[Malignant parotid tumors: epidemiology in Togo]. / Tumeurs malignes de la parotide: épidémiologie au Togo.

INTRODUCTION: We had for aim to determine the epidemiological profile of malignant parotid tumors in sub-Saharan country: Togo. PATIENTS AND METHODS: We retrospectively studied the files of patients seen and treated for malignant parotid tumors, from January 1989 to December 31, 2008, at the Tokoin teaching hospital. Patients treated for another malignant tumor at the same time were excluded from the study. RESULT AND DISCUSSION: Ninety-six patients were included. Thirty-one tumors (32.29%) were malignant, in 18 male and 13 female patients with a sex ratio of 1.38. The average age was 39years (range 24-70years of age). Two patients could not undergo surgery. Histologically, there were 10 cases of squamous cell carcinoma (32.26%), 6 cases of adenoid cystic carcinoma (19.4%), 6 cases of adenocarcinoma (19.4%), 4 cases of carcinoma in pleomorphic adenoma (12.90%), 3 cases of mucoepidermoid carcinoma (9.7%), 1 case of acinar carcinoma (3.2%), and 1 case of cystadenocarcinoma (3.2%). DISCUSSION: Squamous cell carcinoma was the most frequent histological type observed in Togo, contrary to literature data for which mucoepidermoid carcinoma is the most frequent malignant parotid tumor.

A bulky dermoid cyst of the floor of the mouth.

INTRODUCTION: Bulky dermoid cysts of the floor of the mouth are very rare and may pose a problem of diagnosis. They also raise problems for the anesthesiologist and surgeon. We report the first case to be described in Togo. CASE REPORT: A 23-year-old man was admitted for a submental submandibular sublingual mass. It was soft, depressable, painless, without adenopathies, raising the tongue against the palate and creating a "second tongue-like" aspect. Resection on intra-oral route removed an intact cyst of 13cm long axis. Histology diagnosed dermoid cyst. DISCUSSION: Dermoid cysts of the floor of the mouth present as a submental sublingual mass, which may cause dyspnea and disorders of swallowing, chewing and/or vocal function. Differential diagnosis concerns sublingual, submental and cervical masses. Definitive diagnosis is founded on the histology specimen. Imaging may assist diagnosis. Intubation may be problematic. The resection approach may be intra-oral or cervical. CONCLUSION: Dermoid cysts of the floor of the mouth are rare. They may induce functional disorder. An intra-oral approach is preferable when possible.

[Intrapetrous cholesteatoma. A retrospective study of seven operated cases]. / Cholestéatome intrapétreux. Etude rétrospective de sept cas opérés.

INTRODUCTION: Intrapetrous cholesteatoma can be recalled with regard of facial paralysis, mixed deafness, cholesteatoma visible under an otoscopy and some characteristic signs in imaging. Its treatment is a real dilemma between its complete exeresis and the preservation of the facial nerve. METHODOLOGY: We studied the diagnostic and therapeutic aspects of the 7 operated cases from 1994 to 2004. RESULTS: We noted 5 men and 2 women with an average age of 37.29 years. One case was primitive. We observed 6 translabyrinthic lesions, 5 supralabyrinthic lesions and 2 infralabyrinthic lesions. The surgical approach was: translabyrinthic (1 case), translabyrinthic and suprapetrous (2 cases), suprapetrous (1 case), suprapetrous and petrectomy (1 case), petrectomy (2 cases). The diversion of the facial nerve was often associated. After the surgical operation the activity of the facial nerve was conserved in 4 patients and improved in 2 patients. The facial nerve paralysis that appeared on a patient after being operated on, totally recovered after 7 months. In spite of the appropriate surgical approach, the residual lesions were not rare (2 cases). This situation imposes a clinical and radiological follow-up for life. CONCLUSION: Intrapetrous cholesteatoma is rare. The X-ray confirmed the diagnosis. The new MRI techniques allow to detect recurrences and residues. A second surgical operation can be necessary.

[Tumours of the accessory salivary glands. Epidemiological and anatomopathological aspects]. / Tumeurs des glandes salivaires accessoires. Aspects epidémiologiques et anatomopathologiques.

INTRODUCTION: Several series of studies on the tumours of the accessory salivary glands have shed light on their anatomopathological and epidemiological aspects in Western countries. Only a few studies of this kind have been carried out in our countries. OBJECTIVES: To study the anatomopathological and epidemiological aspects of the accessory salivary glands in order to compare the literature data. METHODOLOGY: This is an analytic, descriptive and retrospective study conducted over a period of 10 years at the ENT and the Anatomo-pathology Departments of the CHU in Lomé. RESULTS: Tumours of the salivary glands represented in our study 17.19% of the ORL tumours. Tumours of the accessory salivary glands represented 71.43% of tumours of the salivary glands. Benign tumours represented 71.43% and malignant tumours 21.43%. Women were more affected than men. The average age of appearance of benign tumours was 47.87 years for men and 31.91 year for women. The average age of appearance of malignant tumours was 38 years far the women. The commonest site was the palate. The majority of benign tumours were pleomorphic adenomas. Adenoid cystic carcinoma was the principal malignant tumor. CONCLUSION: Pleomorphic adenoma and adenoid cystic carcinoma were the principal tumours of the accessory salivary glands. The commonest site was the palate. Women were more affected than men. The average age of appearance of malignant tumours was seven years later than benign tumours. (full article translated in English available on www.ent-review.com).

