Oral and Maxillofacial Surgery - Conference Papers

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Browsing Oral and Maxillofacial Surgery - Conference Papers by Author "Adekunle, A.A."

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    Open Access
    Breast feeding practices among mothers of children with oro-facial cleft in an African cohort.
    (Unilag Press, 2019, 2019-08-21) Adekunle, A.A.; Adamson, O.O.; James, O.; Adeyemo, W.L.; Ogunlewe, M.O.
    Background The challenge of breastfeeding in infants with cleft lip is achieving a seal around the nipple, but this can still be achieved with some effort, a cleft of the palate on the other hand makes it difficult to achieve the required intra oral negative pressure to suck, making feeding more challenging in this population which may result in inadequate nutrient intake (Chen et al. 1990; Ize-Iyamu and Saheeb 2011; Miller 2011).There is limited literature from our environmentabout breastfeeding practices among mothers of babies with oro-facial cleft. Objective:The study was carried out toassess the breastfeeding practices among mothers of children born with oro-facial cleft. Methodology: This was a cross sectional descriptive study using an interviewer administered questionnaire. Sample population was all mothers of babies aged between 1 and 18 months with non -syndromic oro-facial cleft attending the cleft clinic of the department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-araba, Lagos. Result: A total of 65 mothers participated in the study. Initiation of breastfeeding was reported by majority (83%, n=54) of the mothers, however, only 18.5%(n=10) of this proportion continued exclusive breastfeeding. Inability of the babies to suck was reported by 46% (n=30) of the mothers as being the most important challenge in breast feeding. There was a significant correlation between type of cleft and challenge in breastfeeding (fishers exact P = 0.001). Sixty three percent (n= 41) of the mothers reported they received no counselling on overcoming challenges associated with feeding their babies with a cleft at the facility where they delivered. Sixty nine percent (n=45) reported they first received nutritional information from the cleft clinic at presentation. The most commonly adopted substitute for breastfeeding was the use of regular feeding bottles (n=24, 43.6%). Conclusion:Rate of initiation of breastfeeding for children with oro-facial cleft in this African cohort is higher than reported in other populations despite the low level of nutritional counselling of the mothers after delivery.
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    Open Access
    Cardiovascular anomalies in patients with oro-facial clefts: a prospective case controlled study
    (Unilag Press, 2019, 2019-08-21) James, O.; Sokunbi, O.J.; Agbogidi, F.O.; Adekunle, A.A.; Ogunlewe, A.O.; Ekure, E.N.; Adeyemo, W.L.; Ladeinde, A.L.; Ogunlewe, M.O.
    BACKGROUND Orofacial clefts are among the most common birth defects, occurring in about 1.7 per 1000 newborns (Correia-Costa et al 2010). The reported incidence varies with different studies, however a nationwide hospital-based study in Nigeria reported a prevalence of 0.5 per 1000 live-birth (Butali et al 2014). This heterogeneous group of disorders can occur as an isolated condition or in association with other congenital anomalies or syndromes (Rittler et al 2008; Altunhan et al 2012; James et al 2014;). The frequency and type of associated malformations observed varies considerably across studies (Hagberg et al 1998; Stoll et al 2000; Wehby and Murray 2010; James et al 2014). The study by Hagberg et al (1998) indicated that 21–37% of orofacial cleft patients have other anomalies of which 24–51% involved the cardiovascular system. Cardiovascular anomaly is always a concern in a child born with a cleft palate (Fillies et al 2007; Sekhon et al 2011; Harry et al 2013). This anomaly may have an impact on the timing of cleft repair and the need for sub-acute bacterial endocarditis prophylaxis (Fillies et al 2007). The presence of these anomalies may mandate cardiac surgery before cleft repair (Fillies et al 2007). Cardiac anomaly may also impact on the incidence of anaesthetic risk/complication during surgery under general anaesthesia (Shprintzen et al 1985; Fillies et al 2007). The incidence and pattern of cardiac anomalies associated with orofacial cleft in our environment is also still unknown. It is therefore important to identify the types of cardiac anomalies and their pattern of presentation in Nigerian patients. The result of this study will provide baseline information on the incidence and pattern of presentation of cardiovascular anomalies in Nigerian subjects with congenital oro-facial cleft and possibly facilitate the development of a surgical management protocol for cleft patients with the cardiac abnormalities. AIM: To study the prevalence and pattern of cardiovascular anomalies in a population of patients with orofacial clefts and compare with those of age and sex matched control subjects. METHODOLOGY This study was conducted at the Oral and Maxillofacial Surgery Cleft Clinic, Pediatric and Community Health Outpatient Clinics of the Lagos University Teaching Hospital. Subjects were all consecutive cleft lip and palate subjects aged 2 months and above. Age and sex matched control subjects who are without cleft lip and palate were also recruited. All eligible subjects (cases and controls) who attend the cleft lip and palate clinic of the hospital had a full clinical examination done at the first visit and during subsequent review appointments. Socio demographic characteristics of the patients and other variables as well as other relevant clinical information about the cleft lip and palate disorder was recorded on a proforma As part of the evaluation, cardiovascular assessment was carried out on all the subjects (case and control) by a Pediatric Cardiologist. All subjects thereafter had electrocardiography (ECG) and Echocardiography tests done. The results were then interpreted by the pediatric cardiologist. The systemic assessment, ECG and echocardiography report was documented in another profoma. RESULT: A total of 120 subjects who satisfied the inclusion criteria participated in the study with 60 subjects in each group. There were 63 (52.5%) males and 57 (47.5%) females with a male-to-female ratio of 1.1:1. Of the 60 subjects in the oro-facial cleft group, 14 (23.3%) had bilateral cleft lip and palate, 12(20%) had unilateral cleft lip and palate, 13(21.7%) had isolated cleft of the palate. Four (6.67%) of the control subjects was diagnosed with congenital heart defects while 17(28.3%) of the oro-facial cleft group had congenital heart defect (p=0.001) Conclusion: This study shows a statistically significant higher incidence of cardiovascular anomalies in subjects with orofacial clefts than age and sex matched control subjects.
