Study Design This is a multi-centre retrospective study. Objective To determine the prevalence of blindness and pattern of facial trauma associated with blindness among Nigerians. Methods A multi-centre retrospective study of all patients with facial trauma resulting in blindness, that were co-managed by maxillofacial surgeons and ophthalmologists in 4 Nigerian public tertiary hospitals between January 2010 and December 2019 was undertaken. Data was analysed by IBM SPSS Statistics (version 21.0 for windows, IBM© Inc, Chicago, IL). Results Of 2070 patients who presented with major facial injuries during the study period, 61 eyes of 56 (2.7%) patients were blind. Blindness was bilateral and unilateral in 5 (8.9%) and 51 (92.1%) patients, respectively. The mean age (SD) at presentation was 36.2 (16.6) years, and 47 (83.9%) of these patients were males. Road traffic accident (n = 27; 48%) was the commonest mechanism of facial trauma, the cheek (n = 18; 40.9%) was the commonest site of associated soft tissue injury and zygomatic complex fracture (n = 19; 24.1%) was the commonest related fracture. Globe rupture (n = 34; 55.7%) was the leading cause of blindness. Enucleation (n = 7; 13.2%) and evisceration (n = 22; 41.5%) were performed on 29 eyes of which 12 (41.4%) patients had ocular prosthesis post-operatively. Conclusions Blindness was recorded in 2.7% of Nigerians with facial trauma. The commonest mechanism of trauma and cause of blindness in at least one eye were road traffic accident and globe rupture, respectively. Eye removal surgery was necessary in about half of the blind eyes.
The ear is commonly involved in keloid formation, being often pierced. This study estimates the value of pre-excision triamcinolone injection of earlobe keloid, by comparing recurrence rates in patients who only received postexcision triamcinolone injection to those who had it administered before and after excision. The prospective intervention study involved 18 keloid lesions in as many consenting patients who presented with pedunculated earlobe keloid from January 2005 to January 2007. Triamcinolone doses were administered 10 mg/cm of lesion or sutured excision site. Each patient was followed-up for 10 years. Aggregate length of keloid lesions at presentation was 24.4 cm in Group A and 26.5 cm in Group B. Aggregate length of postexcision sutured wound in Group A was 16.1 cm, and 14.8 cm in Group B. Group A patients received a total of 1610mg of triamcinolone, while a total of 4660mg of same drug was administered to Group B patients, among whom 3180 mg was delivered presurgically. Total number of clinic visits during the course of treatment in Group A was 10, while that of Group B was 22. No patient with recurrent keloid was recorded in both groups. The authors concluded that there is no advantage to presurgical injection of triamcinolone when excision is considered as part of treatment protocol of a keloid lesion. This study helps to eliminate an ostensibly needless part of a commonly used treatment protocol.