[Soft palate perforation during endemic syphilis, a case study]. / Perforation du palais mou au cours de la syphilis endemique (un cas).

The authors report a case of soft palate perforation during endemic syphilis. The diagnosis of endemic syphilis was based on the absence of factor in favor of venereal syphilis, highly positive results suggesting VDRL/TPHA association, histology of velar perforation banks and the satisfactory response with closure of the perforation velar after 4 weeks of treatment with Benzathine benzylpenicillin.

Les auteurs rapportent un cas de perforation du palais mou au cours de la syphilis endémique. Le diagnostic de la syphilis endémique a été posé sur la base de l'absence de facteurs enfaveur de la syphilis vénérienne, du résultat fortement positif du couplage VDRL/TPHA, des données de l'histologie des berges de la perforation et de la réponse satisfaisante avec la fermeture vélaire à 4 semaines de traitement par benzathine Benzyle Pénicilline.

[Mediastinitis complicating cervical cellulite: 8 cases observed in the ear, nose and throat department of the Gabriel Toure university hospital, Bamako (Mali)]. / Mediastinite compliquant une cellulite cervicale : a propos de 8 cas observes dans le service orl du chu Gabriel Toure de Bamako (Mali).

OBJECTIVE: The objective of this work was to analyze the diagnostic circumstances and the therapeutic management of mediastinal disease of a cervical origin. PATIENTS AND METHODS: We conducted a longitudinal prospective and retrospective descriptive study in the ENT department of the Gabriel Touré Hospital in Bamako, involving the records of patients treated for mediastinitis complicating cervical cellulite from January 2011 to April 2014. RESULTS: Eight patients met our inclusion criteria. The median age was 29 years, the standard deviation was 10.23 years with extremes of 25 and 57 years. All were initially admitted for dental reasons. The median time to consultation was 13 days with extremes of 10 days and 1 month. Six patients had non-steroidal anti-inflammatory drugs before entry into the service. Cervical and thoracic CT scan was used to guide diagnosis in all cases. Seven patients underwent mediastinal drainage through cervicotomy, 3 patients underwent percutaneous pleural drainage under ultrasound guidance. We had two deaths. CONCLUSION: Mediastinitis in cervical cellulitis is a serious infectious disease where the mortality rate remains high. Mediastinal drainage was performed by cervical route. Prevention is based on the awareness and the importance of dental hygiene and getting proper and early treatment for dental cavities.

OBJECTIF: L'objectif de ce travail était d'analyser les circonstances de diagnostic et la prise en charge thérapeutique des affections médiastinales à point de départ cervical. PATIENTS ET MÉTHODES: Nous avons mené une étude descriptive longitudinale pro et rétrospective dans le service d'ORL du CHU Gabriel Touré de Bamako et qui a concerné les dossiers des patients traités pour médiastinite compliquant une cellulite cervico-faciale de janvier 2011 à Avril 2014. RÉSULTATS: Huit patients ont répondu à nos critères d'inclusion. L'âge médian était de 29 ans, l'écart type était de 10,23 ans avec des extrêmes de 25 et 57 ans. La porte d'entrée a été dentaire dans tous les cas. Le délai médian de consultation était de 13 jours avec des extrêmes de 10 et 1 mois. Six patients avaient eu des antiinflammatoires non stéroïdiens avant leur admission dans le service. Le scanner a permis d'orienter diagnostic, en montrant des signes en faveur de médiastinite, dans tous les cas. Sept patients ont bénéficié d'un drainage du médiastin par voie de cervicotomie, 3 patients ont bénéficié d'un drainage pleural percutané sous guidage échographique. Nous avons eu deux décès. CONCLUSION: La médiastinite au cours de la cellulite cervicale représente une pathologie infectieuse grave avec une mortalité qui reste élevée. Le drainage médiastinal a été effectué par voie cervicale. La prévention repose sur la sensibilisation de la population et sur l'importance de l'hygiène dentaire et la prise en charge correcte et précoce des caries dentaires.

[Cervico-facial cellulitis during pregnancy: about a series of 10 cases in Mali]. / Cellulite cervico-faciale au cours de la grossesse. À propos d'une série de 10 cas au Mali.

