Perforations Tympaniques: Aspects Epidemiologiques et Etiologiques en Orl au Centre Hospitalier Universitaire Sylvanus Olympio de Lome au Togo

Objectif : décrire les aspects épidémiologiques et étiologiques des perforations tympaniques. Patients et Méthode: Il s’est agi d’une étude rétrospective descriptive des perforations de la membrane tympanique au service d’ORL du centre hospitalier universitaire Sylvanus Olympio de Lomé allant du 1er Janvier 2021 au 31 Mai 2022. Etaient inclus tous les dossiers des patients dont la plainte ou l’une des plaintes se rapportait à l’oreille, avec entre autres, une perforation tympanique à l’examen otoscopique. Les données ont été traitées et analysées par le logiciel SPSS 28.0. Résultats : 153 dossiers ont répondu aux critères d’étude. L’âge moyen des patients était de 29 ans avec une étendue de la variable de 9 mois à 83 ans. Le sexe masculin a été rapporté dans 79 cas avec un sex-ratio   de 1,1. Les patients exerçant une fonction libérale représentaient 34% des cas. Le motif de consultation était une otorrhée purulente dans 40,5% des cas. L’otoscopie avait montré une perforation unilatérale dans 83,7% des c as dont 43,8% des cas à droite. Cette perforation était non marginale dans 79,2% des cas et non ponctiforme dans 56,7% des cas. Les perforations étaient dues à l’otite moyenne aigue dans 51% des cas, à l’otite moyenne chronique suppurée simple dans 24,2% des cas et aux traumatismes dans 22,8% des cas. Conclusion: la perforation tympanique est souvent due à l’otite moyenne aigue chez les patients jeunes consultant pour une otorrhée purulente dans le contexte d’exercice des auteurs.   Objective: To describe the epidemiological and etiological aspects of tympanic perforations. Method: A descriptive retrospective study of perforations of the tympanic membrane presenting in the ENT department of the Sylvanus Olympio university hospital in Lomé from January 1, 2021 to May 31, 2022. All records patients whose chief complaint or one of the complaints was ear related including a tympanic perforation on otoscopic examination, were considered and included in the data collection. Data was processed and analyzed using SPSS 28.0. Results: 153 files met the study criteria. The average age of patients was 29 years old with a variable range between 9 months 83 years. The male gender was reported in 79 cases with a sex ratio of 1.1. Patients exercising a liberal profession represented 34% of cases. The main reason for consultation was purulent otorrhea in 40.5% of cases. Otoscopy had shown a unilateral perforation in 83.7% of cases including 43.8% of cases on the right ear. This perforation was non-marginal in 79.2% of cases and irregular in 56.7% of cases. Perforations were following acute otitis media in 51% of the cases, simple chronic suppurative otitis media in 24.2% of the cases and traumatic injury in 22.8% of the cases. Conclusion: Tympanic perforation is often due to acute otitis media, particulary in young patients

Cellulites Cervico-Faciales D’origine Dentaire au CHU Sylvanus Olympio de Lome Au Togo

