[Cervicofacial cellulitis of dental origin: etiology, epidemiological and therapeutic aspects]. / Aspects étio-épidémiologiques et thérapeutiques des cellulites cervico-faciales d'origine dentaire.

OBJECTIVES: Cervicofacial cellulitises are dominated by dental affections. The aim of this study is to describe etio-epidemiological and therapeutic aspects of cervicofacial cellulitis of dental cause at the CNHU-HKM in Cotonou (Benin). METHODS: It's a retrospective study from 1998 to 2007 included patients with inflammatory cervicofacial tumefaction of dental cause. A glycaemia, a HIV serology and a blood formula numeration are realized. Some patients practiced standard oral and dental radio. Patients were hospitalized and received mono, bi or triple antibiotic. Lancing with swab of pus for cytobacteriological and antibiogram examination was realized for some of patients. Dental cares were been systematic. RESULTS: 68 cases whose 53 dental cause where been collected 77.94%. Bracket concern patients between 0-20 and 20-40 years old (64.15%). Males were, more concerned. Dental traumatisms find again (18.88%), tooth decay (56.60%) and 24.53% patients practiced dental extraction. Anti inflammatory practiced by 67.92% patients associated to antibiotic in 41.51% cases. The three latest molar were concerned to 26 patients. Among those last 22 had attack of mandibular teeth. Treatment consisted in lancing drainage to 2/3 patients in 83.40% cases associated to tri antibiotic. Evolution has been favourable with recovery to 86.67%; 6 decreases to 13.33% cases. CONCLUSIONS: Cervicofacial cellulitises are dangerous, rapidly responsible of deceases by extension. A better oral and dental hygiene would improved prognosis.

[Seven cases of inverted nasosinusal papilloma treated at Cotonou]. / Sept cas de papillome inversé nasosinusien pris en charge à Cotonou.

OBJECTIVE: Sinonasal inverted papilloma is a rare benign tumor with a high recurrence rate and potential malignant transformation. The purpose of this study was to analyze the clinical and radiological aspects and to identify the suitable surgical approaches to be used in developing countries. METHODOLOGY: In 3 years, 7 cases have been analyzed in a retrospective study. Patients presented with unilateral nasal obstruction and epitasis, a whitish unilateral polypoid mass, sinonasal opacity with osteolysis on CT scan or on sinus X-ray. Using these data we adopted the Krouse staging which classifies the disease in four stages and accordingly the appropriate surgical approach was used. The diagnosis was confirmed by histological examination of the biopsied specimen. RESULTS: Average age 48.28 years, predominant sex male. Symptom: unilateral nasal obstruction 5, bilateral nasal obstruction 1, epistaxis 5. The average time-delay before consultation was 73 months. The combined endonasal endoscopic and vestibular was the most commonly used approach (4 cases). The results were satisfying. After a minimal follow up of 2 years, one case of recurrence was detected after 4 years. CONCLUSION: CT scan is an essential tool for the diagnosis and detecting the extension of sinonasal inverted papillomas. Better results were obtained with a surgical approach that combined a vestibular approach and an endonasal endoscopic approach in our region.

[Congenital cholesteatoma of the mastoid]. / Le cholestéatome congenital de la mastoïde.

UNLABELLED: The congenital cholesteatoma of the mastoid is rare and asymptomatic. CASE REPORT: We report a case of a young boy (5 year old) who presented mastoiditis, post auricular fistulisation and polyp of the external auditory canal. The mastoidectomy was performed and a cholesteatoma of the mastoid and the antrum was removed. No cholesteatoma was found in the tympanic cavity and the ossicular chain was normal. This surgery implies the complete removal of cholesteatoma and its matrix. One year after the patient showed no recurrency. CONCLUSION: The silent evolution of the congenital cholesteatoma explains the delay of its diagnosis and the risk of mastoiditis.

[HIV and ENT manifestations: epidemiologic and clinic aspects at CNHU of Cotonou and CHD Oueme-Plateau]. / Manifestations ORL et VIH: aspects epidemiologiques et cliniques au CNHU Cotonou et au CHD / Oueme.

From October 1st, 2003 to March 31, 2004 about six months, 45 patients with ENT manifestations of HIV have been followed as well at the ENT service of CNHU of Cotonou and at the departmental hospital of Porto-Novo. 26 among then have HIV serologic positif. From this prospective study, we retain that the patients from 20 to 49 years old represented 84,6%. Male has predominated: 57,7%. The socio-professional strata with low revenue and those with itinerant professions are the greatest target: 87,7%. The transmission mode has been heterosexual in 80%. The HIV1 has been isolated in 88,5%. As a result of clinical observation, 50,3% of patients have recurring infections of superior aero-digestive tract : otitis, sinusitis and oropharyngeal mycosys. The facial paralysis has been noted in 10,8%, chronic cervical adenopathies 10,8% and parotid tumors 8,1%.

[Cemento-ossifing fibroma: two cases]. / Le fibrome cémento-ossifiant: deux cas.

INTRODUCTION: Cemento-ossifying fibroma is a rare benign tumor which can affect both jaw bones, particularly the mandible. CASE REPORTS: We report two cases of cemento-ossifying fibroma which illustrate the radiological and anatomic features of these tumors. Differential diagnosis between cementifying fibroma and ossifying fibroma was particularly difficult. The cementifying fibroma was treated by surgical resection followed by immediate reconstruction with an iliac bone graft. The ossifying fibroma was treated by enucleation-resection. DISCUSSION: The clinical, radiological and histological features of cementifying and ossifying fibroma allow distinction. Surgical treatment is achieved by enucleation resection for small-sized ossifying fibromas and mono-bloc resection with bone reconstruction for large-sized cementifying and ossifying fibromas.

[Parathyroid cervical hematoma: a case report]. / Hématome cervical d'origine parathyroïdienne: à propos d'un cas.

Haemorrhagic cysts of the parathyroid gland are rare. Our case report concerns a presentation with a constrictive cervical haematoma, confirmed by ultrasound-guided aspiration. The haematoma, rapidly recurred, indicating exploration of the neck and haemostasis. Histological examination of excised tissue showed the haemorrhagic nature of the cyst.

[A case of Waardenburg-Klein syndrome observed at the Cotonou NUHC]. / Un cas de syndrome de Waardenburg-Klein observé au C.N.H.U. de Cotonou.

Waardenburg-Klein syndrome is an "Oculo-dermato-auditif" dysplasia described in 1947 by Waardenburg and by Klein in 1950. Canthus dystopia and congenital deafness are the main symptoms. Three clinical types have been reported: type I: presents the full symptomatology; type II: without canthus dystopia; type III: presents not only the complete syndrome but also an orthro-osteomyodysplasia of the upper limbs. This clinical case in a small 3.5-year-old boy with congenital deafness, bilateral iris hypochromia and retina albinism without canthus dystopia was classed as type II Waardenburg-Klein syndrome. The patient had a second apparently fortuitous hereditary affection: hemoglobinopathy (Hb AS). But this seems to be fortuitous.