Background: A large-scale outbreak of meningococcal meningitis, serotype C, occurred from December 2016 to June 2017 in some states in Nigeria. Meningitis is associated with significant morbidity and mortality. The most common sequel of this disease is hearing loss. The mechanism could be through spread of infection to the ear via the cochlear duct. Objective: The study objective was to assess the hearing threshold of patients diagnosed with meningitis during an outbreak of meningococcal meningitis in Sokoto. Materials and Methods: This was a cross-sectional descriptive study carried out on patients diagnosed with meningitis managed at the meningitis emergency response center in Sokoto. A standardized semi-structured questionnaire was used to obtain relevant information after which the patients were examined and their hearing thresholds were measured. Results: A total of 72 patients were recruited in the study. Twenty-eight (38.9%) patients had varying degrees of hearing loss. The mean duration of illness was 3.28 +/- 2.75 days. The mean duration of illness among patients with hearing loss was 5.32 +/- 3.28 days and that among those without hearing loss was 1.98 +/- 1.13 years (t = 6.230,P< 0.001). Steroids were administered to forty (55.6%) patients by the managing physician. Out of these, only seven (17.5%) were observed to have hearing loss. Conclusion: Meningitis is a common cause of acquired hearing loss. We observed a prevalence of early hearing loss of 38.9% among our patients. Patients who stayed longer before presenting to the hospital had worse hearing compared with those that presented earlier. We observed that steroid use was beneficial and was associated with reduced prevalence of hearing loss.

Background: Exposure to noise has been observed to have deleterious effect on the health status of individuals working within the noisy environment. Continuous exposure to high and unwarranted sound remains a major cause of hearing disorder all over the world. Occupational noise-induced hearing loss (NIHL) constitutes a worldwide problem in industries and contributes about 16% of hearing loss among adults globally. Aims and Objectives: The aim and objective was to evaluate the impact of occupational noise exposure on the auditory performance of workers at a cement company. Methods: This was a cross-sectional descriptive study of consenting workers at a cement company (public liability company). A total of 341 respondents were recruited for the study with equal number of controls matched for age and sex. Ear examination was done and based on the exclusion criteria, 23 participants with diseased ears were excluded. There hundred and eighteen participants (616 for both study group and control group) each had an interviewer–administered, semi-structured questionnaire and underwent diagnostic pure-tone audiometry. A digital sound level meter (Type 2 well-calibrated TOMTOP-Model Number H4320) with a range of 30–130 dB was used to map out the sound in the respective departments. Results: One hundred and one (31.8%) noise-exposed workers had mild (23.3%), moderate (7.2%), and severe (1.3%) hearing loss in their right ears as against the 21 (6.6%) in the controls. This was found to be statistically significant (P = 0.000). Seventy-seven (24.2%) noise-exposed workers also had mild (17.9%), moderate (6.0%), to severe (0.3%) sensorineural hearing loss in the left ear with the controls having 6.3%; this was also found to be statistically significant (P = 0.000). The presence of notch at 4 kHz audiometric configuration was 14.5% and 17% in better and worse ears, respectively. Three hundred (94.3%) workers in the noise exposed group worked for <8 h in a day (40 h/week) irrespective of the intensity of noise they were exposed to. Conclusion: This study has revealed a high prevalence of sensorineural hearing loss in the factory. This pattern of sensorineural hearing loss, coupled with the significant presence of 4 kHz audiometric notch among the noise-exposed workers (16.9%) in the worse ear when compared with the controls (3.1%) in the worse ear, strengthened the assertion that the hearing loss of the workers was likely attributable to occupational NIHL.

Background: Neck trauma is a potentially life threatening clinical condition often presenting as a challenging surgical emergency to otolaryngologist due to high concentration of vital structures in the neck that are at risk. We aimed to study the clinical profile and management challenges of neck trauma in our environment.Methods: This is a retrospective study in which case records of patients diagnosed with neck trauma over 6 years (January 2013 to December 2018) were reviewed. Data extracted included the demography, etiology, presenting symptoms, nature of trauma, surgical intervention and their complications.Results: A total of 28 cases of neck trauma 15 (53.6%) males and 13 (46.4%) females with an M: F ratio of 1.2:1 was analyzed. Age range 8 years to 60 years with a mean age of 30.2 years. The highest incidence was 39.3% in patients within the age group 21-30years. Hoarseness and difficulty in breathing were the commonest presenting symptoms. The commonest etiology of neck trauma in this study is accidental 17 (60.7%) followed by homicidal 6 (21.4%) with zone II site of the neck being the commonest site of injury. Most cases presented to the hospital 2-8 hours of trauma except 5 patients that took more than 24 hours. Nineteen of the patient had emergency tracheostomy and Neck exploration. Most common complication was supraglottic stenosis 12 (42.8%). No mortality recorded in this study.Conclusions: Neck trauma is a potentially life threatening surgical emergency requiring timely multi-disciplinary management thereby reducing complications and postoperative morbidity.

