[Basicervical ectopic goiter associated with a eutopic thyroid gland: a case report]. / Une association d'un goitre ectopique basi-cervical et d'une glande thyroïde eutopique: à propos d'un cas.

Thyroid gland is an endocrine gland playing a major role in energy and phosphocalcic metabolism, among others. It commonly occurs in the anterior cervical and pretracheal region. Ectopic thyroid is quite rare. It is dominated by ectopic basilingual thyroid. We here report the case of a patient with goiter in normal cervical position (eutopic) and ectopic thyroid tissue in basicervical position. Cervicotomy revealed the ectopic nodule and the diagnosis was confirmed by histology. This clinical case illustrates a differential diagnosis of cervical masses.

[Cochlear implantation in Senegal: challenges, limits and perspectives]. / Implantation cochléaire au Sénégal: enjeux, limites et perspectives.

A cochlear implant is an electronic prosthesis used in the rehabilitation of profound bilateral hearing loss. It directly stimulates cochlear nerve fibers by bypassing the hair cells. This high-performance technology, which appeared 60 years ago, has spread widely throughout the world and is regularly used in hearing rehabilitation. In developing countries, the adoption and development of this tool are still lagging behind. The authors analyze factors delaying the penetration of cochlear implants in Senegal.

Gingival metastasis of a breast carcinoma.

We report a case of metastasis to the gingiva of breast carcinoma. The breast tumor was treated with neoadjuvant chemotherapy followed by a radical mastectomy associated with axillary dissection. The gingival lesion occurred 7 months after surgery; the metastasis was confirmed by a biopsy.

[A risk of thyroid surgery: the non-recurrent inferior laryngeal nerve: a clinical case]. / Un danger de la chirurgie thyroïdienne: le nerf laryngé inférieur non récurrent (cas clinique).

Lesions of the inferior laryngeal nerve are the most devastating complications of thyroid surgery. Identifying the inferior laryngeal nerve is all the more difficult when its path is atypical. We report a case of right non-recurrent inferior laryngeal nerve detected during thyroidectomy.

[Inverted papilloma: a study of 13 cases in the Oto-Rhino-Laryngology at the National University Hospital of Fann]. / Papillome inversé: à propos de 13 cas au Service d'Oto-Rhino-Laryngologie du Centre Hospitalier National Universitaire de Fann.

INTRODUCTION: Inverted Papilloma (IP) is a rare benign tumour of the nose and paranasal sinuses histologically characterized by invagination of the outer layer of the epithelium in the underlying chorion. Its most distinctive feature is a strong local aggressiveness, a tendency to recur and an unpredictable risk of association with epidermoid carcinoma. The purpose of this study was to report the epidemiological, clinical, paraclinical data as well as to assess the outcomes of endoscopic endonasal surgery. METHODS: We conducted a retrospective study on a series of 13 patients whose data were collected in the Oto-Rhino-Laryngology at the National University Hospital Center of Fann, from 1st January 2012 to 31st December 2017. All patients followed up for inverted papilloma confirmed by anathomopathological examination were included in the study. RESULTS: The average age of patients was 44 years, the sex-ratio was 2.25. All patients had nasal obstruction; 53% of them had rhinorrhea followed by epistaxis in 30% of cases. Right-sided symptoms were reported by 69% of patients, left-sided symptoms by 23% and bilateral symptoms by 7% of patients. Anterior rhinoscopy showed endonasal mass in all patients. All patients underwent CT scan; the MRI was performed in a single patient. Endoscopic resection of IP was performed in 10 patients (76.9%) while external approach was used in 23% of cases. Surgery helped to clarify where the tumor had originated: in 46% of cases in the maxillary sinus, in 15% in the lower nasal turbinate, in 15% in the mid-turbinate, in 7% in the ethmoid bulla and in 7% in the lateral wall of the nasal fossa. One patient had recurrence after an average period of 26 months. Malignant transformation to squamous cell carcinoma occurred in one patient. CONCLUSION: Inverted papilloma is a very aggressive tumor. CT scan is essential to highlight its spread, especially to bone. The advent of endoscopic surgery has revolutionised treatment, providing excellent results. But, there is nevertheless a risk of recurrence after surgery which motivates an indication for long term monitoring.

Indications and Morbidity of Reoperative Thyroid Surgeries in a Military Hospital of Senegal.

OBJECTIVES: To describe reoperative thyroid surgeries in our department. STUDY DESIGN: Retrospective cross-sectional and descriptive study at the Ouakam Military Hospital in Dakar (Senegal), over a period of eight and a half years. METHODS: The study involved all records of patients who had a reoperative thyroidectomy regardless of the indication and time of the second surgery. Parameters evaluated for first and reoperative surgery were time interval between the two surgeries, operative indications, surgical procedures, intraoperative findings, pathological examination, and morbidity. RESULTS: 30 records of patients were selected out of a total of 698 thyroidectomies (4.3%). Thyroid cancers diagnosed on first surgical specimens were the first indications of reoperations (46.67%) followed by neck hematoma (20%). Completion thyroidectomy with a prophylactic central lymph nodes dissection was the most performed surgical procedure (43.33%) followed by haemostasis (20%). During reoperation, we found active bleeding (20%), textiloma (6.67%), and fourth branchial cleft fistula (3.33%). The morbidity accounted for 10%: lymphorrhea, permanent hypocalcemia, and permanent recurrent nerve palsy, in one case, respectively. There were no statistically significant differences between the morbidity in patients reoperated on and the one for patients operated on once. CONCLUSION: We did not find an increased risk of postoperative morbidity after reintervention.

[Post-intubation tracheal lacerations during cervical spine surgery: about 3 cases]. / Plaies trachéales post intubations dans la chirurgie cervicale: à propos de 3 cas.

We report 3 rare cases of post-intubation tracheal lacerations detected during cervical spine surgery. Our study involved 3 patients aged 27, 30 and 42 years admitted to the operating room for total thyroidectomy for heterogeneous multinodular goitre under general anesthesia. Orotracheal intubation using 7.5 rigid guide probe and balloon cuff was performed. During surgery we discovered a protrusion of the balloon cuff at the surgical site through posterolateral tracheal rupture. The treatment was based on closure of the tracheal rupture in 2 cases and on surgical abstention in the third case, followed by a drainage of the thyroid lodge. The postoperative course was uneventful. Post-intubation tracheal lacerations are rare. Intraoperative detection during cervical spine surgery is exceptional. They have multiple causes: intubation difficulties, membranous rupture caused by probe beak, by a rigid guide, coughing effort with inflated balloon at the awakening, balloon hyperinflation, structural and anatomical changes of the trachea in patients with chronic goiter. There is no consensus about treatment.