Safety of transtympanic application of 4 % manuka honey in a chinchilla animal model.

The antimicrobial and anti-biofilm properties of manuka honey (MH) are currently being explored in the treatment of chronic recalcitrant rhinosinusitis. Due to similarities between chronic rhinosinusitis and chronic otitis, manuka honey may find applications in the management of challenging cases of chronic otitis media implicating biofilms. The goal of this study was to investigate the safety of topical application of 4 % MH in the middle ear. Eleven adult female chinchillas had one of their ears randomly assigned to receive transtympanic 4 % MH, while the contralateral ear served as control. Auditory brainstem-evoked response (ABR) was performed before and after MH application. The facial nerve function and vestibular system were assessed clinically. The animals were euthanized one month following the last application, and the cochleae samples were processed for light and scanning electron microscopy. There was no statistically significant differences between ABR thresholds in both control and experimental ears before and after the application of MH. No morphological differences were seen in both groups of cochleae. The outer hair cell counts for both groups were comparable. Our results suggest that 4 % MH appears not toxic to the cells of the cochlea after 4 weeks of application. The long-term effects of prolonged contact on the structure and function of the cochlea however need further investigations.

Review of skull base surgery in a Nigerian teaching hospital.

BACKGROUND AND OBJECTIVES: There is dearth of information on skull base surgery in Nigerians. This study was conducted to determine types of skull base lesions describe surgical approaches to the lesions and determine outcome of surgical management of the lesions over the study period. METHODS: We retrospectively reviewed the case notes of the patients who underwent skull base neurosurgical procedures between January 2001 and June 2007 in our centre. We obtained information on demography, clinical presentation, diagnosis, cranial computerised tomography findings, type of surgery, intraoperative findings and outcome of surgical management at the time of discharge from the hospital. RESULTS: Brain tumours were diagnosed in 28 patients, head injuries in 9 patients and one patient each had anterior encephalocele and frontal sinus mucocele. Eighteen patients had frontal craniotomy, three patients had temporal craniotomy and two patients had lateral rhinotomy in addition to bifrontal craniotomy. Two patients had frontoorbitotomy while retrosigmoid craniectomy was performed in one patient. Thirty three patients showed significant postoperative improvement at discharge. CONCLUSION: Brain tumour was the most common indication for skull base surgery in our centre. These tumours were mainly located in the anterior cranial fossa. Frontal craniotomy was the most common surgical approach. Non-availability of modern neurosurgical facilities confined us to the use of mainly traditional approaches. The availability of these facilities will assist in improving our management outcome in the future.

A retrospective analysis of aetiology and management of epistaxis in a south-western Nigerian teaching hospital.

BACKGROUND: Epistaxis is a common otolaryngological emergency and is often due to lesions within or around the nose and systemic conditions. Controlling epistaxis presents a challenge in the underdeveloped, resource-poor centres where there are limited facilities. OBJECTIVE: To describe the aetiopatogenesis of epistaxis in our hospitals. METHODS: This was a retrospective review of the cases of epistaxis managed at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile Ife, over a three-year period: January 2003 - through December, 2005. Information on sociodemographic characteristics, clinical presentation and management of epistaxis was obtained from the hospital records both in the accident and emergency units and the ENT outpatient clinic. RESULTS: A total of 106 cases were managed during the period. The peak age incidence was in the 21-40-year group. There was a significant male preponderance, ratio 3.4:1. Trauma contributed to 75 (70.9%) of the cases managed. Maxillofacial injuries were the most common injury encountered (50.7%). This was mainly secondary to the road traffic accident (RTA). Malignant neoplasms were the second most common aetiological factor seen in this study while idiopathic causes were the third most common. There were two cases with systemic problems associated with renal failure. Nasal packing was adequate to control the epistaxis in most cases. Nasal packing was done with gloved finger cots and vasellinated gauze. Two patients (1.9%) had external carotid artery ligation. Eleven patients (10.4%) received blood transfusion. CONCLUSION: Epistaxis is a common presentation of head and neck trauma. Non-surgical control of epistaxis (nasal packing) is adequate in many cases. Reducing the incidence of trauma from RTA will reduce the incidence of emergency epistaxis in our centers.

