We report a case of pharyngeal foreign body with cutaneous migration in the form of a fishbone in a 24-year-old rural resident, presented with odynophagia, dysphagia, pain and left antero-latero-cervical swelling fist...We report a case of pharyngeal foreign body with cutaneous migration in the form of a fishbone in a 24-year-old rural resident, presented with odynophagia, dysphagia, pain and left antero-latero-cervical swelling fistulated to the skin following ingestion of a fishbone during a meal that had been evolving for 2 weeks. Vital parameters were normal, with an unremarkable psychological examination. Clinical examination revealed a left antero-latero-cervical swelling that was painful to palpation, fistulous to the skin and draining frank pus, revealing a sharp fishbone. A standard X-ray showed that the foreign body had exited the pharynx and was located in the soft tissues of the lower neck. An exploratory cervicotomy was performed, allowing extraction of a serrated fishbone. The post-operative course was favorable.展开更多
Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as wel...Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.展开更多
Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the mi...Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.展开更多
Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidem...Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.展开更多
Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of p...Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of parotidectomies in the ENT department of the Idrissa Pouye General Hospital in Dakar. Patients & Methods: We conducted a retrospective study between January 1, 2004 and December 31, 2012, including all patients who had been consulted for a parotid tumor with or without histological evidence collected in the otolaryngology and anatomy-pathology department of the Idrissa Pouye General Hospital in Dakar. Results: We collected 31 patient files. The mean age was 47.45 years, with extremes of 16 and 74 years. Females predominated, with a sex ratio of 0.82. Swelling of the parotid region was the main reason for consultation in 100% of cases. Parotidectomy was the most frequently performed procedure, accounting for 41.93%. Benign tumors accounted for 72% of cases, the majority being pleomorphic adenomas (50%). The outcome was favorable in 67.74% of cases. Conclusion: Management of parotid tumors at HOGIP would be improved by informing and educating patients to consult early, and by upgrading the technical platform.展开更多
Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our cont...Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.展开更多
Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 5...Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.展开更多
Background:Laryngopharyngeal reflux disease(LPRD)is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may pre-dispose to malignancy.The magnitude and clinical ch...Background:Laryngopharyngeal reflux disease(LPRD)is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may pre-dispose to malignancy.The magnitude and clinical characteristics of this condition are not well known among patients attending Otorhinolaryngology services in Tanzania.Materials and methods:This was a hospital based descriptive cross sectional study,conducted in the wards and clinics of Otorhinolaryngology department of Muhimbili National Hospital.Patients with symptoms of Laryngopharyngeal reflux disease were included in the study.Data was collected using questionnaires and clinical examination forms,were processed and analysed by using SPSS.Results presented in frequency tables,cross tabulations and figures.Results:This study recruited 256 participants among them males were 131(51.2%).The mean age was(41.38±13.94)years.Prevalence of Laryngopharyngeal reflux disease was 18.4%without gender predilection.The commonest symptoms were globus sensation,hoarseness of voice and excessive urge to clear the throat with 95.7%,88.1%and 83.0%respectively while the most observed signs were thick endolaryngeal mucus,Vocal cord oedema and partial ventricular obliteration with 90.9%,88.6%and 72.7%respectively.Lying down less than two hours after meal and spices foods consumption were the leading risk factors.Hypertension and Diabetes Mellitus type 2 were the most prevalent co morbid conditions associated with Laryngopharyngeal reflux disease.Conclusion:The prevalence of Laryngopharyngeal reflux disease is high among patients attending Otorhinolaryngology services at Muhimbili national hospital.All patients with Laryngopharyngeal reflux disease related symptoms should get thorough evaluation for early diagnosis and treatment.展开更多
Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and ...Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the University Hospital Gabriel Toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.展开更多
Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurrin...Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.展开更多
Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct in...Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)fluorescence.The most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG injection.This narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in LC.Authors screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its use.Literature search retrieved four prospective cohort studies,three case-control studies,and one case report.In the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during LC.Literature includes several reports of intragallbladder ICG administration,but a standardized technique has not been established yet.Published data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG fluorescence.Evidence-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of further studies and multicenter data collection into large registries.展开更多
