[Epidemiology of otomycoses at the University Hospital of Yopougon (Abidjan-Ivory Coast)]. / Épidémiologie des otomycoses au centre hospitalier et universitaire de Yopougon (Abidjan-Côte d'Ivoire).

OBJECTIVE: Otomycosis is a fungal infection, which leads to a damage of the external auditory meatus. The disease is worldwide in distribution but is said to be more common in tropical countries. Though otomycosis presumably occurs frequently in Africa, reports on its incidence and etiology are rare from Côte d'Ivoire. The objective of this study was to evaluate the prevalence of the disease and to identify aetiological agents as well as the risk factors. MATERIAL AND METHODS: A cross-sectional study was carried out in the Otorhinolaryngology Department of the University Teaching Hospital of Yopougon from September 2007 to February 2008. For laboratory investigation, specimens were collected by means of a sterile swab. Samples were inoculated on Sabouraud's Dextrose Agar with and without antibiotics and incubated at 30°C for a period of 1 to 2 weeks. Identification was performed by direct microscopic examination on Cotton Blue Mount preparation and slide culture examination was used for differentiation of morphology. Biotyping was performed using Carbohydrate Fermentation tests, Carbohydrate Assimilation Tests (galerie Api 20 CAux TM - Sanofi Pasteur), Germ tube Test, detection of chlamydospore formation on corn meal agar. RESULTS: A total of 110 patients (sex-ratio=1.2) with suspected cases of otomycosis were investigated. Itching, otalgia, and hypoacusis were the symptoms reported by the patients and the apparent signs were debris in the ear, scabs and inflammation of the external auditory meatus. Of these, 88 cases (80%) were confirmed specifically of mycotic etiology on the basis of positive culture with 92 isolates consisting of yeasts (65.2%) and moulds (34.8%). The predominant etiological agents were Aspergillus flavus (28.4%), Candida guilliermondii (19.3%) and Candida parapsilosis (18.2%). The predisposing factors included previous otological pathology (P=0.010), frequent scratching of the external ear canal and use of ear drops (RR=3.47; IC 95%=1.3-9.27). CONCLUSION: This study revealed the great prevalence of otomycosis in Abidjan, some predisposing factors and the aetiological agents. Management of otomycosis must include mycological examination for diagnosis and information for changing behaviour patterns leading to infection.

[A specific plain X-ray in the diagnosis of elongated styloid apophysis in the Ivory Cost]. / Intérêt du profil oblique menton dégagé dans le diagnostic des apophyses styloïdes allongées en Côte d'Ivoire.

OBJECTIVES: To appreciate the value of a simple radiographic incidence and its effectiveness for the search and the measurement of elongated styloid apophysis (ESA) and to recommend it in the routine search of ESA in practice. PATIENTS AND METHOD: This prospective study was realized over a period of 3 years. It involved the study of ESA from conventional radiographic imaging; the face low incidence in comparison with an experimental incidence, the oblique profile chin lift (OPCL). 101 patients presenting with stylalgia were investigated. RESULTS: Out of the 101 patients, the low face cliché found 49 ESA having an average length of 5 cm. The OPCL allowed to identify 63 ESA, 54 of which were bilateral and 9 unilateral. It also helped identify other associated abnormalities: otitis media (5 cases), dental pathologies (4 cases), dental condensing osteitis (2 cases). The comparative analysis demonstrated a better efficiency of the OPCL in comparison to the standard incidence: the LOW FACE (Roc curve). The OPCL allowed the exposure in one incidence the styloid process and to better appreciate the lower and superior borders of the styloid process giving a better estimate of its measurements. CONCLUSION: It appears from this study that the experimental incidence, the OPCL presents a real interest in the investigation of the ESA but also in the study of the soft tissues of the pharynx, the cervical spine, and the temporo-mastoid region. It also allows the detection of other.