Aminu Bakari

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.

Otologic surgeries in National Ear Care Centre, Kaduna, Nigeria: A 5 years review

Background: Otologic surgeries that endure are based on a detailed knowledge of anatomy, physiology, and pathology of the temporal bone. Ear surgeries are challenging to most otolaryngologists practicing in Nigeria. The aim was to present a 5 years review of indications, types, complications, success, and limitations of the ear surgeries at the study center. Materials and Methods: A 5 years retrospective review of all the otologic surgeries are done under general and local anesthesia from July, 2009 to July, 2014. Results: There were 1067 patients who had ear, nose, and throat surgeries within the period under review, out of which 68 were ear surgeries. Prevalence was 6.37%, there were 25 (37%) males and 43 (63%) females, male: female 1:1.7. Age ranged from 1 to 58 years, mean age 21 ± 6 years. Chronic suppurative otitis media was the most common diagnosis 39 (57.4%) and indication for tympanoplasty 31 (46.6%). Meatocanaloplasty was the least with 2 (2.9%), mastoidectomy 7 (10.3%), myringotomy and grommet insertion 11 (16.2%), excisional biopsy 7 (10.3%), foreign body removal 4 (5.90%), tympanomastoidectomy 3 (4.40%), and pinnaplasty 3 (4.40%). Forty-one (60.3%) achieved resolution of symptoms while 8 (11.8%) had persistence of symptoms. One (1.5%) had revision surgery. The success rate is about 60.3% within the period under review. Postoperative complications (facial nerve paralysis, persistence discharge from the mastoid cavity, worsened deafness, postauricular fistula) were seen in 14 (20.6%). While 4 (5.9%) were lost to follow-up. Conclusion: Ear surgeries are still underdeveloped when compared to nose and throat surgeries in our center. Complication (chronic suppurative otitis media) was the most common indication for ear surgery. Provision of adequate training facilities, especially in the field of otology and review of the training curriculum for otorhinolaryngology residency in Nigeria is indispensable.

Rhinoentomophthoromycosis in Northern Nigeria: Report of two cases

Rhinoentomophthoromycosis is a rare granulomatous disease restricted to the nose and its surrounding tissues. The disease occurs mostly in tropical rainforest of Africa, India, South and Central America, and South East Asia. Etiological diagnosis of the disease may be difficult because the fungal element is rarely found in the tissue and if present may be fragmented. Two cases of managed subcutaneous zygomycosis (rhinoentomophthoromycosis) from the Savannah region of Northern Nigeria are presented. A review of clinical presentation, investigations, and treatments outcome are described. High index of suspicion is required so that treatment can be started early to avoid attendant consequences and improve the outcome.

Tympanometric assessment among a select cohort of deaf students

Background: Children and young adults with profound hearing impairment and/or deafness are equally at risk of developing other ear diseases such as otitis media with effusion (OME) and/or middle ear infections. Otoscopic diagnosis of middle ear effusion is often problematic, and clinicians′ skills in that regard are notably variable. The objective of this study is to present the tympanometric findings among hearing-impaired students from a group of special schools for the hearing impaired in Kaduna metropolis. Participants and Methods: This was a prospective cross-sectional study conducted for 4 months between February and May, 2014. Students aged 7-18 years attending Kaduna State Special Education School for the deaf, Katsina road, and Demonstration School for the Deaf, Kawo, Kaduna, were recruited for the study. An interviewer-based questionnaire was developed to capture the student′s demographic characteristics and clinical information. This was followed by ear examination and tympanometric tests. The data were analyzed using Statistical Package for the Social Sciences software, version 16. Results: A total of 294 participants were recruited into the study group, and there were 173 males (58.8%) and 121 females (41.2%). The age of the participants ranged from 7 to 18 years. The mean age of the study group was 13.6 years with a standard deviation of ΁ 3.6 years. Forty-three (14.6%) of them had dull and retracted tympanic membranes while the rest had intact shiny tympanic membrane. Tympanometric test showed that 281 participants (89.5%) had type A tympanogram while types B and C accounted for 21 (7.1%) and 9 (3.1%), respectively. Among the 43 participants with dull and retracted tympanic membrane via otoscopic examination, 13 had type A tympanogram (normal) while the rest had middle ear disorders (type B and C tympanograms). Conclusion: Middle ear diseases such as OME and eustachian tube dysfunction were found among the study population. There is a need for the provision of regular awareness lecture and periodic ear examination to prevent, detect, and treat imminent otologic diseases.

Management of severe cut throat injury in Zaria, Nigeria

Cut throat injury is a potentially life threatening emergency often encountered by ear, nose, and throat surgeons. In recent years, there has been increasing incidence of violence as well as severe injuries from armed robbers and insurgents using sharp knives in Northern Nigeria. The use of knives as a weapon for armed robbery when applied to the neck often results in fatal consequences because of the potential for injury to vital structures. Early appropriate interventions often reduce the morbidity and mortality associated with cut throat injuries. We present a report of a successfully managed case of severe cut throat with complete transection of the larynx and muscles of the posterior neck resulting in near decapitation inflicted using a sharp knife during a robbery incident. Securing airway in the early management of patient with cut throat injury is very important. There is a need for patient and meticulous repair of damaged structures. This may reduce the morbidity and mortality associated with such cases.

The pure tone audiogram assessment of the students of a special school for deaf in Kaduna

Background: Hearing impairment in children is an important public health problem. Children with hearing impairment are educated in special schools (schools for the deaf) and in our locality all are assumed to be deaf without necessarily subjecting them to audiological evaluation in some cases. The objective of this study was to identify the cause of hearing impairment, type and degree of hearing loss, and use of hearing aids among students attending special schools for the deaf in Kaduna. Patients and Methods: This was a cross-sectional study conducted over a period of 4 months between February and May, 2014. Students aged 7-18 years attending Kaduna State Special Education School for the deaf, Katsina road, and demonstration school for the deaf, Kawo Kaduna, were recruited for the study. A questionnaire investigating the student′s biodata, causes of hearing impairment, and use of hearing aids was administered. This was followed by ear examination and pure tone audiometric tests. The data were analyzed using Statistical Package for the Social Science version 16. Results: A total of 307 participants were recruited as the study group. Among them, 58.6% were males and 41.4% were females. The mean age of the study subjects was 13.5 ± 3.6 standard deviation (SD) years. Only 27.7% of the study population have a known cause of their hearing impairment. Two hundred and ninety seven (97.4%) of the students had sensorineural hearing loss, while out of the remaining subjects 5 (1.6%) have conductive and 3 (0.9%) have mixed hearing losses. Two hundred and sixty eight (87.3%) of the participants had profound hearing loss while 37 (12%) had mild-to-severe hearing loss. Two students (0.7%) were found to have normal hearing. No student was found to be using hearing aid. Conclusion: In majority of the students, the cause of the hearing impairment is unknown. Some of the students have residual hearing and none of them is using hearing aids. Further evaluation and possible amplification may be required to rehabilitate some of these students into normal schools.

Life threatening retropharyngeal Burkitt's lymphoma mimicking adenoid obstructive disease

The commonest sites of non-Hodgkin′s lymphoma in the head and neck are the cervical nodes, Waldeyer′s ring and extra lymphatic organs such as the sinuses, larynx, salivary glands and oral cavity etc. We present the case of a 10 year old with upper airway obstruction secondary to retropharyngeal Burkitt′s lymphoma. The presenting features here are very similar to obstructive adenoid enlargement. Emergency tracheotomy, biopsy, and chemotherapy led to resolution and subsequent decanulation. This case is highlighted in relation to the increasing recognition of AIDS related lymphomas globally.