Hearing outcome of early postnatal exposure to hypoxia in Sprague-Dawley rats.

Objective: To determine the effect of experimentally induced hypoxia, in the first 10 days of life, on physiological hearing in a Sprague-Dawley rat model. Methods: A prospective, controlled animal study was carried out using 22 male rat pups. The rats in the hypoxic group (n = 12) were reared in hypoxia for the first 10 days of life, and subsequently reared in normoxia, while those in the control group (n = 10) were reared in normoxia for the duration of the experiment. Hearing was assessed using auditory brainstem response testing at approximately 72 days of age. Results: The hypoxia group had higher auditory brainstem response thresholds for all frequencies tested (more pronounced at 16 kHz), compared with controls. Wave I-V inter-peak latencies were more prolonged in the hypoxic rats, while both groups had similar wave I latencies. Conclusion: Chronic postnatal hypoxia induced permanent hearing loss in this Sprague-Dawley rat model. Prolonged wave I-V inter-peak latencies suggested functional abnormality in the central auditory pathway.

Ototoxicity of baby oil in a chinchilla animal model.

OBJECTIVE: Baby oil is commonly used to soften ear wax in order to aid its removal. The aim of this study was to determine the potential ototoxicity of baby oil. METHOD: A prospective controlled animal study was conducted using ten chinchillas with normal hearing function. Each had bilateral myringotomies. One ear was randomly assigned to receive 1 ml of baby oil while the other ear received an equal volume of 0.45% NaCl. Distortion product otoacoustic emissions (DPOAEs) and Auditory Brainstem Response (ABR) measurements were recorded at baseline (post myringotomy and pre application of product) and on days 5 and 15 after application. Two months after application of baby oil, the cochleae were processed for light microscopy and qualitative comparisons were made between the cochleae of both control and experimental ears. RESULTS: There was no statistically significant difference in DPOAE between experimental and control ears at 5 and 15 days after treatment. ABR results did not reveal ototoxicity at days 5 and 15 post treatment. None of the animals developed facial paralysis or any signs of vestibular toxicity. There were no overt mucosal changes in the middle ear of the ears exposed to baby oil compared to the control ears. Light microscopy showed comparable features in the organ of Corti, stria vascularis, spiral ligament and the spiral ganglion cells of both groups of cochleae. CONCLUSION: Baby oil did not produce ototoxic effects when applied ototopically in chinchillas with non-intact tympanic membrane.

Challenges in management of chronic suppurative otitis media in a developing country.

BACKGROUND: In developing countries, the rate of complications from chronic suppurative otitis media is still high, due to factors associated with poverty. This study aimed to determine the prevalence of chronic suppurative otitis media and associated complications. PATIENTS AND METHODS: We prospectively studied all patients presenting with chronic suppurative otitis media to the ear, nose and throat unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, over a two-year period. RESULTS: One hundred and sixty new cases of chronic suppurative otitis media were seen. These constituted 11.1 per cent of all new cases and 21.5 per cent of all otological cases seen. About half (51.7 per cent) of these patients were younger than 15 years. Most patients were from rural areas and had been previously managed by unlicensed, untrained practitioners. Complications were mostly seen in children. Intracranial complications were seen in 10 (6.3 per cent) cases; this was associated with a high mortality rate. CONCLUSION: This study found that, in Nigeria, a developing country, 'safe' chronic suppurative otitis media was not without serious problems. Provision of adequate health facilities may reduce such problems.

Oesophageal denture impaction producing Horner's syndrome: a case report.

BACKGROUND: Dentures in the oesophagus have been associated with various complications; however, Horner's syndrome following denture impaction has not been reported in our locality. CASE REPORT: Horner's syndrome developed in a 26-year-old woman following accidental swallowing of an upper denture which then became impacted in the oesophagus. The denture was retrieved via cervical oesophagotomy. The syndrome abated completely by the seventh day post-surgery. The clinical features of Horner's syndrome are discussed. CONCLUSION: Compression of the stellate ganglion, with resultant Horner's syndrome, can be associated with denture impaction in the cervical oesophagus.