Objectif: décrire les aspects épidémiologiques, cliniques, thérapeutiques, et évolutifs des cellulites cervico-faciales d’origine dentaire au CHU Sylvanus Olympio (SO) de Lomé. Patients et méthodes : Il s’est agi d’une étude transversale descriptive réalisée sur une période de sept ans, à propos de 373 dossiers médicaux colligés dans le service d’Oto-Rhino- Laryngologie et de Chirurgie Cervico-Maxillo-Faciale du CHU SO de Lomé, comportant des informations cliniques et paracliniques faisant cas de cellulites cervico-faciales d’origine dentaire. Résultats : L’âge moyen de nos patients était de 38,5 ans ± 15,2. Le délai moyen de consultation était de 11 jours. Les motifs les plus fréquents étaient la tuméfaction douloureuse (94,1%) et l’odontalgie (90,6%). Une automédication à base AINS/antalgiques a été retrouvée dans 33,0% des cas. Cliniquement, la tuméfaction était submandibulaire dans 60,1% des cas et associée à la carie dentaire dans 74,8% des cas. Les dents cariées étaient majoritairement les molaires inférieures dans 81,9% des cas. L’examen cytobactériologie des prélèvements a été réalisé chez 189 patients et 97 prélèvements se sont révélés positifs et isolant le streptocoque dans 32 cas. La radiographie panoramique a permis de noter un granulome dans 51,0% des cas, suivi du kyste apical dans 35,5% des cas. Le traitement médical était fait d’une bi-antibiothérapie réadaptée secondairement sur la base d’antibiogramme. Un drainage chirurgical avec extraction dentaire différée a été effectué dans 86,1% des cas. L’évolution était favorable chez la majorité des patients avec 6,9% de décès. Conclusion : Les cellulites cervico-faciales d’origine dentaire restent d’actualité. Le diagnostic doit être précoce, la prise en charge est pluridisciplinaire mais un accent doit être mis sur la prévention. Objective: to describe the epidemiological, clinical, therapeutic and progressive aspects of head and neck cellulitis of dental origin at Sylvanus Olympio University Hospital (SO), Lomé. Material and method: This was a descriptive cross-sectional study carried out over a period of seven years, concerning 373 medical files collected in the Department of Oto-Rhino- Laryngology and Head and Neck Surgery of the Sylvanus Olympio University Hospital in Lomé, with clinical and paraclinical information on head and neck cellulitis of dental origin. Results: The mean age of our patients was 38.5 ± 15.2 years. The average consultation time was 11 days. The most common reasons were painful swelling (94.1%) and toothache (90.6%). Selfmedication based on NSAIDs / analgesics was found in 33.0% of cases. Clinically, swelling was sub-mandibular in 60.1% of cases and associated with tooth decay in 74.8% of cases. The decayed teeth were predominantly lower molars in 81.9% of cases. The cytobacteriological examination of the specimens was carried out in 189 patients and 97 samples were positive and isolating the streptococcus in 32 cases. Panoramic X-ray revealed granuloma in 51.0% of cases, followed by apical cyst in 35.5% of cases. The medical treatment was made of a bi-antibiotherapy rehabilitated secondarily on the basis of antibiogram. Surgical drainage with delayed tooth extraction was performed in 86.1% of cases. The evolution was favorable for the majority of patients with 6.9% of deaths. Conclusion: Head and neck cellulitis of dental origin remains valid. The diagnosis must be early, the management is multidisciplinary but an emphasis must be placed on prevention

Perforations Tympaniques: Aspects Epidemiologiques en Orl au Centre Hospitalies Sylvanus Olympio de Lome au Togo

Objectif : décrire les aspects épidémiologiques et étiologiques des perforations tympaniques. Patients et Méthode: Il s’est agi d’une étude rétrospective descriptive des perforations de la membrane tympanique au service d’ORL du centre hospitalier universitaire Sylvanus Olympio de Lomé allant du 1er Janvier 2021 au 31 Mai 2022. Etaient inclus tous les dossiers des patients dont la plainte ou l’une des plaintes se rapportait à l’oreille, avec entre autres, une perforation tympanique à l’examen otoscopique. Les données ont été traitées et analysées par le logiciel SPSS 28.0 et Excel. Résultats : au total, 153 dossiers ont répondu aux critères d’étude. L’âge moyen des patients était de 29 ans avec des extrêmes de 9 mois et 83 ans. Le sexe masculin était retrouvé dans 79 cas avec un sex-ratio H/F de 1,1. Les patients exerçant une fonction libérale étaient retrouvés dans 34% des cas. Le motif de consultation était une otorrhée purulente dans 40,5% des cas. L’otoscopie avait montré une perforation unilatérale dans 83,7% des cas dont 43,8% des cas à droite. Cette perforation était non marginale dans 79,1% des cas et non ponctiforme dans 56,9% des cas. Les perforations étaient dues à l’otite moyenne aigue dans 51% des cas, à l’otite moyenne chronique suppurée simple dans 24,2% des cas et aux traumatismes dans 22,8% des cas. Conclusion: la perforation tympanique est souvent due à l’otite moyenne aigue chez les patients jeunes.   Objective: to describe the epidemiological and etiological aspects of tympanic perforations. Method: This was a descriptive retrospective study of perforations of the tympanic membrane in the ENT department of the Sylvanus Olympio university hospital in Lomé from January 1, 2021 to May 31, 2022. Included were all the files of the patients whose complaint or one of the complaints related to the ear, with, among other things, a tympanic perforation on otoscopic examination. Data were processed and analyzed using SPSS 28.0 and Excel software. Results: in total, 153 files met the study criteria. The average age of patients was 29 years with extremes of 9 months and 83 years. The male gender was found in 79 cases with an M/F sex ratio of 1.1. Patients exercising a liberal function were found in 34% of cases. The reason for consultation was purulent otorrhea in 40.5% of cases. Otoscopy had shown a unilateral perforation in 83.7% of cases including 43.8% of cases on the right. This perforation was non-marginal in 79.1% of cases and non-punctate in 56.9% of cases. Perforations were due to acute otitis media in 51% of cases, simple chronic suppurative otitis media in 24.2% of cases and trauma in 22.8% of cases. Conclusion: Tympanic perforation is often due to acute otitis media in young patients consulting for purulent otorrhea in the context of the authors' exercise

