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Thyroidectomy under Local Anaesthesia: A Viable Option in a Resource Limited Community

International Journal of Otolaryngology and Head & Neck Surgery 2021年第5期10卷 383-391页

作者： enoch auta dahilo David Femi Folorunsho Fredrick M. Damtong Olumide Akitoye Ibeneche Onyemuchechi Gbujie Semen Stephen Yikawe Emmanuel Sara Kolo Titus Sunday Ibekwe Department of ENT/Head & Neck Surgery University of Abuja Teaching Hospital Abuja Nigeria Department of ENT/Head & Neck Surgery Nigerian Air Force Hospital Abuja Nigeria Department of ENT/Head & Neck Surgery Aminu Kano Teaching Hospital Kano Nigeria

Background: In most centers worldwide, thyroidectomy is performed under general anaesthesia as a result of advances in anaesthetic technique, consideration for patients’ safety and surgeons’ convenience. However, in some developing countries such as Nigeria, facilities and expertise for general anaesthesia are not equitably distributed. As such, they are not available in some health centers especially in the rural communities. Hence, the need to explore other suitable alternatives such as operating under local anaesthesia. Aim: This study aims to highlight the feasibility and safety of thyroidectomy under local anaesthesia at a surgical outreach in a rural community in Nigeria. Patients and Methods: The study site was conducted at Bethany Medical Centre, Gboko, Benue State, Nigeria. It was a one-week surgical outreach. Neck infiltration with local anaesthesia was carried out using 2% xylocaine with adrenaline 1:200,000 and a standard open technique was used to carry out all thyroidectomies. Results: Out of seventy (70) patients that presented during the study period, 31 (44.3%) met the inclusion criteria and were operated within the seven (7) days period. There were 3 (10.7%) males and 28 (89.3%) females. There ages ranged between 22 to 65 years, average was 43 years. The average duration of surgery was 90 minutes, and 3 days’ hospital stay. Those followed up two weeks post-operation recuperated well with no notable complications. Conclusion: Thyroidectomy under local anaesthesia is safe and feasible in our rural communities and in selected cases can be a suitable alternative to general anaesthesia.

关键词： Thyroidectomy Local Anaesthesia Goiter Nigeria

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Early on Set Presbyacusis in Gwagwalada Area Council of Federal Capital Territory, Abuja

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International Journal of Otolaryngology and Head & Neck Surgery 2021年第3期10卷 238-249页

作者： David Femi Folorunso enoch auta dahilo Ibeneche Onyemuchechi Gbujie Fredrick M. Damtong Oladeji Raheem Quadri Basil E. Nwankwo Titus Sunday Ibekwe Onyekwere George Nwaorgu Department of ENT/Head & Neck Surgery University of Abuja Teaching Hospital Gwagwalada-Abuja Nigeria Department of ENT Federal Teaching Hospital Gombe Gombe State Nigeria Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka Anambra State Nigeria Department of Otorhinolaryngology University College Hospital Ibadan & College of Medicine University of Ibadan Oyo State Nigeria

Background: Presbyacusis is a major cause of hearing loss among seniors. The condition attracts attention following the prediction of World Health Organization that elderly population is expected to hit 1.2 billion by 2025 out of which more than 500 million of them will suffer from sensorineural hearing loss(SHL) worldwide. The studies have shown that this begins to reflect on audiograms as from the third decade, mainly in the high frequencies. Aim/objective: This study evaluated the early on-set presbyacusis at Gwagwalada Area Council of the Federal capital territory-Abuja. Method: It was a multi-stage sampling, prospective, cross-sectional study done in FCT, Abuja. Participants from age 20 years and above were recruited into the study after signing informed consent. The presumed risk factors as highlighted in the questionnaire were screened out. Results: Two hundred and two participants were recruited into the study, out of which twelve were excluded from the analysis on account of various exclusion criteria. The age range of the participants was 20 to 79 years, with an average age of 54.8 ± 5.6 years. One hundred and fourteen (60.0%) males and seventy-six (40.0%) females participated in the study. The commonly reported associated symptom was tinnitus. About 32.0% of the participants had moderate sensorineural hearing loss. However, the prevalence of presbyacusis was 28.2% for age below 65 years and 78.8% for 65 years and above. The cumulative prevalence was 54.2%. Conclusion: The study has shown that presbyacusis occur as early as the third decade of life, possibly subclinical before age 65 years. The prevalence was 28.2% before age 65 years and 78.8% from age 65 years, there was a steady increase in percentage of participants with SNHL from age 20 years, and a significant sudden increase from 65 years was observed with a sloping tracing at high frequency.

关键词： Presbyacusis Age-Related Hearing Loss Young Adults Sensorineural Hearing Loss and Pure Tone Audiometry

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