Browsing by Author "Adeyemo, A. A."
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Item Asynchronous video-otoscopy with a telehealth facilitator(Mary Ann Liebert , Inc, 2013-04) Biagio, L.; Swanepoel, D. W.; Adeyemo, A. A.; Hall, J. W.; Vinck, B.Objective: The study investigated whether video-otoscopic images taken by a telehealth clinic facilitator are sufficient for accurate asynchronous diagnosis by an otolaryngologist within a heterogeneous population. Subjects and Methods: A within-subject comparative design was used with 61 adults recruited from patients of a primary healthcare clinic. The telehealth clinic facilitator had no formal healthcare training. On-site otoscopic examination performed by the otolaryngologist was considered the gold standard diagnosis. A single video-otoscopic image was recorded by the otolaryngologist and facilitator from each ear, and the images were uploaded to a secure server. Images were assigned random numbers by another investigator, and 6 weeks later the otolaryngologist accessed the server, rated each image, and made a diagnosis without participant demographic or medical history. Results: A greater percentage of images acquired by the otolaryngologist (83.6%) were graded as acceptable and excellent, compared with images recorded by the facilitator (75.4%). Diagnosis could not be made from 10.0% of the video-otoscopic images recorded by the facilitator compared with 4.2% taken by the otolaryngologist. A moderate concordance was measured between asynchronous diagnosis made from videootoscopic images acquired by the otolaryngologist and facilitator (j = 0.596). The sensitivity for video-otoscopic images acquired by the otolaryngologist and the facilitator was 0.80 and 0.91, respectively. Specificity for images acquired by the otolaryngologist and the facilitator was 0.85 and 0.89, respectively, with a diagnostic odds ratio of 41.0 using images acquired by the otolaryngologist and 46.0 using images acquired by the facilitator. Conclusions: A trained telehealth facilitator can provide a platform for asynchronous diagnosis of otological status using video-otoscopy in underserved primary healthcare settingsItem Audit of open pediatric tracheostomies at the university college hospital, Ibadan(2020-06) Oyelakin, O.A.; Adeyemo, A. A.Background: Tracheostomy is the creation of a communication between the trachea and the overlying skin, maintained by a tube. This is done either by an open or percutaneous technique. Anatomical and physiological variation of the paediatric trachea and adjoining structures necessitates finite skills and consistent competence in performing pediatric tracheostomies, lack of which may cause higher mortality and morbidity outcome in tracheostomies in the pediatric age group. Objectives: There are inadequate local data on the outcomes of pediatric tracheostomies; therefore, we conducted a local audit of pediatric tracheostomy to describe our experience. Methods: A retrospective study of pediatric patients who had tracheostomies from June 2011 to December 2017 was done. Results: Thirty‑four patients were identified, all of whom had an open tracheostomy. The age range was 3 weeks to 16 years; M: F ratio was 2.4:1. Indications for surgery were obstructive (88.2%) and prolonged‑assisted intubation (11.8%). Recurrent respiratory papillomatosis, retropharyngeal abscess, and foreign‑body aspiration were the main obstructive causes. Three patients (8.8%) had repeat procedures, and these patients were initially discharged on tracheostomy tube and instructions were given for home care. Conclusion: Despite the evolving local challenges peculiar to clinical practice in developing countries, the outcome of pediatric tracheostomy in our hospital is goodItem Auditory lifestyles, attitudes to noise and beliefs about hearing loss and hearing protection among undergraduates in southern Nigeria(2019-07) Udoh, A. E.; Adeyemo, A. A.Noise tolerance is a possible reflection of the attitudes of young people, and probably influenced by beliefs on hearing loss and the use of hearing protection devices. This study addressed the attitudes and beliefs of young Nigerians towards noise thereby providing background data that is necessary for design of culturally relevant interventions to reduce noise exposure and hearing loss. This study determined the attitude towards noise and beliefs about hearing loss and hearing protection among young people in Nigeria. It was a cross-sectional study using semi-structured questionnaires was conducted. The subjects were 427 university undergraduate students. Data was collected on their attitudes to noise and beliefs about hearing