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The Sokoto River joins the Niger about 75 km downstream of the border and The River Benue enters Nigeria from the Cameroon flowing south-west, and has by blocking the connecting channel between the swamps and the river with a. The present study was conducted in Sokoto state located in the North-West of In some cases, both language and traditional use in the region mix up at least two de SilvaIsolation of a new resorcinolic lipid from Mangifera zeylanica Hook.f.
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The names of foreign bodies removed were not documented in 93 cases Table 1. Age range of patients with ear foreign bodies in Sokoto,, Nigeria. Significant ear trauma to the external auditory meatus contusion, laceration and tympanic membrane perforation complicated failed attempted removal before presentation in 41 patients Conductive deafness was documented in the affected ears after the removal of ear foreign bodies based only on live voice tests compared with the unaffected ears of 30 patients Simple and straight forward cases of ear foreign bodies were removed by nurses and junior resident doctors Complicated or difficult cases were reserved for the senior resident or consultant.
Some children required minimal sedation with ketamine to ease the removal of foreign body that were not cooperative. One adult female patient 0. Ear Foreign bodies are common otorhinolaryngological emergencies in most Otorhinolaryngological clinics in Nigeria a sub-Saharan nation in West Africa and is a common daily problem all over the world.
It occurred more in children between the ages of 1 and 10 years This is a similar finding by many authors who report that it is a disease of children.
Children commonly play and try to explore body orifices out of curiosity. Therefore the need to watch children carefully and do periodic ear examination in order to detect presence of ear foreign bodies cannot be overemphasized especially when most families in sub-Saharan Africa leave their children under the care of extended families.
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Ear foreign body such as button battery which have alkaline substance when dissolved causes liquefactive necrosis and if left undetected could cause otitis externa, meatal stenosis, otitis media, facial nerve paralysis and deafness with attendant problems. No button batteries were recorded in this report. The names of most of the foreign bodies were not documented in 93cases Most records of patients were incomplete. Record keeping of names of foreign bodies is important and how they are removed.
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It helps to plan on both preventive and intervention measures. However types of foreign bodies vary from different reports from different parts of the world even though almost every conceivable object has been known to be inserted in the ear. Successful removal of foreign bodies through the per meatal approach occurred in The 41 patients One patient underwent posterior tympanotomy to remove the foreign body under general anesthesia.
Those who had perforated tympanic membranes Although objective hearing assessment was not done in these patients, the harm caused by these untrained personnel were preventable.
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There was no mortality recorded despite these complications. Objective hearing assessment would have shown the degree and pattern of hearing loss. It is also important for medico-legal reasons in cases of litigation. It is therefore unfortunate that some patients presenting with ear foreign bodies could end up becoming deaf in the society which is preventable if untrained personnel continue to make attempts to remove ear foreign bodies.
This is likely to affect the quality of life of these patients particularly children whose learning capabilities may be impaired in a region where there are no sufficient resources to cope with handicapped children and address their problems. Under this circumstance, a deaf child will end up becoming a liability to the family or society. Management of deafness as a result of tympanic membrane perforation with or without ossicular chain disruption or destruction is far more complex and expensive to handle with variable results.
Standard methods are available for removal of ear foreign bodies which are taught and carried out in centers with competent emergency physicians and or ENT surgeons such as: 1 Ear syringing of non-vegetative objects. Trial and error in this area should be avoided. From our study While it may be true that it might be impossible for all ear foreign bodies to be removed by the ENT specialist, 15 the outcome is usually better with those who have had basic training to do so.
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This basic training is now available in various Otorhinolaryngological departments of Health institutions and the National Ear care center in Nigeria in order to prevent complications in handling minor ENT ailments when the specialist is not available. Two of these patients had successful removal through the per meatal approach while one required a posterior tympanotomy to remove the impacted metallic boris. A computerized tomographic CT scan is superior to conventional x-rays and will usually show more details.
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This must not necessarily be carried out before surgical extraction except in selected cases with suspected intracranial involvement such as may occur in missile injuries. Every case of EFB should be treated on its on merit. Methods of foreign body removal vary with the types of foreign bodies.