Prof J. A. E EZIYI

Peri-oral injuries are common findings in paediatric patients; however, tongue injury following entrapment in bottles and cans is rare and has not been reported in our locality. A case of a 9- year old previously healthy female child who got her tongue tightly entrapped in an half opened aluminium milk can while in school is hereby presented. This case highlights the result of careless and often dangerous play and misadventures of children and the challenge of management. It calls for vigilance and close supervision of children by caregivers at home and at school. Early presentation, immediate intervention and treatment can prevent grave consequences.

Background: We examined the performance of different Machine Learning Algorithms while also comparing two methods of voice assessment to look at the workability of automating triage of patient that will need prompt office laryngoscopy. Methods: We recruited consecutive adult subjects excluding those with a history of being regular singers or choristers in the past one year and those with the previous history of laryngeal trauma. We then carried out the perceptual voice assessments on the GRBAS Scale and also obtained the basic acoustic parameters of the voice samples. Laryngeal examinations with 70-degree Hopkins’ Rod were then carried out by another examiner for all the participants to identify gross laryngeal changes or lesions. We then evaluated each machine learning algorithm comparing the perceptual and acoustic parameters in determining how well each algorithm predicts the presence of those categorized with having lesion or not by the laryngeal examination. Results: One hundred and twenty respondents were analyzed out of which 89(74.2%) were females. The mean age was 46.5 ± 9.2 years. The perceptual evaluation generally outperformed the acoustic evaluation. Also, the Naïve Bayes Classifier (NBC) outperformed other algorithms with a F1 score of 0.55 followed by Artificial Neural Network (ANN) with the score of 0.53. However, the ANN outperformed the other with regards to the Area-under-the-curve (AUC). Conclusion: When these metrics are taken together, the ANN still remains the best algorithm for this dataset. We are however cognisance of the needed improvement to the various aspects of this work including a larger dataset more scientific sampling.

Background:It is established that there is a strong relationship between perception and outcome of learners' satisfaction, achievement, and success and that a positive learning environment well received by learners is necessary for positive learning outcomes. This study is a first step in providing an answer to the question "how do learners perceive preclinical medical education in Ife" with the aim of obtaining information which can serve as basis for the review of teaching methods and improvement of learning environment.
Methodology:
A questionnaire adopted from two validated questionnaires (Dundee Ready Education Environment Measure questionnaire from Dundee and another from a study carried out in Bangladesh) was administered to 187 respondents comprising 106 final year students and 81 newly qualified doctors to obtain the information about their perception of teaching and learning of the three major preclinical participants. Items were rated using the 5-point Likert scale, and each item was scored 4-0. Data were analyzed using the descriptive and inferential statistics. Values were expressed as the mean of scores.
Results:
The mean gross scores for the 19 items rated for anatomy, biochemistry, and physiology were 28.92, 35.76, and 45.06 (out of 76), respectively. Physiology had the highest score in all the subdomains examined, with 62% of the respondents rating their overall quality of learning experience in the subject "very good." Scores for perception of learning environment were generally low (7.54 ± 0.43, 10.44 ± 0.42, and 12.51 ± 0.47, out of a total of 28 for anatomy, biochemistry, and physiology, respectively).
Conclusion:
The opinion of learners in this study emphasizes the need for the improvement of teaching methods and learning environment.

We describe a case of malignant glomus tumour affecting the neck of a 24-year-old woman who presented with painful neck masses and amenorrhoea. Malignant glomus tumours of the neck are rare disease and can be confused with paragangliomas. After resection surgery, postoperative complications of bilateral chylothorax (without chylous fistula) and diabetes insipidus were successfully managed, and the patient remains well after long-term follow-up.

Aims: This study is aimed at determining the presentation, predispositions, types and treatment outcomes of patients diagnosed with otomycosis in our center. Materials and methods: We reviewed 83 cases of otomycosis who visited the otorhinolaryngology clinic of our center in the period of 5 years. Diagnosis of otomycosis was clinically based on presentation and findings on otoscopic appearance. Results: Records of 83 cases of otomycosis consisting of 40 males and 43 females were analysed. The mean age was 43.19 ± 20.74 years. Twenty-eight (33.7%) patients were asymptomatic with the otomycosis discovered following otoscopy during a clinic visit. Pruritus, ear ache and hearing loss were the commonest complaints among the symptomatic patients. Unilateral disease was seen in 57 (68.7%) of the patients and bilateral disease in 23 (27.7%) of the patients. The affected side was not stated in 3 (3.6%) of the patients. Examination findings revealed in most cases (78, 94.0%) reveal presence of fungal debris. The use of ototoptic medication was noted as the risk factor for more three-quarter of those with identifiable risk factor. Total fifty-one (61.4%) patients had complete resolution. Conclusion: We found otomycosis to be predominantly an adult disease and it is an incidental finding many case. The overall outcome is good regardless of the mode of treatment employed. Clinical significance: The limitation to due to non-available of a particular mode of treatment should not impair obtaining a good outcome when managing otomycosis. © 2018, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved.

