Paediatric otorhinolaryngology, head and neck emergencies at a Tertiary Health Care Centre in Nigeria

Background: Paediatric otorhinolaryngology emergency is a common disorder worldwide which is poorly reported in most developing countries like Nigeria. Methods: This study was aprospective hospital-based study of paediatric patients with otorhinolaryngology, head and neck emergency in the Ear, Nose and Throat (ENT) department carried out between June 2016 and May 2018. Data were obtained by using a pretested interviewers assisted questionnaire. All data were analysed using SPSS version 18.0. Results: Paediatric otorhinolaryngological emergencies accounted for 7.6% of all patients seen in the unit. There were more males (69.5%). Common aetiologies were foreign body impaction (43.3%), infection/inflammation(32.6%) and tumour(1.3%). Anatomically the emergencies involved the ear in 42.1%, 30.9% nasal and 23.2% throat respectively. The most common clinical features were foreign body impaction in 35.2%, pain in 31.3%, bleeding in 19.7%, difficulty breathing in 17.6% and nasal blockage in 15.9%. Common sources of referral were paediatricians in  32.6%,casualty officers in 28.8%, a family physician in 22.3% and self -reporting in 15.0%. Complications at presentation include: 27.0%  injury/bleeding, 18.0% otitis externa, 11.2% rhinosinusitis and 10.3% perforated tympanic membrane. Conclusion: Pediatric otorhinolaryngology emergencies are common in our centre and were associated with complications at presentation due to wrong interventions. Keywords: Paediatric, Head, Neck Otorhinolaryngology, Emergency, Nigeri

PATTERNS OF SELF EAR CLEANING AMONG OTORHINOLARYNGOLOGY PATIENTS IN DEVELOPING COUNTRY

Aims and objectives: Self ear cleaning is a common bad health practice among many patients despite associated complications. This study aimed at determining the prevalence, sociodemographic, clinical presentation, associated complications and management of self ear cleaning among patients in a tertiary hospital in sub Sahara Africa. Materials and methods: This is a prospective hospital based study of patients with history of self ear cleaning. The study was carried out over a period 6 months between June and November, 2017. Informed consent was obtained from patients. Pretested interviewers assisted questionnaire was administered to obtain data. Data obtained were collated and statistically analyzed by using SPSS version 16. Results: The prevalence of self ear cleaning was 93.4%. There were 47.9% males with male to female ratio of 1:1. Common reasons for self ear cleaning were 35.1% personal hygiene, 21.8% dirty/earwax and 11.8% itching. Both ears were most commonly cleaned among the patients in 46.9%. Right ear in 31.8% was commoner than left ear in 21.3%. Commonest object used in ear cleaning was cotton bud in 44.5%. Other objects were finger, feather and key in 24.6%, 15.6% and 14.7% respectively. Common clinical presentation were dirty/earwax in 35.1%, otalgia in 29.4%, hearing loss in 27.5% and itching in 24.2%. Long time (chronic) ear cleaning accounted for 63.5% while short time (acute) ear cleaning accounted for 36.5%. Frequency of ear cleaning in these patients were daily in 49.3%, weekly in 17.1%, monthly in 13.3% and occasional in 20.4%.Major diagnosis was 34.6% personal hygiene, 22.7% allergy and 18.5% earwax impaction. No complications were recorded in 39.3%. Common complications were external auditory canal injury in 28.9%, impacted foreign body in 25.6% and traumatic perforated tympanic membrane in 6.2%. All patients had health education. Other treatment was conservative/medical treatment in 71.1% and foreign body removal in 17.5%. Conclusion: Ear cleaning was higher among the patients. Majority of the patients believed it is beneficial. This is associated with available complications

SOCIODEMOGRAPHIC PROFILE AND PATTERN OF SINONASAL INJURIES AT THE EKITI STATE UNIVERSITY TEACHING HOSPITAL, ADO-EKITI, SOUTH-WEST NIGERIA

Background: Sinonasal trauma is a common otorhinolaryngology disorder worldwide. This study aimed at determining the prevalence, sociodemographic features, aetiology, clinical presentation, management and outcome of injuries to the nose and paranasal sinuses. Materials and Methods: This was a prospective study of patients with sinonasal injuries that presented at our tertiary health institution. Consented patients were studied between October 2015 and September 2017. Analysis of obtained data was done with SPSS version 16.0. Results: The prevalence of sinonasal injury was 2.7%. There were 67.1% males and 32.9% females with male to female ratio of 2:1. Foreign body was the commonest cause of injury in 35.4% followed by road traffic accidents in 24.4%. Commonest anatomical region of sinonasal injury were nasal cavity and nasal vestibule in 57.3% and 19.5%. Common clinical features among the patients were pain in 72.0%, bleeding in 53.6% and foreign bodies impaction in 35.4%. Acute sinonasal injury in 95.1% was commoner than chronic sinonasal injury (≥13 weeks) in 4.9%. Commonest associated complications of the sinonasal injuries were rhinosinusitis in 37.8% others were 22.0% epistaxis, 11.0% nasal septal abscess and 3.7% adhesion. Pre-hospital treatment in the patients was 62.2%. Major treatments offered to the patients were conservative/medical therapy in 53.7%. Commonest surgical interventions were 35.4% foreign body removal and 7.3% epistaxis control. Conclusion: Sinonasal injuries are common in the otorhinolaryngology practice. Commonest causes are self-inflicting foreign bodies impaction and road traffic accident. Pre-hospital treatment in the patients was very high

