Aspects Clinique Et Paraclinique Des Paralysies Bilatérales Des Cordes Vocales

L’immobilité bilatérale des cordes vocales peut mettre en jeu le pronostic vital du patient. L’objectif de l’étude a été d’analyser les éléments diagnostiques à évaluer avant la prise en charge. Il s’est agi d’une étude transversale et descriptive portant sur les cas d’immobilité bilatérale des cordes vocales reçus entre 1 er Janvier 2008 et le 1 er Mars 2018. Les données socio-démographiques, cliniques, paracliniques et les étiologies ont été recueillies. En dix ans 56 patients ont été reçus et examinés. L’âge moyen a été de 56 ans avec une sex-ratio de 1,07. Les principaux signes répertoriés étaient la dyspnée (44 cas ; 78,6%), la dysphonie (8 cas ; 14,3%) et les fausses routes (2 cas ; 3,6%). Les cordes vocales étaient immobiles en adduction paramédiane (29 cas ; 51,79%), en adduction médiane (25 cas ; 44,64%) ou en abduction (2 cas ; 3,6%). Les deux principales causes retrouvées ont été l’intubation prolongée et la thyroïdectomie totale. La paralysie des cordes vocales est peu fréquente. La nasofibroscopie est la clé du diagnostic. L’intubation prolongée et la chirurgie thyroïdienne en sont les causes les plus fréquentes. Bilateral immobility of the vocal cords can be life-threatening. The aim of the study was to analyze the diagnostic elements to be assessed before treatment. This was a cross-sectional and descriptive study on the cases of bilateral immobility of the vocal cords received between January 1, 2008 and March 1, 2018. Socio-demographic, clinical, paraclinical and etiology data were collected. In ten years 56 patients have been received and examined. The average age was 56 with a sex ratio of 1.07. The main signs listed were dyspnea (44 cases; 78.6%), dysphonia (8 cases; 14.3%) and false routes (2 cases; 3.6%). The vocal cords were immobile in paramedian adduction (29 cases; 51.79%), in median adduction (25 cases; 44.64%) or in abduction (2 cases; 3.6%). The two main causes found were prolonged intubation and total thyroidectomy. Vocal cord paralysis is uncommon. Nasofibroscopy is the key to diagnosis. Prolonged intubation and thyroid surgery are the most common causes

Ambulatory ENT Surgery: Eight Years of Experience in A Tropical Environment

Introduction Ambulatory surgery allows minimizing the time spent in the hospital, which could reduce the transmission of nosocomial pathologies and the occupation of hospital resources and infrastructures. The objective of the study was to assess the ambulatory activity of the ENT department of Military Teaching Hospital of Cotonou since its creation. Materials and methods The study was monocentric retrospective covering an eight-year period from January 1, 2013, to January 1, 2021. It concerned all ENT surgeries where the patient was discharged on the same day, regardless of the type of anaesthesia used. A pre-established survey form was used to collect data from the medical records. The variables studied were socio-demographic factors, eligibility criteria, indications and conversion to inpatient mode. Results Over the study period half of the procedures performed (334 patients) corresponded to indications for outpatient surgery and then were included. Of these, 130 patients (38.9%) were rejected for various contraindications like geographical and financial accessibility and communication difficulties. A total of 204 patients (61.1%) underwent ENT ambulatory surgery. The sex ratio was 3 males to 5 females (0.6). Children under 15 years of age accounted for 43.7% (n=146). Tonsillectomy with or without adenoidectomy was the most frequent surgery accounting for half of the outpatient surgery cases. Pharyngeal surgery was the most performed: (126 patients) followed by cervico-facial surgery (44 patients). Reconversion to inpatient mode occurred in 39 patients (19.12%). No respiratory complications were noted. No deaths were recorded.   Conclusions  Ambulatory care is a mode of management mainly used for pharyngeal surgery, in particular tonsillectomy and adenoidectomy in children. The main contraindications to patient eligibility were geographical and financial accessibility and communication difficulties. This activity would benefit from being better structured with specific staff and premises