ABSTRACT
Aim.Review the literature from 1990 to 2013 to determine known anatomic sites; risk factors; treatments; and outcomes of head and neck squamous cell carcinoma (HNSCC) in sub-Saharan Africa.Methods.Using a systematic search strategy; literature pertaining to HNSCC in sub-Saharan Africa was reviewed and patient demographics; anatomic sites; histology; stage; treatment; and outcomes were abstracted. The contributions of human immunodeficiency virus (HIV); human papillomavirus (HPV) and behavioural risk factors to HNSCC in the region were assessed. Results of the 342 papers identified; 46 were utilized for review; including 8611 patients. In sub-Saharan Africa; the oropharyngeal/oral cavity was found to be the most common site; with 7750 cases (90% of all cases). Few papers distinguished oropharyngeal from oral cavity; making identification of possible HPV-associated oropharyngeal squamous cell carcinoma (SCC) difficult. SCC of the nasopharynx; nasal cavity; or paranasal sinuses was identified in 410 patients (4.8% of all cases). Laryngeal SCC was found in 385 patients (4.5% of all cases); and only 66 patients (0.8% of all cases) with hypopharyngeal SCC were identified. In 862 patients with data available; 43% used tobacco and 42% used alcohol; and reported use varied widely and was more common in laryngeal SCC than that of the oropharyngeal/oral cavity. Toombak and kola nut use was reported to be higher in patients with HNSCC. Several papers reported HIV-positive patients with HNSCC; but it was not possible to determine HNSCC prevalence in HIV-positive compared to negative patients. Reports of treatment and outcomes were rare.Conclusions The oropharyngeal/oral cavity was by far the most commonly reported site of HNSCC reported in sub-Saharan Africa. The roles of risk factors in HNSCC incidence in sub-Saharan Africa were difficult to delineate from the available studies; but a majority of patients did not use tobacco and alcohol
Subject(s)
Carcinoma , Epithelial Cells , Head , Neck , Oropharyngeal Neoplasms , ReviewABSTRACT
Dog bites are a poorly understood and complex public health problem. Children are most frequently the victims of dog bites and the face is often the favoured target. A review of dog bite wounds in small children presenting to the Red Cross War Memorial Children's Hospital was carried out over a period of 13.5 years (1991-2004). One thousand eight hundred and seventy-one dog bite wounds were admitted from a total of 125;677 patients treated. From 1;871 patients presenting with dog bite injuries; we identified 596 children who sustained injuries to the head; face or neck. Dog bites to the head; face or neck were responsible for 0.5of all trauma unit presentations and 32of all dog bite injuries. The mean age of the children was 5.1 years. Male children accounted for 68of the patients. The peak incidence was noted in children aged 2 to 4 years old. One hundred and seventy-two (29) bites occurred between the summer months of December and February. Two hundred and forty-nine (42) patients presented to hospital between the hours of 12:00 and 18:00 hours and 275 (46) children presented between 18:00 and 0:00 hours. A large proportion of all attacks occurred either inside or outside the victim's own home and at the home of friends or family. Superficial injuries were treated with wound cleaning; suturing and dressing. There were no fatalities. Dog bites are relatively common in small children; but do not represent a major cause of morbidity and mortality
Subject(s)
Bites and Stings , Child , Dogs , Face , Head , NeckABSTRACT
Dog bites are a poorly understood and complex public health problem. Children are most frequently the victims of dog bites and the face is often the favoured target. A review of dog bite wounds in small children presenting to the Red Cross War Memorial Children's Hospital was carried out over a period of 13.5 years (1991-2004). One thousand eight hundred and seventy-one dog bite wounds were admitted from a total of 125;677 patients treated. From 1;871 patients presenting with dog bite injuries; we identified 596 children who sustained injuries to the head; face or neck. Dog bites to the head; face or neck were responsible for 0.5 of all trauma unit presentations and 32 of all dog bite injuries. The mean age of the children was 5.1 years. Male children