Indications and outcome of tracheostomy in Ilorin, North Central Nigeria: 10 years review.

BACKGROUND: The study aims to highlight common indications as well as outcome of treatment among patients with tracheostomy in Ilorin, North-Central Nigeria. METHODS: A review of clinical records of all patients with tracheostomy over a period of ten years (2002-2011), using the Theatre, Ward, ICU and the emergency register after approval from the ethical review committee. Data retrieved included; demographic profile, primary diagnosis, indication for tracheostomy, surgical technique, hospital admission and care outcome of management. All information retrieved input and analysed using an SPSS version 17.0 and data analyzed descriptively. RESULTS: Seventy-six patients had complete data for analysis, age range from 1-89yrs, and mean age of 41.9yrs. There are 48males and 28 females with M:F ratio of 1.6:1. Majority of the patients were in the 3rd-5th decade. About 47.4% had temporary tracheostomy. The commonest indication for tracheostomy is upper airway obstruction secondary to aerodigestive tract tumors in 60.5%, then trauma in 26.3%. The complications are higher among the under tens'. Out of the 36 temporary tracheostomy only 18 were successfully decannulated. The mean hospital stay was 22±2days. Overall 15% mortality was recorded. CONCLUSION: Common reason for tracheostomy is essentially same earlier documentation in developing countries, common among males, emergency type still most common, neoplasm, prolonged intubation and trauma are the commonest indications, its complication is still high among the under tens'. The outcome is good with 15% mortality due to the primary disease and not from tracheostomy.

Indications and outcome of tracheostomy in Ilorin, North Central Nigeria: 10 years review

Background: The study aims to highlight common indications as well as outcome of treatment among patients with tracheostomy in Ilorin, North-Central Nigeria. Methods: A review of clinical records of all patients with tracheostomy over a period of ten years (2002-2011), using the Theatre, Ward, ICU and the emergency register after approval from the ethical review committee. Data retrieved included; demographic profile, primary diagnosis, indication for tracheostomy, surgical technique, hospital admission and care outcome of management. All information retrieved input and analysed using an SPSS version 17.0 and data analyzed descriptively. Results: Seventy-six patients had complete data for analysis, age range from 1-89yrs, and mean age of 41.9yrs. There are 48males and 28 females with M:F ratio of 1.6:1. Majority of the patients were in the 3rd­5th decade. About 47.4% had temporary tracheostomy. The commonest indication for tracheostomy is upper airway obstruction secondary to aerodigestive tract tumors in 60.5%, then trauma in 26.3%. The complications are higher among the under tens'. Out of the 36 temporary tracheostomy only 18 were successfully decannulated. The mean hospital stay was 22±2days. Overall 15% mortality was recorded. Conclusion: Common reason for tracheostomy is essentially same earlier documentation in developing countries, common among males, emergency type still most common, neoplasm, prolonged intubation and trauma are the commonest indications, its complication is still high among the under tens'. The outcome is good with 15% mortality due to the primary disease and not from tracheostomy

Clinical Presentation and Outcome of Sinonasal Tumors in a Nigerian Tertiary Hospital - 6-year Review.

BACKGROUND: Sinonasal tumor is an uncommon tumor in Nigeria, but the burden of the disease in terms of morbidity and mortality is on the increase. The aim of this study is to evaluate the pattern of presentation and outcome of sinonasal tumor in our center. METHODOLOGY: This was a retrospective review of all the patients with sinonasal cancer seen in Ear, Nose, and Throat Department of the hospital between January 2008 and December 2013. The patients' biodata, clinical presentation, stage of the disease at presentation, identifiable risk factors, histopathological findings, and outcome were presented. RESULTS: A total of 22 patients were diagnosed with sinonasal cancer out of 71 patients (31%) with head/neck cancers during the period of study. There were 12 males (54.5%) and 10 females (45.5%) with a mean age of 51 ± 2.1 years. Epistaxis, nasal blockage, and discharge were seen in all patients though 41% of patients presented first to the ophthalmologist due to proptosis. Identifiable risk factors were exposure to wood dust (29%) and petrochemical products in (11%). Most patients presented first at advanced stages of the disease (82%). Histologically, well-differentiated squamous cell carcinoma was the most common (54.6%) followed by nonintestinal well-differentiated adenocarcinoma in 18.2% and plasmacytoma (9.1%). Chemoradiation was the mainstay of management in (38%) though 13.6% had total maxillectomy with postsurgical chemoradiation and 50.4% defaulted due to cost of management. CONCLUSION: Health education on early presentation and efforts at early detection of the disease are needed to achieve cure. Exposure to the identifiable risk factors should be reduced by protective measures. Easy access to radiotherapy at affordable price will surely improve the outcome of this disease.

