‘Buhari has right to seek second opinion elsewhere’
Head of Nose, Ear and Throat (E.N.T) Department at the Lagos State University Teaching Hospital (LASUTH), Lagos, Dr Vincent Adekoya, an ENT surgeon, explained how important the ear could be in healthy living, even as he stated that President Muhammadu Buhari has the right to seek second opinion anywhere else for his ear infection.
Kindly describe the structure of the ear?
Basically, the ear has three parts: outer, middle and inner ear. Our ear performs two functions: the function of hearing and the function of balance. The organs that perform these functions are inside the inner ear.
What you have in the middle ear are the three smallest bones in the body that conduct sound. The outer ear acts as the passage of the sound.
What are the likely diseases that can affect the ear?
We generally classify diseases in medicine into congenital, traumatic and neoplastic condition (which include cancer and non-cancer diseases),metabolical conditions and neurological problems. Any of these can affect the ear. When the ear is infected, you will have some symptoms.
Symptoms of ear disease include hearing loss, discharge in the ear, pain in the ear, noise in the ear and dizziness. Note that dizziness can be due to heart and ear problems. When dizziness is due to hearing problem, the person may feel a turning-sensation, imbalance or unsteadiness. But whenever someone has dizziness in form of fainting-attack and blacking out, it may be due to heart problem.
Another symptom a patient may present in E.N.T clinic is speech problem, because somebody that is not hearing may not be able to speak.
Do we have enough E.N.T specialists in Nigeria?
Most of the E.N.T surgeons in Nigeria are based in Lagos, Abuja, Enugu and Ibadan. E.N.T surgeons can never be adequate. Remember that the population of Nigeria is about 160 million. But we have about 200 to 250 E.N.T surgeons to cater for these populations. I do not think that the number of E.N.T doctors is quite adequate.
Do these surgeons have a capacity to take care of a sick president?
All over the world, we are all doing the same thing, because we go for local and international conferences, and we are all saying the same thing. Knowledge-wise and education-wise, we are all doing the same thing. What may just be different may be that in some centres, there may not be some sophisticated equipment to help in performing surgery. The economy is not so good and most of the centres cannot afford some of the sophisticated equipment that may aid in the current way of making diagnosis and performing surgery. In medicine, we learn everyday.
Training should be continuous.
Are you saying that we do not have well-equipped facilities to handle E.N.T issues?
No, I will not say so. It depends on the disease case we are confronting. In our centre, we have equipment that can cater for common cases and some of the rare cases.
What are the challenges of practicing as E.N.T surgeon in the country?
I think there is no challenge per se because the training of resident doctors is quite adequate. They go for update courses and attend conferences locally and internationally. I do not see much challenge, except in some centres that are not able to provide current equipment necessary for diagnosis and surgical procedures.
In all sincerity, do you think that the president needs to travel abroad for E.N.T treatment?
Like I used to say, I welcome second opinion strongly. I do not know the E.N.T specialist that saw the president. But remember that the president has the right to say he needs to seek second opinion elsewhere.
Could the second opinion not have been gotten in Nigeria?
Something about medicine is that you cannot be talking about a case you do not know about. I do not know about the case. So, I will not be able to talk about it at all. I do not know the complaints, I have not examined the patient and I have not done any test on him. Whether the condition is a simple or complex one, I do not know.
How common are E.N.T issues in Nigeria?
Patients with E.N.T problems are so many, because ear, nose and throat are exposed to the environment. So, they get issues easily. Like in our clinic, we see about 60 to 70 patients on our clinic days, and we have our clinic two times a week.
Another thing we need to do in the country is to inject more manpower. Where about three or four doctors have to see about 70 patients (an E.N.T doctor needs about 30 minutes to properly take patient history, examine and treat patients). You can imagine how many patients the doctor can see from 8:00 am to 4:00 pm!
A lot of people have E.N.T complaints. Any E.N.T clinic you go to, you will see that the doctors there are very busy. Even appointments in some centres may take two to three months, even in abroad, to see E.N.T specialists. A lot of people go oversea to see E.N.T specialists, but when they come back, we often asked them “did you see an E.N.T surgeon?” The reply is often negative, because the appointment period was too long.
What could be responsible for people coming down with E.N.T problems?
People’s habits can make them to have ear problems. We often see some people wearing ear sets, exposing themselves to generator noise and noise at social gatherings. All these cause pollutions that can damage the ear.
Again, some people who own bakeries burn things, thereby creating pollution that could lead to asthma. This is why you see a lot of people coming down with E.N.T problems, arising from their own habits of noise pollution and burning of things indiscriminately. Some people pollute their drinking water by putting boreholes close to their water supply.This exists because there are no proactive measures to check people who are doing wrong things. But we need to check most of these things. If somebody is becoming a nuisance to the society, they should be checked.
Are you saying that we can use the law to control the rate at which people are coming down with E.N.T issues?
Yes! People need to be educated that conversing over the telephone for a very long time can cause hazards by gradually damaging their inner ear cells. People get their ears damaged by listening to music through earphones. After then, we may recommend to them to start using ear aids, which cost about N200, 000 or do a chochlear implants, which cost about N5 million.
How cheap is treatment of E.N.T conditions?
Treatment of E.N.T condition is not cheap at all. By the time a patient comes to an E.N.T clinic, we have some basic tests like audiometry and endoscopic tests he may have to undergo. Some people may require a computerised tomography (CT) scan. To do audiometry test will cost about N20,000 and endoscopic test will cost about N20,000 to N35,000. One may need to do a CT scan or magnetic resonance imaging (MRI) tests depending on the need.
You said when people stay on the phone for a long time, their ears can get damaged. What to do you mean by long time?
Most of the damages that happen do not happen suddenly. Imagine someone conversing on the phone for about 10 to 20 minutes everyday for a couple of months! I have about three or four people working in telecom industry that want to leave their jobs. Why? Because when they are using answering phones, over time, it will start giving them what is called hypachusis (hearing impairment), which will start giving them discomfort and making them become easily annoyed.
Some people have threatened to take their employers to court, even though they have resigned from their jobs.Some people have severe to profound hearing problems because what they are exposed to or are taking some drugs that can damage their ear.
Are you saying self-medication can damage the ear?
Even drugs that are prescribed by doctors can damage the ear.
What class of drugs are we talking about?
Some drugs that are used to treat malaria and infections can damage the ear.
What do you think needs to be done to move E.N.T field forward?
What needs to be done is for government to encourage sponsoring of doctors for conferences for exposures in complex surgeries. They need to sponsor some surgeons to some centres where the latter can spend two or three months to learn the (complex) surgeries and come back to Nigeria to train the junior ones again, make presentation in conferences, or do some training courses for others.
What is your message to Nigerians?
Nigerians need to go natural.When God created us, we hear normally. So, you do not need to put something in your ear to aid your hearing, except experts have prescribed such aid. Nigerians should not use something that will damage their ears. Industry operators should look for a way of controlling noise. Some young men who work in these factories have had their hearing system damaged by noise.