Background: Epistaxis remains a common otorhinolaryngological emergency in most hospital emergency departments with varied manifestations. The pattern as seen in a tertiary health institution in sokoto, Nigeria is the subject of this paper. Method: This is a 5year retrospective study (January 1995-December 1999 of all cases of epistaxis presenting at or referred to the Ear, Nose and Throat (ENT) Department of Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, Nigeria whose data were analyzed. Results: A total number of 72 cases were seen with epistaxis out of 3,706 new cases seen at the ENT clinic. The incidence of epistaxis amongst UDUTH ENT patients was 19/1000.There were 45males(62.5%) and 27 Females(37.5%) with a male to female ratio of 1.7:1.Their ages ranged between 1and 70 years with the 0-10 age range recording the highest number (26.4%).The commonest cause of epistaxis was idiopathic(29.2%),followed by trauma(27.8%) and hypertension(18.0%).Non surgical methods(97.2%) such as observation alone (34.7%)without active intervention to arrest bleeding, and nasal packing(34.7%),being the commonest intervention measures used to actively arrest bleeding followed by cauterization of the bleeding points(11.1%) were the frequent treatment measures. Surgical extirpation was carried out in 2cases (2.8%) to arrest the epistaxis Conclusion: Although epistaxis is a common otorhinolaryngological emergency and varied in its manifestation, it affects mainly the young people (<30years {62.5%}) in this environment with idiopathic, trauma, and hypertension being the common causes which are amendable to treatment with excellent results. Key words: Epistaxis, patterns, Sokoto, Nigeria Résumé Contexte: L'épistaxis demeure une urgence otorhinolaryngologique commune des les services d'urgence de la plupart des hôpitaux avec des manifestations variées. Le mode de présentation observé dans une structure de santé tertiaire à Sokoto au Nigeria a fait l'objet de ce travail. Méthode: Il s'agit d'une étude rétrospective sur 5 ans (de janvier 1995 a décembre 1999) de tous les cas d'épistaxis consultant ou adresses au service d'Otorhinolaryngologie (ORL) du Centre Hospitalier Universitaire (CHU) d'Usmanu Dan Fodiyo de Sokoto dont les données ont été analysées. Résultats: Au total 72 cas d'épistaxis sur 3 706 nouveaux cas ont été enregistrés au service d'ORL. L'incidence de l'épistaxis parmi les patients du service d'ORL du CHU Usmanu Dan Fodiyo était de 19/1000. Il y avait 45 hommes (62,5%) et 27 femmes (37,5%) avec un sexe ratio de 1,7 homme pour 1 femme. L'âge variait de 1 à 70 ans avec un pic de fréquence pour la tranche d'âge de 0 à 10 ans (26,4%). L'étiologie la plus fréquente d'épistaxis était idiopathique (29,2%), suivie par les traumatismes (27,8%) and l'hypertension (18,0%). Les méthodes non chirurgicales (97,2%) telle que la mise en observation seule (34,7%) sans méthode d'arrêt du saignement, et le tamponnement nasal (34,7%) ont été les moyens couramment mis en oeuvre pour arrêter le saignement. Elles ont été ...

Background Orofacial clefts are the most common malformations of the head and neck with a World-wide prevalence of 1/700 births. They are commonly divided into CL(P) and CP based on anatomical, genetic and embryological findings. A Nigerian craniofacial anomalies study “NigeriaCRAN” was set up in 2006 to investigate the role of gene-environment interaction in the etiology of orofacial clefts in Nigeria. Subjects and Methods DNA isolated from saliva from the Nigerian probands was used for genotype association studies and direct sequencing on the cleft candidate genes: MSX1, IRF6, FOXE1, FGFR1, FGFR2, BMP4, MAFB, ABCA4, PAX7 and VAX1, and the chromosome 8q region. Results A missense mutation A34G in MSX1 was observed in nine cases and four hap map controls. No other apparent etiologic variations were identified. A deviation from HWE was observed in the cases (p= 0.00002). There was a significant difference between the affected side for unilateral CL (p=0.03) and, between bilateral clefts and clefts on either side (p=0.02). A significant gender difference was also observed for CP (p=0.008). Conclusions The replication of a mutation previously implicated in other populations suggests a role for the MSX1 A34G variant in the etiology of CL(P).