Knowledge, attitudes and practices of adult patients seen in ENT consultation facing COVID-19 in Lomé, Togo.

Introduction: The objective of this study was to verify the knowledge, attitudes and practices of patients received in an ENT consultation in Lom´ in the face of COVID-19 in order to better guide information, education and communication campaigns. Methods: This was a descriptive and analytical cross-sectional study that took place from May 4 to June 5, 2020, in the ENT department of the Sylvanus Olympio University Hospital in Lom´, the country's leading reference hospital center. An anonymous questionnaire with open and closed questions was given during the first 5-10 minutes of a regulatory ENT consultation. Only patients 15 years of age and older who gave their consent were included in the study. The consent of patients aged 15 to 18 was confirmed by their parent or guardian accompanying them. Results: A total of 166 patients were enrolled in the study and one interviewee was not aware of the presence of COVID-19 on Togolese territory. Radio and TV programs and newspapers were the main source of information for the respondents (86.14%). Patients' overall knowledge of COVID-19 in terms of symptoms, routes of transmission and barrier measures was rated as good. More than 79% of respondents reported being afraid of COVID-19. The attitudes and practices of those surveyed were diverse and varied. Respondents who thought they had been infected tended to take preventive self-medication (p = 0.0003). Low education was been associated with fear of COVID-19 (p = 0.0112). Conclusion: Further awareness-raising and with the right explanations, is still necessary to ensure what has been learned and avoid fear, stigma and bad practice when faced with COVID-19

Perforations Tympaniques: Aspects Epidemiologiques en Orl au Centre Hospitalies Sylvanus Olympio de Lome au Togo

Objectif : décrire les aspects épidémiologiques et étiologiques des perforations tympaniques. Patients et Méthode: Il s’est agi d’une étude rétrospective descriptive des perforations de la membrane tympanique au service d’ORL du centre hospitalier universitaire Sylvanus Olympio de Lomé allant du 1er Janvier 2021 au 31 Mai 2022. Etaient inclus tous les dossiers des patients dont la plainte ou l’une des plaintes se rapportait à l’oreille, avec entre autres, une perforation tympanique à l’examen otoscopique. Les données ont été traitées et analysées par le logiciel SPSS 28.0 et Excel. Résultats : au total, 153 dossiers ont répondu aux critères d’étude. L’âge moyen des patients était de 29 ans avec des extrêmes de 9 mois et 83 ans. Le sexe masculin était retrouvé dans 79 cas avec un sex-ratio H/F de 1,1. Les patients exerçant une fonction libérale étaient retrouvés dans 34% des cas. Le motif de consultation était une otorrhée purulente dans 40,5% des cas. L’otoscopie avait montré une perforation unilatérale dans 83,7% des cas dont 43,8% des cas à droite. Cette perforation était non marginale dans 79,1% des cas et non ponctiforme dans 56,9% des cas. Les perforations étaient dues à l’otite moyenne aigue dans 51% des cas, à l’otite moyenne chronique suppurée simple dans 24,2% des cas et aux traumatismes dans 22,8% des cas. Conclusion: la perforation tympanique est souvent due à l’otite moyenne aigue chez les patients jeunes.   Objective: to describe the epidemiological and etiological aspects of tympanic perforations. Method: This was a descriptive retrospective study of perforations of the tympanic membrane in the ENT department of the Sylvanus Olympio university hospital in Lomé from January 1, 2021 to May 31, 2022. Included were all the files of the patients whose complaint or one of the complaints related to the ear, with, among other things, a tympanic perforation on otoscopic examination. Data were processed and analyzed using SPSS 28.0 and Excel software. Results: in total, 153 files met the study criteria. The average age of patients was 29 years with extremes of 9 months and 83 years. The male gender was found in 79 cases with an M/F sex ratio of 1.1. Patients exercising a liberal function were found in 34% of cases. The reason for consultation was purulent otorrhea in 40.5% of cases. Otoscopy had shown a unilateral perforation in 83.7% of cases including 43.8% of cases on the right. This perforation was non-marginal in 79.1% of cases and non-punctate in 56.9% of cases. Perforations were due to acute otitis media in 51% of cases, simple chronic suppurative otitis media in 24.2% of cases and trauma in 22.8% of cases. Conclusion: Tympanic perforation is often due to acute otitis media in young patients consulting for purulent otorrhea in the context of the authors' exercise

