Prevalence and Pattern of Hearing Loss among Young Adults in Tertiary Institutions with Habitual Headphone/Earphone Usage in Kaduna Metropolis.

Background: World Health Organisation estimates that 1.1 billion young people worldwide could be at risk of hearing loss due to unsafe listening practises and nearly half of the teenagers and young adults are exposed to unsafe levels of sound from the use of personal audio devices. Aim: This study aimed to determine the prevalence and pattern of hearing loss among students with habitual use of headphone/earphone in tertiary institutions in Kaduna. Participants and Methods: This was a prospective cross-sectional study of young adults with prolonged headphone/earphone usage in Kaduna and a group of nonheadphone/earphone users matched for age and sex as controls. Ethical approvals were obtained from relevant bodies and informed consent was also obtained from all participants. Data were obtained by clinical interview and audiometric evaluation of the participants and the data obtained were descriptively analysed using SPSS version 20.0. Frequency tables were generated and chi-square test and Student's t test were used to test for a possible association of variables. The level of significance was set at P < 0.05. Results: Two hundred and seventy-two prolonged headphone/earphone users with same number of controls participated in this study. The mean age for subjects and controls was 22.6 ± 3.4 and 23.2 ± 4.2, respectively. Using the better hearing ear, 48 and 20 of the subjects and controls, respectively, had hearing loss, giving a prevalence of 17.6% and 7.4% among the subjects and controls, respectively. Of the 48 subjects with hearing loss, 89.6% had a mild hearing loss. Majority, 91.7% had sensorineural hearing loss and the hearing loss was bilateral in all the participants (both subjects and controls). High frequencies were the most affected (64.6%). Conclusion: This study revealed that hearing impairment was more common among prolonged headphone/earphone users. In the majority of the prolonged headphone/earphone users, the hearing impairment was bilateral, mild, sensorineural, and mostly affects higher frequencies.

A Rare Case of Low-grade Nasopharyngeal Papillary Adenocarcinoma in a Young Adult Woman: A Case Report from a Tertiary Hospital in Northwestern Nigeria.

Low-grade nasopharyngeal papillary adenocarcinoma (NPAC) is a rare nasopharyngeal malignancy that runs an indolent course. It presents with a variety of symptoms including but not limited to nasal obstruction, runny nose, postnasal drip, and nasal bleeding. The main stay of treatment is surgery, but other adjuvant treatments including radiotherapy and photodynamic therapy have been used with varying degrees of successes. Due to its low grade nature and absence of distant metastases, its prognosis is excellent. Here, we report the case of a 22-year-old young woman with low-grade NPAC who was treated in our hospital by simple surgical excision.

Allergic rhinitis: An indicator of otitis media with effusion in children seen at aminu kano teaching hospital, Kano.

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction involving nasal mucosa characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness, and eyes itching. Tympanometry is a simple, rapid, and objective test that can be easily carried out. The use of tympanometry in clinical setting can improve detection of middle ear effusion and other middle ear abnormalities. AR has been found to be one of the predisposing factors to developing Otitis Media with Effusion (OME) in children. Patients and Methods: A case-control study was used to determine the prevalence of OME among children with AR as cases and those without allergy as controls. The study participants were children aged 4-12 years with clinical diagnosis of AR attending ENT clinics of Aminu Kano Teaching Hospital, whereas controls were children age 4-12 years without history of AR, ear diseases, or other respiratory system related ailments attending general outpatient clinics in Aminu Kano Teaching Hospital. An interviewer-administered score for AR (SFAR) questionnaire was filled out for all the participants, those with score of 6 and above were selected as cases. The two groups had complete ENT examination and tympanometry done, findings were recorded, and analyzed using SPSS version 21. Results: The mean age of the cases was 6.8 ± 2.1 years, whereas it was 7.5 ± 2.6 years for the controls. The mean difference was 0.7 and was not statistically significant (t = 2.35, df = 258, P value = 0.20). Type B tympanogram suggesting OME was found in 7.3% of subjects and in 2.8% of controls. Type C tympanogram suggesting negative middle ear pressure was found in 15.5% of subjects and in 4.6% of controls. Type A tympanogram suggesting normal middle ear pressure was found in 75% of subjects and in 90% of controls. Acoustic reflex was found to be absent in 29.6% of subjects and in 15.4% of controls and this found to be statistically significant (χ2 = 7.77, df = 1, P value = 0.001). The difference between type A, B, and C tympanograms of subjects and that of controls was found to be statistically significant (Type A χ2 = 14.62, df = 4, P value = 0.01, Type B χ2 = 14.06, df = 4, P value = 0.01, Type C χ2 = 17.01, df = 6, P value = 0.01). Type B tympanogram was used as an indicator to suggest OME for the purpose of this study. Conclusion: Participants with AR were found to have more abnormalities of tympanometric parameters and higher prevalence of type B tympanogram suggesting OME than controls.