Background/objectives: Ear foreign bodies are common otorhinolaryngological emergencies which must be removed otherwise they may present with various complications. This paper reviews cases of ear foreign bodies seen over a seven year period from January 1995 to December 2001 in the Ear, Nose and Throat (ENT) department of Usmanu Danfodiyo University Teaching Hospital Sokoto, Nigeria. Method: This is a retrospective study of all case folders of patients who presented with ear foreign bodies whose clinical features and management modalities were analyzed . Results: The total number of patients reviewed were 207.There were 126males (60%) and 81 females (40%) with a male to female ratio of 1.5:1.Their ages ranged from 1 to 65years with 61.8% being children under 10years old. Agricultural seed was the commonest documented foreign body (15%). Deliberate insertion by patients accounted for 70% of the cases while accidental insertion accounted for 30%. Ear foreign bodies became complicated in 41 patients (19.8%) at presentation one of them requiring a major surgical operation (posterior tympanotomy) to remove the foreign body. About 99.5% of the foreign bodies were removed through the per meatal approach with 79.8% being carried out by the nurses and doctors who had received basic training to do so. Conclusion: Ear foreign bodies may become complicated and so needs to be removed using standard methods which should be carried out by those specially trained to do so.

Rhinosinusitis in this region was more of chronic (83.6%) variety than acute (16.4%) variety. Infective causes (67.1%) and allergy (28.8%) were the commonest etiological factors. About (86.3%) were amendable to medical treatment while surgical treatment was carried out in 13.7% of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist, conventional surgical measures may be used.

BACKGROUND: Cancer of the nasopharynx poses diagnostic and therapeutic difficulties because of the hidden nature of the nasopharyngeal space, which allows for significant spread of the disease before diagnosis and hence poor prognosis. OBJECTIVE: To describe the clinical and histological characteristics of nasopharyngeal cancer in a tertiarty health institution in Northern Nigeria. METHODS:Clinical features of patients with nasopharyngeal cancer presenting at the Ear, Nose and Throat clinic of a University Teaching Hospital in North western Nigeria seen over a five-year period were analysed. RESULT: A total number of 30 cases, [22(73.3%) males and 8(27.7%) females] with a male to female ratio of 2.8:1 were seen. The mean age was 39.1years with the fourth decade of life recording the highest number of 16 cases(53.3%) and the least in the thirth decade. The commonest clinical features were neck swelling caused by cervical lymphadenopathy 28(93.3%), epistaxis 25(83.3%), nasal obstruction 20(66.7%),and deafness 11(36.7%).Others were otalgia 9(30%), palatal swelling 8(26.7%),cranial nerve involvement 7(23.3%) and visual impairment 6(20%). According to the UICC 1997 staging for nasopharyngeal carcinoma,23(76.7%) and 7(23.3%) were T3 and T4 or stages III and IV respectively.The histological diagnoses were squamous cell carcinoma 23(76.7%) cases, non-Hodgkins lymphoma 3(10%) cases, plasmacytoma 2(6.7%) cases, rhabdomyosarcoma one (3.3%) case, karposis sarcoma one (3.3%) cases. Seventeen (56.7%) patients though accepted in principle never went for radiotherapy. Only 2(6.7%) were still alive three and six years respectively from the time of diagnosis after chemoradiation while all others (93.3%) had died within one year of diagnosis. CONCLUSION: Nasopharyngeal cancer in Northern Nigeria is characterised by presentation with advanced disease, high mortality and low 5-year survival rates. Free or highly subsidized medical programme for early detection and treatment will reduce the high mortality rate associated with nasopharyngeal cancer in this region. WAJM 2009; 28(3): 151-155.