Solitary neurofibroma of the right lateral wall of the oropharynx

Solitary neurofibroma of the oropharynx is extremely rare. Imaging explorations may be necessary, but the diagnostic certainty is pathological. We report a case of benign tumour of the oropharynx in a 25-year-old woman who was seen for a consultation with dysphagia, a change in voice and dyspnea in the supine position. The excision was performed under general anaesthesia with orotracheal intubation via the oropharyngeal route. Pathological examination of the surgical specimen revealed neurofibroma. Although rare, solitary neurofibroma of the oropharynx should be considered in any benign tumour in the area

Relationship between the Recurrent Laryngeal Nerve and the Inferior Thyroid Artery in the Togolese Subject: Surgical Anatomy Study from 227 Thyroidectomies

Introduction Identification of the recurrent laryngeal nerve during thyroid surgeries is recommended to preserve its functionl integrity. This study aims to determine the relationship between the recurrent laryngeal nerves and the inferior thyroid arteries during thyroidectomies, as well as any particularities and intraoperative complications. Materials and Methods Observational cross-sectional study of all culturally Togolese patients who underwent thyroidectomy with nerve dissection in the ENT department of Sylvanus Olympio University Hospital from 1 January 2013 to 30 June 2017, i.e. a period of 4 years 6 months. Results The sex ratio was 0.14 i.e., 7 women for 1 man and the average age of 41.82 years. Tissue nodules and multinodular goiters were the most operated lesions in 40.97% and 33.04%, respectively, with a plunging character in 17 cases. We had 306 cases of nerve dissection but the recurrent laryngeal nerve could not be found in 1 case on the right. It was globally retro-arterial (under the trunk and under the branches of the inferior thyroid artery) in 75.08% of cases with prevalence of the truncal, pre arterial situation in 16.07% and inter-arterial in 3.28% cases. The nerve was non-recurrent (type II pathway) in 1 case on the right. There was no recurrence injury. Parathyroid devascularization (5 cases) was autotransplanted. The surgeon's experience did not have a significant impact on the occurrence of intraoperative complications (p = 0.24). Conclusion This observational cross-sectional anatomical-surgical study supports the existing data on the relationships between the recurrent laryngeal nerve and the inferior thyroid artery by confirming their variability. Nevertheless, it was marked by the predominance of the retro arterial truncal situation of the nerve unlike the literature that most often reports a situation of the nerve under the arterial branches

Relationship between the Recurrent Laryngeal Nerve and the Inferior Thyroid Artery in the Togolese Subject: Surgical Anatomy Study from 227 Thyroidectomies