protection and hearing loss. Youths Attitude to Noise (YANS) and Beliefs about Hearing Protection and Hearing Loss (BAHPL) instruments were completed by the subjects. Majority of the subjects had neutral attitude towards noise and neutral attitude in Beliefs About Hearing Protection and Hearing Loss while only a minority used any form of hearing protection devices. Indifference is the main attitude of young Nigerians towards noise and hearing loss. Future interventions should focus on the harmful effects of noise, emphasizing the need to avoid exposure to loud noise while encouraging use of hearing protection devices during noise exposureItem The correlation between snot-22 and visual analogue scale in the assessment of symptom severity in chronic rhinosinusitis(Science Publishing Group, 2019) Idugboe, O. J.; Adeyemo, A. A.; Totyen, E. L.Chronic rhinosinusitis is an inflammatory process involving the sinonasal mucosa, lasting 12 weeks or longer. It is often characterized by a complex of debilitating symptoms usually classified into minor and major symptoms. Estimating symptom/ disease severity using structured questionnaires can be challenging. This is especially so in rural areas where a combination of low literacy levels and language barrier may present communication difficulties. In view of the aforementioned challenges, it has become imperative to explore the correlation between the 22- item sino-nasal outcome test (SNOT-22) and a simpler means of evaluating symptom severity in chronic rhinosinusitis; hence this study. To determine the correlation between SNOT-22 and visual analogue scale (VAS) questionnaire scoring of symptom severity in chronic rhinosinusitis. This was a twelve month prospective cross sectional study of fifty- two consecutive newly diagnosed adult patients with chronic rhinosinusitis. Age of patients ranged from 19 – 91 years. Male to female ratio was 1: 1.26. There was a significant positive correlation between VAS and SNOT-22 in moderate and high symptom severity in patients with CRS. This study found a positive correlation between SNOT-22 and VAS scoring of disease severity in moderate and severe diseases and an insignificant correlation between these two instruments in mild disease. VAS can be used as a guide to symptom severity in the pre-treatment patients with CRSItem Denture impaction in the oesophagus: correlation of site and duration of impaction with sequelae(2019-06) Adeyemo, A. A.; Ogunkeyede, S. A.Background: Denture restores aesthesis and function of missing teeth. Accidentally swallowed denture is an otorhinolaryngology emergency. The types of denture base and oesophageal anatomy influence the site of impaction. Objective: To review site of denture impaction and factors associated with site of impaction. To correlate site and duration of denture impaction before removal with associated sequelae. Method: A retrospective study of 27 patients managed in Otorhinolaryngology Department of University College Hospital Ibadan, Nigeria for oesophageal partial denture impaction, between August 2006 and September 2016. The demographic and clinical data of the patients were extracted from the hospital records, and statistical tables were used to illustrate the data. Results: A total of 27 patients; 14(51.9%) males and 13(48.1%) females, (M: F, 1.1:1) were studied. The age ranged from 24 to 77 years (mean age 49.0 ± 14.2years). Dentures were worn for 3 to 30 years (mean 3.8 ± 2.3years) without follow-up visit to dentist and 85.2% were upper dentures. All patients had history of accidental ingestion of denture, and the mean site of impaction was 18.2 ± 3.2cm from upper incisor, typically at upper cervical oesophagus in elderly patients and in lower oesophagus in females. There was no association between site of denture impaction, duration of denture impaction and operative findings. Conclusion: Advanced age and female gender are associated with site of denture impaction. Late hospital presentation significantly promotes sequelae associated with management of impacted dentures. It is recommended that fundamental changes in denture designs, education on regular follow-ups and avoidance of ill-fitting dentures would reduce the prevalence of denture impactionItem Evaluation of histopathology examination of routine tonsillectomy and adenoidectomy specimens in developing countries(2011) Adeyemo, A. A.; Okolo, C.; Ogunkeyede, S. S.Objective: Healthcare costs are usually borne directly by patients or relations in developing countries; therefore reducing waste in the system is very important. This study aims to determine the necessity of full histopathology examination in routine