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.

Transient-evoked otoacoustic emission findings in children (1-12 years) with cerebral palsy in Kano, Nigeria.

BACKGROUND: Children with cerebral palsy (CP) suffer from multiple problems and potential disabilities. These range from musculoskeletal problems, mental retardation, epilepsy, ophthalmologic and hearing impairment among others. Consequences of hearing loss include problems with speech and language development. Early detection in this difficult-to-test population may prevent these consequences of hearing loss. An otoacoustic emission assessment is useful in this regard. This study assessed transient-evoked otoacoustic emissions (TEOAEs) in children with CP. MATERIALS AND METHODS: The study population were children with CP who presented at the paediatric neurology clinic during the study period. An equal number of control population matched for age and sex were also recruited using simple random sampling. An interviewer-administered questionnaire was used to obtain relevant clinical information. All participants selected underwent a detailed ear, nose and throat examination and TEOAE testing. RESULTS: There were 330 participants in this study, categorised into CP cases (165) and non-CP controls (165). The age range of the participants was 1-12 years, with a mean age of 4.44 ± 2.92 among CP patients and 4.47 ± 2.90 among the controls. The male-to-female ratio was 2:1. TEOAEs were 'failed' in 83.6% of the CP patients and in 28.5% of the controls. This study found a statistically significant difference in 'failed' TEOAE result between the CP patients and the controls (P = 0.0001). CONCLUSION: This study found a high prevalence of 'failed' TEOAEs in children with CP in Kano.

Stage of chronic kidney disease and cochlear function: A cross-sectional survey.

BACKGROUND: Studies have shown that hearing loss increases in patients with chronic kidney disease (CKD) with decreasing glomerular filtration rate. The hearing loss in CKD patients may worsen over time which in turn will negatively affect the patient's ability to effectively communicate with people, resulting in low self-esteem, social isolation, anger and depression. We aimed to assess the relationship between stage of CKD and hearing threshold in patients with CKD in Kaduna. PATIENTS AND METHODS: A cross-sectional study of patients with CKD in Kaduna. Individuals were selected consecutively using convenience sampling. Ethical approval and informed consent were obtained. The patients were grouped based on the stage of the disease. The pure tone audiometry was carried out using a Diagnostic Audiometer (Graphic Digi-IS, USA). The hearing threshold of the patients was then compared based on stage of the disease. The data collected was analysed using Statistical Product and Service Solutions, version 20. RESULTS: Sixty CKD patients (120 ears) were assessed. Their mean age was 43.2 ± 13.4 years and 70% were males. Of the 120 ears studied, 51 (42.5%) had normal hearing thresholds and 69 (57.5%) had hearing loss. Of the 69 ears with hearing loss, 11 (15.9%), 22 (31.9%) and 36 (52.2%) were in Stage III, IV and V, respectively, and the difference was statistically significant (P = 0.006). All those with Stage III CKD had mild hearing loss and the hearing loss worsen with advancing stage. Stage III CKD had significantly better hearing than those with stage IV and V (P < 0.001). CONCLUSION: Our study showed a statistically significant relationship between advancing stage of CKD and hearing loss. The hearing loss worsen with advancing stage of CKD.

Comparison of Flexible Nasopharyngoscopy with Plain Radiograph in the Assessment of Children with Adenoid Hypertrophy.

