OBINNA R E M I G I U S OKWESILI | University of Nigeria Teaching Hospital, Enugu (original) (raw)

Papers by OBINNA R E M I G I U S OKWESILI

Journal of Advances in Medicine and Medical Research, 2024

Background: Facial anthropometry provides useful information on different facial features as well... more Background: Facial anthropometry provides useful information on different facial features as well
as population-specific variations that are crucial in forensic science and facial surgeries. The major
aim of this research was to determine normal facial and orbital parameters in adult Igbos living in
Enugu, Nigeria and to investigate the correlation between these variables.
Materials and Methods: This was an anthropometric study of adult Igbos of Igbo ancestry residing
in Enugu metropolis, a town in South-eastern Nigeria. The morphological facial height, the
maximum facial width, orbital width and intercanthal distance of each subject were measured. All
data were collated and analyzed.
Results: Subjects studied were 312. They had a mean age of 37.05. The mean morphological
facial height was 116.26 mm for males and 109.66mm for females. The mean maximum facial width
for males was 121.31 mm, and for females 119.25. The mean facial index for males was 96.06, and
92.17 for females (p < 0.01) The mean right eye width of the men was 38.01mm and that of the
women was 37.22 mm (p <0.05). The mean intercanthal distance of males was 34.94 mm, and
33.22mm for females. There was significant correlation (p <0.01) between maximum facial width
and the widths of both eyes and the intercanthal distance respectively. Morphological facial height
had a similar correlation. However, there was no significant correlation between the facial index and
the eye widths and none with intercanthal distance.
Conclusion: There is strong correlation between orbital parameters and facial parameters except
for facial index which had no significant correlation. The findings of this study have potential
applications in forensic science, in the planning and assessment of facial reconstruction, aesthetic
surgeries and orthodontics, as they provide valuable information about the facial structure of the
Igbo population.

Nigerian Journal of Medicine, 2024

It is common practice to reconstruct small nasal defects following the nasal subunits principle b... more It is common practice to reconstruct small nasal defects following the nasal subunits principle but for near-total nasal defects, the best method of reconstruction based on esthetic considerations is still debatable. For large defects that involve both sides of the nose symmetrically, near-total resurfacing results in satisfactory cosmetic outcome. We present a case of a middle-aged man who had nasal resurfacing of the nose with a paramedian forehead flap following the excision of a broad benign cutaneous lesion on a background of long-lasting generalised skin disease.

Scholars Middle East Publishers, 2024

Background: The cephalic index and head circumference are important anthropometric parameters tha... more Background: The cephalic index and head circumference are important anthropometric parameters that can provide insights into the physical characteristics and growth patterns of populations. There is dearth of data on Cephalic Index and Head circumference of Igbo Children and Adolescents. Method: This study examined 725 Igbo children and adolescents aged 5 to 19 years in Enugu, Southeastern Nigeria, using a cross-sectional approach. Results: The majority of participants exhibited mesocephalic head shape (43.2%), with brachycephalic and dolichocephalic shapes observed in 32.7% and 14.2% of the population, respectively. Mean head circumference increased with age in both sexes. Cephalic indices in boys under 12 and girls under 15 were below 80 but increased above these ages. Changes in head shape, potentially towards brachycephalization, were noted as children grew. Significant correlations were found between head circumference and cephalic index with age, height, weight, and body mass index, suggesting their relevance in forensic and anthropological investigations. Conclusion: Our results indicate diversity in head shapes and sizes, with mesocephalic heads being most common. As age increases, head circumference also tends to increase, and changes in head shape towards brachycephalization was observed. These findings underscore the importance of understanding anthropometric variations in different populations and suggest avenues for further research, particularly longitudinal studies, to explore the factors influencing these patterns.

Nigerian Journal of Clinical Practice, 2023

Background: It is a common practice to subjectively categorize cleft lip deformities into narrow ... more Background: It is a common practice to subjectively categorize cleft lip deformities into narrow and wide cleft. The proposed grading of unilateral cleft lip can serve as a predictive factor of the difficulties to be encountered during repair and the expected outcome of surgery. Materials and Methods: This was a 5-years retrospective study of the records of 32 patients with unilateral cleft lip that presented to a single surgical unit. We grouped the patients based on the age at surgery. We calculated the alar base width ratios of the cleft to non-cleft sides, and this was used for grading. We graded the clefts using ratio of 1.00-1.50 for mild cleft, 1.51 to 2.00 for moderate cleft, 2.01-3.00 for severe cleft, and >3.00 for extensive cleft lip. Results: The youngest child was 1 month old, while the oldest was 50 years. Majority of the patients (17) were older than 2 years at the time of surgery. Only nine babies (28.1% of the patients) were able to have their surgery done within the age of 6 months. Those that had extensive unilateral cleft lip were 10 (31.3%). However, a total of 18 (56.3% of the patients) had cleft lips that were either mild or moderate grade. Conclusion: This grading of unilateral cleft lip helps in objective preoperative assessment of the severity and in predicting the difficulty expected during lip repair. It is also helpful in assigning clefts to trainees and in determining which patients should be referred to an experienced surgeon.

