Necrotizing fasciitis of the head and neck is a rare and potentially fatal disease. It is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue resulting in tissue necrosis and likely death. It is commonly of dental or pharyngeal origin. Factors affecting the success of the treatment are early diagnosis, appropriate antibiotics and surgical debridement. Our study showed eight patients, five males and three females with mean age of 49.25 years (range 20-71 years). Clinical presentations were a rapidly progressing painful neck swelling, fever, dysphagia and trismus. The aetiology varied from idiopathic, pharyngeal/tonsillar infection, trauma and nasal malignancy. There were associated variable comorbidities (diabetes mellitus, HIV infection, hypertension and congestive cardiac failure). All the patients received early and aggressive medical treatment. The earliest time of surgery was 12 h after admission because of the poor financial status of patients. Three cases came in with complications of the disease and were not fit for extensive debridement under general anaesthesia. For them limited and reasonable bed side debridement was done. Mortality was 50 % from multiple organ failure, HIV encephalopathy, aspiration pneumonitis and septicemia. The duration of hospital stay for the patients that died ranged from 1 to 16 days and 4 to 34 days for the survivor. Our study heightens awareness and outlines the management challenges of necrotizing fasciitis of the head and neck in a poor resource setting.

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This paper studies changes observed in pregnant women at the 3 stages of pregnancy in Calabar. Eighty pregnant women and eighty non-pregnant women were used. Most signs and symptoms occurred more in the first trimester while others occurred more in the third trimester. Vomiting, loss of appetite, excess salivation, Nausea gastroesophageal reflux, fever, headaches otomycosis were predominant in our study.

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Noise above a certain acceptable level or sustained noise may cause damage to the ears. The aim of this study is to determine the prevalence and level of awareness of noise induced hearing loss in Calabar. Seventy-five workers from two noise producing companies, in Calabar-Flour mill and Wartsilla were chosen for this study. An author administered questionnaire was used to record sociodermographic data, occupation, access to ear protection, number of working years, etc; Rhine's test, Webers test, otoscopy and pure tone audiometry were done for each of the participants. Workers in the generator house, loading bay and production plant were regarded as noise exposed workers while others were non-noise exposed. Forty-one of the noise exposed workers in flour mill (66.83%) had mild hearing loss and ten (16.66%) had moderate loss. In Wartsilla, twenty six workers (50.98%) of the noise exposed workers had mild hearing loss and six(11.76%) had moderate loss. Three non-noise exposed workers in each of the companies also had mild hearing loss. 40% of the participants never heard about ear protection devices; 60%, knew about them. 50% had seen them and 30% felt better using them.

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Objectives: Nasal polyps are the commonest intranasal masses. It has a worldwide distribution and significantly reduces the productivity of affected individuals. Early diagnosis and treatment can lead to better treatment outcomes. The aim of the study were: To study the occurrence, types, associated co-morbidities, and management of polyps in Calabar, Nigeria. Materials and Methods: A retrospective study of all nasal polyps seen between January 2009 and January 2019. Records of all intranasal masses seen during the period including age, sex, aetiopathological profile, and histopathology results were obtained from the records department, theater, and the wards. Patients who had nasal polyps either had nasal polypectomy with/without antral lavage, or Caldwell Luc operation. Results: One hundred and eighty-two intranasal masses were seen during the study period. One hundred and thirty-four of them (73.625%) were nasal polyps; 62.6% were inflammatory polyps, 14.7% had chronic rhinitis, 9.7% inverted papilloma, and 2.24% squamous cell carcinoma. About 31.3% of the polyps were right-sided, 31.3% bilateral, 26.9% left-sided, and 10.44% antrochoanal polyps. About 97% of the patients presented with nasal blockage, 53.23% with rhinorrhoea, 41.79% signs of anosmia, and 29.85% sneezing. Comorbidities seen include diabetes mellitus 1.6%, hypertension 4.5%, allergy 70%, and asthma 25%.Squamous cell carcinoma was the most common malignancy found and inverted papilloma was the most common benign tumor present. Conclusion: Nasal polyps occur globally. They are the most common intranasal masses. They seem to occur more in males and occurrence increases with age. Not all nasal polyps turn out as polyps histologically as this study shows; we had chronic rhinitis, inverted papillomas, squamous cell carcinomas, etc. The comorbidities found were diabetes mellitus, hypertension, allergy, and asthma. Diabetes and hypertension may have been incidental but the number of patients with asthma and allergy shows a definite link between these two and allergy. Treatment for nasal polyps may be medical or surgical and the best form of surgery is endoscopic sinus surgery. However, financial constraints could prevent patients access to FESS.

Malignant peripheral nerve sheath tumor (MPNST) is an uncommon soft-tissue sarcoma, with origin from the peripheral nerves or somatic tissues associated with nerve sheath. This tumor rarely affects the nose. The clinicopathological presentations vary from one case to another and depend on cells of origin. Hence, the diagnosis is often difficult. We report a 36-year-old woman who presented in our facility with progressive nasal swelling, facial deformity, and mucopurulent rhinorrhea of 3 years duration. Examination revealed a significant facial disfigurement. She was also found to be seropositive. Computerized tomography scan of paranasal sinuses showed an expansile, subtle enhancing, predominantly low-density mass, with area of air density within it, completely occupying the nasal cavity. No calcific focus, lytic or sclerotic surrounding bones changes seen. Her tumor was resected under general anesthesia with a wide margin, and regional vital structures were preserved. The histological/immunohistochemistry revealed MPNST. She had adjuvant radiotherapy and chemotherapy 2 weeks after surgery. However, a nodule was seen on the floor of the nose few days after completion of radiotherapy, which was biopsied, and histological report was positive for malignancy. The persistence of the malignancy and HIV hampered her facial reconstruction. Also, limited finance hampered procurement of the nasal prosthesis. She was followed up for 1 year before she was lost.