Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2021
OBJECTIVE The aim of this study was to describe the clinicopathologic features of salivary gland ... more OBJECTIVE The aim of this study was to describe the clinicopathologic features of salivary gland tumors (SGTs) that were managed at a major referral center in Ghana. STUDY DESIGN This was a retrospective study of all histologically diagnosed and managed Ghanaian patients with SGTs during the period January 2008 to December 2017. Information collected included age, gender, affected gland, presenting symptom, treatment modality, histologic diagnosis, and complications. Descriptive summaries of variables were generated. The χ2 test with Fisher's test was used to compare categorical variables with subsequent testing of association. RESULTS The study included 116 patients, with 49 males (42.2%) and 67 females (57.8%), representing a ratio of 1:1.4. There were 82 (70.7%) benign SGTs and 34 (29.3%) malignant SGTs. The most common benign SGT was pleomorphic adenoma, which accounted for 62.1% of all SGTs. Malignant SGTs occurred more in older people, and the occurrence of SGTs was significantly at a lower age in males compared with females. CONCLUSIONS Although the general pattern of SGTs did not seem to differ significantly in comparison with the findings of a review performed 10 years earlier, the findings of this study could inform hypotheses generation for future studies to explore the risk factors and associations peculiar to the Ghanaian environment.
Introduction – Despite the significant prevalence of both latent herpes zoster and HIV, oro-facia... more Introduction – Despite the significant prevalence of both latent herpes zoster and HIV, oro-facial presentation of the former in the presence of the later and associated with teeth exfo liat ion is rarely reported.
Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other ... more Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other injuries may be the initial focus of attention of the primary attending surgeon who may miss the maxillofacial injuries to the detriment of the patient. To determine the incidence of injuries associated with maxillofacial injuries at Korle Bu Teaching Hospital (KBTH) from January 2009 to December 2010. A prospective study was carried out on patients who were referred to the Maxillofacial Unit of the University of Ghana Dental School and KBTH over the two years with maxillofacial injuries. Their age, sex, type of injury in the maxillofacial region, its aetiology and concomitant injuries were charted. The data was analysed using SPSS 16.0 software. Two hundred and fifty eight (258) patients were seen of which 67 (26.0%) had concomitant injuries. The average age was 29.1 years. The peak incidence was in the age group 21-30 (N=73, 28.3%). 74% were male and 26.0% female. The commonest cause o...
Medical science monitor : international medical journal of experimental and clinical research, 2002
A popular variety of wood, pieces of which are chewed as an oral hygiene practice in Southern Gha... more A popular variety of wood, pieces of which are chewed as an oral hygiene practice in Southern Ghana, was tested for its capacity to reverse experimentally lowered pH of saliva. This was done to determine whether (Garcinia manii) stick-chewing neutralizes acidogenic challenge to teeth, and thereby potentially affords dental caries prevention benefit. Seventy-two volunteer medical students gave (baseline) saliva samples by spitting 3-4 times into a 25 ml conical flask. They then rinsed their mouths with a five-percent aqueous solution of glucose. Subsequent to the glucose rinse, half of the subjects (chewers), pre-selected by drawing lots, chewed a popular chewing stick Garcinia manii for five minutes, while the other half (controls) did not. The pH of saliva samples given by the volunteers at various time intervals was measured using a Kent EIL 7020 pH meter, and the results were analysed by the Analysis of Variance (Anova) method. As expected, saliva pH was reduced in both groups af...
Prostate cancer is recognised to be the commonest type of malignancy in the male in many parts of... more Prostate cancer is recognised to be the commonest type of malignancy in the male in many parts of the world. Prostate cancer has a propensity to metastasize to bone, however metastasis to the jaw is uncommon and indeed among metastatic tumours of the jaws which are a rarity, only about 9% originate from a prostatic primary. We report a case of histologically proven metastatic prostate cancer to the right mandible which necessitated a hemi-mandibulectomy in order to improve the patient's quality of life.
We report a case of a 59‐year‐old woman who presented with swelling of the right cheek. CT Scan s... more We report a case of a 59‐year‐old woman who presented with swelling of the right cheek. CT Scan showed three calculi located anteromedial to the masseter, and well isolated from other major salivary glands. Calculi were surgically removed with standard intraoral incision and exploration.