The objective of this work was to analyze the predisposing factors, diagnostic and therapeutic aspects of cervico-facial cellulitis on pregnancies and to determine maternal-fetal prognosis. We conducted a longitudinal observational descriptive study from January 2011 to March 2013 including records from pregnant women with cervicofacial cellulitis treated at the Oto-Rhino-Laryngology (ORL) and cervico-facial surgery department at Gabriel Touré Hospital in Bamako. Ten women met our inclusion criteria. The median age was 23 years. The entry way was dental in all cases. Three women had taken antibiotics and 3 others antibiotics associated with non steroidal anti-inflammatory. The medico-surgical treatment had permitted to cure 8 cases. Two cases of death were recorded and 4 cases of stillbirths. The cervico-facial cellulitis during pregnancy is a serious pathology that can be life-threatening to the mother and or child. Prevention is based on the control of dental status and informing women about the importance of dental hygiene.

[Giant mucocele maxillary sinus: About a case]. / Mucocele geante du sinus maxillaire: A propos d'un cas.

The maxillary mucocele sinus are rare and may extend outside the sinus and cause a facial deformity and orbital manifestations. OBSERVATION: We report a case of giant mucocele of the right maxillary sinus from a 48 year old man. The history of disease has found a right cheek tumefaction. hypoesthesia of the right hemifacial, nasal obstruction lasting for 2 years. CT scan of the facial confirmed diagnosis by showing a cystic mass of the right maxillairy sinus bulging into the right nasal cavity with bone thinning without bone lysis. The treatement is removal of the mucocelique pochet by Caldwell-Luc under general anesthesia and allowed disparition of symptoms. CONCLUSION: Africa the Caldwell-Luc seems to us preferable because of diagnosis tardif the origin of the importance of the expansion.

INTRODUCTION: Les mucocèles du sinus maxillaire sont rares et peuvent s'étendre en dehors du sinus et entrainer une déformation faciale et des manifestations orbitaires. OBSERVATION: Nous rapportons un cas de mucocèle géante du sinus maxillaire droit chez un homme de 48 ans. L'histoire de la maladie a retrouvé une tuméfaction jugale droite, une hypoesthésie de l'hémiface droite, une obstruction nasale évoluant depuis 2 ans. Le scanner du massif facial a confirmé le diagnostic en montrant une masse kystique du sinus maxillaire droit bombant dans la fosse nasale, avec amincissement des parois osseuses, sans lyse osseuse. Le traitement, a consisté à l'exérèse de la poche mucocélique par voie de Caldwell-Luc sous anesthésie générale, et a permis la disparition de la symptomatologie. CONCLUSION: En Afrique le Caldwell-Luc nous semble préférable du fait du diagnostic tardif à l'origine de l'importance de l'expansion.

[Foreign bodies of the esophagus in the adult: report of 26 cases]. / Corps etrangers de l'oesophage chez l'adulte: à propos de 26 cas.

INTRODUCTION: The foreign bodies of the oesophagus see each other at any age. They are more frequent at the child's than at the adult. The cutting foreign bodies can constitute an urgency because of the risk of oesophagienne perforing or bleeding. OBJECTIVE: Bring report the epidemiological and clinical profile of the foreign bodies of the oesophagus in our practice, and underline the difficulties of coverage(care) at the adult. MATERIAL AND METHOD: A forward-looking study was realized of April, 2007 in Mars 2009 in the service ENT of the University hospital (CHU) Gabriel TOURE of Bamako concerning 26 grown-up patients presenting a foreign body of the oesophagus. RESULTS: Both sexes are affected in a equivalent way. The average age was of 32 years with extremes of 15 years and 65 years. The patients from 31 to 45 years old were the most touched. The false tooth was the foreign body most frequently met (58 %). Three patients presented complications has type of oesophagienne perforing (2) and of oeso-trachéale fistula (1) the outcome of which was fatal afterward. The oesophagoscopie in the stiff tube under general anesthesia allowed to extract 92 % of the foreign bodies. CONCLUSION: The foreign body of the oesophagus is a pathology so frequent at the adult and the diagnosis is mostly evident. Among the foreign bodies, false teeth raised problems of therapeutic coverage. The prevention passes by the regular medical supervision of false teeth, the training formation of the staff, the improvement of the technical trayp, and a good education of the patient.

[Medical handicap and otorhinolaryngologic foreign bodies about 4 original cases]. / Handicap et Corps Etrangers ORL, a propos de quatre observations originales.