Accidental Decannulation OF TRACHEOSTOMY TUBES - Case Series.

Tracheostomy tube (TT) is usually removed in a planned manner once the patient ceases to have the condition that necessitated the procedure. Accidental decannulation or extubation refers to inadvertent removal of tracheostomy tube out of the stoma. It could prove fatal in an otherwise stable patient. We review a variety of unexpected and often-overlooked causes of accidental decannulation with suggestions on preventive measures. We therefore present three cases of accidental decannulation of tracheostomy tubes in order to report our experiences in the management of the condition. CONCLUSION: Accidental decannulation occurs both in hospitalized and patient on home care of their tracheostomy tubes. Reduction in neck circumference due to weight loss predisposes to accidental decannulation, which could be prevented by suturing the flange to the skin.

Presentation of preauricular sinus and preauricular sinus abscess in southwest Nigeria.

BACKGROUND AND AIM: Preauricular sinus abscess is a common congenital external ear disease. This abscess is usually misdiagnosed because it is commonly overlooked during physical examination. In Nigeria, the prevalence was 9.3% in Ilorin, north central Nigeria This study is to determine the distribution and clinical presentation of the preauricular sinus abscess in Ekiti, south west Nigeria. MATERIALS AND METHODS: This is a prospective hospital based study of all patients with diagnosis of preauricular sinus abscess seen in our clinic carried out between April 2008 to March 2010. Detailed clinical history, administered interviewer's assisted questionnaires full examination and. Data obtained were collated and analysed. RESULTS: Preauricular sinus were noticed in 184 (4.4%) out of 4170 patients seen during the study period. Preauricular sinus abscess were noticed in 21 (11.4%) of the preauricular sinuses especially in children. Unilateral preauricular sinus abscess accounted for 90.5%. Common presenting complaints were preauricular swelling (81.0%), 90.5% with recurrent earaches, 76.2% with ear discharges. All patients had antibiotic / analgesic while 17 out of 21 (81.0%) had surgical excisions. CONCLUSION: Preauricular sinus abscess were noticed among 11.4% of the preauricular sinuses especially in children, unilateral preauricular sinus abscess accounted for 90.5%. Common complaints were otorrhoea, earaches, and swelling and they were mostly managed surgically.

Otologic and audiological evaluation among HIV patients in Ilorin, Nigeria.

BACKGROUND: HIV infection is the highest cause of death worldwide and presenting eventually with ENT regions. OBJECTIVE: This study is to determine the prevalence of hearing loss and hearing patterns among adults Nigerians with HIV and causal relationships between CD4+ counts with the degree of hearing impairments. METHODS: This prospective study was carried out among all consecutive HIV positive patients attending the clinic at the University of Ilorin teaching hospital (U.I.T.H.), Ilorin, Nigeria between January and July, 2008. They all had audiological assessments with a pure tone audiometer within the frequency range 250 to 8,000 Hz to determine their hearing thresholds together with their CD+ counts estimations. RESULTS: 89 were evaluated in the age range of 18 to 56 years (Mean 36.4 years, SD of 8.82) and the modal age group was 21-39 years (59.6%), 40-56 years (38.2%).There were 51 males (57.3%) and 38 females (42.7%) with a male/female ratio of 1.3:1.0. Otological symptoms included tinnitus (15.7%), vertigo (15.7%), otalgia (14.6%) and hard of hearing (10%). Examinations showed bilateral serous Otitis media (glue ear) in 58 patients (65.1%) with no affectation of the facial nerves. PTA showed mixed, conductive and SNHL in 32 patients (36%), 20 patients (22.5%), 9 patients (10.1%) respectively and only 15(16.9%) had normal hearing thresholds. The CD4+ counts ranged between 12 to 616. CD4 counts with hearing loss mostly < 300mm3. CONCLUSION: The prevalence of hearing loss is 87% among HIV infected patients, mostly mixed HLwith causal relationships between reduced CD4+ counts of less than 300/mm3 with severity of hearing loss. The hearing loss can interfere with the communication and specific knowledge vital to the development of best practices towards ensuring the inclusion of hearing impaired in HIV/AIDS prevention and treatment programmes.