p class="abstract"> Background: Prevalence of ear infections in primary school children in Nigeria is scarcely documented and available studies are mostly hospital based. The aim of this Community based study is to define the point prevalence of ear infections among school children.Methods: Using a multi- staged stratified sampling technique, 630 pupils aged 6-12years, attending Government owed primary schools in two local government areas in the South Western Nigeria were recruited for the application of a structured questionnaire, single examination and classification using their socioeconomic index.
Results: Three hundred and seven (48.7%) were females and three hundred and twenty three (51.3%) were males. Chronic otitis media had the highest prevalence of 7.9%, followed by acute otitis media and otitis externa (3.2%) while otomycosis (1.6%) had the lowest. Majority of the infections were unilateral and more prevalent in the males. It was observed that all the ear infections were more prevalent in pupils from the low socioeconomic class although not statistically significant.
Conclusions: These results shows that ear infections is still common in our primary schools and that socioeconomic status and sex of the pupils did not significantly affect the occurrence of these ear infections. There is a need to incorporate health education programme in schools to prevent ear infections and the attendant disabilities.

The Facial nerve is the most common cranial nerve to be paralysed due to the fact that it has a long intracranial route, related to the ear and parotid gland and thus susceptible to injuries and infections. This study aims to describe the epidemiology and management of facial nerve palsy. A retrospective cohort review of patients that presented to ORL-HNS Department of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Nigeria from November 2008 to March 2015 was done. The age, sex, clinical presentations, duration of symptoms prior to presentation, aetiology/diagnosis, treatment and outcome were obtained. Twenty-six patients with age ranging from 1.7 to 83 years and a male: female ratio of 1.6:1 was analysed. Facial nerve palsy occurred more on the left (61.5%) and all unilateral. Otogenic aetiology accounted for 34.62% (9 Cases) followed by idiopathic (26.92%), 5 (19.23%) were due to Malignant parotid tumour, 3 (11.55%) due to temporal bone fracture, and a case (3.84%) due to iatrogenic trauma. The duration of facial nerve palsy before presentation ranged from 1 day to 1 year with a mean of 6.1months. All the patients had eye care, other modalities of treatment included one or a combination of antibiotics, steroids, physiotherapy, acyclovir and surgery. None had facial nerve decompression, repair or grafting done. Outcome was good in 4 cases (15.4%), satisfactory in 10 cases (38.5%) and unsatisfactory in 3 cases (11.5%), 9 cases (34.6%) were loss to follow up. Facial nerve from otogenic causes ranked highest in our environment. Late presentation and defaulting during treatment is still a challenge in our environment and affect the outcome of facial nerve palsy.Keywords: facial nerve palsy, ear infection, iatrogenic, trauma, Parotid tumours.

Background: Personal music players (PMPs) are widely used among young adults of Nigeria, but information on knowledge about their usage and effect on hearing health has not been studied in Nigeria. Objectives: The aim of the study was to determine the pattern of usage, knowledge and attitude towards loud sound output from PMPs among young Nigerian adults. Methods: This was a prospective, observational survey. Subjects were recruited from a cross-section of undergraduate students of Obafemi Awolowo University, Ile-Ife. A structured questionnaire that detailed the type and usage of PMPs was administered. Subjects were also asked about episode of adverse hearing effects and the attitude of the respondents to issue of recreational noise and hearing loss. Results: There were 985 respondents, comprising 594 (60.3%) males and 391 (39.7%) females. Of the 985 students, 967 (98.2%) admitted listening to music on PMPs. The mean age of the student was 24.4 (6.0) years, with 891 (92.1%) of the 967 using earphones while listening to music. Mobile phones were the most common PMPs being used by 768 (79.3%) of the respondents. Five hundred and thirty (54.8%) were listening to music for more 1 h per day and 536 (55.4%) were listening to music for more than 3 days per week. Further, 502 (52.3%) were listening to music at the level of loudness, which was self-assessed to be high volume. Conclusions: Mobile phones are the most common PMPs in the present study population and most of the respondent were listening to music at the level of loudness that should call for concern.