On March 11, 2019, the WHO declared COVID-19 a pandemic disease. It is a respiratory tropism SARS COV 2 infection. In the emergency of the pandemic, in medical imaging, only computed tomography (CT) of the lungs was f...On March 11, 2019, the WHO declared COVID-19 a pandemic disease. It is a respiratory tropism SARS COV 2 infection. In the emergency of the pandemic, in medical imaging, only computed tomography (CT) of the lungs was favored to assess lung lesions. In addition, many cases of post-COVID-19 cognitive disorders have been reported. As the curve dips and services restart correctly, other imaging techniques have been used to better explore the disease. The objective of this presentation is to illustrate the contribution of metabolic imaging in the exploration of post COVID-19 cognitive disorders and to discuss the pathophysiological mechanisms. Hypometabolism brain lesions are objective signs of functional impairment whose pathophysiological mechanism is not yet fully understood. Metabolic imaging with PET-SCAN is a suitable tool for exploring these disorders, both for the severity and extent of the lesions and for the topography of the brain damage.展开更多
Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invagina...Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.展开更多
Nasopharyngeal liposarcoma is an extremely rare clinical entity. Less than ten cases have been reported in the literature. It mainly occurs in humans. The non-specificity of the clinical and radiological signs explain...Nasopharyngeal liposarcoma is an extremely rare clinical entity. Less than ten cases have been reported in the literature. It mainly occurs in humans. The non-specificity of the clinical and radiological signs explains the difficulty of the diagnosis confirmed by anatomopathological and immunohistochemical examinations. Its pathogenesis remains obscure and often correlates with genetic abnormalities. Pleomorphic liposarcoma is its rarest subtype, remarkable for its aggressiveness and rapidity of growth. Complete surgical excision remains the treatment of choice. We report a case of liposarcoma whose diagnosis was made during histological examination coupled with immunohistochemistry. .展开更多
Benign paroxysmal positional vertigo(BPPV) is the most frequent episodic vestibular disorder. It is due to otolith rests that are free into the canals or attached to the cupulas. Well over 90% of patients can be succe...Benign paroxysmal positional vertigo(BPPV) is the most frequent episodic vestibular disorder. It is due to otolith rests that are free into the canals or attached to the cupulas. Well over 90% of patients can be successfully treated with manoeuvres that move the particles back to the utriculus. Among the great variety of procedures that have been described, the manoeuvres that are supported by evidenced-based studies or extensive series are commented in this review. Some topics regarding BPPV treatment, such as controlling the accuracy of the procedures or the utility of post-manoeuvre restrictions are also discussed.展开更多
Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,includi...Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.展开更多
Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acr...Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation. transient and distortion product otoacoustic emmisions(TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography(VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.Results: This study showed statistically significant difference between control and study groups in pure tone audiometry(PTA) and otoacoustic emissions results. Fitfty percent of vitiligo patients had peripheral vestibular disorders(10 vestibulhar neuritis and 5 posterior canal benign paroxysmal positional vertigo.Conclusion: The results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.展开更多
Background Lockdowns were implemented to limit the spread of COVID-19.Peritraumatic distress(PD)and post-traumatic stress disorder have been reported after traumatic events,but the specific effect of the pandemic is n...Background Lockdowns were implemented to limit the spread of COVID-19.Peritraumatic distress(PD)and post-traumatic stress disorder have been reported after traumatic events,but the specific effect of the pandemic is not well known.Aim The aim of this study was to assess PD in France,a country where C0VID-19 had such a dramatic impact that it required a country-wide lockdown.Methods We recruited patients in four groups of chatbot users followed for breast cancer,asthma,depression and migraine.We used the Psychological Distress Inventory(PDI),a validated scale to measure PD during traumatic events,and correlated PD risk with patients*characteristics in order to better identify the ones who were the most at risk.Results The study included 1771 participants.91.25%(n=1616)were female with a mean age of 32.8(13.71)years and 7.96%(n=141)were male with a mean age of 28.0(8.14)years.In total,38.06%(n=674)of the respondents had psychological distress(PDI>14).An analysis of variance showed that unemployment and depression were significantly associated with a higher PDI score.Patients using their smartphones or computers for more than 1 hour a day also had a higher PDI score(p=0.026).Conclusion Prevalence of PD in at-risk patients is high.These patients are also at an increased risk of developing post-traumatic stress disorder.Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.展开更多
Since 1987,60 cases of allergic rhinitiswere treated by He-Ne laser acupointirradiation with good effect in most cases.These are reported in the following.