Prevalence of snoring and symptoms of sleep disordered breathing among primary school pupils in Ilorin, Nigeria.

BACKGROUND/AIM: Snoring is the production of sound from the upper aero-digestive tract during sleep due to turbulent airflow This study is to determine the prevalence, pattern, night and daytime symptoms of snoring among nursery and primary school pupils in Ilorin, Nigeria due to its public health importance. MATERIALS AND METHODS: This cross sectional survey was carried out among nursery /primary school pupils in Ilorin, Kwara state between April and September, 2010. Ten schools were selected randomly from 100 schools sited within the 3LGAs of Ilorin municipality. Also private and public schools with different parental social economic status were selected. The pupils were selected from nursery 2 to primary 6 in each school using the class registers with the aid of a table of random numbers with 1500 children assessed. The parents/guardians were made to fill the questionnaires and same returned with visitations to the schools twice weekly and reminders sent via phone calls. Data were analyzed using EPIINFO 2002 version 2 software. RESULTS: 1500 questionnaires were given out but 909 were completely filled and returned (response rate of 61%.). There were 598(65.8%) non snorers (NSn) and 311(34.2%) snorers (Sn) at different scales with 153 male snorers to 158 female snorers. The ages of the children ranges from 3 to 16 years (mean ± SD, 8.3 ± 4.8 years. The mean age for the Sn was 8.2 and 8.3 for NSn (range 3-6 years). No statistical difference in age, gender or socio-economic status between Sn and NSn. 598(65.8%) were non snorers (NSn) and 311(34.2%) were snorers (Sn) especially in the age groups 3-6 years, 121(38.9%) and above 6 years of age 101(32.7%) and below 3 years were 89(28%). CONCLUSION: Snoring is an important health problem among the pupils as a significant percentage snores and most of them are between third and sixth year of life.

A survey of facial nerve dissection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria.

OBJECTIVE: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear, Nose, and Throat (ENT) Surgeons. MATERIALS AND METHODS: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear, Nose, and Throat Surgeons in Nigeria, on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy, limited superficial parotidectomy, and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. RESULT: About half (47.5%) of them routinely used the antegrade technique, while only a few (12.5%) used the retrograde technique. A large number of them (40%), however, used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60%) and limited superficial parotidectomy (62%). However, the retrograde approach was the technique of choice by most of them (47%) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. CONCLUSIONS: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated.

Audit of Pediatric ENT Injuries.