Background: Ludwig's angina is a potentially life-threatening condition characterized by bila... more Background: Ludwig's angina is a potentially life-threatening condition characterized by bilateral cellulitis of the submandibular, submental, and sublingual spaces. Intravenous (I.V) penicillin G or amoxicillin-clavulanate (Augmentin) has been recommended for use as empirical management before obtaining culture and sensitivity results. Aim: The aim of this study was to compare the therapeutic efficacies and clinical outcomes of I.V benzylpenicillin with I.V Augmentin in the empirical management of Ludwig's angina. Methods: This was a prospective randomized clinical study carried out to measure the rate of swelling reduction (using the lobar rate, Adam's rate, and interincisal distance) and other clinical parameters among the two drug groups (I.V penicillin G and Augmentin). Descriptive summaries of variables were generated, and Student's t-test was used to compare the mean outcomes of the two groups. Results: A total of 26 individuals participated in the study, consisting of 46% (12) males and 54% (14) females. The participants ranged from 13 to 61 years with mean and median of 34.4 (±12.7) and 35 years, respectively. Only 8% of the cases of Ludwig's angina were not attributable to odontogenic factors, compared to 92% resulting from odontogenic causes. There was no significant difference in the efficacy of the two antibiotics used in this study. Conclusion: The efficacies and the clinical outcomes of the two antibiotics were similar. Benzylpenicillin is probably a suitable empirical alternative where Augmentin cannot be afforded, to reduce the mortality associated with the condition.
Journal of Cranio Maxillo Facial Surgery Official Publication of the European Association For Cranio Maxillo Facial Surgery, Mar 1, 2009
Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of co... more Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of combinations of bony or soft tissue adhesions between the mandible and maxilla with cleft of the lip or palate, aglossia, popliteal pterygium and van der Woude syndrome have been reported. The aim of this paper is to report a case of fibrous maxillomandibular fusion of the jaws, with synechiae of buccal mucosa and the gingivae, which was referred to the Oral and Maxillofacial team of the Korle-Bu Teaching Hospital, Accra, Ghana soon after delivery. Separation of the fusion was done under nitrous oxide/oxygen sedation. Cleft of the hard palate was discovered during surgery. Maxillomandibular syngnathia is considered rare and synechiae with other maxillofacial abnormalities without syngnathia could exist and should not be ruled out. This report adds more information to the literature, by reporting a baby with synechiae and a cleft of the palate. Prompt, definitive diagnosis and management of other abnormalities in the baby could only be done under deep sedation. This was necessary to avoid deformity and early death.
Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of co... more Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of combinations of bony or soft tissue adhesions between the mandible and maxilla with cleft of the lip or palate, aglossia, popliteal pterygium and van der Woude syndrome have been reported. The aim of this paper is to report a case of fibrous maxillomandibular fusion of the jaws, with synechiae of buccal mucosa and the gingivae, which was referred to the Oral and Maxillofacial team of the Korle-Bu Teaching Hospital, Accra, Ghana soon after delivery. Separation of the fusion was done under nitrous oxide/oxygen sedation. Cleft of the hard palate was discovered during surgery. Maxillomandibular syngnathia is considered rare and synechiae with other maxillofacial abnormalities without syngnathia could exist and should not be ruled out. This report adds more information to the literature, by reporting a baby with synechiae and a cleft of the palate. Prompt, definitive diagnosis and management of other abnormalities in the baby could only be done under deep sedation. This was necessary to avoid deformity and early death.
Background: The oro-facial region including the jawbones, the maxilla and mandible and related ti... more Background: The oro-facial region including the jawbones, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla, especially, in West African children. We report results from a retrospective study spanning eight years on the frequency, clinical presentation, sites and character of lower face tumours seen in the main referral hospital in Ghana. Patients and methods: Records of consecutive patients of all age and sex seen by the first author's team at the Department of Oral and Maxillofacial Surgery, Korle-Bu Teaching Hospital with tumours affecting the lower part of the face from January 1996 to December 2003 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 394 patients with oro-facial swellings were retrieved from the registry out of which 210 had lower face tumour and tumour-like lesions. The complete data set was obtained for 171 patients, comprising 99 (58%) males and 72 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), pain (41%) and ulceration (29%). The tumours were predominantly found in the right (43%), anterior (19%) and left (18%) aspects of the lower face. The remainder making up 20% were found in the floor of the mouth, tongue and lips. Seventy eight (45.6%) of the patients presented with lesions that were classified as malignant of which 54 (62%) were diagnosed as squamous cell carcinoma (SCC). Sixty-two (36.3%) had benign odontogenic tumours and thirty-one (18.1%) had non-odontogenic tumour-like lesions. Fifty-four (62%) of malignant tumours were squamous cell carcinoma; 58 (93.6%) of the benign odontogenic tumours were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged between 11 and 30 years. Malignant tumours were more commonly detected in patients between 41 and 70 years (63%). Conclusion: Tumours and tumour-like lesions of the lower face comprising the mandible, tongue and adjacent structures are a diverse group of neoplasm and are seen commonly in practice of Maxillofacial surgery. Both malignant and benign tumours are seen in the Ghanaian population. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumours seen respectively; the two representing more than 65% of all tumours.