This letter is a commentary on the article titled "Evaluation of variations in sinonasal region with computed tomography", published in the January 2016 issue of World Journal of Radiology. The authors defin...This letter is a commentary on the article titled "Evaluation of variations in sinonasal region with computed tomography", published in the January 2016 issue of World Journal of Radiology. The authors definition of the secondary middle turbinate is incorrect. The authors stated that the secondary middle turbinate is an accessory turbinate that is seen between the superior and middle turbinates. It should originate from the middle meatus posterosuperior to the ethmoid infundibulum.展开更多
文摘We report a case of pharyngeal foreign body with cutaneous migration in the form of a fishbone in a 24-year-old rural resident, presented with odynophagia, dysphagia, pain and left antero-latero-cervical swelling fistulated to the skin following ingestion of a fishbone during a meal that had been evolving for 2 weeks. Vital parameters were normal, with an unremarkable psychological examination. Clinical examination revealed a left antero-latero-cervical swelling that was painful to palpation, fistulous to the skin and draining frank pus, revealing a sharp fishbone. A standard X-ray showed that the foreign body had exited the pharynx and was located in the soft tissues of the lower neck. An exploratory cervicotomy was performed, allowing extraction of a serrated fishbone. The post-operative course was favorable.
文摘Thyroidectomy is a complete or partial surgical removal of the thyroid gland. The aim was to review the particularities of thyroid surgery in children, to review our operative indications and our working method as well as the results by comparing them with the data in the literature. This was a retrospective study covering a sixteen-year period from January 2003 to December 2018. We collated 29 patient records from 3 to 15 years of age. The epidemiological aspect, the indication and the operative gesture, the anatomopathological result were studied. Data were processed using Epi Info version 3.5.4 and Microsoft Excel 2010. Our study shows that thyroid surgery in children accounted for 2% of all thyroidectomies performed (1350 cases). Females were most affected, with a sex ratio of 0.16. The mean age was 12 years, with extremes of 3 and 15 years. Three indication groups: Graves’ disease 62%, heteromulti nodular goiter (HMNG) 28%, thyroid nodule 10%. Thyroid surgery was total in 65.5% of cases;subtotal thyroidectomy in 20.7%. Partial thyroidectomy was performed in 13.7% of cases. We dissected 54 recurrent nerves, and the parathyroids were controlled. Drainage was systematic. We noted one complication (3.4%). It involved immediate postoperative dyspnea requiring a life-saving tracheotomy, and decanulation was performed 48 hours after surgery.
文摘Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.
文摘Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.
文摘Introduction: The parotid tumors are benign or malignant, primary or secondary neoformations developed at the expense of the parotid gland. The aim of the present study was to describe the indications and results of parotidectomies in the ENT department of the Idrissa Pouye General Hospital in Dakar. Patients & Methods: We conducted a retrospective study between January 1, 2004 and December 31, 2012, including all patients who had been consulted for a parotid tumor with or without histological evidence collected in the otolaryngology and anatomy-pathology department of the Idrissa Pouye General Hospital in Dakar. Results: We collected 31 patient files. The mean age was 47.45 years, with extremes of 16 and 74 years. Females predominated, with a sex ratio of 0.82. Swelling of the parotid region was the main reason for consultation in 100% of cases. Parotidectomy was the most frequently performed procedure, accounting for 41.93%. Benign tumors accounted for 72% of cases, the majority being pleomorphic adenomas (50%). The outcome was favorable in 67.74% of cases. Conclusion: Management of parotid tumors at HOGIP would be improved by informing and educating patients to consult early, and by upgrading the technical platform.
文摘Introduction: Squamous cell carcinomas of the lip essentially pose a therapeutic management problem. In the West, their treatment is done under general anesthesia and follows the classic rules of oncology. In our context of exercise, we sometimes have a different attitude dictated by various constraints. Observation: 55-year-old patient with no notable history, seen in consultation for a very large ulcerative-budding lesion on the right 2/3 of the lower lip with mucocutaneous involvement without lymph node findings found on examination. Faced with this suspicious lesion and the patient’s financial difficulties, we decided to operate under local anesthesia to remove this tumor. The oncological excision was followed by immediate plasty using a Camille-Bernard flap with a good immediate aesthetic and functional result and postoperative day 7. The patient was unable to take his surgical specimen to anatomy-pathology and was lost to follow-up due to lack of financial resources. On anatomo-pathological analysis of the surgical specimen, the margins were healthy with confirmation of squamous cell carcinoma (anapathological reading made for scientific interest). Discussion: The particular mentality of certain patients and their difficult financial conditions push us to have an unconventional therapeutic attitude in oncology, but which nevertheless makes it possible to resolve certain problems that we often face. Local anesthesia is possible and realistic in cases like ours and the results can be acceptable and life-saving.
文摘Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.
