An Audit of 6 years of Oral and Maxillofacial Surgical Conditions admitted for Interventional Treatment at Muhimbili National Hospital, Dar es Salaam – Tanzania

Background: The world wide pattern of OMFS conditions has been rarely reported despite its significance in the head and neck medicine; maxillofacial trauma and tumors. The main objective of this study was to audit oral and maxillofacial surgical (OMFS) conditions admitted for interventional treatment at Muhimbili National Hospital. Methods: Patients presenting to the OMFS unit with oral and maxillofacial pathological conditions between January 2003 - January 2009 were studied prospectively. Data for analysis were obtained from the daily operation list and includes age, sex, location, diagnosis of the pathological lesion, surgical procedure and date of procedure. Results: During the study period, the unit offered specialized services to 454 patients. Among them, 222 were males and 232 females. The mean age of the patients was 31.7 and the range was 79 years. Patient aged 21-30 years were mostly affected. Of the pathological lesions attended, benign tumors were the most common 255(56.2%) followed by fractures 58(12.8%), cysts 46(10.1%), malignant tumors 36(7.9%) and chronic infections 17(3.7%). Of the 255 cases of benign tumors 155(60.8%) were located on the mandible and 64 (25.1%) on the maxilla. Malignant tumors were 36 cases in which 11(30.6%) were located on the mandible. Maxillofacial fractures accounted 58 cases in which 31(53.4%) cases were located on the mandible. Cysts were 46 cases of which 17(37%) were located on the floor of the mouth, 10(21.7%) on the mandible and 7(15.2%) on the maxilla. Tumor excision was the commonest procedure performed 119(26.2%), followed by Tumor excision + reconstruction 89(19.6%), ORIF+IMF 51(11.2%), Fistulectomy 45(9.9%), Tumor enucleation 45(9.9%), Wide surgical excision 27(5.9%), Sinusectomy 16(3.5%) and Sequestrectomy 15(3.3%). Conclusion: There is a significant burden of OMFS conditions attended at MNH. We suggest that the government enhance the state of medical infrastructure in the local hospitals in terms of manpower and facilities for the diagnosis and treatment of simpler OMFS disease as well as timely referral on to regional center for the more complex issues. This will reduce the burden of OMF conditions experienced by this hospital and improve OMF services country wide.