarettes, Cannabis, and Codeine; Group II: Group I substances and intravenous Pentazocine. Group III: Group II substances and intravenous Ketamine. Specific Substance Involvement scores for each of the psychoactive substances and their associated level of risk were determined, based on the ASSIST V3 questionnaire. All participants had tympanometry and pure tone audiometry. A Pure Tone Average (PTAv) was calculated. Data were analysed using SPSS 25 and statistical significance was set at a p-value 0.05. Results: There were 36 (87.8%) males and 5 (12.2%) females. The mean age of the test and comparison groups was 27.93 5.47 years and 27.98 5.70 years (p = 0.969). The mean PTAv of the test and comparison groups were 16.07 ± 5.53 dBHL and 11.01± 3.52 dBHL: (p 0.001). The p-value for the difference in the mean PTAv between sub-groups of the test group was 0.173, 0.037, and 0.719, respectively, between Group I and II, Group I and III, and Group II and III, respectively. Conclusion: Hearing thresholds were higher among individuals with dependence on MPS and statistically significant in those that were dependent on cigarettes, cannabis, and codeine. Further studies are needed on the relationship between PS and hearing loss.

Prevalence of Revision Adenoidectomy in a Tertiary Otorhinolaryngology Centre in Nigeria.

Introduction: Remnants or the regrowth of adenoid tissue after adenoidectomy may present with clinical symptoms that could warrant a revision surgery. Aim and Objectives: This study aims to determine the prevalence and risk factors of revision adenoidectomy in our centre. Materials and Methods: This is a retrospective case-control study conducted in a tertiary otorhinolaryngology centre over a 10-year period. Cases of revision adenoidectomies were identified and matched with controlled cases of single-stage adenoidectomies within the same period. All information was entered into the Statistical Package for the Social Sciences (SPSS) version 25 and analysed using descriptive and cross-tabulation analysis. Results: A total of 1249 adenoidectomies were performed during the period of review with 26 being revision cases. The prevalence of revision adenoidectomy was found to be 2.1% with the mean interval between surgeries being 2.1 years. Age ≤ 2 years (odds ratio (OR) = 95.25, P < 0.0001), allergy (OR = 0.09, P < 0.0001), recurrent tonsillitis (OR = 0.79, P = 0.006), recurrent/chronic middle ear infections (OR = 7.5, P < 0.0001), and the primary surgeon being a junior registrar (OR = 11.5, P < 0.0001) were significantly associated with revision adenoidectomy. The performance of adenoidectomy without tonsillectomy also carries a significant odd (P = 0.04). Conclusion: Revision adenoidectomy is low in our setting. Young age at primary surgery, the presence of allergy, surgeon's designation, the extent of surgery, and recurrent middle ear and tonsil infections are factors associated with revision adenoidectomy. These should be considered in risk stratification and surgery planning.

Neonatal Hearing Screening, with Otoacoustic Emission, among Normal Babies in a Northeastern Nigerian Hospital.

Background: Hearing is necessary for speech and language development, children with bilateral hearing loss often have impaired speech and language abilities thus limiting educational attainment. Early detection and intervention will help minimize such effects. Therefore, neonatal hearing screening program has been advocated in developing countries. Objective: TThe objective of this study is to determine the prevalence of hearing loss and risk factors among full-term inborn neonates delivered in a University Teaching Hospital with transient evoked otoacoustic emission (TEOAE). Materials and Methods: All full-term neonates delivered in a University Teaching Hospital were included in this prospective cross-sectional study. The hospital's ethical committee gave approval. The researcher obtained informed consent from the parents and administered a questionnaire for demographic, prenatal, and postnatal data. A comprehensive head and neck examination preceded the preliminary otoscopy. With the help of a hand-held otodynamic otoport, Neonatal Hearing Screening Program otoacoustic emission (OAE), each ear's hearing was assessed. Statistical Product and Service Solutions (SPSS) version 22.0 was used to analyse the data. Results: 150 full-term neonates were screened, of which 72 (48%) were males and 78 (52%) were females. Neonates that failed the TEOAE in both ears were 12 (8%). 18 (12%) neonates had a refer in right ear only, while 24 (16%) had a refer in the left ear only. The only significant risk factor with a referral outcome of TEOAE was family history of childhood hearing loss (23.1%). Conclusion: This study found a high prevalence (8%) of failed TEOAE of full-term neonates delivered in our hospital with a significant risk factor of family history of childhood hearing loss.

Endsocopic Internal Maxillary Artery Cauterization in a Patient with Severe Posterior Epistaxis: A Case Report.

Epistaxis from the posterior superior region of the nasal cavity might be fatal in some cases. It is particularly severe in an individual with hypertension, arterial aneurysm of traumatic origin, and bleeding from posterior lateral nasal artery, which is frequently difficult to reach and ligate directly on a bleeding area. Certain cases have been reported in which the bleeding could be stopped only by ligating/embolization of the external carotid artery or the internal maxillary artery at its branching off from the external carotid artery. Despite the multiple anastomoses, the effect of such ligation or cauterization is effective if properly done. We present a case of a 25-year-old young man with a 3-month history of recurrent epistaxis resulting from an internal maxillary artery aneurysm following trauma. The clinical presentation, diagnosis, and successful endoscopy treatment of posterior epistaxis are presented.

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.