Prevalence and Prognostic Profile of Otologic Emergencies in a Low Resource Country

Abstract

Background: Emergency care is a measure of quality of care in a health system. Method: Cases that met the inclusion criteria for otologic emergencies over a 3-year period, January 1, 2003- December 31, 2005 in the Otorhinolaryngology, Head and Neck Surgery department, University College Hospital, Ibadan, Nigeria, were studied. Retrieval of files utilised the ICD-10 version 10 standard codes. Results: We evaluated 231 otologic emergencies (OE) of the 346 otolaryngologic emergencies with 113 males (48.9%) and 118 females (51.1%). These constitute 66.7% otolaryngologic emergencies and 22.5% ENT outpatients, respectively. Their ages ranged from 2weeks-101 years, with a mean age of 29.4years ± 22.3. Age group 0-10 yr had 58(25.1%), the highest. Bloody otorrhoea was the most common presentation with 94 (40.7%). Of this, 39(16.9%), constituting 1.0% oto-laryngologic consultations, being from domestic violence (slaps). Women and children accounted for 94.9% of the victims. Sixty-one patients (26.4%) had acute otitis media while forty-five (19.5%) were cases of road traffic accident with CSF leak. The study recorded 23 (10.0%) cases of vertigo which were majorly BPPV (n=11, 4.8%). Sixteen cases (6.9%) had facial nerve palsy of which 2 (0.9%) were secondary to malignant otitis external that expired. Fifteen patients (6.5%) had sudden hearing loss. All the 3 (1.3%) cases of otogenic tetanus, 2 (0.9%) of intracranial complications of chronic suppurative otitis media (CSOM) and the 4 (1.7%) cases of middle ear tumours succumbed. Overall morbidity 27 (11.7%) and fatality was 11 (4.8%). Conclusion: Otologic emergencies are the most prevalent in Otolaryngologic practice with a significant grave prognosis.