tonsillectomy and adenoidectomy in children. Methods: A retrospective chart review of patients 18 years and younger who underwent tonsillectomy and/or adenoidectomy between January 1986 and December 2006 at the University College Hospital, Ibadan, Nigeria was done. The age, sex, surgical procedure and pathology results were recorded. Histology reports were broadly classified into: non-neoplastic and neoplastic pathologies. Charts of neoplastic pathologies were pulled and the medical history reviewed. Results: A total of 244 patients met the inclusion criteria with a mean age of 5.3 ±4.7 years. There were 150 males (61.5%) and 94 females (38.5%). Tonsillectomy and adenoidectomy were performed together on 74 patients (30.3%) while tonsillectomy and adenoidectomy alone were performed on 60 (24.6%) and 110 (44.7%) patients, respectively. Review of the pathology reports revealed two cases of malignancies with an incidence of 0.82%. Conclusion: Medico-legal factors will suggest the review of all surgical specimens. Therefore it is important to identify innovative approaches to reduce costs of histopathology examination in routine tonsillectomies and adenoidectomiesItem Evolving telemedicine practice: experiences of health care workers during covid-19 pandemic(2021) Adeyemo, A. A.; Ogunkeyede, S. A.; Ogundoyin, O. A.; Oyelakin, O. A.Background: Telemedicine is employed in patient care when direct physical contact is not possible or discouraged, as was seen during the COVID-19 pandemic. The use of smartphone technology could make telemedicine affordable and available in low and medium-income countries (LMICs). However, the evolution of telemedicine care depends on multiple factors. Aim: To explore the practice of telemedicine by Nigerian health care workers (HCWs) during the COVID-19 pandemic Methods: A cross-sectional study of the Nigerian HCWs on telemedicine practice in patient care during the COVID-19 pandemic period. Recruitment of respondents was done through dedicated WhatsApp and Telegram social media platforms for HCWs over a period of 40 days (May 1st and June 10th, 2020).Results: A total of 481 HCWs participated in the study consisting of 153(31.8%) doctors, 150(31.2%) nurses and 178(37%) other HCWs. Though 89.2% of the HCWs agreed that telemedicine is important, it was only 266 (55.3%) that practiced telemedicine, phone consultation was the form of telemedicine used in all the health institutions. Telemedicine was practiced more by doctors 91(18.9%), nurses 79(16.4%) and pharmacists 35(7.3%) than other groups of health care workers. Inadequate COVID-19 screening test and lack of personal protective equipment were strong motivators for the attending HCWs to practice telemedicine. Conclusion: There was widespread use of phone consultation by all cadres of health care workers during the pandemic. Hence there should be a health policy that will encourage greater use and acceptance of telemedicine in clinical practice and in the patients care beyond the pandemic periodItem Hearing healthcare gaps in LMICS: snapshot from a semi-urban community in Nigeria(2021-06) Adeyemo, A. A.; Ogunkeyede, S.; Dania, O.Background: Low and middle-income countries (LMICs) have high prevalence of hearing loss which are mainly due to preventable causes. While urban communities in LMICs are likely to have functional hearing healthcare delivery infrastructure, rural and semi-urban communities may have different reality. Objectives: This study aimed to provide: (i) a snapshot of the burden of ear diseases and (ii) a description of available hearing healthcare resources in a semi-urban Nigerian community. Methods: A cross-sectional study of households selected by multistage random sampling technique. Seventy-four participants: 39 males and 35 females with mean age of 34 years ± 5.24 were recruited and answered a structured questionnaire. In addition, the availability of hearing healthcare services in 15 health centers within the community were determined. Results: All participants reported recent occurrence of ear complaints or gave similar history in a household member. Common complaints were ear discharge, ear pain and hearing loss. Medical intervention was sought from patent medicine stores, hospitals and traditional healers. None of the assessed hospitals within the study site was manned by an ENT surgeon or ENT trained nurse. Conclusion: Despite the heavy burden of ear complaints there is inadequate hearing healthcare delivery in a typical LMIC community. This highlights the need for urgent improvement of hearing healthcareItem Helminthiasis and chronic suppurative otitis media in Ijoun community in Ogun