The multiple variant of aero-digestive foreign bodies' pathology determine many complex aspects with regard to their physiopathology, nature, and their location. The presence of a medical handicap or any particular condition could increase morbidity and expose to major risks. We are reporting here about 4 cases including an esophagus foreign body in a leprosies patient, an esophago-gastric case in a mental disorder patient, and two laryngeal-tracheal-bronchial cases during epileptic episodes. From the rarity of such accidents in an adult to their happening during a loss of consciousness or a delirious state, the clinical history is always missing. The symptoms are atypical and may misguide. The classical penetration syndrome cannot be reported. Only a clinical examination carefully conducted and completed with targeted para clinical examinations can help make early diagnosis. Endoscopy of the Esophagus on one hand, and endoscopy of the trachea and lungs on the other hand were used to extract these foreign bodies.

[Foreign body in the pharynx incidentally found]. / Corps etranger du pharynx de decouverte fortuite.

Diagnosis and therapeutic of foreign bodies of the oropharynx are not difficult in general. The diagnosis is usually obvious for the adult. We report a case of foreign body of the oropharynx observed in a patient, psychologically stable, which occurred two months after a traumatism. The patient was not aware of the existence of the foreign body. It was extracted two months after the accident by endo-oral track under general anaesthesia. The nature of the foreign body, the fortuity of its discovery and its presence for a long time reported here are of interest.

[Morbidity of the tumours of the sphere head and neck in Bamako]. / Morbidite par tumeurs de la sphere tete et cou a Bamako.

This work reports the results of one year (November 2004-October 2005) descriptive study of tumours located in the head and neck areas in the ENT department of the University-Hospital of Gabriel Toure in Bamako. Were included in the study patients whose files showed epidemiology data: age, sex, profession, residence and period of the medical checking, and exposition factors: anatomic location, results of histology and image data of the tumours. Where excluded from the study the patients whose file were not completed and those that have had eye and brain tumours From the data base of the department, a total of 60 cases of tumours were monitored and 25 others cases were excluded according to the criteria. Among the 60 cases, 24 tumours (40%) were malign and 36 were benign. Goiter was the most found benign tumor according to the results of the hystology analysis. In most cases (15 out of 36, 41.67%) the histology analysis showed an colloid adenoma Other rare tumors like rhinoscleroma (5 cases out of 36, 13.89%), nose invertus papilloma (2 cases out of 36, 5.55%) where found. These were easily diagnosed and treated. In the group of malign tumors, the pharyngolaryngeal cancer was the most found (11 cases out of 24) and the most predominant histology of these cancers was the epidermoid carcinoma. Two of these cancers were found in patients below fifteen years of age, but no other risk factors like expositions was noted in the files of these two patients. Other malign tumors have been found: nose and sinusal cancers and thyroid carcinoma. In most cases these tumors were diagnosed at an advanced stage.

Corps etranger du pharynx de decouverte fortuite

Les corps etrangers de l'oropharynx posent rarement de difficultes tant sur le plan diagnostic que therapeutique. Le diagnostic est le plus souvent evident chez l'adulte. Nous rapportons un cas de corps etranger de l'oropharynx observe chez un patient; psychologiquement stable; au decours d'un traumatisme. Le patient a ete admis dans un tableau de dysphagie 2 mois apres le traumatisme. Le corps etranger etait meconnu par le patient. Il a ete extrait par voie endo-buccale sous anesthesie generale 2 mois apres le traumatisme. La nature; la decouverte fortuite et la longue duree de sejour rapportees ici en constituent l'interet

[Laryngo-pharyngeal cancer at a health service of last resort in Mali: anatomo-clinical and therapeutic aspects]. / Les cancers laryngo-pharynges dans un service de sante de dernier recours au Mali: aspects anatomo-cliniques et thérapeutiques.