Background: Obstructive adenoid hypertrophy is one of the commonest disorder seen in paediatric otorhinolaryngology clinics. It has a wide range of complications that can lead to cardiopulmonary and developmental problems; hence, early diagnosis and treatment are paramount in preventing the complications. Several modalities for the assessment of adenoid hypertrophy have been described in the literature, of which plain radiograph and flexible nasopharyngoscopy are the most popular. In this study, traditional method of evaluating adenoid hypertrophy (plain radiograph) has been compared with newer flexible nasopharyngoscopy. Materials and Methods: This is a cross-sectional study of randomly selected children with clinical diagnosis of obstructive adenoid disease. All eligible participants underwent clinical examinations, flexible nasopharyngoscopy and postnasal space X-ray. The findings were compared using the chi-square test and Pearson's correlation test. Results: The age of the participants ranged between 2 and 10 years with mean of 4.5 ± 2.5 years. There were 79 (56.4%) males and 61 (43.6%) females. The adenoid hypertrophy observed using flexible nasopharyngoscopy among the participants ranged between 20 and 90% with mean of 67.4 ± 15.4%. The adenoid enlargement measured using adenoidal-nasopharyngeal ratio on plain radiograph ranged between 0.40 and 0.96 with mean of 0.7 ± 0.09. The Pearson's correlation test revealed strong correlation between flexible nasopharyngoscopy and plain radiograph (r = 0.858, P = .000), and there was statistically significant association between the two methods (χ 2 = 148.8, P = .000). Conclusion: There was a strong correlation between flexible nasopharyngoscopy and plain radiograph of the postnasal space in the assessment of obstructive adenoid disease in children.

Hearing threshold of deaf pupils in Kaduna metropolis, Kaduna, Nigeria: A cross-sectional survey.

BACKGROUND: Hearing loss in paediatric age group may be inherited, developmental or caused by maternal rubella. It may also be due to complications at birth or certain infections such as meningitis and measles. Ototoxicity and exposure to excessive noise also contribute significantly. Majority of hearing loss in children can be prevented primarily. We aimed to share our findings on assessing the hearing thresholds of pupils in deaf schools in Northwestern Nigeria. PARTICIPANTS AND METHODS: This was a cross-sectional study which assessed the hearing threshold of pupils in deaf schools in Kaduna metropolis, Kaduna, Nigeria. Approval was obtained from the State Ministry of Health Ethics Committee. Multi-staged sampling method was used to enrol 430 deaf pupils. Consent was obtained and a structured pre-tested questionnaire was used to generate data on the participant's biodata, history and detailed examination findings as well as pure-tone audiometry. Collated data were documented and entered into Statistical Product and Service Solutions version 20 for windows then analysed. RESULTS: Mean pure-tone average of the right ear was 103.4 ± 8.3 and the left ear was 104.3 ± 8.9. Majority had bilateral profound hearing loss (99.0%). Severe hearing loss was seen in 0.9%, whereas the remaining 0.1% had moderate hearing loss. The hearing loss sensorineural in majority (97.6%) and the remaining 2.4% had mixed hearing loss. High-frequency hearing loss predominated (98.6%). CONCLUSION: Majority of the deaf pupils had bilateral, profound, sensorineural hearing loss, involving higher frequencies.

Impact of operator hearing threshold on manual blood pressure measurement.

INTRODUCTION: Une déficience auditive non détectée chez le personnel de santé pourrait affecter leur capacité à obtenir une pression artérielle (PA) précise avec des conséquences négatives sur les soins aux patients. Le but de cet article était de déterminer l'impact de l'audition de l'opérateur sur la mesure manuelle de la pression artérielle. Méthodologie: Une étude transversale portant sur 25 patients et 60 personnel de santé composé de 25 médecins (groupe 1), 25 infirmières (groupe 2) et 10 10 personnes qualifiées sélectionnées ayant une audition normale formé (groupe 3). Personnel du groupe 3 on mesurée le PA de chaque patient, ce qui a été jugé exact. Après une formation préliminaire sur la technique de mesure de la PA, une personne Des groupes 1 et 2 ont mesuré la PA d'un patient en utilisant la technique d'auscultation manuelle et ont ensuite procédé à un dépistage du ton pur Audiométrie (PTA) avec le seuil de la meilleure oreille auditive enregistrée. Résultats: La majorité du personnel avait une audition normale (PTA ≤25 dB), 22% Avait un seuil d'audition> 25 dB au dépistage, avec une perte auditive débilitante notée chez une seule personne (2%). Il y avait un accord complet dans les mesures entre les participants ayant un seuil auditif ≤25 dB et le groupe témoin, mais chez les participants dont le seuil est> 25 dB, 100% Ont enregistré une PA diastolique inexacte et 64% ont enregistré une PA systolique inexacte avec tendance à sous-estimer la tension systolique et à surestimer la tension diastolique. CONCLUSION: La déficience auditive n'est pas rare chez le personnel de santé, ce qui entraîne des enregistrements inexacts de la PA. Les audiogrammes doivent être obtenu chaque fois que le personnel de santé remarque des différences fréquentes dans la mesure de la PA par rapport aux collègues. Formation sur la mesure de la PA a permis une mesure précise de la pression artérielle par tous les participants normaux de l'audition. Résumé Introduction: Undetected hearing impairment among health personnel could affect their ability to obtain accurate blood pressure (BP) measurements with consequent negative impact on patient care. The aim of this paper was to determine the impact of operator hearing threshold on manual BP measurement. METHODOLOGY: A cross-sectional study involving 25 patients and 60 health personnel consisting of 25 doctors (Group 1), 25 nurses (Group 2), and 10 specially selected, normal hearing and trained control group (Group 3). Group 3 personnel measured BP of each patient and this was considered accurate. After preliminary training on BP measurement technique, one person each from Groups 1 and 2 measured BP of a patient using manual auscultation technique and then proceeded to have a screening pure tone audiogram (PTA) with threshold of the best hearing ear recorded. RESULTS: Majority of personnel had normal hearing (PTA ≤25 dB), 22% had hearing threshold >25 dB on screening, with debilitating hearing loss noted in one person (2%). There was a complete agreement in BP measurements between participants with hearing threshold ≤25 dB and the control group, but in participants with threshold >25 dB, 100% recorded inaccurate diastolic BP and 64% recorded inaccurate systolic BP with tendency to underestimate systolic and overestimate diastolic BP. CONCLUSION: Hearing impairment is not uncommon among health personnel, resulting in inaccurate BP recordings. Audiograms should be obtained whenever health personnel notice frequent differences in measured BP compared to colleagues. Training on BP measurement technique resulted in accurate BP measurement by all normal hearing participants.