State, Nigeria(2018-02) Abdullahi, Z.. A.; Morenikeji, O. A.; Adeyemo, A. A.; Ogunleye, V. O.This study, carried out in a rural community in Ogun state Nigeria, aims to determine the prevalence of soil-transmitted helminths, bacteria causing Chronic Suppurative Otitis Media (CSOM), and their coinfection among school-aged participants. Formol-ether sedimentation technique was used to check for helminth eggs in stool samples. Ear swabs collected were cultured on chocolate, blood and MacConkey agar plates. CD4+T lymphocyte count was derived using a flow cytometre. Study participants were between 5 and 19 years old. Three hundred participants were sampled, 108 (36%) were infected with helminth parasites: Ascaris lumbricoides (28.7%), hookworm (6.7%) and Strongyloides stercoralis (0.7%). The prevalence of helminth infection between the sexes was not statistically significant (χ2 = 0.497; P= 0.390), but statistically significant between the age groups (χ2 = 10.10; P=0.016). Mixed helminthic infections were found in only 3.3% of the study population. Seventeen participants (5.7%) were found to have CSOM. Bacteria isolated in the ear swabs were Pseudomonas aeruginosa, Staphylococcus aureus, Klebiella pneumoniae, Proteus mirabilis and Haemophilus influenzae. Only two percent (2%) of study population were co-infected with helminth and bacteria. Heavy intensity of helminths and heavy growth of bacteria was found in the coinfected when compared with single infected children. This study showed the presence of otitis media in the study area, and that helminthiasis might have an effect on its presentation. Efforts to control CSOM in the study site may need to consider the inclusion of mass dewormingItem Human immunodeficiency seropositivity among mother-child pairs in South west Nigeria: a community-based survey.(2001) Omotunde, O. O.; Olaleye, D. O.; Saliu, I.; Odaibo, N. G.; Adeyemo, A. A.A community based survey to determine the prevelence of human immunodeficiency infection in Nigeira women and children in south western Nigeria is reported. A multi-stage cluster random sampling procedure was used to select mother-child pairs from 35 enumeration areas in south western Nigeria. The final study sample consisted of 460 mothers and 476 children (including 16 sets of twins). A commercially available recombinant antigen-based ELISA method was used to test for HIV-I and HIV-2 anti-body in sera and western blotting was used as a confirmatory test for initially reactive samples. Only one mother-child pair (out of 460 mother-child pairs) was found to the positive for HIV antibody giving a mother-child concordance for HIV infection of 0.22%. Antibody to either HIV-1 of HIV-2 was detected in 3.8% (18/476) of the children's sera and in 4.3% (20/460) of mothers sera. HIV-1 reactivity was commoner than HIV-2 reactivity (2.9% versus 0.8% among children and 2.8% versus 1.5% among mothers). There were many more positive samples in the rural than in urban areas among children (7.1% versus 1.1%) and also among mothers (6.8% versus 2.4%),(p<0.001). Ths, HIV infection appears to be a real problem in south western Nigeria. The lack of concordance between mother-child sera suggests that vertical transmission may not be a major route of tansmission of HIV infection in children in South western Nigeria. It suggested that certain high risk practices(such as the re-use of unsterillised hypodermic needles for injections and surgical knives in local scarfication) which are common practices, especially in rural areas, need to be investigated as potential major modes of transmission of the infection. Control programmes need to take note of these finidngs in order to adequatly paln comprhensive health education which will cover the whole population, invluding children.Item Human T-cell lymphotropic virus types I and II infections in mother-child paris in Nigeria(Oxford University Press, 1999) Olaleye, D. O.; Omotade, O. O.; Sheng, Z.; Adeyemo, A. A.; Odaibo, G. N."A community-based survey to determine the prevalence of human T-cell Iymphotropic type I (HTLV-I) and type II (HTLV-II) virus infections in mothers and children in south-western Nigeria was carried out using blood samples collected in 1993. A multistage cluster, random sampling procedure was used to select 460 mother-child pairs (476 children because there were 16 sets of twills) from 14 enumeration areas. A commercially available, whole HTLV-I lysate antigen-based ELISA method was used to screen for HTLV-I and HTLV-II antibodies in the samples. A synthetic peptide antigen-based ELISA was then used to differentiate between antibody reactivity to either HTLV-I or HTL V-ll. Reactivity to HTLV-I