[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.

[Migrant foreign body of the oesophagus: report of a case]. / Corps étranger de l'aesophage migrant: à propos d'une observation.

OBJECTIVE: Evaluate the risk brought by the traditional practice in the evolution of the foreign bodies of the aesophagus. CASE REPORT: 30 years old male with migration from the oesophagus of a fish bone in soft tissue of the neck, which could have been favored by the traditional practice. The diagnosis of migration was suspected when a laterocervical mass appeared after a traditional processing. The rigid aesophagoscopy was negative and the scanner allowed to identify the foreign body in an extraluminal location. It was removed by cervicotomy. Postoperative was uneventful.

[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.

Morbidite par tumeurs de la sphere tete et cou a Bamako

Ce travail rapporte sur une annee (nov 2004-oct 2005) les resultats d'une etude descriptive realisee sur les tumeurs de la tete et du cou dans le service ORL de l'hopital Gabriel Toure de Bamako. Ont ete inclus tous les patients dont les dossiers comportaient les parametres suivants : epidemiologique (age; sexe; profession; residence et delai de consultation); facteurs d'exposition; localisation anatomoclinique et resultat histologique; et les donnees de l'imagerie. Ont ete exclues toutes les tumeurs de cette region dont les dossiers etaient incomplets ainsi que les tumeurs de l'oeil et de ses annexes et les tumeurs endocraniennes. Nous avons pu colliger 60 cas; et 25 dossiers n'ont pu etre exploites. Parmi les 60 cas retenus; 24 tumeurs etaient des tumeurs malignes (40) et 36 tumeurs benignes. Dans les tumeurs benignes; le goitre a ete le plus retrouve avec a l'etude histologique une predominance de l'adenome colloidal (15 cas sur 36 soit 41;67). D'autres tumeurs rares ont ete notees entre autre le rhinosclerome (5 cas soit 13;89); le papillome inverse des fosses nasales (2 cas soit 5;55). Ces tumeurs benignes n'ont pas pose de problemes de prise en charge. Quant aux tumeurs malignes; nous avons eu une predominance de cancers pharyngo-larynges (11 cas/24) avec le carcinome epidermoide comme type histologique le plus frequent. Dans ce lot on a eu deux carcinomes chez des enfants de moins de quinze ans. Nous n'avons pas pu relever de particularites; entre autre pas de facteurs d'exposition individualisable. D'autres tumeurs malignes tels que les cancers nasosinusiens et les carcinomes de la thyroide ont ete relevees. Ces tumeurs malignes ont generalement consulte a un stade avance de la maladie

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