[Tuberculosis in newborns in a tropical neonatology unit]. / Tuberculose du nouveau-né dans une unité de néonatologie tropicale.

UNLABELLED: We report three cases of tuberculosis observed in a neonatal unit in a country characterized with a high endemia of tuberculosis. CASE REPORTS: Case 1. A term infant presented at the age of 35 days, with cough since day 18, respiratory distress and bronchopneumonia. Her mother had unrecognised tuberculosis since pregnancy. Post mortem biopsies of the infant confirmed the diagnosis of tuberculosis and social survey found out pulmonary tuberculosis in the newborn's aunt. Case 2. A term infant presented at the age of 30 days with cough since day 13, respiratory distress, nodular pulmonary lesions and right pleural effusion. Her mother had cough and stomatitis since the eighth month of pregnancy and nodular pulmonary lesions. Tuberculosis and HIV were confirmed in the mother and the infant. Social survey found tuberculosis in the newborn's paternal uncle. Case 3. A term but hypotrophic infant presented on the first day of life, with haemorrhagic troubles and respiratory distress. Tuberculosis and HIV were confirmed in the mother and the infant. Social survey found tuberculosis in the father, in a friend of her and in her three-month-old child. CONCLUSION: Congenital or neonatal tuberculosis is an under-estimated emergent disease, with a need for early diagnostic methods and consensual therapeutic protocols to improve its management.

[Fish hooks: an unusual and sharp foreign body in the hypopharynx]. / L'hameçon: un corps étranger inhabituel et vulnérant de l'hypopharynx.

Foreign bodies in the hypopharynx occur commonly. A myriad of objects have been observed. In this report we describe a case involving a fish hook in a 10-year-old girl. The presence of this uncommon, sharp-pointed object was disclosed by plain radiography. The child was hospitalized three days after ingestion. Two attempts to perform endoscopic retrieval failed. Open cervicotomy was undertaken and allowed successful removal. The authors discuss management of this special type of foreign body and review several other unusual case reports in the literature.

[Choanal atresia: an abnormality not to be overlooked. Study of three cases in the University Hospital Center of Lome, Togo]. / Atrésie choanale: une malformation à ne pas méconnaitre. Etude de trois cas au Centre Hospitalier Universitaire de Lome, Togo.

Choanal atresia is an uncommon congenital malformation which the midwife or obstetrician must recognize at birth. In this report the authors describe three cases observed at the University Hospital Center of Lome, Togo, in which diagnosis was made late, i.e. at the ages of 7 days, 13 days and 8 months. Atresia identified by rhinoscopy was bilateral in one case and unilateral in two cases. All three cases were treated by transnasal divulsion, using a rubber catheter in 2 cases and a curette in one case, followed by calibration with a Portex catheter that was removed after two months. At 6 months after treatment, all three children presented normal nasal ventilation. Since it can be easily diagnosed and treated, choanal atresia is curable and better training is needed to ensure detection at birth.

[Choanal atresia. An unrecognized malformation. Report of 3 cases at the Lomé University Hospital Center]. / Atrésie choanale. Une malformation à ne pas méconnaître. Etude de 3 cas au Centre Hospitalier Universitaire de Lomé.

The choanal atresia is a rare congenital malformation. Its clinical diagnosis is easy and must be done at the birth by the midwife or the obstetrician. We recommend the aspiration in all hospital maternity wards. This attitude avoids the unrecognized of an unilateral choanal atresia. The authors report three cases with a successfully treatment.

Atresie choanale: une malformation a ne pas meconnaitre: etude de 3 cas au Centre Hospitalier Universitaire de Lome (Togo)

L'atresie choanale est une malformation congenitale rare. Son diagnostic clinique facile doit etre realise des la naissance par la sage-femme ou l'obstetricien. Pour cela; nous conseillons l'examen du nouveau-ne avec aspiration naso-pharyngee systematique dans toutes les maternites. Cette attitude evitera la meconnaissance de l'atresie choanale unilaterale. Le traitement repose sur la divulsion avec calibrage de la choane atresiee. Les auteurs rapportent 3 cas diagnostiques en ORL dans les delais de 7 jours a 8 mois et traites avec succes par la divulsion