Introduction Identification of the recurrent laryngeal nerve during thyroid surgeries is recommended to preserve its functionl integrity. This study aims to determine the relationship between the recurrent laryngeal nerves and the inferior thyroid arteries during thyroidectomies, as well as any particularities and intraoperative complications. Materials and Methods Observational cross-sectional study of all culturally Togolese patients who underwent thyroidectomy with nerve dissection in the ENT department of Sylvanus Olympio University Hospital from 1 January 2013 to 30 June 2017, i.e. a period of 4 years 6 months. Results The sex ratio was 0.14 i.e., 7 women for 1 man and the average age of 41.82 years. Tissue nodules and multinodular goiters were the most operated lesions in 40.97% and 33.04%, respectively, with a plunging character in 17 cases. We had 306 cases of nerve dissection but the recurrent laryngeal nerve could not be found in 1 case on the right. It was globally retro-arterial (under the trunk and under the branches of the inferior thyroid artery) in 75.08% of cases with prevalence of the truncal, pre arterial situation in 16.07% and inter-arterial in 3.28% cases. The nerve was non-recurrent (type II pathway) in 1 case on the right. There was no recurrence injury. Parathyroid devascularization (5 cases) was autotransplanted. The surgeon's experience did not have a significant impact on the occurrence of intraoperative complications (p = 0.24). Conclusion This observational cross-sectional anatomical-surgical study supports the existing data on the relationships between the recurrent laryngeal nerve and the inferior thyroid artery by confirming their variability. Nevertheless, it was marked by the predominance of the retro arterial truncal situation of the nerve unlike the literature that most often reports a situation of the nerve under the arterial branches

Cancers primitifs oto-rhino-laryngologiques et cervico-maxillo-faciaux: aspects épidémiologiques et histopathologiques

Introduction: notre objectif a été d'établir le panorama des cancers primitifs oto-rhino-laryngologiques et cervico-maxillo-faciaux dans un service de référence au Togo. Méthodes: il s’est agi d’une étude rétrospective descriptive, portant sur les cancers diagnostiqués dans le service d’ORL et de chirurgie cervico-maxillo-faciale du CHU Sylvanus Olympio de Lomé. Elle a été réalisée sur une période de 10 ans (1er Janvier 2005 au 31 Décembre 2014). Résultats: les cancers ORL et cervico-maxillo-faciaux représentaient 0,48% des consultations et 15,3% de l’ensemble des tumeurs ORL. L’âge moyen des patients était de 47 ans, avec des extrêmes de 3 mois et 86 ans. On notait une prédominance masculine; la sex-ratio était de 1,45. L’alcoolotabagisme prédominait dans le cancer du larynx. Les cancers des voies aérodigestives supérieures (VADS) ont représenté 64,8%, avec une prédominance des cancers de la cavité buccale (36,2% des VADS), suivi des cancers de l’oropharynx (18,5% des VADS) puis des cancers du larynx (18,1% des VADS). Les adénopathies cervicales malignes primitives représentaient 18%. Les lésions les plus rares étaient les cancers de l’oreille et du tissu osseux maxillo-mandibulaire (2,24% chacun). L’histologie était dominée par le carcinome épidermoïde (61,4%) suivi du lymphome non hodgkinien (23,2%). Conclusion: les cancers ORL et cervico-maxillo-faciaux sont fréquents au Togo et diagnostiqués à tout âge. Les cancers prédominants sont ceux de la cavité buccale, du pharynx et les adénopathies cervicales malignes primitives.The Pan African Medical Journal 2016;2

Multiple Squamous Cell Carcinoma in a Patient Using Skin Bleaching Products in Togo

Background. The cosmetic use of skin bleaching products is common among women in sub-Saharan Africa despite numerous reported cutaneous and systemic complications. We report the first case of squamous cell carcinoma in a woman using skin bleaching products in Togo. Case Report. A 65-year-old woman with a 30-year history of skin bleaching products use consulted in dermatology for a tumor of the neck that had been evolving for 2 years. There was no personal or family history of cancer. The patient was obese (BMI = 38.3 kg/m2) and had high blood pressure. Clinical examination noted multiple ulcerative and cauliflower tumors of the neck. The presence of stretch marks, skin atrophy, and ochronosis was noted in the examination of the rest of skin. There were no lymph nodes. HIV serology was negative. Histology of a tumor biopsy concluded to an invasive skin squamous cell carcinoma. The cervical, thoracic, abdominal, and pelvic TDM revealed pulmonary metastases. The patient underwent complete surgical removal of the right latero-cervical tumor. The left latero-cervical tumors were not removed because they infiltrated the large vessels. Chemotherapy before surgery was prescribed but not honored for financial reasons. The patient died 2 months after her first consultation in respiratory distress. Conclusion. Squamous cell carcinoma is one of the complications of skin bleaching in sub-Saharan Africa. It is necessary to intensify awareness campaigns on the complications of this practice, in order to reduce their incidence, in our context where this practice is very frequent