BACKGROUND: Ear, Nose and throat (ENT) injuries are relatively common in children. Sometimes they may result in disfigurement or dysfunction of the affected parts. This study was aimed at the pattern and mechanisms of ENT injuries encountered by children in Ilorin located in north central Nigeria. It is therefore our hope that the information will go a long way to assist other African countries as well in health care plans for children. OBJECTIVES: The study was aimed at determining the pattern and causes of ENT injuries in children in Ilorin. METHODOLOGY: This was a descriptive cross sectional, prospective study of all pediatrics patients aged 15 years and below who were managed between January 2005 and December 2009 (a period of 5 years) for ENT trauma in the accident & emergency unit, wards and clinics of University of Ilorin Teaching Hospital. Most of them were treated as out-patients; a few of them needed admission for some procedures. Patients with injuries to other areas than ENT were not included in this study. The data that were analyzed included the age, sex, presenting complaints, duration of symptoms prior to presentation, diagnoses, treatments and complications. RESULTS: Two hundred and seventy-one children were studied, of which 168 (62.0%) were males and 103 (38.0%) were females. Most of the children, 97 (35.8%), were between age group of 6-10 years, 81 (29.9%) aged 5 years and below, while the rest were 11-15 years of age. Injuries due to foreign bodies in Ear, Nose and Throat accounted for 80 (29.5%) of the causes. Falls accounted for 60 (24.4%) of cases while Road Traffic Injuries (RTI), 42 (15.5%) of cases. Bleeding was the commonest presenting symptom. Most of the children, 97 (35.8%) presented within 1 hour of injury while the least, 45 (16.6%), presented more than 8 hours after the injury. 132 (48.7%) had injuries in the Ear, 117 (43.2%) in the Nose and 22 (8.1%) in the Throat. CONCLUSION: ENT injuries in pediatrics are relatively common in our environment with injuries from FB insertion/ingestion being the commonest. This is closely followed by falls. Several disabilities and morbidity may result from the trauma like anosmia, facial palsy and permanently depressed nose. These have impact on psychology of the child. For these reason close monitoring of children by parents and care-givers cannot be overemphasized. Also these injuries are avoidable causes of death and disability in children.

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Nasal osteogenic chondrosarcoma: a case report.

BACKGROUND: Osteosarcomas and chondrosarcomas are the most common malignancies of the jaw bones. Nasal osteogenic chondrosarcoma is rarely reported. OBJECTIVE: To draw attention to a rare tumour, osteogenic chondrosarcoma. METHODS: A middle aged woman presented with a three month history of nasal blockade and mucopurulent discharge. She was fully clinically evaluated including anterior rhinoscopy and plain radiograph. RESULTS: Detailed history, physical examination and plain radiography showed features suggestive of antrochoanal polyp with differential diagnoses of sino nasal and nasopharyngeal tumour. At emergency tracheostomy, examination under anaesthesia, meticulous nasal and nasopharyngeal tumour clearance was done. Histopathological examination of the mass revealed osteogenic chondrosarcoma. CONCLUSION: Though rare, osteogenic chondrosarcoma affects nasal bones. Clinically the tumour mimicks an antro-choanal polyp and is associated with the challenge of recurrence.

Aetiological profile of nasal trauma in Ilorin North-Central Nigeria.

BACKGROUND: The nose being the most prominent part of the face is easily traumatized in facial injuries and these has been found to be common among the Caucasians compared to the Africans and Asians. The aim is to highlight the Aetiological profile of nasal trauma in Ilorin north-central Nigeria. METHOD: A prospective study was carried out at the University of Ilorin Teaching Hospital Ilorin, Ilorin, north central Nigeria over a period of one and half years of all trauma cases seen at the A/E department of the hospital and those with nasal trauma were further studied. The data retrieved include demographic data, clinical presentation, and timing of presentation, examination findings, intervention offered and the outcome. Data were entered into SPSS 11.0 and analyzed descriptively. RESULTS: A total of one hundred and six (106) patients with nasal trauma were seen during the study period with a prevalence rate of 7%. The age range 6 months to 65 years with the majority of the patients in the age range 21-34 years (35.8%). The Male to female ratio was 1.7:1.0 and most patients were students (28.3%), followed by the traders (22.6%) the least were children (8.5%).Road traffic injury (RTI) constituted the highest cause of the nasal trauma (57.5%),assaults (17%), falls from heights (8.5%) and others were 17%.Majority of the patients presented within 1-6 hours of occurrence of the injury (61.3%) and only 24.5% presented less than an hour of the incidence. The common forms of presentation were epistaxis (40.6%), nasal lacerations and epistaxis (25.5%) and nasal fractures in only 10.4%. Involvement of both the passengers and the pedestrians was (57.5%) and most of them, 44.3% had surgical intervention and 40.6% had conservative treatment with a mortality rate of 0.9%. CONCLUSIONS: The pievalence of nasal trauma.is 7% with RTI being the commonest cause in nearly two thirds of cases and cases of assaults only accounted for 17%.The commonest forms of presentation were epistaxis,nasal lacerations and nasal fractures in that order and most of them were surgically treated. Measures should be adopted to reduce incidence of RTI, with regulations enforced to protect pedestrians most of whom were the victims of these injuries.