The purpose of this study is to describe the clinical, anatomic and therapeutic aspects of laryngitis--pharyngeal cancers in Mali. It was a prospective, descriptive and cross sectional study which was help in the ORL and cervical facial department of the university hospital center Gabriel TOURE between April 2006 and March 2007. The study looked at 18 patients hospitalized for larynx or hypo pharynx cancer, diagnostic was confirmed histologically. The parameters (age, other favorable features, clinical signs, endoscopic aspect of the tumor, histological type and treatment type) have been analyzed. Men were the most affected (66.7%), with an average age of 58.17 year old. Chronic smoking has been the most evocated factor of risk (55.17) with an average consumation of 39.5 P/A. A delay in consultation was noticed (60% with a period greater than 1 year after the first symptoms appear). The burgeoning aspect (66.7%) end the carcinoma epidemic type of the tumor (94.7%) have dominated the anatomy pathologic table. Only 27.8% of patients had surgery because of late diagnosis.

Les cancers laryngo-pharynges dans un service de sante de dernier recours au Mali : aspects anatomo-cliniques et therapeutiques

Le but de ce travail etait de decrire les aspects anatomo-cliniques et therapeutiques des cancers laryngo-pharynges au Mali. Il s'agissait d'une etude prospective descriptive et transversale qui s'est deroulee dans le service d'ORL et de chirurgie cervico-faciale du centre hospitalo-universitaire Gabriel TOURE sur un an allant du 1er Avril 2006 au 31 Mars 2007. Elle a porte sur 18 malades hospitalises dans ce service pour cancer du larynx ou de l'hypopharynx confirme a l'histologie. Les parametres (l'age; certains facteurs favorisants; les signes cliniques; l'aspect endoscopique de la tumeur; le type histologique et le type de traitement) ont ete analyses. Les hommes ont ete les plus touches (66;7); l'age moyen etait de 58;17 ans. Le tabagisme chronique a ete le facteur de risque le plus evoque (55;5) avec une consommation moyenne de 39;5 P/A. un retard de consultation a ete note (60a un delai superieur a 1 an apres l'apparition des premiers symptomes). L'aspect bourgeonnant (66;7) et e type carcinome epidermoide de la tumeur (94;7) ont domine le tableau d'anatomie pathologique. Seuls 27;8de nos patients ont beneficie d'un traitement chirurgical; compte tenu du retard accru de diagnostic

Cellulite peri-orbitaire et poly sinusite paranasale : analyse de deux cas colliges au service ORL de l'hopital Gabriel Toure de Bamako; Mali. Cas clinique

Les auteurs rapportent deux cas de cellulites periorbitaires colligees sur une annee dans le service ORL. Ces deux cas ont la particularite d'etre survenue chez des enfants dans un contexte de pyorrhee alveolodentaire et de poly sinusites faciales associees. Le parcours therapeutique avant l'hopital a ete emaille de traitement traditionnel dans un cas et d'automedication dans l'autre. Dans les deux cas le medecin referent a ete un ophtalmologiste. Les deux patients ont ete admis en hospitalisation ORL au stade de phlegmon periorbitaire collecte ayant necessite un drainage chirurgical sous anesthesie generale. Les suites operatoires ont ete simples; cependant un des enfants admis au stade d'une acuite visuelle reduite a la simple perception lumineuse n'a pas recupere de sa perte de vision

[Epidemiologic aspects of pharyngitis, Bamako]. / Aspects epidemiologiques de l'angine a Bamko.

We are reporting here a 12 month-prospective study on epidemiologic aspects of sore throat in the ENT department of the national hospital Gabriel Touré. We recorded 260 cases of sore throat with 23 loco-regional complications representing 1.8% of all pathologies in our department; the sex ratio was 2.6 in favour of women, and the age group most affected was 20-24 years (18.07%). Sore throat was most frequently diagnosed at the beginning and at the end of the rainy season respectively May and October. In 63 of the cases, local and regional complications were seen, and represented by peri-tonsils phlegm (54%), chronic tonsillitis (41.3%), retropharyngeal abscess (3.2%), and cervical adeno-phlegm (1.6%). Therapy with antibiotics should be of rule, and well justified surgical decisions should be made after informed consent of the patient. Sore throat with its complications should really benefit of better attention and better management.

