Background: Fibrous dysplasia mainly presents in its monostotic form in the cranio-facial region with serious cosmetic disfigurement and functional derangement of the affected and adjacent structures putting both patient and the attending surgeon in great dilemma. Surgical treatment is the only rewarding and generally accepted treatment option, however, controversy over the surgical technique to be adopted still exists. While in the past, surgeons generally adopted conservative shaving or contouring technique, over the recent years, advocates of radical surgery are winning more disciples. Objective: To highlight the locally destructive, functionally degrading nature of a neglected or poorly excised (shaved) lesion in patients and highlight the outcome of total excision and surgical technique adopted to obviate the need for autologous bone grafting and two-staged surgery. Subjects and Method: We present case series of three patients with giant monostotic fibrous dysplasia of the maxilla, surgically treated in our Centre, who were part of a total of eight cases managed over the past fifteen years in our department of Ear, Nose and Throat-Head and Neck Surgery. The pre-operative clinical assessment, relevant investigations and post-operative outcome are presented. Our surgical technique is highlighted. All the patients had unilateral lesion of the maxilla with gross cosmetic and functional defects. Two of the patients had ischaemic (pressure) atrophy of the cheek soft tissue and skin leading to skin metaplastic changes including leukoplakia, hyperpigmentation. Post-operative follow-up showed satisfactory cosmetic outcome and significant reversal of malocclusion and dental anarchy. There was no recorded recurrence throughout the follow-up period ranging from four to eleven years. Nasal airway was re-established bilaterally in all the cases. Conclusion: Total or near total excision surgical technique with periosteal preservation is our treatment of choice in the management of monostotic cranio-facial fibrous dysplasia. Given the fact that the growth of the tumours often does not cease after puberty against How to cite this paper:
Background: In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients' safety and surgeons' convenience. However, in some developing countries such as Nigeria, facilities and expertise for general anaesthesia are not equitably distributed. As such, they are not available in some health centers especially in the rural communities. Hence, the need to explore other suitable alternatives such as operating under local anaesthesia. Aim: This study aims to highlight the feasibility and safety of thyroidectomy under local anaesthesia at a surgical outreach in a rural community in Nigeria. Patients and Methods: The study site was conducted at Bethany Medical Centre, Gboko, Benue State, Nigeria. It was a one-week surgical outreach. Neck infiltration with local anaesthesia was carried out using 2% xylocaine with adrenaline 1:200,000 and a standard open technique was used to carry out all thyroidectomies. Results: Out of seventy (70) patients that presented during the study period, 31 (44.3%) met the inclusion criteria and were operated within the seven (7) days period. There were 3 (10.7%) males and 28 (89.3%) females. There ages ranged between 22 to 65 years, average was 43 years. The average duration of surgery was 90 minutes, and 3 days' hospital stay. Those followed up two weeks post-operation recuperated well with no notable complications. Conclusion: Thyroidectomy under local anaesthesia is safe and feasible in our rural communities and in selected cases can be a suitable alternative to general anaesthesia.
Background: Presbyacusis is a major cause of hearing loss among seniors. The condition attracts attention following the prediction of World Health Organization that elderly population is expected to hit 1.2 billion by 2025 out of which more than 500 million of them will suffer from sensorineural hearing loss(SHL) worldwide. The studies have shown that this begins to reflect on audiograms as from the third decade, mainly in the high frequencies. Aim/objective: This study evaluated the early on-set presbyacusis at Gwagwalada Area Council of the Federal capital territory-Abuja. Method: It was a multi-stage sampling, prospective, cross-sectional study done in FCT, Abuja. Participants from age 20 years and above were recruited into the study after signing informed consent. The presumed risk factors as highlighted in the questionnaire were screened out. Results: Two hundred and two participants were recruited into the study, out of which twelve were excluded from the analysis on account of various exclusion criteria. The age range of the participants was 20 to 79 years, with an average age of 54.8 ± 5.6 years. One hundred and fourteen (60.0%) males and seventy-six (40.0%) females participated in the study. The commonly reported associated symptom was tinnitus. About 32.0% of the participants had moderate sensorineural hearing loss. However, the prevalence of presbyacusis was 28.2% for age below 65 years and 78.8% for 65 years and above. The cumulative prevalence was 54.2%. Conclusion:The study has shown that presbyacusis occur as early as the third decade of life, possibly subclinical before age 65 years. The prevalence was 28.
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