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    Open Access
    Necrotizing fasciitis: A five years review of cases seen at the Lagos University Teaching Hospital
    (FDS, CMUL 2019, 2019-10-09) James, O.; Anorue, E.I.; Adamson, O.O.; Adeyemi, M.O.; Adekunle, A.A.; Ladeinde, A.L.; Ogunlewe, M.O.; Adeyemo, W.L.
    Background: Cranio-facial necrotizing (CFN) fasciitis of the head and neck is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue. This results in tissue necrosis and may lead to death. It is commonly triggered by odontogenic or pharyngeal infections. Aim: To retrospectively review cases seen in our center to determine the factors that might affect the outcome Patient and methods: This was a five years retrospective study of patients presenting with necrotizing fasciitis, treated at the Department of Oral and Maxillofacial Surgery, LUTH from 2014 to 2018. The medical records were reviewed for: aetiology, trigger factors and sites of infection, clinical manifestations, underlying medical condition, type of surgical treatment, medical and surgical complications, length of hospital stay and outcome of treatment. Results: Twenty –three patients with head and neck necrotizing fasciitis were treated during the study period. There were 11 males and 12 females in this group. The average age was 43 years, with age range between 22 and 84 years. Triger factor in most cases was odontogenic infection (18, 78.3%) while the upper part of the neck was the most prevalent site of presentation. Clinical presentations were a rapidly progressing painful neck swelling, fever, ulceration and trismus. Sixteen patients (69.5%) had no significant comorbidity. The other 7 patients (30.4%) had at least one significant comorbidity: diabetes (5 patients, (21.7%), malnutrition (2, 8.7%), alcoholism (2, 8.7%). All cases received early and aggressive medical treatment followed by serial surgical debridement. Sixteen cases were treated on outpatient bases. The duration of hospital stay for those admitted ranged from 4 to 34 days . Conclusion: Maintaining a high index of suspicion is crucially important for diagnosing CNF. Early diagnosis, timely resuscitation, and aggressive surgical debridement are the key to a successful clinical Necrotizing fasciitis requires early diagnosis and management to improve prognosis. Keywords: Necrotising, fasciitis, odontogenic, infection
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    Open Access
    Retrospective study of the clinicopathologic factors of recurrent Ameloblastoma of the jaws
    (2019-10-09) James, O.; Adamson, O.O.; Fashina, A.A.; Adeyemi, M.O.; Agbogidi, F.O.; Adekunle, A.A.; Adeyemo, W.L.; Ladeinde, A.L.; Ogunlewe, M.O.
    Background: Ameloblastomas are benign, locally aggressive, polymorphic neoplasms of proliferating odontogenic epithelial origin. Clinically, ameloblastoma appears as an aggressive odontogenic tumour, often asymptomatic and slow growing, with no evidence of swelling. Aim: To retrospectively review recurrent ameloblastomas cases during a 10-year period and to determine the recurrence rate of ameloblastoma and clinicopathologic factors involved in recurrence. Methodology: Records of clinicopathologically diagnosed and treated cases of recurrent ameloblastoma for a period of 10 years (2008 –2018) were obtained from the Department of Oral and Maxillofacial surgery, LUTH. Information derived include patients’ demographics, initial diagnosis, previous surgery done, year of recurrence, localisation of tumor and histologic diagnosis of recurrent tumor. Results: During the period of this study (2009-2018), 247 ameloblastoma cases were treated during the of which 32 (12%) were recurrent cases. 19 (59.4%) were females while 13 (40.6%) were males. Male to female ratio is 1:1.5. The ages ranges from 11- 60 with a mean of 37.03±12.57. Recurrence was more observed in the mandible 26 (81.3%) than the maxilla 4 (12.5%) and craniofacial region 2 (6.3%). The number of years for recurrence to occur ranges from 1-30 years with median of 4 years and interquartile range of 7.75. Most recurrence occurs between 3-5 years (40.6%) followed by 1-2 years (25%) of initial surgery. Conclusion: The recurrence rate after conservative treatment was higher than that after radical treatment. The choice of treatment should be adapted to the macroscopic and histological characteristics of each tumour.