or HTLV -II antibodies was found in 43 per cent (20/460) of mothers and in 1.1 per cent (5/476) of children in both rural and urban communities and all the positive children were males. None of the 16 sets of twins in this study was positive for either HTLV-I or HTLV-ll. Also none of the mother-child paired sera tested showed concordance for either HTLV-I or HTLV-II antibody positivity. The lack of concordance between mother and child sera suggests that vertical transmission may not be the major route of transmission of HTLV infection to children in south-western Nigeria. Other modes of transmission, such as the re-use of unsterilized needles for injections and surgical knives in local scarification, which are common practices in the region, need to be investigated as they may prove to be more important than vertical transmission. These findings have important implications for any control programme for diseases that can be spread by the same routes as HTL V infection (the human immunodeficiency viruses, hepatitis B, and hepatitis C infections)."Item Knowledge of caregivers on the risk factor knowledge factors of otitis media(2012-10) Adeyemo, A. A.Introduction: Otitis media (OM) is common in children. In developing countries, it is the most common cause of hearing impairment. Many factors predispose to OM, some of which are modifiable through lifestyle changes. This study aimed to determine the knowledge of caregivers on the risk factors (RFs) associated with OM and their willingness to modify their lifestyle to reduce the risk of OM. The impact of socioeconomic status (SES) on the knowledge and willingness in lifestyle alteration was also assessed. Materials and Methods: This is a prospective study using a modifi ed Ear Infection Survey questionnaire. The SES of caregivers/mothers was determined, and they were interviewed to determine their knowledge of RFs for OM and their willingness to undergo lifestyle modifi cations. Results: One hundred caregivers (96 females) were interviewed, majority of whom (81%) were in the higher SES. There were signifi cant differences between low and high SES in day care attendance, siblings and parents with history of OM. Apart from daycare attendance and household smokers, all other RFs were higher among the lower SES. Individuals from low SES background had poorer knowledge of the RFs for OM. A strong willingness to modify behavior to avert a surgical procedure for OM is seen in both groups. Conclusion: Caregivers in both SES groups were willing to undergo behavioral modifi cations in reducing the risk of OM; utilizing this knowledge in educational programs will help to reduce the prevalence of OM in children. This must be coupled with training and encouragement of health workers to disseminate information on RFs of OMItem Metastatic cervical lymphadenopathy masquerading as extrapulmonary tuberculosis(2012) Adeyemo, A. A.Introduction: Cervical lymphadenopathy can be due to various pathologies especially in the young. A high index of suspicion is required in the management of cervical lymphadenopathy to prevent misdiagnosis and wrong treatment. Case report: Here present the diagnostic challenge in the case of a young lady with nasopharyngeal carcinoma who initially presented solely with cervical lymphadenopathy. Previous fine needle aspiration cytology had suggested tuberculosis (TB) and she was commenced on anti-TB drugs. However failure of improvement and worsening symptoms led to another review in ENT clinic. A subsequent nasopharyngeal biopsy confirmed nasopharyngeal carcinoma. She subsequently improved after commencement of appropriate treatment. Conclusion: In regions with a high prevalence rate of tuberculosis, care must be taken to exclude malignancy in patients with cervical lymphadenopathy even when cytology suggests a granulomatous infectionItem Mothers’ perspectives of newborn hearing screening programme(2018) Jatto1, M. E.; Ogunkeyede, S. A.; Adeyemo, A. A.; Adeagbo, K.; Saiki, O.Background: Newborn hearing screening programs identifies newborns with hearing loss. The early identification enables prompt intervention through hearing rehabilitation. Accurate knowledge of the program and its benefit will impact on the uptake of the program by the citizenry. We hypothesized that there is a gap in the knowledge of parents on hearing screening and rehabilitation measures in Nigeria. Aim: To determine the knowledge and perceptions of mothers of newborn children on hearing screening. Methods: A cross sectional observational study among mothers of newborn children at immunization clinics. Semi structured questionnaire on gestational duration, mode of