Otorhinolaryngology

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    Application of the international classification of functioning, disability and health with specific focus on disabling hearing impairment in legislation and policy in South Africa
    (Faculty of Law, University of the Free State, 2013) Smith, Magteld
    English: Disability legislation faces two potentially contradictory perceptions. Persons with disabling hearing impairment (DHI) are committed to eradicating discriminatory attitudes and practices, and removing barriers to communication and integration. Legislation should be aimed at breaking down these barriers, and be designed to assist persons with DHI to overcome stereotyped assumptions about their disability and ability. To achieve these goals, a common framework for describing functional status information is needed in order to make this information comparable and of value. The World Health Organization's International Classification of Functioning, Disability and Health (ICF), which has been approved by all its member states, including South Africa, provides a common language and framework to be used in legislation. This article analyses disability legislation in South Africa, with specific focus on DHI, in order to determine the application and definition consistency. It finds that some legislation includes some elements of disability. This endeavour may have extensive implications for the development of law and public policy to supplement the ICF and the Constitution of South Africa.
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    Manifestation and diagnosis of tuberculosis of the larynx at the Universitas Academic Hospital Bloemfontein
    (University of the Free State, 2018-10) Matimba, Abongile; Moncho, M.; Musoke, J.; Seedat, R. Y.
    Introduction and Aim: Tuberculosis (TB) is the most frequent granulomatous disease involving the larynx. However, the incidence is unknown at Bloemfontein. Hence, the aim of this study was to determine the incidence, clinical presentation and optimal diagnostic methods for laryngeal TB in patients presenting with laryngeal lesions to Universitas academic hospital in Bloemfontein. Methods: This was a prospective study conducted over one year from 1 May 2017 to 30 April 2018. All patients (n=80) undergoing direct laryngoscopy under general anaesthesia were included and a biopsy was sent for histopathological examination, Xpert MTB/RIF and TB microscopy, culture and sensitivity. Results: Of the 80 patients, five (6,25%) were diagnosed with laryngeal TB. The median age at presentation was 56,0 years (range 18.1- 83.5 years) with the majority 64 (80%) being males. The most common symptom was dysphonia in all five patients with laryngeal TB. The most frequent endoscopic presentation was a granulomatous like lesion, present in three patients, followed by tumour and ulcerofungative lesion in one patient each. Three patients with laryngeal TB patients had active pulmonary lesions (cavities in the upper lobes) and (hilar lymph nodes) and two had inactive pulmonary lesions (upper lobe fibrosis) on CXR.The diagnosis of laryngeal TB was based on histology alone in two patients, histology, together with a positive tissue Xpert MTB/RIF in another patient and on positive tissue TB cultures in the last two patients.None of the biopsy specimens submitted to histology or microbiology were positive on direct microscopy for AFB. Conclusion: We diagnosed TB in 6.25% (5/80) of patients who presented with laryngeal lesions. The diagnosis of laryngeal TB required a combination of histopathology, culture and PCR.The successful management of patients with laryngeal TB requires a high clinical index of suspicion, prompt diagnosis and early initiation of anti-tuberculosis chemotherapy.
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    Quality of life assessment in patients with allergic rhinitis at Universitas Hospital, Bloemfontein
    (University of the Free State, 2019-02) Ramdhani, Devesh; Seedat, Ry; Daniller, T.
    Introduction: Allergic rhinitis represents a global health problem that can adversely affect quality of life, impacting academic performance, social life and affecting work performance. Aims: The aims of this study were to determine the impact of allergic rhinitis on the Quality of Life of adult patients attending the Ear Nose and Throat clinic at the Universitas Academic Hospital Complex and to determine the change in the Quality of Life of patients with allergic rhinitis after one month of treatment. Methods: This was a prospective, descriptive study of patients over the age of 18 years who were diagnosed with allergic rhinitis at the Department of Otorhinolaryngology at Universitas Hospital between 1 May 2017 and 30 April 2018. Clinical data was recorded on a data form and the patients completed the Juniper mini Rhinoconjunctivitis Quality of life Questionnaire. Patients were reassessed after one month of treatment and again completed the Juniper mini Rhinoconjunctivitis Quality of life Questionnaire. Results: 85 patients were included in the study. Patients were aged 18 to 78 years of age with the mean of 37.86 years. There were 64.7% female and 35.3% males. 50% presented with moderate- severe intermittent disease, 44% with mild persistent disease, 4% with mild intermittent disease and 2% with moderate- severe persistent disease. There was a significant improvement in quality of life following one month of treatment. The greatest improvements were in daily activities, nasal symptoms and eye symptoms. Conclusion: Allergic rhinitis adversely affected quality of life, with a significant improvement in quality of life following one month of treatment.