Pattern of presentation of ear , nose, throat, head and neck injury in a developing country

Objective: Ear, nose, throat, head and neck injuries are a common otorhinolaryngology disorder worldwide. This study aimed at determining the prevalence, sociodemographic features, aetiology , clinical presentation management and outcome of injuries to the ear, nose, throat, head and neck region. Methods: This was a prospective study of patients with otorhinolaryngolology , head and neck injuries that presented at our tertiary health institution. Consented patients were studied between October 2015 and September 2017. Analysis of obtained data was done with SPSS version 16.0. Results: The prevalence of ear, nose, throat, head and neck injury was 9.4%. There were 63.5% males 36.5% females with male to female ratio of 1.5:1. Foreign bodies' impaction was the commonest cause of injury in 32.3% followed by road traffic accidents in 19.8%. Commonest anatomical region were ear and nose in 49.7% and 28.5% respectively . Common clinical features among the patients were pain in 46.5%, bleeding in 37.8% and foreign bodies' impaction in 32.3%. Presentations for otorhinolaryngology care among the patients were common in 95.1% acute injury than 4.9% chronic injury (≥13 weeks). Commonest associated complications of the injuries were otitis media in 18.8% others were 14.9% otitis externa, 9.4% perforated tympanic membrane and 6.3% epistaxis. Pre-hospital treatment in the patients was 67.4%. Major treatment offered to the patients was conservative/medical therapy in 28.8%. Conclusion: Ear , nose, throat, head and neck injuries are common in the otorhinolaryngology practice. Commonest causes are self inflicting foreign bodies' impaction and road traffic accident. Pre-hospital treatment among the patients was very high

Otologic diseases presentation and management among elderly patients in a tertiary health institution, South West Nigeria

Background: Otologic diseases is one of the commonest presentation among elderly patients at the ear, nose and throat clinic worldwide.This study aimed at determining the prevalence, pattern, sociodemographic features, effect on quality of life and management of elderly patients with otologic diseases inEkiti state, Nigeria.Materials and Methods: This was a cross sectional, prospective hospital based study of elderly patients with otologic diseases. The study was carried out in ear, nose and throat department of the study center over a period of 5 years. Data was taken using pretested interviewers assisted questionnaire. Data obtained were collated and statistically analyzed using SPSS version 18.0.Results: The prevalence of otologic diseases in elderly patients was 5.3% of the patient population. Elderly male were 42.9% and male to female ratio was 1:1.5. Rural dwellers in 47.2% were less commoner than urban dwellers in 52 8%.Common otologic diseases in this study were 20.1% earwax impaction, 14.9% presbycusis, 9.9% otomycosis, 9.6% ototoxicity, 6.4% otitis externa and 6.1%benign paroxysmal positional vertigo. Bilateral otologic diseases was predominant in 55.1% than unilateral in 44.9%. Right otologic diseases accounted for 26.5%.Common clinical features among the elderly patients were hearing impairment in 57.4%, earache in 26.8%, ear discharge in 25.9%, earwax impaction in 25.4%, and aural blockage in 24.5%.Sensorineural hearing loss in 39.7% was commoner than conductive hearing loss and mixed hearing loss in 28.6% and 9.3% respectively. Type A, tympanometry (normal) was the commonest findings in 26.8%. Pure tone audiometry revealed 31.5% mild, 17.2% moderate and 12.5% moderate-severe hearing impairment.  Associated Comorbid illnesses were 31.2% sinonasal disorder, 22.7% throat diseases, 21.3% arthritis, 19.5% hypertension,13.4%, diabetes mellitus and 12.0% cardiopulmonary diseases. Common effect on quality of life in these elderly patients were 28.6% depression, 26.5% isolation, 25.9% embarrassment and 21.0% anxiety. Commonest mode of management were pre-hospital treatment in 62.4%, conservative/medical treatment in 50.7% and surgery/procedures in 47.4%.Conclusion: Otologic diseases in elderly patients are common in our center. Common otologic diseases among these elderly patients were earwax impaction, presbycusis and otomycosis. These were associated with comorbid illnesses like arthritis, hypertension and diabetes mellitus. There was negative impact on the quality of life of the elderly patients. &nbsp