World Journal of Advanced Research and Reviews, 2024

Background: The nose is an important aesthetic unit that is essential in defining the facial appe... more Background: The nose is an important aesthetic unit that is essential in defining the facial appearance of an individual and also helps in identifying a tribe or race. Understanding the distribution of nose types within the Igbo population is crucial for elucidating patterns of human diversity, population genetics, and evolutionary anthropology. The aims of this study were to determine some nasal parameters of Igbo adults, analyze the distribution of the types, check sexual dimorphism, and to correlate the parameters with age, height, weight and body mass index (BMI) respectively Materials and Methods: This was a descriptive cross-sectional study of 312 Igbos in Enugu of Southeastern Nigeria using cluster sampling. The nasal dimensions were measured with digital Vernier's calipers and the nasal indices were calculated. Weight and height were also measured and BMI calculated. All data were collated and analyzed. Results: The mean age was 37.05 (±15.83). The age range was 20 to 69 years and they were grouped into 20-29 years group, 30-39, 40-49, 50-59 and 60-69 years groups. The range nasal height was 37.24-57.63mm for males, while range for females was 32.43-52.97mm. The range for nasal width was 37.04-51.29mm for males and 32.93-48.52mm for females. The mean nasal widths of males were significantly wider than those of females in all age groups respectively (p < 0.01). The mean nasal indices for males and females were 91.91 (platyrrhine) and 86.26 (platyrrhine) respectively. Majority of the sample population had platyrrhine nose (67%) while 32% of them had mesorrhine nose and only 1% of them had leptorrhine nose. There was a significant positive correlation between height of nose and width of nose of adult Igbos with their age, height and weight (p value <0.01) and a significant negative correlation with body mass index (p <0.01). Conclusion: This study provides valuable insights into the distribution of nose types among the Igbo people of SouthEast Nigeria. We have characterized the prevalence of different nose types and explored potential associations with demographic and anthropometric factors. The major nose type of Igbos is platyrrhine, while the minor one is mesorrhine. Knowledge of nasal parameters are applied in forensic studies; and in surgeries involving the nose, and this ensures that individuals do not lose their identities even after extensive nasal surgeries.

Journal of the West African College of Surgeons, 2024

Background: Tissue necrosis from pentazocine abuse is becoming a burden in our environment. Penta... more Background: Tissue necrosis from pentazocine abuse is becoming a burden in our environment. Pentazocine is an opioid of the benzomorphan class. It is commonly used for post-traumatic and postoperative pain and vaso-occlusive pain of sickle cell disease (SCD). Its prolonged use can lead to addiction and may result in severe injection site necrosis, often worsened by infection due to a lack of aseptic principles during administration. Although pentazocine is a controlled drug in our environment, it is readily available. Objectives: To review patients with tissue necrosis from pentazocine injection, share the challenges in their management, and proffer solutions. Materials and Methods: Clinical summaries of patients with tissue necrosis and ulcers due to pentazocine addiction were reviewed. Results: Twenty-five patients, comprising nine females and 16 males aged 22-61 years, were recorded. Twenty had SCD, while five had other underlying conditions. The duration of abuse was 1-16 years, while the average maximum daily dose was 348.75 ± 346.04 mg. Most patients used multiple sites for injection. Lesions included abscesses, tissue necrosis with ulcers, lymphoedema, exposed necrotic bones, and osteomyelitis. Most had multidisciplinary care. The outcome of wound care was good in two. Three had major limb amputations, four died, three signed against medical advice, six were still receiving care while seven were lost to follow-up. None was completely weaned from the drug at the time of this report. Conclusion: Rising cases of tissue necrosis from pentazocine abuse are disturbing. Treatment is frustrating. Concerted efforts at prevention should be made to stem the tide.

Nigerian Journal of Medicine, 2023

This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Journal of the West African College of Surgeons, 2023

The radial forearm flap is a fasciocutaneous flap that has been used for reconstructing defects i... more The radial forearm flap is a fasciocutaneous flap that has been used for reconstructing defects in the craniofacial region, either as a free flap or a pedicled flap. The pedicled radial forearm flap is a reliable option for reconstructing scalp defects. Microvascular free tissue transfer has, however, remained the preferred choice in the reconstruction of most complex scalp defects in the craniofacial region. We present the cases of a 37-year-old woman with an ulcerated malignant lesion on the forehead and a 40-year-old woman with a large malignant tumor on the scalp. Excision of both lesions, which turned out to be squamous cell carcinomas, resulted in complex defects that were reconstructed with pedicled radial forearm flaps. Both patients had satisfactory results and were counseled for radiotherapy.