Background: Diabetes mellitus (DM) is a syndrome of chronic hyperglycemia due to relative insulin deficiency or resistance. The risk of complications of diabetes has been observed to increase as a function of the duration of hyperglycemia. Objective: The objective of this study is to determine the effect of duration of DM on hearing thresholds among type 2 diabetics. Methodology: This was a cross-sectional descriptive study conducted between October 2015 and May 2016 in Usmanu Danfodiyo University Teaching Hospital Sokoto among type 2 diabetic patients attending the Endocrine Clinic of the hospital. Patients had their blood sugar and hearing thresholds measured. Results: A total of 170 type 2 diabetics were recruited into the study, out of which 98 (57.6%) were females and 72 (42.4%) were males. The mean age was 46.49 +/- 10.02 years. One hundred and twenty-two (71.8%) had elevated hearing thresholds. The mean duration of diabetes among participants was 7.81 +/- 5.34 years, with durations ranging from <1 year to 30 years. The mean pure tone average increased with increase in duration of diabetes (P <0.001). Simple linear regression showed that increase in duration of diabetes was positively related with hearing threshold (P <0.0001). For every year increase in duration of type 2 DM, a 1.036 dB HL increase in pure tone average is to be expected. Conclusion: This study demonstrated a relationship between duration of diabetes and hearing threshold. It has shown that as the duration of hyperglycemia increased, the hearing threshold among participants also increased.

Thyroglossal duct cyst (TGDC) is the most common paediatric midline neck lesion. It is rare in the adult population. Metaplastic change is mostly associated with the adult variant. We report the first ever cases of thyroglossal duct cyst in the adult as seen in our region, with a review of literature. Case Report 1 .A 42-year old man, presented with a painless anterior neck swelling of more than3months’ duration. Neck examination revealed a midline 4cm x 6cm cyst below the hyoid bone, which moved on deglutition and on protrusion of the tongue. Thyroid function test was within normal values. Histology of the excised cyst (Sistrunk’s operation) confirmed thyroglossal cyst. Case Report 2 . A 20-year old female student presented with a midline neck swelling of 5years’ duration. Examination showed a 3cm x 4cm cystic non-tender midline anterior neck mass that moved on deglutition and on tongue protrusion. Thyroid function test showed a slight elevation in levels of T3 and T4. A neck ultrasound scan revealed an oval hypoechoic mass on the left thyroid cartilage of the larynx. She had a modified Sistrunk’s operation and histology confirmed the diagnosis of thyroglossal cyst. Conclusion : Thyroglossal duct cyst commonly presents as a midline anterior neck asymptomatic swelling. Its tendency to undergo malignant degeneration in adults emphasizes the importance of meticulous clinical, radiological and histological evaluation.

Introduction: Laryngeal stenosis is partial or circumferential narrowing of the endolaryngeal airway from congenital or acquired causes. It can present with life threatening upper airway obstruction, and the goal of treatment is restoration of good quality voice, respiration and laryngeal competence. We report a case of laryngeal stenosis following strangulation by a trapped overflowed head scarf, whilst being transported on a motor cycle and highlighted the treatment challenges. Methodology: A case of laryngeal stenosis studied, clinical findings, investigation results and treatment analysed. Results: A 70-year-old Nigerian elderly woman presented with three weeks’ history of hoarseness and progressive difficulty in breathing, following pulling of her long head scarf into the back wheel of the motor cycle taking her home. She had immediate loss of consciousness, which lasted for about 60 minutes. There was associated bout of cough while eating. Examination revealed life threatening upper airway obstruction. X-ray soft tissue neck showed soft tissue mass obliterating larygotracheal air column. Flexible nasopharyngolaryngoscopy showed grossly distorted laryngeal inlet with invisible vocal cords. CT scan of the larynx showed multiple and displaced fractures of the laryngeal cartilages. Microlaryngoscopy findings were pin-hole laryngeal lumen with firm collapsed mucosa. Emergency tracheostomy was done to relieve the upper airway obstruction. Attempts were made to excise the collapse mucosa and insert a stent proved difficult. Referral for endoscopic laser excision was caution because of the potential risk of aspiration. She was counselled and coping well with the tracheostomy.