Correlation of Bacterial Isolates from Middle Ear and Nasopharynx in Patients with Chronic Suppurative Otitis Media in Ilorin, Nigeria.

PURPOSE: To determine the association between isolates in the middle ear (ME) and nasopharynx of patients with chronic otitis media in Ilorin, north-central Nigeria. METHODS: An ethically approved case control study was carried out in the Ear, Nose, and Throat clinic amongst consenting cases using normal subjects as controls. A microbiology investigation form giving the results for otoscopy, aspirate and swabs was filled out for both the ME and nasopharynx. The experimental procedure was carried out and bacteria were identified according to colony characteristics, morphological appearance, Gram-staining, and standard biochemical testing. Data obtained were analysed with SPSS version 16.0 and Epi Info 3.5.1 using the mean, standard deviation and chi-square results. RESULT: A total of 140 cases and 70 controls, were recruited. The Gram stain reaction of the ME aspirates were positive in 28.6% and negative in 71.4% of cases. Nasopharyngeal swabs revealed 64.3% Gram positive and 35.7% negative organisms. Overall, there was no relationship between the ME and nasopharyngeal isolates amongst cases, with a P value of 0.000. However, there was a relationship amongst the isolate from the nasopharynx of cases and controls, with the exception of Klebsiella pneumoniae, at P < 0.009. CONCLUSION: There was no relationship amongst the bacterial isolate from the ME and nasopharyngeal specimen of patients with otitis media.

Peritonsillar abscess in northern Nigeria: a 7 years review.

BACKGROUND: The aim of this study was to describe the clinico-epidemiologic profile of peritonsillar abscess (PA) seen in our center in northern Nigeria. METHODS: This was a to retrospectively review of all patients with PA managed in our hospital over a 7-year period. Case notes were reviewed and information retrieved included biodata and clinical information were entered into an SPSS statistical software version 20.0 and analysed descriptively and result presented in table and figures. RESULTS: A total of 25 patients were seen during the study period age ranged from 2-52 years with a mean age of 25.96 years; 14.1 (SD 2.8). Male to female ratio of ≈ 1.1:1.0. Right side was affected in 60%. The period of presentation of patients with PA varied between 4-12 days with a mean duration of 6.5 days. The presenting complaints in these patients varied from sore throat alone in 4 (16%), fever and sore throat in 17 (68%), others 16%. The duration of hospital stay varied from between 1 to 8 days with mean of 4.2 days; 3.32 days (SD 1.1). All the patients had incision and drainage with no recurrence of symptoms. CONCLUSION: PA is an Ear, Nose and Throat emergency that is commoner amongst the young adult males and the modality of treatment is still incision and drainage in our setting.

Foreign bodies in the aerodigestive tract: time for comprehensive preventive measures.

Background: Foreign body (FB) in the aerodigestive tract presents more commonly in children and remains a surgical emergency with potential for fatal complications. Objectives: To describe management and outcomes of aerodigestive FB managed at University of Ilorin Teaching Hospital (UITH) and proffer preventive measures. Methods: A 9-year retrospective review of all patients with foreign body in the aerodigestive tract managed between March 2011 and July 2020. Results: Sixty-six patients were studied. Median age was 9years with M:F ratio =1.6:1. FB was ingested in 38(57.6%) patients, aspiration occurred in 28(42.4%). Denture was most common FB 20(30.3%); plastic whistle/valve placed in dolls or football accounted for 4(6.1%). When ingested, FB was impacted in cervical 17(44.7%), upper thoracic 10(26.3%) and middle thoracic 2(5.3%) oesophagus. Oesophagoscopy was used in 30(8.9%) for retrieval. When aspirated, FB was located in the right bronchus 10(35.7%), left bronchus 7(25.0%), hypopharynx and trachea 2(7.1%) each, and cricopharynx 1(3.5%); no FB was found in 3(10.7%) patients. Direct Laryngoscopy was the method of retrieval in 3(10.1%) patients while others had rigid bronchoscopy. Mortality rate was 1.5%. Conclusion: Children are most vulnerable group. Preventive effort should include public health education and close monitoring of children by parents and care givers during play.

Management and Outcome of Rhinosinusitis in Nigeria.

OBJECTIVE: The aim of this study is to present the management and outcome of treatment of rhinosinusitis in Nigeria. STUDY DESIGN: A retrospective review of the case notes of patients with rhinosinusitis between January 2009 and December 2014. SETTING: Study at the University of Ilorin Teaching Hospital, Nigeria, using retrieved case notes after ethical approval was received. SUBJECTS AND METHODS: The information retrieved included sociodemographic data, clinical presentation, duration, endoscopic examination, and other clinical management protocols with follow-up. All information was entered into SPSS version 20 and analyzed descriptively, and results are presented in tables and figure. RESULTS: A total of 5618 patients were seen in the ear, nose, and throat clinic over the 6-year period. Of the patients, 445 had rhinosinusitis, and only 410 had complete data for analysis. Patient age ranged from 2 to 75 years (mean ± SD, 31.8 ± 1.2 years). The male to female ratio was 1.2:1. The duration of symptoms varied from 3 days to 10 years, with 78.7% having symptoms between 3 and 120 months. About 82.4% had nasal discharge, 51.3% had sneezing, 78.9% had alternating nasal obstruction, and 49.3% had nasal itch. Of the patients, 61.4% had a predisposition, of which 30.9% were allergic, 23.3% were infective, and 7.2% were vasomotor. Ethmoidal-maxillary sinuses were commonly affected radiologically. About 63% of patients had medical treatment, and only 28.7% had surgical intervention, of which 37% were scheduled for surgical treatment and 7.3% refused. Improved symptoms were noticed in 72.6% of patients, and 1.4% reported no improvement. CONCLUSION: Rhinosinusitis is still common, affecting active males economically with more chronic cases and more allergic predisposition. Early medical management is still effective, and endoscopic sinus surgery is now a better surgical option with better outcome in 72.6%.