Background: We undertook this study to detect emerging pattern in the challenges in managing patients with laryngeal cancer in our setting. Methodology: We review the 16 patients with histologically confirmed laryngeal carcinoma managed at the Otorhinolaryngology Head and Neck surgery Department of Obafemi Awolowo University Teaching Hospitals complex between 1 st January 2008 and 31 st December 2013. Result: There were 11 males and 5 females with mean age of 58.0 years. Three (18.8%) patients who were all males had history of smoking. History of significant alcohol intake was found in 4 (25.0 %) males and 1 (6.3%) female. Fifteen (93.8%) patients presented as an emergency with airway obstruction necessitating emergency tracheostomy. Eight (50.0%)patients had total laryngectomy as primary treatment modality and 1 (6.25%) patient had radical radiotherapy as her primary treatment modality. Six (37.5%) patients refused further treatments after their initial emergency Tracheostomy, Laryngoscopy and Biopsy and were subsequently lost to follow up. One (6.35%) patient died before commencement of definitive treatment. Among the laryngectomy group, 2 (12.5%) died on admission, 2 (12.5%) was lost to follow up and1 (6.25%) had stoma recurrence; Three (18.75%) patients are alive. All the patients with loco-regional failure had it within 18 months with only 1 (6.25%) survival at 2 years. Conclusion: Late presentation and treatment refusal remain the major challenges in this study. There is thus an urgent need for health education to promote early presentation.

Objective: To study the psychosocial consequences of severe deafness and the effects on the socioeconomic position of the affected individuals. Methods: A cohort study of a deaf student attending a special education secondary school for the deaf and some of their teachers were randomly selected for the study. Sociodemographic characteristics, self‑reported deafness, employment situation, and financial conditions, psychosocial consequences such as social isolation, denial of privileges, educational attainment, the level of achievement, and satisfaction with life were assessed using a semi‑structured questionnaire. Results: All the participants had severe to profound hearing loss, and all of them could communicate by sign language. Adverse psychosocial consequences were found in this study population. A significant percentage was not satisfied with their current placement. A significant percentage reported limitation in their achievements and more than a third of them admitted to having been denied privileges as a result of being deaf. Social isolation was a major source of worry for 70% of the respondents and close to 40% admitted to being angry mainly because of the attitude of the society towards them. Underemployment was found in 44%, of the sampled population. Conclusion: Hearing impaired individuals are faced with economic and psychosocial adverse consequences. Labor market and educational policies must take into consideration these challenges to integrate this segment of our population into the active, productive sector of the economy.

Background: Literature on awareness of the harmful effect of noise on the health, hearing, and the quality of life of Nigerians engaged in noisy occupation is scarce. Objective: The objective was to assess the knowledge, attitudes, and practice of sawmill workers and owners to noise pollution; and the need for prevention with the use of hearing protection devices. Subjects and Methods: This was a purposive sampling of sawmills in 6 local government areas in Osun state. The respondents were studied using interviewer-administered questionnaires. The workplace noise levels were assessed. Results: A total of 412 male respondents, consisting of 400 sawmill workers and 12 sawmill owners were studied. The mean age of the respondents was 32 years. Average time of exposure to noise was 10 h/day. The average level of noise at the sawmills was 108 ± 9 dB. 140 (35.0%) sawmill workers could not identify the sources of noise correctly. 140 (85.0%) would endure noise exposure, and 376 (94.0%) did not know that hearing loss could be due to noise exposure. 176 (44.0%) of the workers believed that noise had no impact on health, while 373 (93.3%) did not believe that noise was associated with a change in productivity. None of the sawmill owners was familiar with policy on noise control and none of them provided earmuffs or plugs for their workers. Conclusion: Sawmill workers and their employers in the present study were not aware of the harmful effects of noise on their health. Hearing protection devices were therefore not available or worn by most sawmill workers. The sawmill workers were thus at risk of developing noise-induced hearing loss.

We undertook this study to describe the morphology and anatomical variations of ethmoidal sinus in adult Nigerians using computerized tomographic scan, bearing in mind the significance of this sinus in inflammatory pathologies of the other paranasal sinuses and endoscopic sinus surgery. This was a descriptive study of computerized tomographic scans of the paranasal sinuses of 114 subjects constituting 228 ethmoids. All the slides were examined to identify the ethmoidal sinuses and the various anatomical variations. The dimensions of the ethmoids were also measured. There were 83 (72.8%) males in this study. The mean age was 45.6 ± 19.3 years. The means of the length, anterior width, posterior width and height of the ethmoid were 41.4, 11.8, 16.7 and 30.1 mm, respectively. Keros Type III olfactory fossa was found in 163 sides (71.5%). Agger nasi cell was the commonest variation present in 102 sides (44.7%). The most frequent pattern of attachment of uncinate process seen is to the lamina papyracea (191, 32%). We concluded that the dimensions of the ethmoids among the Nigerians studied are similar to findings in other studies. The predominant type of olfactory fossa depth and pattern of insertions of uncinate process suggest that the study population may be at higher risk of certain complications during functional endoscopic sinus surgery (FESS).

Bilateral chylothorax following injury to or ligation of the cervical portion of the thoracic duct is a rare but potentially dangerous complication. We report a case of bilateral chylothorax without any evidence of chylous fistula in a 24 year old woman following a left modified radical neck dissection for a primary neck cancer. The patient was effectively treated by conservative management.