Clinico-pathological pattern of nasopharyngeal carcinoma in Ilorin, Nigeria.

BACKGROUND: Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high. AIM: The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria. MATERIALS AND METHODS: This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1 st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991 WHO classification. RESULTS: A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable risk factors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by well-differentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%). CONCLUSION: Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease.

Tuberculous otitis media: a case presentation and review of the literature.

A 42-year-old farmer being treated for pulmonary tuberculosis was referred to our clinic after developing otorrhoea and hearing loss in his right ear. Examination revealed a large subtotal perforation in the right ear in addition to a purulent discharge with right facial nerve palsy. Audiometry indicated a 35 dB conductive hearing loss at 0.5, 1 and 2 kHz with air-bone gaps of 12, 15 and 10 dB, respectively. A middle ear biopsy was performed under direct visualisation, with a middle ear lavage which was positive for allergic fungal sinusitis (AFS). The final diagnosis was tuberculous otitis media (TOM). Clinical symptoms and signs should be reviewed in every case of chronic otitis media keeping the possibility of tuberculosis in mind. Otorrhoea in a patient with known or suspected active pulmonary tuberculosis should be assumed to be TOM until proven otherwise.

Clinico-Pathological Pattern of Nasopharyngeal Carcinoma in Ilorin, Nigeria

Nasopharyngeal carcinoma is an uncommon tumour in Nigeria but the burden of the disease in terms of morbidity and mortality is very high. The aim of the study was to document the clinic-pathological characteristics of nasopharyngeal carcinoma in Ilorin, North central Nigeria. This was a retrospective review of all patients seen in ENT department, University of Ilorin Teaching Hospital with the diagnosis of nasopharyngeal carcinoma between January 1st 1999 and December 31st,2008. The patient's biodata, clinical presentation and histopathological findings are presented. The histopathological diagnosis was in accordance with the 1991 WHO classification. A total of 30 patients with histologically confirmed nasopharyngeal carcinoma seen during the study period accounted for 2% of the total cancers recorded in Ilorin cancer registry. There were 20 males and 10 females with a mean age of 48.7 ± 15.9 years. The commonest presenting complaint was cervical lymphadenopathy in 96.7% of patients followed by epistaxis (66.7%) and hearing loss (66.7%). Identifiable risk factors included regular intake of ungutted salted smoked fish (76.7%) and tobacco use (23.3%) with some having both risk factors. Histologically, undifferentiated carcinoma was the commonest (70%) followed by welldifferentiated keratinizing squamous cell carcinoma (20%) and differentiated nonkeratinizing squamous cell carcinoma (10%).Undifferentiated carcinoma was the commonest type of nasopharyngeal carcinoma reported from this study especially among males in the 4th and 5th decades of life. Identifiable risk factors included consumption of ungutted salted smoked fish with tobaccon usage. Early diagnosis with effective referral system and easy access to radiotherapy would improve the survival outcome in patients with the disease

Parental satisfaction with post-adenotonsillectomy in the developing world.

