Les oesophagites caustiques: conduite a tenir au stade sequellaire (a propos de onze cas)

Pathologie grave en tous lieux; les brulures caustiques de l'oesophage representent un veritable fleau en Afrique; qu'elles soient d'origine accidentelle ou dues a des tentatives suicidaires. Dans les formations hospitalieres de Libreville chaque annee 40 oesophagites corrosives sont habituellement recensees. Il s'agit dans la majorite des cas d'enfants de moins de cinq ans qui ingerent un produit corrosif laisse a leur portee. Au Gabon c'est l'eau de javel qui est responsable dans 90 pour cent des cas

La dysplasie fibreuse de la face a Libreville: a propos de 12 cas

Les auteurs rapportent 12 cas de dysplasie fibreuse de la face observes en 7 ans dans le Service ORL du Centre Hospitalier de Libreville et comparent leurs resultats aux etudes de la litterature et en particulier a celles effectuees a Dakar. Malgre l'absence de scanner; les bilans radiologiques sont tres evocateurs et nous retrouvons toutes les images caracteristiques decrites dans cette affection. L'attitude therapeutique fondee sur l'exerese tumorale complete d'emblee est imposee par les conditions locales: suivi des malades aleatoire rendant difficile la detection des redicives et d'eventuelles degenerescences malignes

Le traitement des otomycoses: a propos de cinquante cas

L'otomycose devient une affection frequente dans nos services de consultation. A peu pres 20 pour cent des otites externes rentrent dans cette categorie. Leur diagnostic est tres souvent pose lors de l'examen otoscopique et confirme par l'examen direct et les cultures. En general un traitement bien conduit aboutit a une guerison clinique definitive. A condition de refrener l'abus de certaines gouttes auriculaires. Toute resistance au traitement doit faire suspecter une participation du terrain et rechercher d'autres localisations mycosiques; ainsi que la presence d'anticorps anti HIV I et II

[Otorhinolaryngologic aspects of Kaposi's sarcoma in Africa]. / Aspects otorhinolaryngologiques du sarcome de Kaposi en Afrique.

Such aspects are numerous from a disease with multiple factors among them immunodeficiency playing a key-role. O.R.L. aspect are more frequently observed than some ten years ago: this is mainly due to Kaposi's sarcoma in its epidemic form. Nevertheless one has to keep in mind that Kaposi's sarcoma in this endemic african form coexists with its second form without any well-marked border. Finally, many uncertainties are still existing among others its very peculiar cancerous nature.

[New approaches to phycomycoses (apropos of 2 cases of rhino-entomophthoromycosis)]. / Approches nouvelles des phycomycoses (à propos de deux cas de rhino-entomophtoroses).

It is an uncommon affection (only 100 cases reported), observed primarily in African peri-equatorial zone. The rhinoentomophtoromycoses are caused by a phycomycetous fungus, class of zygomycetes: Conidiobolus coronatus. They are subcutaneomucus mycoses with centro-facial localizations. During the past ten years, three points have been put into light. 1. A true therapeutic revolution thanks to imidazoles. 2. A better knowledge of this disease in which caricatural forms are far form being the most numerous. 3. A socio-cultural African approach better understood, as such a disease is still considered as the result of a transgression or a fault.

[Maxillofacial location of Burkitt's lymphoma in Africa (apropos of 7 cases)]. / Les localisations maxillo-faciales du lymphome de Burkitt en Afrique (a propos de sept cas).

Omnipresent disease, Burkitt's lymphoma is the most frequent non-Hodgkin malignant lymphoma in children (NHML). As a matter of course, maxillo-facial lesions are not exclusive, as we thought thirty years ago, but it is evident that they are extremely frequent in tropical areas. They strike all facial quadrants. Their aspects are always impressive, they perfectly diminish by a well applied polychemotherapy.

[Endonasal rhinosporidiosis (apropos of 2 cases observed in Gabon)]. / La rhinosporidiose endonasale (à propos de 2 cas observés au Gabon).

Being endemic in India and Sri Lanka, rhinosporidiosis is not much known in Africa where only few cases have been reported for the last 20 years. It is a chronic mycosis striking electively two target zones: nasal and conjunctival mucosae. Many features are still unknown about this pathogenic agent which belongs to the group of phycomycetes. But it has never been yet possible to cultivate it nor to inoculate it to animals. It has a cyclic development, well described by Ashworth. Its treatment is both surgical and medical (fungicides).

[Fungal otitis in Libreville. Study of 83 cases]. / Les otites mycosiques à Libreville. Etude de 83 cas.

83 cases of mycotic otitis of external ear are reported during a period of 27 months from three departments of otorhinolaryngology in Libreville (Gabon, Central Africa) Prevalence is estimated at about 25% among all infectious otitis. The main functional signs are pruritus, otorrhea, pain and hypoacousia. The physical examination shows masse of white, grey, black or creamy caseous debris, invading the external auditory meatus (EAM) which is sometimes inflammatory. Fungal species responsible of otitis are Aspergillus (54%), yeasts (45%) mainly Candida, infrequently Fusarium (1%). A niger (26%), A. flavus (17%), Candida parapilosis (18%), Candida albicans (9%) are predominant species isolated (70%) among all the 21 species of identified fungi from otomycosis in Gabon. Therapy, done by thorough washing of the ear followed by insertion into the EAM of a wick soaked in Econazole or Amphotericin B, is quickly effective.

[Human coenurosis. Localization to the sternocleidomastoid muscle]. / La cénurose humaine. Localisation au muscle sterno-cleido mastoïdien.

Coenurosis, a parasitic affection rarely observed in man, is due to the presence in the tissues of larval forms of Taenias that live in certain domestic or wild carnivorous animals during their adult stage. The disease was confirmed in a young Senegalese patient after surgical excision of a cyst from the lateral side of the neck. Pathological and epidemiological data suggest that the affection is due to Taenia serialis serialis.