Aliyu Mohammed Kodiya

Clinico-pathological profile of sinonasal masses: an experience in national ear care center Kaduna, Nigeria

BackgroundThe presence of a mass in the nose and paranasal sinuses may seem to be a simple problem; however it raises many questions about the differential diagnosis. The aim of this study is to evaluate the clinico-pathological profile of sinonasal masses in our environmentThis is a retrospective analytical review of all the patients with sinonasal masses that presented to the national ear care center, Kaduna over a six year (2003-2008) period. Their biodata, clinical profile and histological diagnoses were analyzed.FindingsA total of 76 patients were analyzed, age range 5 to 64 yrs with a mean age of 33.3 yr median and modal age of 35.00 (SD = 13.1 ± 1.5). Majority of the patients were in the age groups 21-50 yrs. There were 34 male and 42 female with M: F ratio of 1:1.2. The main presenting symptoms are nasal blockage 97.4% and rhinorrhea 94.7%. It was bilateral in 34 (44.7%), left side in 24(31.6%) and right side in 18(23.7%) patients. The commonest clinical diagnoses were simple nasal polyp 47(61.8%) and antrochoanal polyp 10(13.2%). About 59 (77.6%) were benign, 2 (2.6%) were malignant and 15 (19.7%) were lost to follow up. The commonest histological diagnosis is simple inflammatory nasal polyp in 28 (36.8%) patients and the least was nasal capillary hemangioma 2 (2.6%). About 55(72.4%) patients had surgical treatment.ConclusionsNasal obstruction and rhinorrhea are the commonest symptoms of presentation, simple inflammatory nasal polyp is still the commonest histological pattern seen in our environment, and surgery is still the best modality of treatment for benign tumor thus the need for advocacy for early recognition and referral to the ENT surgeon.

Management Strategies of Peritonsillar Abscess in the Tropics: A Survey of Surgeons’ Preference

Peritonsillar abscess (PTA) or Quinsy is one of the common abscesses of the head and neck that requires urgent attention. Its treatment may often require hospital admission. Needle aspiration, incision & drainage and tonsillectomy have been the various treatment policies available depending on surgeon’s preference. We present a survey of current practices in the management of PTA of practicing ENT surgeons in Nigeria. Questionnaires were mailed to members of the Otorhinolaryngological Society of Nigeria (ORLSON). Of the 60 surgeons surveyed, 56.7 % advise tonsillectomy in patients with history of recurrence, 20 % when there is previous history of tonsillitis and 23.3 % in patients with single attack of PTA. Overall 96.7 % of surgeons advises interval tonsillectomy and only 3.3 % advice abscess/quinsy tonsillectomy. There is paucity of literature on PTA in the tropical region, the survey therefore serves as a baseline information for further research especially outcome based in order to establish a standard criteria for choice of a treatment policy in our region. We suggest maintaining the policy of interval tonsillectomy in the appropriate patients for the time being.

Solitary isolated neurofibroma of the soft palate

Neurofibroma of the soft palate is an unusual tumor and probably only two cases have been reported in English literature previously. Solitary isolated neurofibroma of the soft palate not associated with von Recklinghausens disease is even more infrequent. To the best of our knowledge, this case represents the third reported in English literature. Complete surgical excision was achieved after tracheostomy due to envisaged difficulty in intubation. We present a 40-year-old man with an uncommon soft palatal neurogenic tumor.

Antibiotic Sensitivity Pattern of Bacterial Isolates in Patients with Chronic Rhinosinusitis in Kaduna, Nigeria

Introduction  A common practice in the management of patients with chronic rhinosinusitis (CRS), the empirical use of antibiotics may contribute to treatment failure and to the development of antimicrobial resistance. Objective  To determine the antibiotic sensitivity pattern of aerobic and anaerobic bacteria associated with CRS. Methods  This was a prospective cross-sectional study in which endoscopically guided middle meatal swabs (IBM Spss, version 16.0, Chicago, IL, USA) were aseptically taken from patients diagnosed with CRS after obtaining informed consent and ethical clearance. The samples were sent to the laboratory for qualitative and semiquantitative analysis via gram stain, aerobic, anaerobic cultures and antibacterial sensitivity tests. The collected data was analyzed using SPSS for Windows, version 16 (SPSS Inc, Chicago, IL, USA). Simple statistical parameters and paired sample t -test were used, as appropriate. Results  There were 74 (56.92%) bacterial growths, out of which 55 (74.32%) were aerobic and 19 (25.68%) were anaerobic isolates, from a total of 130 patients. About 13 (17.5%–18%) of these bacterial growths yielded a mixed growth of aerobic and anaerobic isolates. The most common bacterial isolates were 26 (35.14%) Staphylococcus aureus , Haemophilus influenzae 9 (12.16%), Streptococcus viridians 8 (10.81%), and Streptococcus pneumoniae 5 (6.76%). Augmentin, ciprofloxacin, and Peflacine were found to be most effective, followed by levofloxacin, Rocephin, erythromycin and Zinat in that order. Conclusion  Augmentin, ciprofloxacin and Peflacine have a sensitivity of 100%, while most of the organisms show resistance to Ampiclox, amoxicillin, and Septrin.