delivery, birth asphyxia, knowledge on hearing loss and newborn hearing screening were administered. Results: Participants were 48 mothers with age range from 18 to 42 years. Awareness of newborn hearing screening was poor among the mothers; sources of information on newborn hearing screening were antenatal clinic, mass media and friends. The educational level of the participants had no association with awareness (p = 0.11), but the willingness to accept newborn hearing screening, was associated with socioeconomic status (p = 0.04) and the level of education (p = 0.02). The participants were not aware of factors responsible for hearing loss in childhood. Conclusion: There is inadequate knowledge about newborn hearing screening and risk factors for infant hearing loss among the mothers, though they demonstrate willingness to accept the newborn hearing screeningItem Nasopharyngeal carcinoma in Ibadan, Nigeria: a clinicopathologic study(Pan African Medical Journal, 2020-06-20) Ogun, G. O.; Olusanya, A. A.; Akinmoladun, V. I.; Adeyemo, A. A.; Ogunkeyede, S. A.; Daniel, A.; Awosusi, B. L.; Fatunla, E. O.; Fasunla, A. J.; Onakoya, P. A.; Adeosun, A. A.; Nwaorgu, O. G.Introduction: nasopharyngeal carcinoma is relatively common in our environment. It is one of the most difficult malignancies to diagnose at an early stage. The aim of the study was to determine the clinical features, clinical disease stage of nasopharyngeal carcinoma at presentation and at diagnosis as well as the histologic types at the University College Hospital, Ibadan, Nigeria. Methods: this was a ten year retrospective study of all histologically confirmed nasopharyngeal carcinoma between January 2007 to December 2016 using clinical and pathology records and files. Results: there were 73 cases. The male: female ratio was 1.7. The age of patients ranged from 12 to 80 years with a mean age of 39 ± 16 years. The median age at diagnosis was 40 years. The peak age group of occurrence was 40-49 years. The most common symptoms were namely epistaxis in 67.1% of patients at presentation, neck mass/swelling (64.4%) and nasal mass/obstruction (63.0%). Majority (54.8%) of the patients presented late with stage 3 or 4 disease. Most (94.5%) of the tumours were of the non-keratinizing squamous cell carcinoma subtype. The keratinizing and basaloid variants accounted for 4.1% and 1.4% of the tumours respectively. Conclusion: vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the worldItem Otolaryngologic lesions among human immunodeficiency virus-infected children(Indian Society of Otology, 2018) Babatunde, O. D.; Adeyemo, A. A.; Oladokun, R. E.Background Otolaryngologic (ORL) lesions are common in children. ORL lesions occur even more commonly and more severely in HIV-infected children. The few avail- able literature has reported a high prevalence in human immunodeficiency virus (HIV)- infected children; however, there are inadequate data on the impact of HIV infection on hearing and the pattern of manifestations of ORL lesions among African children. Objectives This study was conducted to describe the prevalence and manifestations of ORL lesions among HIV-infected children and controls in Nigeria. Materials and Methods A prospective comparative cross-sectional study design was adopted. Clinical evaluation was done, and hearing assessment was done using oto- acoustic emission for all participants and pure tone audiometry for participants aged s 5 years. Hearing thresholds were defined according to the World Health Organization classification. Results One hundred children were studied: 50 HIV-infected and 50 HIV-negative children. The prevalence of ORL lesions among HIV-infected children was 66%, whereas it was 46% (p = 0.044) among HIV-negative children. ORL lesions were more prevalent among children between the 18-month and 5-year age group (p = 0.003) irrespective of HIV status. The lesions that were associated with HIV infection were cervical ade- nopathy (44%, p = 0.010) and hearing loss (36%, p = 0.023). Conclusion The frequency of ORL lesions is high in HIV-infected children, but improved outcomes following use of medications may be responsible for the slight disparity in prevalence when compared with HIV-negative childrenItem Pediatric head and neck malignancies in sub-Saharan Africa(2012) Adeyemo, A. A.; Okolo, C. A.Introduction: Cancers are relatively rare in children however recent reports suggest that malignancies are becoming a major source of pediatric deaths. Method: Using the database of the cancer registry of the University College Hospital, Ibadan we reviewed all newly diagnosed cases of head and neck cancers in children under 19years