Tonsil-derived stem cells as a new source of adult stem cells

Located near the oropharynx, the tonsils are the primary mucosal immune organ. Tonsil tissue is a promising alternative source for the high-yield isolation of adult stem cells, and recent studies have reported the identification and isolation of tonsil-derived stem cells (T-SCs) from waste surgical tissue following tonsillectomies in relatively young donors (i.e., under 10 years old). As such, TSCs offer several advantages, including superior proliferation and a shorter doubling time compared to bone marrow-derived mesenchymal stem cells (MSCs). T-SCs also exhibit multi-lineage differentiation, including mesodermal, endodermal (e.g., hepatocytes and parathyroid-like cells), and even ectodermal cells (e.g., Schwann cells). To this end, numbers of researchers have evaluated the practical use of T-SCs as an alternative source of autologous or allogenic MSCs. In this review, we summarize the details of T-SC isolation and identification and provide an overview of their application in cell therapy and regenerative medicine.

A Case of Angioleiomyoma of the Maxillary Sinus

Angioleiomyoma (ALM) is a benign tumor that occurs most frequently in the subcutaneous tissue of the upper and lower extremities. ALM arising in the sinonasal tract is rare, with fewer than 1% of cases presenting in this region. Only two cases localized to the sinuses have been reported to date in the literature. We report a case of a 30-year-old man complaining of a headache noted to have a concomitant lesion in the maxillary sinus. Histopathological examination following surgical resection confirmed a diagnosis of ALM. This report is the first known report of ALM limited to the maxillary sinus, and the first report to present the imaging data in the ALM in the sinus.

Challenges of Management of Arteriovenous Malformation of the Pinna in a Low Resource Setting: A Case Report

Arteriovenous Malformation (AVM) is a lesion of vascular development characterized by an abnormal communication between an artery and a vein without an intervening capillary bed. AVM of the pinna is very rare with very few reported cases in Africa. Management of an AVM is often daunting, most especially in a resource challenged centre like ours where facilities for super selective embolization are not available. We present the case of a 17-year-old female with a pulsatile swelling of the left pinna since childhood. Clinical and radiological diagnosis of arteriovenous malformation was made. She was managed surgically with left external carotid artery ligation, partial auricular resection and postauricular scalp rotation flap cover of the cartilage remnant. The aetiopathogenesis, clinical presentation, diagnostic confirmation and treatment options are discussed. We also discuss the challenges of managing AVM in poor resource settings like ours.

Retropharyngeal emphysema: An unusual aetiology—A case report and literature review

Introduction: Retropharyngeal emphysema is a potentially life threatening condition which may require urgent diagnosis and intervention. It has been documented to occur following trauma to the aerodigestive tract and is usually accompanied by subcutaneous emphysema of the cervical region. This condition may be complicated by mediastinal emphysema and pneumomediastinum. Foreign body ingestion is quite common in little children and in this environment;a cultural practice is for mothers or other caregivers to attempt to remove these foreign bodies by forcing their finger(s) down the oropharynx and Hypopharynx of these young children. This usually results in injuries to these anatomical sites. Retropharyngeal emphysema complicating this practice is rarely reported. Case presentation: We present the case of a 4-year-old Nigerian boy who presented with stridor and severe dyspnoea following repeated attempts at removal of a purportedly ingested foreign body by his mother. Examination revealed oedema of the soft palate with small multiple bleeding shallow lacerations of the oropharyngeal walls. Oxygen therapy was commenced and preparations for urgent upper airway intervention made. Soft tissue neck X-ray revealed retropharyngeal and subcutaneous emphysema with upper airway compromise. Conservative treatment with high dose steroids and antibiotics led to a gradual resolution of the condition. Conclusion: This is a rarely reported complication of this relatively common socio-cultural “foreign body removal method”. Public awareness is required to stop this potentially life threatening practice.

Neonatal Hearing Screening Using Transient Evoked Otoacoustic Emission in a Sub-Urban Population in Nigeria

Objective: To determine the proportion of neonates with referral result on testing with transient evoked otoacoustic emission (TEOAE) and the associated risk factors. Method: Prospective evaluation of all neonates born in the Hospital within 6 months using the TEOAE. A hand-held Etymotic Research Otoacoustic Emission Scanner (Ero-scan Combo) was used with the child sleeping in the cot or the mother’s hand. Right and left ears were tested separately and the result was displayed automatically as “pass” when 100% of the in-built criteria were met and “refer” if otherwise. The subjects that passed in both ears were regarded as passes, while those with a refer in either the right/left ears or both ears were regarded as referrals and were thus subjected to rescreening in six weeks or on discharge from the special care baby unit. Analysis was done to find association between the outcome of TEOAE and the clinical and epidemiological risk factors. Result: TEOAE was carried out on 386 neonates, (194 males (50.3%) and 192 females (49.7%)). The mean age at screening was 2.3 days (SD = 1.5), the mean gestational age was 38.0 weeks (SD = 2.7) while the mean birth weight was 2.9 kg (SD = 0.7) and the mean Apgar score at 1 and 5 minute were 8.3 (SD = 1.0) and 9.8 (SD = 0.6). At the first step hearing screening, referral rate was 112 (29.0%);at the second stage, 31 (8.5%) neonates had referral in one or both ears. Fisher’s exact test showed that prematurity, multiple births, jaundice and small birth weight were significantly associated with a referral outcome. However, logistic regression revealed prematurity as a significant predictor of referral outcome with a negative predictive value of 12.61. Conclusion: The referral rate is high with prematurity as a significant predictor. This study calls for commencement of newborn hearing screening and strengthening of the public health measures in the developing countries.