Objectives: To evaluate the yield of clinical and radiological features in the diagnosis of suspected foreign body aspiration in children and to assess factors associated with delayed diagnosis of foreign body aspiration. Study design and setting: Retrospective review of 10 years of experience in tertiary referral centre. Participants: Data were extracted from clinical records of children who underwent rigid bronchoscopy for suspected foreign body aspiration at the University of Nigeria Teaching Hospital Enugu from 2000 to 2009. Main outcome measures: Clinical features and radiological findings were validated against bronchoscopic findings. Results: Data of 103 children, (mean = 2.7 years, range =7 months to 14 years; 64% boys and 36% girls, were analysed. Majority (73%) were under 3 years of age. Foreign body aspiration was proven bronchoscopically in 85 (83%) patients. The most common symptoms were sudden choking crisis (74%) and paroxysms of cough (73%). Independent predictors of proven foreign body aspiration were witnessed aspiration, choking crisis and unilateral decreased breath sounds in univariate (P = 0.001, <0.001, and 0.001 respectively) and multivariable analyses (P = 0.02, 0.001, and <0.001 respectively). The most sensitive and specific clinical features were choking (86%) and witnessed aspiration episode (89%), respectively. Available chest radiographs revealed radio-opaque objects in 27% of patients. Delayed diagnosis of foreign body aspiration (>72 h) was significantly more in younger children (t = 3.29; P = 0.001), as well as in children with no history of witnessed aspiration, negative chest examination and radiological signs (P < 0.001, P = 0.02 and P = 0.04 respectively). Conclusion: To prevent the delayed diagnosis, witnessed aspiration, choking crisis, unilateral decreased breath sounds and radiopaque objects should be checked in all suspected cases. When history is doubtful, regardless of radiological findings, bronchoscopy can be strongly recommended in the presence of two factors.

Rigid esophagoscopy is relatively safe and useful procedure in trained hands for removal of EFBs. Management of long-standing EFBs, dentures, and other sharp objects requires the skills of the most experienced members of the surgical team for a successful outcome. Open surgical treatment is unavoidable in cases of irretrievable esophageal FBs or in the presence of esophageal perforation.

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Objectives To evaluate the quality of life of patients with ongoing tinnitus. Study Design This was a cross-sectional study of patients with ongoing tinnitus. Setting The study was carried out in a tertiary hospital in southeastern Nigeria. Subjects and Methods Subjects are adults who presented to the otorhinolaryngology clinic with tinnitus as their primary complaint. Pure-tone audiometry, tinnitus pitch, and loudness matching were done. The Tinnitus Handicap Inventory (THI) questionnaire was used in assessing their quality of life. Results There were 63 participants within the age range of 16 to 74 years; 20 (31.7%) were male and 43 (68.3%) were female. The mean duration of tinnitus was 26.7 ± 38.1 months. Nineteen (30.2%) participants had bilateral tinnitus while 44 (69.8%) had unilateral tinnitus. The mean THI score was 36.6 ± 19.7. The most reported handicap was anxiety and difficulty with concentration followed by depression and irritability. There was no correlation between the disability shown by the THI score and the age, sex, duration of the tinnitus, the tinnitus pitch, tinnitus loudness, or the laterality of the tinnitus. There was a significant positive correlation between the grade of hearing loss and the level of disability reported in the THI ( P = .01). Conclusion Tinnitus sufferers appear to have poorer quality of life compared with nonsufferers. This quality-of-life affectation is likely to be worse in those with disabling hearing loss but does not appear to be related to their age, sex, symptom duration, or the loudness and pitch of their tinnitus.

Multiple laryngeal papillomatosis clearly followed a more severe and less predictable course than the solitary type in both groups. Although there was a high incidence of tracheostomy in this study, short-duration tracheostomies accounted for the low incidence of extralaryngeal spread.

Unrelieved upper airway obstruction from highly prevalent adenotonsillar hypertrophy (ATH) has the potential of producing structural remodelling of the pulmonary vascular bed with resultant pulmonary hypertension (PH) and cor pulmonale. This cross-sectional study aimed to determine the local prevalence of PH and examine its clinical and radiological pointers among children with ATH. The airway obstruction was evaluated clinically by grading the nocturnal and daytime symptoms of ATH. A Brodsky scale and adenoid-nasopharynx ratio (AN ratio) were used to categorize tonsil and adenoid size, respectively. Mean pulmonary artery pressure (mPAP), was measured noninvasively for each child using Doppler echocardiography and PH was defined by mPAP ≥25 mmHg. Comparison of symptom scores, tonsil and adenoid size and demographic factors was made between children with mPAP ≥25 mmHg and those mPAP <25 mmHg using univariate and multivariate analysis. There was 22.8 % (18/79) prevalence of PH among the 26 children with only adenoid hypertrophy and 53 with ATH. Significant risk factors identified by logistic regression analysis associated with PH were daytime mouth breathing, daytime stertor, and AN ratio >0.75 (P = 0.002, 0.018, and 0.04, respectively), with more than sixfold and fourfold increase risk for daytime mouth breathing and daytime stertor, respectively. Obstructive breathing during sleep was significant only on univariate analysis. Prolonged symptom duration ≥24 months, large tonsils (grades 3 and 4), snoring and mouth breathing during sleep were not significant. This study demonstrated that pulmonary hypertension remains prevalent in children with ATH. Daytime mouth breathing and stertor as well as AN ratio >0.75 are the prime predictors of pulmonary hypertension, with an AN ratio cut-off point of 0.73 on ROC analysis.

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