Extending otology services to rural settings: Value of endoscopic ear surgery.

INTRODUCTION: Few centers, mainly located in urban settings offer otological surgical services, yet majority of patients requiring these services are rural based and are generally unable to access these centers with resulting disease chronicity and complications. This paper aims to describe the access of otological surgical services by a rural population. METHODOLOGY: This is a retrospective study of patients who accessed otological services at three secondary health institutions and one tertiary referral institution. All patients requiring ear surgery over a 4-year period were studied. The initial 2 years without ear endoscopic surgery was compared with the 2 years when ear endoscopic surgery was introduced. Hospital records were studied and relevant data were extracted. RESULTS: Six hundred and nine ears required surgery over 4 years. Age ranged from 3 to 62 years, with a ratio of 1.4 males: 1 female. During the initial 2 years, all patients were referred from the three secondary health institutions to the urban-based tertiary institution for microscopic ear surgery, 94% failed to proceed on the referral. In the second 2 years, 34% were considered suitable for endoscopic ear surgery, of which 78% accepted and had surgery within the locality. Of the 66% referred, only 5% proceeded on the referral. CONCLUSION: With operator training and investment in portable ear endoscopy set, bulk of ear surgery needing magnification can be treated in the rural setting. This represents a most feasible means of extending the service to the targeted population.

Pattern and outcome of surgical management of nasolachrymal duct obstruction in children: a five year review.

OBJECTIVE: To determine the pattern of naso-lachrymal duct obstruction (NLDO) and outcome of dacryocystorhinostomy (DCR) in children in Aminu Kano Teaching Hospital Kano, over a 5-year period. PATIENTS AND METHODS: The clinic and theater registers were used to retrieve the records of all patients below the age of 15 years who presented with NLDO. The information obtained included age, sex, duration, and types of clinical signs at presentation cause of obstruction and outcome of DCR. Successful outcome is defined as patent naso-lachrymal duct 1 year after surgery. All the patients had external DCR with stent inserted into the lachrymal sac and anchored to the columella and left in situ for 6 weeks. Fortnightly for three visits then at 2 months intervals. At each visit, the patient had lachrymal punctal cannulation and irrigation with normal saline to ensure free drainage. RESULTS: There were 17 patients, 9 males and 8 females (M: F = 1.1: 1). Two patients (11.8%) had bilateral disease and 15 (88.2%) were unilateral. The patients' ages ranged between 2 and 10 years. The commonest presenting features were tearing and discharge. In 14 patients (82%) tearing started from birth though patients presented much later. Congenital NLDO occurred in 82%, and in the remaining 18%, obstruction was caused by depressed nasal fracture. Fifteen patients (88%) had successful outcome of DCR at 1-year follow-up. The commonest complication noted was stent extrusion before 6 weeks in 17.6% of cases. Conclusion : NLDO was mostly of congenital origin and was characterized by delayed presentation. Patients have good outcome with external DCR.