An exhausting, but successful week.

Twelve year old girl hit hit by a broken machine belt crushing her larynx and lacerating her pharynx.

Three year old whose house wall fell on him causing a concussion, swollen tongue and upper airway obstruction.

This week was exhausting, but successful. Three patients presented with severe upper airway obstruction requiring emergency tracheostomies. The first patient had complete upper airway obstruction from a carcinoma of the larynx. Following his tracheostomy, his tracheostomy tube obstructed twice due to lack of humidity, suctioning and the use of too small a suction catheter. The second patient, a three-year boy had the wall of his house collapse on him during a heavy rain causing a concussion, orbital fracture and swollen tongue, which required an emergency tracheostomy. The third, a twelve-year old girl, had a crushed larynx caused when a machine belt broke hitting her flush in the anterior neck causing a thyroid cartilage fracture, separation of the true and false cords from the arytenoids and retropharyngeal air. Intubation was impossible and a cricothyrotomy was performed. The following morning the tracheostomy was properly repositioned and the larynx was sutured and stented back into its proper position. Sunday afternoon I slept five hours exhausted. I am in need of tracheostomy tubes of all sizes (as my own supply has dwindled), suction catheters, laryngeal stents and suction machines.

Return From a Visit to the US

Right mastoiditis for twenty-five years with hearing loss, facial paralysis and epidural abscess.

I recently returned to Ghana, accompanied by my wife, after a 45-day home emergency visit to the US because our son ruptured his appendix. He is now fine.
On arrival at the house in Tamale, the refrigerator, air conditioner and washing machine did not work. These problems have now been partially corrected.
The hospital staff warmly welcomed me back and asked about my son. There were no major failures in the ear, nose and throat clinic and our clinical conferences had continued successfully. During my first day back, a 40 year-old woman patient presented with a chronic ear infection, facial paralysis, sensorineural deafness and a frontal headache which required mastoid surgery. Her facial nerve was three times normal size, but intact and responded to stimulation, which indicates it may work again. During surgery, a tear in the middle fossa occurred requiring repair by the new neurosurgeon. The cautery machine did not coagulate, only cut, and this has to be looked into. More probes for the cautery and bits for the drill are needed for future cases.
There is a ton of work.