accounted for 68 of the patients. The peak incidence was noted in children aged 2 to 4 years old. One hundred and seventy-two (29) bites occurred between the summer months of December and February. Two hundred and forty-nine (42) patients presented to hospital between the hours of 12:00 and 18:00 hours and 275 (46) children presented between 18:00 and 0:00 hours. A large proportion of all attacks occurred either inside or outside the victim's own home and at the home of friends or family. Superficial injuries were treated with wound cleaning; suturing and dressing. There were no fatalities. Dog bites are relatively common in small children; but do not represent a major cause of morbidity and mortality
Subject(s)
Age Factors , Bites and Stings/epidemiology , Child , Dogs , Face , Head , Neck , PatientsABSTRACT
But : rapporter les lesions d'origine traumatique tete et cou sur le plan epidemiologique et clinique Materiels et methode : Une etude prospective descriptive d'aout 2007 a janvier 2008 dans le service des urgences chirurgicales de l'hopital Gabriel a permis de colliger 184 patients; dont les criteres d'inclusion ont consiste a recruter tout patient presentant un traumatisme de la sphere tete et cou. Ont ete exclus les patients presentant des lesions purement neurochirurgicales et les lesions associees du reste du corps. Resultats : Les patients colliges etaient plus souvent de jeunes adultes (age moyen : 27 ans) de sexe masculin (sex ratio 4;3 en faveur des hommes) et celibataires residant en milieu urbain et victimes a 93d'accident de la voie publique. Les lesions observees ont consiste en des epistaxis; des fractures de siege et de trait multiples du massif facial; du rachis cervical et du rocher avec souvent plaies delabrantes de l'oreille externe et du nez. Les risques principaux encourus ont ete de 4 ordres : trouble circulatoire; risques d'obstruction des voies aeriennes superieures; deficit fonctionnel et/ou morphologiques et risque letal du fait d'un etat comateux (Glasgow inferieur a 8). La prise en charge bien codifiee a eu des contraintes majeures du fait que les actes d'imagerie; de biologie; de consommables chirurgicaux et de medicaments etaient entierement et prealablement reunis par les patients sur fond propre. Conclusion : L'absence de medicaments et/ou consommables conditionnes en kit specialises en charge de la gestion d'une urgence tete et cou est une distorsion majeure. Le recouvrement en amont et la confection de tels paquets meme au prix d'une politique d'assurance-sante generalisee sera un gage d'humanisation et de prise en charge de qualite dans nos differentes structures de sante
Subject(s)
Head , Neck Injuries , TraumatologyABSTRACT
Les localisations ORL extra ganglionnaires de la tuberculose sont peu communes. La symptomatologie clinique est trompeuse; posant ainsi le probleme de diagnostic differentiel avec la pathologie tumorale. Nous rapportons 12 cas de localisations extra ganglionnaires de tuberculose; colliges au service ORL de l'EPS Fattouma Bourguiba de Monastir entre 1995 et 2009. L'age moyen de nos patients est de 38 ans. L'etude topographique a montre 3 localisations laryngees; 3 au niveau des glandes salivaires; 2 amygdaliennes; 2 rhinopharyngees; 2 rhino sinusiennes. Le diagnostic etait anatomopathologique dans tous les cas. Tous nos patients ont recu un traitement antituberculeux avec une bonne evolution
Subject(s)
Head , Neck , Tuberculosis, Lymph Node/diagnosisABSTRACT
"The management of burns is well covered by many textbooks- notably; Maurice King's ""Primary Surgery Vol. 2; Trauma"" which is available from the Oxford University Press that has two outlets in Kampala. However; there remain some very difficult burns to treat; and these include those of the palmar surfaces of the hands and the plantar surfaces of the feet; and those of the head. The article addresses these problems. It gives a summary of the general principles; e.g. depths of burn and their importance; and effect of the site of body burned. It highlights management in the acute stage: immediate first aid; the first 24 hours; charting the burn; pain relief and monitoring for life or limb-threatening emergencies. The article discusses monitoring progress and fluid balance; feeding in burns; supervision of the burn itself; and the different types or methods of skin grafting."