Management and Outcome of Rhinosinusitis in Nigeria

Abstract

ObjectiveThe aim of this study is to present the management and outcome of treatment of rhinosinusitis in Nigeria.Study DesignA retrospective review of the case notes of patients with rhinosinusitis between January 2009 and December 2014.SettingStudy at the University of Ilorin Teaching Hospital, Nigeria, using retrieved case notes after ethical approval was received.Subjects and MethodsThe information retrieved included sociodemographic data, clinical presentation, duration, endoscopic examination, and other clinical management protocols with follow-up. All information was entered into SPSS version 20 and analyzed descriptively, and results are presented in tables and figure.ResultsA total of 5618 patients were seen in the ear, nose, and throat clinic over the 6-year period. Of the patients, 445 had rhinosinusitis, and only 410 had complete data for analysis. Patient age ranged from 2 to 75 years (mean ± SD, 31.8 ± 1.2 years). The male to female ratio was 1.2:1. The duration of symptoms varied from 3 days to 10 years, with 78.7% having symptoms between 3 and 120 months. About 82.4% had nasal discharge, 51.3% had sneezing, 78.9% had alternating nasal obstruction, and 49.3% had nasal itch. Of the patients, 61.4% had a predisposition, of which 30.9% were allergic, 23.3% were infective, and 7.2% were vasomotor. Ethmoidal-maxillary sinuses were commonly affected radiologically. About 63% of patients had medical treatment, and only 28.7% had surgical intervention, of which 37% were scheduled for surgical treatment and 7.3% refused. Improved symptoms were noticed in 72.6% of patients, and 1.4% reported no improvement.ConclusionRhinosinusitis is still common, affecting active males economically with more chronic cases and more allergic predisposition. Early medical management is still effective, and endoscopic sinus surgery is now a better surgical option with better outcome in 72.6%.

Clinical evaluation and nasoendoscopic scores of patients with chronic rhinosinusitis in Ilorin, Nigeria

“…These symptoms were also accompanied by post nasal drip, hyposmia/anosmia and facial pain/pressure. These were in accord with the findings of other studies carried out in Nigeria [ 6 , 7 , 17 , 20 , 23 , 24 ]. Mucopurulent nasal discharge was found to be the commonest followed by mucoid and watery nasal discharge respectively.…”

“…In a two-year prospective study on the pattern of clinical features of chronic simple rhinosinusitis in Port Harcourt, da Lilly-Tariah [ 7 ] reported 72.7% cases of chronic infective rhinosinusitis as the commonest type of rhinosinusitis followed by vasomotor rhinitis with allergic rhinosinusitis being the least in his series. These were not consistent with other studies [ 6 , 17 , 20 , 24 , 25 ] where allergic rhinosinusitis was commoner when compared to infective CRS. In some of these studies [ 6 , 20 , 24 ], features of both acute and chronic types were considered together irrespective of the duration of the symptoms and allergy was found commonly among patients with acute type of rhinosinusitis.…”

“…[ 19 ] and Afolabi et al . [ 20 ] found a slight male preponderance in their studies on patients presenting with rhinosinusitis. The mean duration of CRS symptoms revealed by this study was also within the range reported by previous studies where mean duration of CRS ranged between 2 to 6 years [ 6 , 7 , 21 , 22 ].…”

Presenting OTO Open

“…In our next article, Gerecci and associates 4 present a case study describing the uncommon condition of takotsubo cardiomyopathy, a condition that can occur secondary to the administration of anesthesia and may result in transient cardiac dysfunction. In our third article, Afolabi and colleagues 5 discuss the management of rhinosinusitis (RS) in Nigeria. 5 The authors review the demographic characteristics of Nigerian patients with RS and examine treatment methods and outcomes in this population.…”

“…In our third article, Afolabi and colleagues 5 discuss the management of rhinosinusitis (RS) in Nigeria. 5 The authors review the demographic characteristics of Nigerian patients with RS and examine treatment methods and outcomes in this population. Finally, our fourth article examines use of the NSQIP calculator as a predictor of length of stay (LOS) in patients undergoing free flap reconstruction.…”