Trachéotomie chirurgicale chez l'enfant au centre hospitalier universitaire de Bouaké à propos de 32 cas / Surgical tracheotomy in children at the university hospital center of Bouake about 32 cases

Objectif : déterminer les indications de la trachéotomie chirurgicale chez l'enfant, décrire la technique et les suites opératoires. Matériel et méthode : il s'agit d'une étude descriptive rétrospective portant sur les trachéotomies pédiatriques réalisées au CHU de Bouaké de janvier 2016 à décembre 2022. Les indications de la trachéotomie, la technique opératoire et l'évolution ont été étudiées. Le test exact de Fisher a été utilisé pour évaluer le lien entre le motif de la trachéotomie et les pathologies au seuil α de 5%. Résultats : pendant la période d'étude, 32 enfants ont été trachéotomisés. Leur âge variait entre 9 mois et 15 ans avec un âge moyen de 7,2 ans. Il s'agissait de 22 garçons et 10 filles. L'impossibilité d'intuber le patient (65,62%) et la dyspnée laryngée sévère (25%) constituaient les motifs de la trachéotomie. Les corps étrangers laryngo-trachéaux et la papillomatose laryngée représentaient respectivement 37,5% et 21,87% des pathologies. Nous n'avons pas noté de lien significatif entre le motif de la trachéotomie et les pathologies (p=1,000). L'intervention a été réalisée sous sédation dans 78,12% des cas. L'ouverture trachéale était en forme de « H ¼ et de siège sous-isthmique. Les suites opératoires étaient simples chez 93,75% des patients. La décanulation a été effective dans 24 cas (75%). Conclusion : les principaux motifs de la trachéotomie dans notre expérience sont l'impossibilité d'intuber le patient et la dyspnée laryngée sévère. Les pathologies étaient dominées par les corps étrangers laryngo-trachéaux et la papillomatose laryngée. Les suites opératoires étaient généralement satisfaisantes.

Objective: to determine the indications for surgical tracheotomy in children, to describe the technique and the postoperative course. Material and method: This is a retrospective descriptive study of pediatric tracheotomies performed at the Bouaké University Hospital from January 2016 to December 2022. The indications for tracheotomy, the operating technique and the evolution were studied. Fisher's exact test was used to assess the link between the reason for the tracheotomy and the pathologies at the α threshold of 5%. Results: during the study period, 32 children were tracheotomized. Their age varied between 9 months and 15 years with an average age of 7.2 years. They were 22 boys and 10 girls. The impossibility of intubating the patient (65.62%) and severe laryngeal dyspnea (25%) were the reasons for the tracheotomy. Laryngo-tracheal foreign bodies and laryngeal papillomatosis accounted for 37.5% and 21.87% of pathologies respectively. We did not note any significant link between the reason for the tracheotomy and the pathologies (p=1,000). The intervention was performed under sedation in 78.12% of cases. The tracheal opening was "H" shaped and sub-isthmic. The postoperative course was simple in 93.75% of patients. Decanulation was effective in 24 cases (75%). Conclusion: the main reasons for tracheotomy in our experience are the impossibility of intubating the patient and severe laryngeal dyspnea. The pathologies were dominated by laryngo-tracheal foreign bodies and laryngeal papillomatosis. The postoperative course was generally satisfactory

[Hearing disorders at the candidates of the National Gendarmerie's competition, Ivory Coast].

Objective: Detect the hearing deficiencies of the candi­da­tes of the gendarmerie's competition. Material and method: Pros­pec­tive study realized over 3 years (2008-2010), in the ENT service of the Gendarmerie to Agban (Abidjan). Examination included an otoscopy and a pure tone audiometry. Results: On 23121 candidates, 1245 had a plug of earwax (5.4%). They were aged from 18 to 25 years old (average age: 22.85 years). Eardrum was pathological in 0.5 % of the cases. Prevalence of hearing loss was 1.5%. Hearing loss included sensorineural hearing loss (56.7%), deafness of transmission (29.4%) and mixed deafness (13.9%). Deafness was unilateral in 79.8% and bilateral in 20.2%. Conclusion: Result of audio­gram will be useful for tracking or assessing cases of noise-induced hearing loss attributable to military service.

[Sinonasal inverted papilloma: our experiences of diagnostic and surgical care in Côte d'Ivoire]. / Papillome inversé naso-sinusien: notre expérience de la prise en charge diagnostique et chirurgicale en Côte d'Ivoire.

OBJECTIVE: To present our experience of the diagnostic and surgical care of sino-nasal inverted papilloma. MATERIAL AND METHOD: Retrospective study over 14 years (1996-2010) realised in the ENT departments in Côte d'Ivoire. Thirteen inverted papilloma confirmed and operated, after computed tomography, were included (7 men and 6 women, from 8 to 55 years old). RESULTS: The nasal obstruction was the main symptom. Twelve inverted papilloma correspond to Krouse stage T3, and 1 case T4. Surgical removal was performed by lateral rhinotomy (8 cases), Caldwell-Luc (4 cases) and De Lima (1 case). Squamous cell carcinoma was associated in 1 case. Recurrence with malignant transformation was observed in 1 case. CONCLUSION: Surgery by external approach allowed to obtaining satisfactory results. It stays of current events in our countries under equipped. Histopathological examination of the surgical specimen must be compulsory.

[Laryngeal dystonia and asthma: diagnostic difficulty and treatment. Case report]. / Dystonie laryngée et asthme: difficulté diagnostique et de prise en charge a propos d'un cas.

