Normal Diameters of Extraocular Muscles: A Nigerian Retrospective Study.

BACKGROUND: The thickness of extraocular muscles (EOMs) is important in the management of several conditions associated with EOM enlargement. This study determined the normative values of EOM diameters in adult patients seen at a teaching hospital in Nigeria. MATERIALS AND METHODS: The study measured the thickness of the EOMs and the interzygomatic line (IZL) on brain images of 300 patients with non-orbital conditions (150 computed tomography [CT] and 150 magnetic resonance imaging [MRI]) archived in the radiological database of Delta State University Hospital, Nigeria, after ethical clearance. The Statistical Package for the Social Sciences (version 23) was used to obtain descriptive statistics and further compare the variables based on gender, age groups and laterality. The association between parameters was tested using Pearson's correlation test. A probability value of <5% was considered significant. RESULTS: The thickest muscles were the medial rectus (0.42 ± 0.08 cm) and superior muscle group (0.42 ± 0.33 cm) on CT and the inferior rectus (0.40 ± 0.08 cm) on MRI. The diameters were symmetrical with sexual dimorphism in the superior muscle group on CT, medial and lateral recti on MRI and sum of all EOMs on both imaging groups (P < 0.05). The superior muscle group and the sum of all EOMs showed significant age group variations and a positive correlation with age. We noted a positive correlation between each EOM diameter and the sum of all EOMs besides the IZL (P < 0.05). CONCLUSION: This study offers normative data regarding EOMs that radiologists and ophthalmologists can use to diagnose disease conditions that cause EOM enlargement and further assess their response to treatment.

Variations of the Nasal Septum in Adult Nigerians: Computed Tomography Study

Abstract Introduction The morphological variants of the nasal septum have been implicated in sinus pathology and pose a challenge during endoscopic surgeries. Objectives The present study aimed at evaluating the prevalence of nasal septum variants in adult Nigerians. Methods The present study was performed at the Radiology Department of Delta State University Teaching Hospital, Nigeria, following ethical approval. Brain computed tomography (CT) scan images of 336 adults were evaluated for nasal septum variants. The angle of the deviated nasal septum was measured, and the severity was classified. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY, USA). The angle of deviation was presented in means and standard deviation. Frequencies of the variants were presented in percentages. The Student t-test was used to compare the angle of deviation, while the chi-squared test was used to compare the frequencies in the different groups. A p-value < 0.05 was considered statistically significant. Results The prevalence of straight and deviated nasal septum was 59.5% and 40.5%, respectively. Deviation was predominant in females (46%) and, more frequently, of moderate severity (75%). The angle of deviation was significantly larger in males (12.55 ± 2.99°) than in females (11.13 ± 2.41°;p = 0.003). Nasal spur had a prevalence of 11.9%, and its coexistence with deviated nasal septum was observed in 5.06%. Septal pneumatization was seen in 10 patients (3%). Conclusions Deviation of the nasal septum occurred more in females and toward the left; however, the angle of deviation was significantly higher in males. Nasal septal spur and pneumatization were the least prevalent variants.

Variations of the Nasal Septum in Adult Nigerians: Computed Tomography Study.

Introduction The morphological variants of the nasal septum have been implicated in sinus pathology and pose a challenge during endoscopic surgeries. Objective The present study aimed at evaluating the prevalence of nasal septum variants in adult Nigerians. Methods The present study was performed at the Radiology Department of Delta State University Teaching Hospital, Nigeria, following ethical approval. Brain computed tomography (CT) scan images of 336 adults were evaluated for nasal septum variants. The angle of the deviated nasal septum was measured, and the severity was classified. Data were analyzed using IBM SPSS Statistics for Windows, version 23.0 (IBM Corp., Armonk, NY, USA). The angle of deviation was presented in means and standard deviation. Frequencies of the variants were presented in percentages. The Student t -test was used to compare the angle of deviation, while the chi-squared test was used to compare the frequencies in the different groups. A p-value < 0.05 was considered statistically significant. Results The prevalence of straight and deviated nasal septum was 59.5% and 40.5%, respectively. Deviation was predominant in females (46%) and, more frequently, of moderate severity (75%). The angle of deviation was significantly larger in males (12.55 ± 2.99°) than in females (11.13 ± 2.41°; p = 0.003). Nasal spur had a prevalence of 11.9%, and its coexistence with deviated nasal septum was observed in 5.06%. Septal pneumatization was seen in 10 patients (3%). Conclusion Deviation of the nasal septum occurred more in females and toward the left; however, the angle of deviation was significantly higher in males. Nasal septal spur and pneumatization were the least prevalent variants.

