Otorhinolaryngologic Emergencies In Nigeria, Sub-Saharan Africa: Implication for Training.

Background: The anatomy and function of the ear, nose and throat (ENT) make pathologies potentially catastrophic. Reports on the epidemiology of otolaryngologic emergencies put the prevalence at between 30 and 80%. There are however very few studies from the developing countries. This study was aimed at determining the magnitude and spectrum of otolaryngologic emergencies in a teaching hospital in a developing country in sub-Saharan Africa.
Methods: This was a two year retrospective review done at the Department of Otorhinolaryngology in the University College Hospital, Ibadan, Nigeria. The clinical records of patients managed as emergencies between July 31, 2001 and 30 June, 2003, were reviewed and the biodata, diagnosis and treatment were extracted and analysed.
Results: Emergencies constituted 22% of the 2544 cases reviewed. The top five diagnoses were recurrent otitis media (24%), foreign bodies in the orifices (21.0%), head and neck trauma (20%), epistaxis (16%) and chronic sinusitis (8.8%). Children accounted for over 40% of the study population, although there was a peak in the third decade due to trauma. More than 80% of the cases were referred by general practice doctors. Only 41% of the cases were managed surgically, the rest required only conservative treatment.
Conclusion: The greater proportion of the cases referred as emergencies did not require surgical intervention and could have been managed conservatively by the referring doctors. It is recommended that the curriculum of otolaryngology posting for general practice trainees should be reviewed so as to increase the duration of exposure from the present one month. This will enable general practitioners to be more adept at instituting the conservative management of otolaryngologic emergencies.