The laryngeal dystonia is often confuse with asthma. But their association in the same patient is possible. In this case the diagnosis is not easy. The management of asthma involves the treatment of the laryngeal dystonia. Failing to have a curative treatment of the dystonia, the anticholinergic by nebulisation are important in the management of the spells and to control asthma.

[A case of nasal foreign bodies by tooth migration]. / Un cas de corps étranger des fosses nasales par migration dentaire.

Foreign bodies are a frequent reason for ENT consultation especially in children. Although the nature of the foreign body can be variable, the discovery of a tooth in a nasal cavity is a rare occurrence. The authors report a case of foreign body inside the nasal cavity caused by tooth migration and discuss its pathologic, diagnostic and therapeutic aspects.

Retrospective study of the rhinoscleroma about 14 cases in ENT departments of university hospitals (Côte d'Ivoire).

PURPOSE OF STUDY: To report the epidemiological, clinical, therapeutic and evolutionary aspects of rhinoscleroma in ENT departments of university hospitals (Côte d'Ivoire). MATERIAL AND METHOD: Retrospective study of rhinoscleroma conducted in the ENT and head and neck surgery departments in Côte d'Ivoire from January 1980 to December 2008 including the cases of confirmed rhinoscleroma and the treated cases. RESULTS: Fourteen cases of rhinoscleroma were found in 28 years. The early manifestations were not specific enough so the patients were seen with clinical status with obvious disorders or physical discomfort. Treatment was medical and surgical. Medical therapy was based on streptomycin, thiopenicol or ciprofloxacin administration. Surgery consisted in removing the fibrous adhesions to correct the functional and aesthetic disorders. CONCLUSION: Rhinoscleroma has become a more and more rare disease because of the sensitivity to the new molecules. Diagnosis can be difficult and delayed because of its clinical polymorphism.

[Extraction of the esophageal foreign bodies by cervicotomy: our experience about 9 cases]. / Extraction de corps étrangers oesophagiens par voie de cervicotomie: à propos de 9 cas.

OBJECTIVE: To present our experience of the extraction of the esophageal foreign bodies by cervicotomy route. PATIENTS AND METHOD: Descriptive retrospective study from 2006 to 2010 realized in the ENT Departments of Yopougon and Treichville's Teaching Hospital. RESULTS: 9 (3.3%) of 270 patients underwent surgery to remove esophageal foreign bodies. The average age of the patients was of 14.6 years (extremes: 8 months and 49 years). The foreign bodies were fish bone, hook of clothes peg, medallion, denture and weld. Cervicotomy was performed at once in 4 cases and after failure of esophagoscopy in 5 cases. There were 2 complications (pharyngostoma and suppuration of the operating site). CONCLUSION: The cervicotomy must be quickly performed in case of perforation with or without neck abscess, sharp or voluminous bodies.

[A case of nasal NK/T cell lymphoma in Africa]. / Un cas de lymphome nasal T/NK en Afrique noire.

INTRODUCTION: Nasal NK/T cell lymphoma is an aggressive, locally destructive and necrotizing lesions. It is exceptional rare in Africa. CASE REPORT: We report a 73 year-old patient's case presenting a nasal obstruction with a chronic purulent nasal discharge. The physical examination showed a chronic nasal lesion involving the nose and infiltrating the pyramid. The histopathological examination performed in a french laboratory diagnosed a nasal T cell lymphoma. Chemotherapy was initiated; radiotherapy being unavailable. CONCLUSION: The difficulties in management of nasal NK/T lymphoma cases are due to diagnostic difficulties and therapeutic problems related to the absence of radiotherapy in our work environment.

[Thyroid localization of myxofibrosarcoma: first case in Africa]. / Myxofibrosarcome à localisation thyroïdienne: première observation en Afrique.

This case report describes a 45-year-old woman who was treated for a bulky ulcerated thyroid tumor with an offensive odor. The tumor had been ongoing for approximately 20 years. The patient had familial medical history of goiter. Histopathological diagnosis of the surgical specimen demonstrated myxofibrosarcoma associated with a classic thyroid tumor (vesicular adenoma). Based on this case, the author reviews the literature describing this rare soft-tissue tumor that is usually located on the extremities. Surgical treatment consists of radical tumor excision. A multidisciplinary therapeutic approach is necessary for efficient management by ensuring proper coordination of adjunctive treatment.

[Benign lymphoid pseudotumors of the nasal cavity and HIV infections]. / Les pseudotumeurs lymphocytaires benignes du cavum et infections a VIH.

OBJECTIVE: To return particular aspects of the benign lymphoid pseudotumor of the cavum. MATERIAL AND METHOD: It is about a prospective survey on 7 years achieved in the ENT services of university hospital of Treichville (1994-1995) and of Bouaké (1996-2001). Five cases have been kept. RESULTS: There were 4 women and 1 man aged between 26 years and 47 years. The main reason of consultation was the hypoacousia and the nasal obstruction. A cavum tumor was founded will all the patients during cavoscopy. The tympanometry confirmed the diagnosis of otitis media with effusion. The histological operative piece exam noted a lymphoid hyperplasia. HIV serology was positive in 4 cases and negative in 1 case. The treatment consisted in surgical removal of the tumor in 1 case and in 4 cases it was associated with the grommet insertion. Three of the 4 HIV-positive patients received antiviral treatment. The evolution was good with all the patients. CONCLUSION: The lymphoid pseudotumors of the cavum must make search for a VIH infection at the young.