Variant neurovascular relations of the sphenoid sinus in adult Nigerians.

BACKGROUND: With the advent of endoscopic sinus surgery, the variant neurovascular relations of the sphenoid sinus are important to surgeons to minimise the iatrogenic complications. This study elucidates the variant neurovascular relations of the sphenoid sinus in adult Nigerians. MATERIALS AND METHODS: This study was conducted at the Radiology Department of Delta State University Teaching Hospital after institutional approval. Brain computed tomography images of 336 patients, aged ≥20 years and spanning over 5 years' duration were utilised. We evaluated the sphenoid sinus for protrusion and dehiscence of neurovascular structures bilaterally. The position of the optic nerve in relation to the sinus was classified from Type 0-4. The Statistical Package for the Social Sciences software version 23 was used for the data analysis. The Chi-square test was used to probe for the association between the variants with regard to side and gender. P < 0.05 was considered statistically significant. RESULTS: Dehiscence and protrusion of the internal carotid artery (ICA) occurred in 34, 10.1% and 83, 24.7% patients correspondingly. The dehiscence of optic, maxillary and Vidian nerves was (26, 7.7%), (60, 17.9%), and (53, 15.8%), whereas the frequency of their protrusion was (50, 14.9%), (76, 22.6%) and (87, 25.9%), respectively. All these variants except the ICA and maxillary nerve dehiscence showed a significant association with the side of occurrence (P = 0.001). Out of the 672 optic canals evaluated bilaterally, a preponderance of Type I (534, 79.5%) was observed followed by II (96, 14.3%), IV (35,5.2%), III (7, 1.0%) and Type 0 (0, 0%). CONCLUSION: Our study has shown that the neurovascular relations of the sphenoid sinus vary from previously documented reports, thus confirming the need for pre-operative evaluation.

Pattern of stroke in a rural Kenyan hospital.

Background: The pattern of stroke in rural population differs from that in urban ones. Although there are many studies on this condition in sub-Saharan Africa, few studies about stroke pattern in a Kenyan rural area exist.. This study therefore aims at describing the characteristics of stroke in a rural Kenyan hospital. Patients and Methods: The study was conducted on 227 consecutive patients admitted with a World Health Organization (WHO) diagnosis of stroke in Kangundo Hospital, a level IV facility in Machakos, Eastern Kenya, between April 2015 and September 2016. The sub-type and anatomical distribution of stroke as well as the age, gender of the patients were recorded prospectively. Diagnosis was made through physical neurological examination and confirmed by Computerized Tomography (CT) scan imaging. Only those with complete bio-data, past medical and social history, clinical and physical findings of the patients and imaging results were included. The data were entered into a pre-formatted questionnaire, analysed for means, standard deviations and frequencies, and are presented in tables and bar charts. Results: Out of 3200 medical admissions, 227 (7.09%) had a confirmed diagnosis of stroke. Ischaemic stroke was more common (67.4%) than haemorrhagic stroke (32.6%). It affected mainly the anterior circulation, especially the middle cerebral artery (39%). The mean age of patients was 68.8 years, (Range 32-96). It was more common in females (62%) than in males (38%). Hypertension was the most common (74%) risk factor followed by alcohol abuse (63%), tobacco smoking (48%) and diabetes mellitus (42%). Conclusion: Ischaemic stroke was the more common major cause of morbidity in the rural hospital studied in Kenya. It occurred most commonly among elderly females, with the most frequent comorbidities being hypertension. In addition, modifiable lifestyle factors like alcohol abuse and cigarette smoking contributed to the prevalence; hence we recommend the control of blood pressure and glucose as well as lifestyle modification to reduce the scourge in our studied population.