British Journal of Oral and Maxillofacial Surgery, 2009
A total of 182 patients with orofacial tumours and tumour-like lesions who attended the oral and ... more A total of 182 patients with orofacial tumours and tumour-like lesions who attended the oral and maxillofacial surgical department of the Korle-Bu Teaching Hospital, Accra, were studied from 1 January 1998 to 31 December 2003. Both malignant and benign tumours were recorded and were more common among men (99/182, 54%) in whom they were seen most often between the ages of 41 and 70 years. Among female patients they were more common in the 11-20 year age group. The mandible, maxilla, and palate were most often affected. A total of 108 tumours were diagnosed as malignant (59%), 27 (15%) as benign odontogenic tumours, and 47 (26%) as benign non-odontogenic and tumour-like lesions. Malignant tumours were usually detected in men between the ages of 41 and 70 years (43% of all men); whilst benign tumours were evenly distributed between the sexes with more among girls in the 11-20 year age group. The most common malignant tumours were squamous cell carcinoma (SCC), (69/108, 64%) and lymphomas (18/108, 17%). The predominant benign odontogenic and non-odontogenic tumours were ameloblastoma and fibro-osseous lesions, respectively. The usual method of treatment was resection (58/182, 32%).
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2021
OBJECTIVE The aim of this study was to describe the clinicopathologic features of salivary gland ... more OBJECTIVE The aim of this study was to describe the clinicopathologic features of salivary gland tumors (SGTs) that were managed at a major referral center in Ghana. STUDY DESIGN This was a retrospective study of all histologically diagnosed and managed Ghanaian patients with SGTs during the period January 2008 to December 2017. Information collected included age, gender, affected gland, presenting symptom, treatment modality, histologic diagnosis, and complications. Descriptive summaries of variables were generated. The χ2 test with Fisher's test was used to compare categorical variables with subsequent testing of association. RESULTS The study included 116 patients, with 49 males (42.2%) and 67 females (57.8%), representing a ratio of 1:1.4. There were 82 (70.7%) benign SGTs and 34 (29.3%) malignant SGTs. The most common benign SGT was pleomorphic adenoma, which accounted for 62.1% of all SGTs. Malignant SGTs occurred more in older people, and the occurrence of SGTs was significantly at a lower age in males compared with females. CONCLUSIONS Although the general pattern of SGTs did not seem to differ significantly in comparison with the findings of a review performed 10 years earlier, the findings of this study could inform hypotheses generation for future studies to explore the risk factors and associations peculiar to the Ghanaian environment.
Introduction – Despite the significant prevalence of both latent herpes zoster and HIV, oro-facia... more Introduction – Despite the significant prevalence of both latent herpes zoster and HIV, oro-facial presentation of the former in the presence of the later and associated with teeth exfo liat ion is rarely reported.
Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other ... more Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other injuries may be the initial focus of attention of the primary attending surgeon who may miss the maxillofacial injuries to the detriment of the patient. To determine the incidence of injuries associated with maxillofacial injuries at Korle Bu Teaching Hospital (KBTH) from January 2009 to December 2010. A prospective study was carried out on patients who were referred to the Maxillofacial Unit of the University of Ghana Dental School and KBTH over the two years with maxillofacial injuries. Their age, sex, type of injury in the maxillofacial region, its aetiology and concomitant injuries were charted. The data was analysed using SPSS 16.0 software. Two hundred and fifty eight (258) patients were seen of which 67 (26.0%) had concomitant injuries. The average age was 29.1 years. The peak incidence was in the age group 21-30 (N=73, 28.3%). 74% were male and 26.0% female. The commonest cause o...
