The first case of human otoacariasis in Cyprus

Otoacariasis is the ear canal infestation by the arthropod Subclass: Acari, usually ticks or mites. It is a common complaint seen in animals. However, there are relatively few documented cases of human otoacariasis. In August 2019, a physically healthy 53-year-old Cypriot man visited Near East University hospital complaining of a blockage, partial deafness, and minor pruritis in his left ear. During the examination of the patient, a mite infestation of his left external auditory canal (EAC) was determined. The mites were removed from the EAC and sent to the laboratory for identification. The mite samples were viewed under Olympus-CX31 light microscopy and identified as Dermatophagoides pteronyssinus. The patient was treated with Permethrin (cream), Xylocaine spray, dilute acetic acid (vinegar), and three ear canal aspirations. After three days, the patient’s ear was re-examined, and the number of mites had greatly decreased within the EAC. Follow up consultations confirmed the eradication of the mite infestation. This is the first case report of human otoacariasis from Cyprus.

Comparative Study between Nasal Endoscopic Findings and Nose and Paranasal Sinus Computerized Tomography in diagnosis of Nose and Paranasal Sinuses Diseases

Background: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors). Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, paranasal sinuses and post nasal space diseases. Subjects and methods: 80 patients with nasal obstruction between the age of 12-60 years old.All patient were examined by nasal endoscopy (rigid or flexible) under local anaesthesia (10 % xylocaine spray and cotton wicks soaked with ephidren 0.5 % and xylocaine 2 % ) and nose, paranasal sinuses and post nasal space C.T. scan,weather without contrast or with it, bone window or soft tissue according to the lesion. Results: Both nasal endoscopy and C.T. scan were an important tools for diagnosis of nasal diseases and complementary to each other. Conclusion: Endoscopic examination of the nose gives a real view of nasal structures, postnasal space, any mass or polyps present.Computerized tomography is an accurate diagnostic method of the Nose, paranasal sinuses and post nasal spaces anatomical variations or pathologies.

CLINICAL PROFILE OF PAEDIATRIC PHARYNGO-OESOPHAGEAL FOREIGN BODIES IN A TERTIARY HEALTH INSTITUTION, NORTH WEST NIGERIA.

Background: Pharyngo-oesophageal foreign bodies (PFB) in children are frequent clinical entity requiring an urgent radiological and endoscopic surgical intervention to avert life threatened complications seen in otorhinolaryngology practice. Objective: The objective of this study is to describe the pattern of pharyngooesophageal foreign bodies’ impaction, management challenges and the need for health education to care givers. Method: A retrospective review of all cases of paediatric patients with suspected or confirmed history of PFB from January 2007 to December 2011. The information retrieved included the biodata, types of foreign body, clinical and radiological findings, treatment and outcome.Results were analysed by simple statistical table. Results: Sixty seven patients diagnosed with Pharyngo-oesophageal Foreign Body, forty three (64%) were males while 24(36%) were females with M: F ratio = 1.8:1 and Mean age of 4.9 years (age range 6months to 13years.).Coins 36(54%) were the commonest PFB. Only 13(19%) presented to hospital within 24hours of ingestion. Common presenting symptom were Vomiting 70%, and dysphagia in 73%. Fifty four (81%) had positive history of FB ingestion and 13(19%) of the patient PFB were detected radiologically. Sixty three (94%) had rigid oesophagoscopy and removal under general anaesthesia while 4(6%) fish bone FB in the tonsils were extracted in the out-patient clinic after xylocaine spray. Post operative complications were noticed in 13(19%). Conclusion: Coin is the commonest pharyngoesophageal foreign body in children. Only 19% of these patient presented to hospital within 24hours therefore public health education to parents and care givers is recommended.

Study of microbial spread when using multiple-use nasal anaesthetic spray

Background: Current economic constraints have led to the emergence of reusable anaesthetic sprays with replacement nozzles (Xylocaine) as an alternative to disposable anaesthetic solutions (Co-phenylcaine) for rhinological procedures. The former costs 213.84 per year vers12,047.69 for the latter, at equivocal doses. However, research regarding the sterility of such instruments is limited. The aim of this in vitro study was to determine whether bottles of Xylocaine could pose a risk of cross-infection to patients. Methods: Two techniques were used. The first was to introduce nozzles into methylene blue and fluorescein dyes, and then analysing the anaesthetic solutions using spectrophotometry for assessment of colour change indicating retrograde contamination. The second method involved spraying Xylocaine into cultures of Staphylococcus aureus with concurrent nozzle changes. This was repeated over a 36-day-period. Sterility checks were performed on the Xylocaine before and after inoculation into the culture. Results: None of the anaesthetic solutions showed the presence of dyed saline following spectrophotometric analysis. No S. aureus was isolated from any of the 30 spray bottles cultures over the 36-day trial period. Conclusion: It was demonstrated that using the Xylocaine spray with disposable nozzles for each patient should not pose a cross infection risk to patients.