AIM/BACKGROUND: Tonsillectomy with or without adenoidectomy is one of the most commonly performed surgical procedures by the otolaryngologists in the pediatric population. The aim of this study is to evaluate parental expectation and satisfaction following tonsillectomy with or without adenoidectomy. MATERIALS AND METHODS: Hospital-based prospective study of all consented parents whose children had tonsillectomy with or without adenoidectomy over a period of 13 months (February 2008 to February 2009) using a cross-sectional method. Pre- and post-surgical questionnaire-based Interview was conducted for them and information retrieved included biodata, pre- and post-surgical symptoms on follow-up in the clinic of obstructive sleep apnoea, snoring, mouth breathing and rhinorrhea, parental expectation and satisfaction after surgery. All data were entered into statistical data using SPSS version 11 and analyzed and the results are presented in tables and figures. RESULTS: A total of 29 patients had adenotonsillar surgery, who were within the age range of 1.50-14 years with a mean age of 5.50 (SD=4.06+/-0.75). M:F ratio was found to be 3:1 (22 males and 7 females). Parents were satisfied with the expected outcome in terms of symptoms post-operatively in 96.6% while only one 3.4% were not satisfied. CONCLUSION: Majority of the parents (96.6%) were satisfied with the expectation of immediate resolution of symptoms; however, obstructive adenotonsillar hypertrophy remains an important problem to be solved to achieve total parental satisfaction in adenotonsillar operations.

Pleomorphic adenoma of the lateral nasal wall--a case report.

AIM/BACKGROUND: We report a rare case of pleomorphic adenoma arising from the lateral nasal wall. PATIENT AND METHOD: A 23 year old woman presented with a 9 month history of right sided nasal mass with progressive nasal obstruction. A CT-Scan of the paranasal sinuses was carried out and the mass was excised intranasally. RESULTS: A CT-Scan of the nose and paranasal sinuses showed a soft tissue mass in the right nasal vestibule measuring 2.33 x 3.04 cm in its widest dimension. There was associated expansion of the cavity with displacement of the nasal septum and thinning of the medial wall of the right maxillary antrum adjacent to it. The microscopic finding showed a lobular duct-like structure within a loose chondromyxoid stroma, which are histological characteristics of pleomorphic adenoma. CONCLUSIONS: Her post-operative clinic visits were uneventful, and she is currently disease-free; nine months after surgery. The diagnosis, clinical behaviour and treatment of pleomorphic adenoma of the lateral nasal wall are discussed from a review of the literature.

Day case adenoidectomy: is it safe?

OBJECTIVE: To document the Clinical outcome of Day Case Adenoidectomy in Children in a Nigerian tertiary health Institution and a private Ear, Nose and Throat Consultant Cinic. METHODOLOGY: This is a prospective study of twenty eight children without any co-morbid condition operated for adenoidectomy between June 2002 and May 2004. The patients were admitted on the day of surgery and discharged within 12 hours post surgery. RESULT: A total number of 28 patients were operated for adenoidectomy. 16 children were treated as planned day cases and 12 were treated as inpatients. 50% of the patients were in the age group of 2-4 years. There were 12 males and 4 females with a M:F ratio of 3: 1. All the parents of the patients had access to cars and 75% resided within 30 minutes of travelling time from the hospital. CONCLUSION: Day case adenoidectomy is relatively safe and may prove advantageous considering long surgical waiting lists, preventing Hospital acquired infection and minimizing cost of hospitalization.

Knowledge and perception of stroke amongst hospital workers in an African community.

BACKGROUND AND PURPOSE: Stroke is a growing public health problem worldwide. Hospital workers are sources of knowledge on health issues including stroke. The present study aimed at assessing the knowledge and perception of a sample of Nigerian hospital workers about stroke. METHODS: Hospital-based, cross-sectional survey. Respondents selected by systematic random sampling were interviewed using a 29-item pre-tested, structured, semi-closed questionnaire. RESULTS: There were 370 respondents (63% female, mean age: 34.4 +/- 7.5 years; 61% non-clinical workers). Twenty-nine per cent of respondents did not recognize the brain as the organ affected. Hypertension (88.6%) was the commonest risk factor identified; 13.8% identified evil spirit/witchcraft as a cause of stroke, whilst one-sided body weakness (61.9%) was most commonly identified as warning symptom. Hospital treatment was most preferred by 61.1% of respondents whilst spiritual healing was most preferred by 13.0%. In the bivariate analysis, higher level of education and being a clinical worker correlated with better stroke knowledge (P < 0.001). CONCLUSION: This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.