Nigerian Journal of Medicine, 2023

IntroductIon Malignant scalp tumors are not common and constitute only about 1%-2% of all scalp t... more IntroductIon Malignant scalp tumors are not common and constitute only about 1%-2% of all scalp tumors. [1] Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common of these malignant tumors. [2] Reconstruction of some scalp defects following oncological resection is quite challenging. [2,3] The size, depth, and location of the scalp defects are important factors that influence the preferred method of reconstruction. [4,5] Only small wounds are managed by direct closure, due to the inelastic galea aponeurosis that makes scalp defects difficult to close. [6,7] Medium-sized wounds are preferably managed with local flaps, which may be advancement flaps, transposition, or rotation flaps. [6-8] Split-skin graft (SSG) is an option for closing some of these defects, although it results in alopecia. [9] Free flaps are frequently used for very large defects that may be complex, although the use of distant pedicled flaps is a less-popular alternative. Either of these flaps still results in alopecia in the reconstructed area. We report our experience in reconstructing scalp defects of various sizes after the excision of malignant tumors utilizing a variety of techniques. MaterIals and Methods This was a retrospective review of patients who had scalp reconstruction after the excision of malignant scalp tumors from June 2010 to May 2014 (four years) at our teaching Background: Malignant scalp tumors are not common and constitute a small percentage of all scalp tumors. Reconstruction of the scalp defects following oncological resection presents peculiar challenges. Aim: The aim of the study is to report our experience in reconstructing scalp defect of varying sizes after the excision of malignant tumours using a variety of techniques. Materials and Methods: This was a retrospective review of patients who had scalp reconstruction after oncological resections from June 2010 to May 2014 (four years) at our teaching hospital in the Southeast of Nigeria. Data on the demographics, nature of the scalp tumors, site, size of the defects, mode of scalp reconstruction, and outcomes were collected and analyzed. Results: Of the 17 patients who had scalp reconstruction, 29.4% of them were men and 70.6% were women (M:F = 5:2). The mean age of the patients was 41.2 ± 4.98 years (range: 19-85 years). The majority of the patients (47.1%) were young adults between 20 and 40 years, and the least involved age group (11.8%) was 13-19 years. The most common etiology of malignant scalp tumors was squamous cell carcinoma (52.9%). The temporal region was the most common site (41.2%) affected. Most of the defects were between 6.1 and 9.0 cm in diameter, followed by defects that were <3 cm in diameter. Neurosurgical assistance was required in 5 (29.4%) patients where the tumor had involved the skull bone. Tumor recurrence was noted in 3 (17.6%) patients within one year of follow-up. Conclusion: Scalp reconstruction after oncological resection presents a peculiar esthetic challenge due to the hair-bearing skin of the scalp and the need to maintain the hairline. The use of local flaps from the scalp remains the first and the best option. For very large scalp defects, free flap through microvascular surgery is the preferred option.

Nigerian Journal of Medicine, 2023

Journal of West African College of Surgeons

Congenital palatal fistula or perforation is rare, unlike the acquired form which commonly result... more Congenital palatal fistula or perforation is rare, unlike the acquired form which commonly results from cleft palate repair. Congenital palatal fistulae are often associated with submucous cleft palate. Only a few of this fistulae are diagnosed shortly after birth. We present the case of a 3-year old girl with congenital palatal fistula coexisting with cleft of the soft palate that was noticed shortly after birth. The palate was repaired using Bardach's palatoplasty and the client was subsequently referred to a speech therapist.

Nigerian Journal of Clinical Practice, 2014

Background: Giant fibroadenoma (GFA) has been defined as fibroadenoma greater than 5 cm in it's t... more Background: Giant fibroadenoma (GFA) has been defined as fibroadenoma greater than 5 cm in it's the widest diameter and/or weighing more than 500 g. A benign lesion, its size also raises the possibility of malignancy requiring differentiation from a malignant breast disease. When unilateral GFA presents with a severe breast asymmetry, due to its size, it is not correctable by simple enucleation alone. Postoperative asymmetry from volume and ptosis disparity results, which needs to be addressed at the primary surgery. The inverted "T" technique, which is effective in volume reduction and ptosis correction in breast hypertrophy, can be applied in the treatment of unilateral GFA. Aim: This is a retrospective review of all GFA treated by inverted "T" method. Materials and Methods: A retrospective review was carried out on all patients with GFA treated by inverted "T" skin pattern method over a period of 20 years (January 1988 to December 2007). The procedures were carried out at the

International Journal of Medicine and Health Development |, 2023

Nigerian Journal of Clinical Practice , 2023

International Journal of Medicine and Health Development, 2023

Gigantomastia is a huge physical and psychological burden on affected patients, and it usually re... more Gigantomastia is a huge physical and psychological burden on affected patients,
and it usually reduces their quality of lives drastically. Bilateral gigantomastia
coexisting with multiple bilateral breast lumps is a rare condition. We have
reported the case of an 18-year-old adolescent who presented with bilateral
gigantomastia and multiple fibroadenomas in both breasts that were treated with
reduction mammoplasty using the inferior pedicle with inverted-T technique.
Treating bilateral gigantomastia using the inferior pedicle with inverted-T
technique gives the best esthetic and functional results. Total resection weight of
more than 1000 g should not be an absolute contraindication to use of inferior
pedicled technique.