文摘Background:Laryngopharyngeal reflux disease(LPRD)is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may pre-dispose to malignancy.The magnitude and clinical characteristics of this condition are not well known among patients attending Otorhinolaryngology services in Tanzania.Materials and methods:This was a hospital based descriptive cross sectional study,conducted in the wards and clinics of Otorhinolaryngology department of Muhimbili National Hospital.Patients with symptoms of Laryngopharyngeal reflux disease were included in the study.Data was collected using questionnaires and clinical examination forms,were processed and analysed by using SPSS.Results presented in frequency tables,cross tabulations and figures.Results:This study recruited 256 participants among them males were 131(51.2%).The mean age was(41.38±13.94)years.Prevalence of Laryngopharyngeal reflux disease was 18.4%without gender predilection.The commonest symptoms were globus sensation,hoarseness of voice and excessive urge to clear the throat with 95.7%,88.1%and 83.0%respectively while the most observed signs were thick endolaryngeal mucus,Vocal cord oedema and partial ventricular obliteration with 90.9%,88.6%and 72.7%respectively.Lying down less than two hours after meal and spices foods consumption were the leading risk factors.Hypertension and Diabetes Mellitus type 2 were the most prevalent co morbid conditions associated with Laryngopharyngeal reflux disease.Conclusion:The prevalence of Laryngopharyngeal reflux disease is high among patients attending Otorhinolaryngology services at Muhimbili national hospital.All patients with Laryngopharyngeal reflux disease related symptoms should get thorough evaluation for early diagnosis and treatment.
文摘Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the University Hospital Gabriel Toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.
文摘Lithium treatment is usually indicated in bipolar disorder. It is associated with hypothyroidism and very rarely with hyperthyroidism. We report here the results of the exploration of a case of thyrotoxicosis occurring during treatment with lithium salts. This was a 16-year-old patient with ongoing lithium treatment for two and a half years who presented with a thyrotoxicosis syndrome without a context of iodine overload or an episode of anterior cervical pain that could suggest subacute thyroiditis or orthopathic sign. The assessment of the exploration of this patient reveals biological hyperthyroidism without anti-TSH receptor antibodies, a normal ultrasound, and white scintigraphy which makes it possible to evoke the diagnosis of subacute thyroiditis (absence of the context of iodine overload). Note the interest in a thyroid assessment before and during treatment with lithium salts. Moreover, scintigraphy occupies a place of choice in the exploration of hyperthyroidism, particularly in the context of normal thyroid ultrasound imaging.
文摘Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric populations.Despite the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)fluorescence.The most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG injection.This narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in LC.Authors screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its use.Literature search retrieved four prospective cohort studies,three case-control studies,and one case report.In the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during LC.Literature includes several reports of intragallbladder ICG administration,but a standardized technique has not been established yet.Published data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG fluorescence.Evidence-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of further studies and multicenter data collection into large registries.
文摘On March 11, 2019, the WHO declared COVID-19 a pandemic disease. It is a respiratory tropism SARS COV 2 infection. In the emergency of the pandemic, in medical imaging, only computed tomography (CT) of the lungs was favored to assess lung lesions. In addition, many cases of post-COVID-19 cognitive disorders have been reported. As the curve dips and services restart correctly, other imaging techniques have been used to better explore the disease. The objective of this presentation is to illustrate the contribution of metabolic imaging in the exploration of post COVID-19 cognitive disorders and to discuss the pathophysiological mechanisms. Hypometabolism brain lesions are objective signs of functional impairment whose pathophysiological mechanism is not yet fully understood. Metabolic imaging with PET-SCAN is a suitable tool for exploring these disorders, both for the severity and extent of the lesions and for the topography of the brain damage.
文摘Introduction: Benign nasosinus tumors (BNST) of epithelial origin are relatively rare and arise from the various lining tissues of the nasal and sinus cavities, and from glands developed from these epithelial invaginations. These include nasosinusal polyps, pleiomorphic adenoma and inverted papilloma. The aim of our study was to investigate the epidemiological, clinical, morphological, therapeutic, and evolutionary particularities of these three clinical entities, including two tumors with the potential for progressive malignancy (pleiomorphic adenoma and inverted papilloma) and one strictly benign tumor with a favorable evolution (nasosinus polyp or Schneider polyp). Materials and Methods: This was a retrospective, analytical, cross-sectional study conducted from January 1, 2006 to December 31, 2019 (13 years), in the Department of Otolaryngology and Cervicofacial Surgery at Adolphe SICE Hospital, Pointe-Noire, Congo-Brazzaville. Results: During the study period, 74 patients were registered for a nasosinus tumor, of which 23 were benign tumors of epithelial origin (31%) distributed as follows: 15 cases of nasosinus polyp, 5 cases of pleomorphic adenoma and 3 cases of inverted papilloma. The mean age was 42.5 for polyps, with an estimated median of 38, and 42.9 for the other two entities (pleomorphic adenoma and inverted papilloma), with an estimated median of 41. Nasosinus allergy accounted for 17% of cases, followed by chronic sinusitis (12%);however, in 49% of cases, the patient’s history was not specified. There was no sexual predominance, the sex ratio being 1.08. Occupation, socio-economic level, and education had no impact on the development of these tumors. Most of our patients (52%, 12 cases) had a consultation delay of more than one (1) year, whatever the histological nature of the tumor. The complete nasosinus syndrome (NSS) included nasal obstruction, rhinorrhea, epistaxis, and anosmia, and was found in 19 cases (83%), most often reflecting a nasosinus polyp. CT scans were performed in all patients, with hyperdense images predominating in 22 cases. Management of benign nasosinus tumors was mainly surgical. Postoperative management was straightforward in 15 cases (65%). Conclusion: Benign nasosinus tumors are dominated by nasosinus polyps. Management of these tumors is essentially surgical, with the best clinical outcome.