Epistaxis et grossesse: à propos de deux observations

Nous avons deux cas d'epistaxis survenus au cours de grossesses a terme. Le premier cas etait secondaire a un polype saignant de la cloison nasale dont la resection a eu lieu en post-partum; l'autre cas a ete observe lors d'une poussee hypertensive inopinee; avec mort foetale. Une surveillance medicale; des soins appropries en milieu hospitalier sont souhaitables. Il s'agit d'un probleme de sante publique necessitant un suivi de la femme enceinte par des consultations prenatales; avec dans certains cas; une coordination multidisciplinaire

Osteites des maxillaires au service de stomatologie de l'Hopital National de Kati (republique du Mali) : a propos de 33 cas

Une etude retrospective ayant pour but de determiner la frequence et la distribution des osteites a ete entreprise dans le service de stomatologie de l'Hopital de Kati entre janvier 1981 et decembre 1986. L'echantillon a ete choisi de facon accidentelle. Les malades etaient originaires du Mali; du Senegal et de la Guinee. L'etude portait sur 33 patients ages de 1 a 55 ans dont 18 hommes et 15 femmes. Les interventions chirurgicales de sequestrectomie endo ou exo-buccale ont ete pratiquees. Le maxillaire inferieur etait le siege prefere avec 29/33 cas (87;9 pour cent) contre 4/33 cas (12;1 pour cent) pour le maxillaire superieur. A l'hopital de Kati; les auteurs ont note chez les cultivateurs moins de cas d'osteites d'origine dentogene que chez les commercants; eleveurs et menageres. La distribution des osteites des maxillaires a montre que les cultivateurs etaient davantage touches par les osteites post-traumatiques que celles d'origine dentogene. Toutefois; quelle que soit l'origine des osteites; leur frequence ne variait pas de facon statistiquement significative selon le sexe des patients

Evaluation de l'efficacite et de la tolerance de la Cetirizine dans le traitement de la rhinite allergique. [Lettre]

L'efficacite clinique et la tolerance de la Cetirizine ont ete evaluees chez 39 patients ages de 13 a 54 ans presentant des signes cliniques de rhinite allergique : obstruction nasale; rhinorrhee sereuse; eternuements; prurit nasal. La duree de la maladie variait entre 7 jours et 20 ans. Seulement 8;54 pour cent des patients ont presente des effets secondaires

Tumeurs de la levre et des joues au Service de Stomatologie de l'Hopital National de Kati (Republique du Mali) : a propos de 44 cas

Une etude d'evaluation sur les lesions tumorales des levres et des joues fut entreprise au Service de Stomatologie et de Chirurgie Maxillo-faciale de l'Hopital National de Kati entre janvier 1981 et decembre 1988. L'echantillon se composait de 20 femmes (45;50 pour cent) et de 24 hommes (54;50 pour cent) avec une moyenne d'age de 30;07 ans. Le choix des patients etait accidentel ou base sur recommandations de tierces personnes. La tranche d'age la plus touchee fut celle comprise entre 19 et 45 ans; 18/44 cas (40;10 pour cent). La predominance etait masculine a 54;50 pour cent. Les ethnies les plus frequemment representees dans les consultations furent celle des Bamanans a egalite avec celle des Peulhs (25;00 pour cent chacune). Le monde paysan etait le plus touche avec 14/44 cas (36;40 pour cent). La localisation au niveau de la levre et des joues de 74;60 pour cent; celle des levres 27;20 pour cent. Les lesions tumorales etaient dominees par les carcinomes 15/44 cas (34;20 pour cent) dont 10/15 cas de carcinomes spinocellulaires (66;66 pour cent). Les patients venant de la region de Kayes representaient 15/44 cas (34;10 pour cent) devant eux de Koulikoro et du District de Bamako (31;80 pour cent)

[ORL manifestations observed in AIDS. Apropos of 65 cases]. / Manifestations orl observées au cours du SIDA. A propos de 65 observations.

We realized a clinical study in 65 patients with acquired immunodeficiency syndrome, aged from 3 to 62 years old (mean, 34 years) (34 males and 31 females) interned or showed in consultations at the hospital Gabriel Touré in Bamako, Mali (departments of ENT diseases and of internal medicine), in order to analyse and to state precisely different otorhinolaryngologic manifestations in AIDS. Oropharyngeal candidiasis was the most prevalent otorhinolaryngologic manifestation (57 %). Other less common lesions were suppurative otitis media (29 %), atrophic pharyngitis (18,5 %), sinusitis (11 %), Kaposi's sarcoma (5 %) localized above all on the palate: they are however a frequent sign of infection by HIV. The manifestations merit a particular attention by otorhinolaryngologist because, although they have few influence on the general evolution of the disease, they appear as additional manifestations of infectious risks in AIDS patients.