old at the hospital between 1981 and 2008. Results: A total of 1,021 cases of Head and Neck cancers were seen in children. The hospital based incidence of pediatric head and neck cancers is 36 cases per year. There were 627 males and 394 females [M:F ratio of 1.6:1] with mean ages of 8.21 and 7.70 years respectively. Boys were more affected than girls in all years of life while the peak age of onset for both sexes is the third year of life. The commonest anatomical site involved is the eye/orbit; other common sites were the nasopharynx, paranasal sinuses, nasal cavity and thyroid gland. Neural malignancies constitute the commonest malignancies seen (35.3%), other are lymphomas (33.1%), squamous cell carcinoma (9.1%) and soft tissue sarcoma (8.6%). Retinoblastoma is the commonest lesion seen among the patients with a slight male preponderance [M:F ratio of 1.2:1] Burkitt lymphoma (BL) is seen in all age groups but there is greater frequency in the older ages. The incidence of carcinomas is higher in the older age groups, relatively rare lesions like Hodgkins lymphoma and thyroid malignancies are almost exclusive to older children. Conclusion: The pattern of head and neck malignancies in children in sub-Saharan Africa is changing; dominant lesions like lymphomas are being gradually replaced by other malignancies such as neural malignancies, soft tissue sarcomas and squamous cell carcinomaItem Pediatric hearing thresholds post-bacterial meningitis(2020-07) Jatto, M. E.; Adeyemo, A. A.; Ogunkeyede, S. A.; Lagunju, I. A.; Nwaorgu, O. G.Introduction: Disabling hearing loss as a sequela of bacterial meningitis results from damage to the auditory system. This study was designed to ascertain the hearing thresholds in survivors of bacterial meningitis and the risk factors of hearing loss in childhood bacterial meningitis. Methodology: One hundred and two children admitted and treated for bacterial meningitis were recruited prospectively along with 102 age- and sex-matched controls who had auditory evaluation using otoacoustic emission and auditory brain stem response tests 48 h prior to hospital discharge. This was also repeated at the follow-up clinic at 1 month after hospital discharge, irrespective of the initial hearing assessment results. Result: There were 57 (55.9%) males and 45 (44.1%) females among the cases (mean age, 5.34 ± 4.40 years) and 55 (53.9%) males and 47 (46.1%) females among the controls (mean age, 5.31 ± 3.15 years). The prevalence of hearing loss was 30.4% among the cases, while it was 6.9% among the controls. The risk factors of hearing impairment in this study were the presence of anemia, leukocytosis, and hypoglycorrhachia. Conclusion: Hearing impairment with varying degrees of severity is a frequent complication of bacterial meningitis in childrenItem Pharyngo-cutaneous fistula post total-laryngectomy: a local experience(2020-03) Ogunkeyede, S. A.; Adeyemo, A. A.; Daniel, A.; Yaro, P. J.; Ogundoyin, O. ABackground: Pharyngo-cutaneous fistula is a major complication of total laryngectomy. Despite its significant impact on the patients' nutrition and management outcome, there is lack of consensus for recognising high-risk patients and factors associated with fistula formation. Hence, this study was aimed at determining the incidence of pharyngo-cutaneous fistula and factors associated with fistula formation. Methods: A retrospective collection of data on all cases of laryngeal cancer diagnosed histologically and had total laryngectomy, in the Otorhinolaryngology Department of a tertiary centre in Southwestern, Nigeria, from 2007 – 2016. The data collected include age, gender, tumour stage, tracheostomy, adjuvant therapy extent of laryngectomy procedure and factors for pharyngocutaneous fistula. Results: Forty-two patients had total laryngectomy, male to female ratio was 7.4:1 and mean age was 52.3 ± 2.1 years. All patients had pathological diagnosis of stage 3 (83.3%) and stage 4 (16.7%) laryngeal cancer, respectively. The incidence of pharyngo-cutaneous fistula was11.9% and the factors related to fistula formation were prior radiotherapy treatment and diabetes. Age, gender, neck dissection procedures, site of primary tumor and emergency tracheostomy did not contribute to fistula formation. Spontaneous fistula closure was achieved in all cases except one patient who had surgical closure. Conclusion: Pharyngo-cutaneous fistula formation post-surgery is related to the presence of co-morbidities. The high percentage of spontaneous closure underscores the need for a conservative management approachItem Policy brief on childhood deafness: early detection is the key(2018-06) Adeyemo, A. A.