文摘Nasopharyngeal liposarcoma is an extremely rare clinical entity. Less than ten cases have been reported in the literature. It mainly occurs in humans. The non-specificity of the clinical and radiological signs explains the difficulty of the diagnosis confirmed by anatomopathological and immunohistochemical examinations. Its pathogenesis remains obscure and often correlates with genetic abnormalities. Pleomorphic liposarcoma is its rarest subtype, remarkable for its aggressiveness and rapidity of growth. Complete surgical excision remains the treatment of choice. We report a case of liposarcoma whose diagnosis was made during histological examination coupled with immunohistochemistry. .
文摘Benign paroxysmal positional vertigo(BPPV) is the most frequent episodic vestibular disorder. It is due to otolith rests that are free into the canals or attached to the cupulas. Well over 90% of patients can be successfully treated with manoeuvres that move the particles back to the utriculus. Among the great variety of procedures that have been described, the manoeuvres that are supported by evidenced-based studies or extensive series are commented in this review. Some topics regarding BPPV treatment, such as controlling the accuracy of the procedures or the utility of post-manoeuvre restrictions are also discussed.
基金the Natural Science Foundation of Hubei Province of China(No.2018CFB602)National Key R&D Program of China(No.2018YFC0116800)National Natural Science Foundation of China(Nos:81630024,81920108011,and 81900925)。
文摘Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.
文摘Objectives: To evaluate audiological and vestibular functions via basic audiological evaluation. otoacoustic emissions and videonystagmography(VNG) in vitiligo patients.Material and methods: 30 vitiligo patients(8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation. transient and distortion product otoacoustic emmisions(TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography(VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.Results: This study showed statistically significant difference between control and study groups in pure tone audiometry(PTA) and otoacoustic emissions results. Fitfty percent of vitiligo patients had peripheral vestibular disorders(10 vestibulhar neuritis and 5 posterior canal benign paroxysmal positional vertigo.Conclusion: The results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.
文摘Background Lockdowns were implemented to limit the spread of COVID-19.Peritraumatic distress(PD)and post-traumatic stress disorder have been reported after traumatic events,but the specific effect of the pandemic is not well known.Aim The aim of this study was to assess PD in France,a country where C0VID-19 had such a dramatic impact that it required a country-wide lockdown.Methods We recruited patients in four groups of chatbot users followed for breast cancer,asthma,depression and migraine.We used the Psychological Distress Inventory(PDI),a validated scale to measure PD during traumatic events,and correlated PD risk with patients*characteristics in order to better identify the ones who were the most at risk.Results The study included 1771 participants.91.25%(n=1616)were female with a mean age of 32.8(13.71)years and 7.96%(n=141)were male with a mean age of 28.0(8.14)years.In total,38.06%(n=674)of the respondents had psychological distress(PDI>14).An analysis of variance showed that unemployment and depression were significantly associated with a higher PDI score.Patients using their smartphones or computers for more than 1 hour a day also had a higher PDI score(p=0.026).Conclusion Prevalence of PD in at-risk patients is high.These patients are also at an increased risk of developing post-traumatic stress disorder.Specific steps should be implemented to monitor and prevent PD through dedicated mental health policies if we want to limit the public health impact of COVID-19 in time.
文摘Since 1987,60 cases of allergic rhinitiswere treated by He-Ne laser acupointirradiation with good effect in most cases.These are reported in the following.
文摘This letter is a commentary on the article titled "Evaluation of variations in sinonasal region with computed tomography", published in the January 2016 issue of World Journal of Radiology. The authors definition of the secondary middle turbinate is incorrect. The authors stated that the secondary middle turbinate is an accessory turbinate that is seen between the superior and middle turbinates. It should originate from the middle meatus posterosuperior to the ethmoid infundibulum.
