Various degrees of hearing loss have been associated with sickle cell anemia. Fifty-six Nigerian children 6 to 15 years old were investigated for presence, type, and degree of hearing loss. Sensorineural hearing loss greater than or equal to 25 dB in two or more frequencies was found in 12 of 56 patients (21.4%). Tympanometry was normal in all patients, but acoustic reflex was elevated or absent in seven of 12 patients with hearing loss. Analysis of the data revealed a significant association between sensorineural hearing loss and the homozygous sickle cell disease, and a significant association between hearing loss and early occurrence of vaso-occlusive crisis. This latter finding suggest that the microvasculature of the cochlea in young infants may be more susceptible to occlusion during sickle cell crisis.
Various surgical procedures have been described for the relief of chronic nasal obstruction due to inferior turbinate hypertrophy, but none has been consistently satisfactory. We have performed total inferior turbinectomy for this condition for 5 years. Of the 39 patients followed for at least 2 years, 90% were relieved permanently of nasal obstruction. However, only 36% and 61% of patients with rhinorrhoea and anosmia respectively were relieved of these symptoms. Complications were minimal. It is concluded that even in a dry, dusty tropical climate, inferior turbinectomy does not appear to disturb the function of the nasal cavity appreciably.
In children, acute epiglottitis is rapidly fatal due to airway obstruction by swollen supraglottic structures, but the oedema is short-lived. Therefore, in many centres short-term endotracheal intubation has replaced tracheostomy as the method of choice for relieving the obstruction. We have tried both methods in 15 children over a period of three years under conditions of limited material and human resources. Tracheostomy was found to be safer. It was concluded that it is better to have a live healthy child with a small scar in the neck than a dead child without a scar.
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