Medical science monitor : international medical journal of experimental and clinical research, 2002
A popular variety of wood, pieces of which are chewed as an oral hygiene practice in Southern Gha... more A popular variety of wood, pieces of which are chewed as an oral hygiene practice in Southern Ghana, was tested for its capacity to reverse experimentally lowered pH of saliva. This was done to determine whether (Garcinia manii) stick-chewing neutralizes acidogenic challenge to teeth, and thereby potentially affords dental caries prevention benefit. Seventy-two volunteer medical students gave (baseline) saliva samples by spitting 3-4 times into a 25 ml conical flask. They then rinsed their mouths with a five-percent aqueous solution of glucose. Subsequent to the glucose rinse, half of the subjects (chewers), pre-selected by drawing lots, chewed a popular chewing stick Garcinia manii for five minutes, while the other half (controls) did not. The pH of saliva samples given by the volunteers at various time intervals was measured using a Kent EIL 7020 pH meter, and the results were analysed by the Analysis of Variance (Anova) method. As expected, saliva pH was reduced in both groups af...
Prostate cancer is recognised to be the commonest type of malignancy in the male in many parts of... more Prostate cancer is recognised to be the commonest type of malignancy in the male in many parts of the world. Prostate cancer has a propensity to metastasize to bone, however metastasis to the jaw is uncommon and indeed among metastatic tumours of the jaws which are a rarity, only about 9% originate from a prostatic primary. We report a case of histologically proven metastatic prostate cancer to the right mandible which necessitated a hemi-mandibulectomy in order to improve the patient's quality of life.
We report a case of a 59‐year‐old woman who presented with swelling of the right cheek. CT Scan s... more We report a case of a 59‐year‐old woman who presented with swelling of the right cheek. CT Scan showed three calculi located anteromedial to the masseter, and well isolated from other major salivary glands. Calculi were surgically removed with standard intraoral incision and exploration.
Background: Ludwig's angina is a potentially life-threatening condition characterized by bila... more Background: Ludwig's angina is a potentially life-threatening condition characterized by bilateral cellulitis of the submandibular, submental, and sublingual spaces. Intravenous (I.V) penicillin G or amoxicillin-clavulanate (Augmentin) has been recommended for use as empirical management before obtaining culture and sensitivity results. Aim: The aim of this study was to compare the therapeutic efficacies and clinical outcomes of I.V benzylpenicillin with I.V Augmentin in the empirical management of Ludwig's angina. Methods: This was a prospective randomized clinical study carried out to measure the rate of swelling reduction (using the lobar rate, Adam's rate, and interincisal distance) and other clinical parameters among the two drug groups (I.V penicillin G and Augmentin). Descriptive summaries of variables were generated, and Student's t-test was used to compare the mean outcomes of the two groups. Results: A total of 26 individuals participated in the study, consisting of 46% (12) males and 54% (14) females. The participants ranged from 13 to 61 years with mean and median of 34.4 (±12.7) and 35 years, respectively. Only 8% of the cases of Ludwig's angina were not attributable to odontogenic factors, compared to 92% resulting from odontogenic causes. There was no significant difference in the efficacy of the two antibiotics used in this study. Conclusion: The efficacies and the clinical outcomes of the two antibiotics were similar. Benzylpenicillin is probably a suitable empirical alternative where Augmentin cannot be afforded, to reduce the mortality associated with the condition.
Journal of Cranio Maxillo Facial Surgery Official Publication of the European Association For Cranio Maxillo Facial Surgery, Mar 1, 2009
Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of co... more Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of combinations of bony or soft tissue adhesions between the mandible and maxilla with cleft of the lip or palate, aglossia, popliteal pterygium and van der Woude syndrome have been reported. The aim of this paper is to report a case of fibrous maxillomandibular fusion of the jaws, with synechiae of buccal mucosa and the gingivae, which was referred to the Oral and Maxillofacial team of the Korle-Bu Teaching Hospital, Accra, Ghana soon after delivery. Separation of the fusion was done under nitrous oxide/oxygen sedation. Cleft of the hard palate was discovered during surgery. Maxillomandibular syngnathia is considered rare and synechiae with other maxillofacial abnormalities without syngnathia could exist and should not be ruled out. This report adds more information to the literature, by reporting a baby with synechiae and a cleft of the palate. Prompt, definitive diagnosis and management of other abnormalities in the baby could only be done under deep sedation. This was necessary to avoid deformity and early death.
Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of co... more Congenital maxillomandibular fusion is a very rare condition with few cases reported. Cases of combinations of bony or soft tissue adhesions between the mandible and maxilla with cleft of the lip or palate, aglossia, popliteal pterygium and van der Woude syndrome have been reported. The aim of this paper is to report a case of fibrous maxillomandibular fusion of the jaws, with synechiae of buccal mucosa and the gingivae, which was referred to the Oral and Maxillofacial team of the Korle-Bu Teaching Hospital, Accra, Ghana soon after delivery. Separation of the fusion was done under nitrous oxide/oxygen sedation. Cleft of the hard palate was discovered during surgery. Maxillomandibular syngnathia is considered rare and synechiae with other maxillofacial abnormalities without syngnathia could exist and should not be ruled out. This report adds more information to the literature, by reporting a baby with synechiae and a cleft of the palate. Prompt, definitive diagnosis and management of other abnormalities in the baby could only be done under deep sedation. This was necessary to avoid deformity and early death.
Background: The oro-facial region including the jawbones, the maxilla and mandible and related ti... more Background: The oro-facial region including the jawbones, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial region; however, odontogenic tumours tend to affect the mandible more than the maxilla, especially, in West African children. We report results from a retrospective study spanning eight years on the frequency, clinical presentation, sites and character of lower face tumours seen in the main referral hospital in Ghana. Patients and methods: Records of consecutive patients of all age and sex seen by the first author's team at the Department of Oral and Maxillofacial Surgery, Korle-Bu Teaching Hospital with tumours affecting the lower part of the face from January 1996 to December 2003 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology. Results: A total of 394 patients with oro-facial swellings were retrieved from the registry out of which 210 had lower face tumour and tumour-like lesions. The complete data set was obtained for 171 patients, comprising 99 (58%) males and 72 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), pain (41%) and ulceration (29%). The tumours were predominantly found in the right (43%), anterior (19%) and left (18%) aspects of the lower face. The remainder making up 20% were found in the floor of the mouth, tongue and lips. Seventy eight (45.6%) of the patients presented with lesions that were classified as malignant of which 54 (62%) were diagnosed as squamous cell carcinoma (SCC). Sixty-two (36.3%) had benign odontogenic tumours and thirty-one (18.1%) had non-odontogenic tumour-like lesions. Fifty-four (62%) of malignant tumours were squamous cell carcinoma; 58 (93.6%) of the benign odontogenic tumours were classified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged between 11 and 30 years. Malignant tumours were more commonly detected in patients between 41 and 70 years (63%). Conclusion: Tumours and tumour-like lesions of the lower face comprising the mandible, tongue and adjacent structures are a diverse group of neoplasm and are seen commonly in practice of Maxillofacial surgery. Both malignant and benign tumours are seen in the Ghanaian population. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumours seen respectively; the two representing more than 65% of all tumours.
British Journal of Oral and Maxillofacial Surgery, 2009
A total of 182 patients with orofacial tumours and tumour-like lesions who attended the oral and ... more A total of 182 patients with orofacial tumours and tumour-like lesions who attended the oral and maxillofacial surgical department of the Korle-Bu Teaching Hospital, Accra, were studied from 1 January 1998 to 31 December 2003. Both malignant and benign tumours were recorded and were more common among men (99/182, 54%) in whom they were seen most often between the ages of 41 and 70 years. Among female patients they were more common in the 11-20 year age group. The mandible, maxilla, and palate were most often affected. A total of 108 tumours were diagnosed as malignant (59%), 27 (15%) as benign odontogenic tumours, and 47 (26%) as benign non-odontogenic and tumour-like lesions. Malignant tumours were usually detected in men between the ages of 41 and 70 years (43% of all men); whilst benign tumours were evenly distributed between the sexes with more among girls in the 11-20 year age group. The most common malignant tumours were squamous cell carcinoma (SCC), (69/108, 64%) and lymphomas (18/108, 17%). The predominant benign odontogenic and non-odontogenic tumours were ameloblastoma and fibro-osseous lesions, respectively. The usual method of treatment was resection (58/182, 32%).
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Papers by Grace Parkins