ABSTRACT
Objectif: décrire l'apport de la tomodensitométrie dans la pathologie ORL non traumatique. Méthodologie : Il s'agissait d'une étude transversale et descriptive allant de mai 2003 à janvier 2017 soit 13 ans et 8 mois, au CHU de Brazzaville. Nous avons inclus dans notre étude tous les patients ayant présentés une pathologie ORL, pour laquelle le bilan diagnostique nécessitait la réalisation d'une tomodensitométrie. Résultats : la fréquence de prescription de la TDM en ORL représentait 3,5%. L'âge moyen 38,2 ± 18,2 ans. Le sexe masculin représentait 59%. La TDM était utile dans le diagnostic devant 51,90% des signes fonctionnels, 48,10% du syndrome tumoral. L'atteinte rhinosinusienne représentait 59,5% suivie du pharynx 17,8%. La pathologie infectieuse représentait 63% (sinusite 51%) et la pathologie tumorale 37% (tumeur du cavum 18%). Conclusion: La prescription de la tomodensitométrie dans les pathologies ORL reste faible. Les indications et les lésions observées sont multiples. La TDM reste un moyen d'exploration complémentaire utile dans la pathologie tumorale qu'infectieuse.
Objective: To describe the contribution of CT scans in non-traumatic ENT pathology. Methodology: This was a cross-sectional and descriptive study from May 2003 to January 2017 (13 years and 8 months), at the University Hospital of Brazzaville. We included in our study all patients who presented an ENT pathology for which the diagnostic work-up required a CT scan. Results: The frequency of prescription of CT in ENT represented 3.5%. The average age of the patients was 38.2 ± 18.2 years. Males accounted for 59%. CT was useful in the diagnosis of 51.90% of the functional signs and 48.10% of the tumour syndrom. Rhinosinus involvement accounted for 59.5%, followed by the pharynx for 17.8%. Infectious pathology represented 63% (sinusitis 51%) and tumour pathology 37% (cavum tumour 18%). Conclusion: The prescription of CT scans in ENT pathologies remains low. The indications and lesions observed are multiple. CT remains a useful complementary means of exploration in tumour and infectious pathology.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Otorhinolaryngologic Diseases , Otorhinolaryngologic Neoplasms , Pharynx , SinusitisABSTRACT
Introduction : La pathologie naso-sinusienne occupe une place importante en ORL. Sa prise en charge passe par une étude de données de la circonscription concernée. Ce travail avait pour but d'établir le profil épidémiologique, et clinique des pathologies naso-sinusiennes. Matériels et méthode : Il s'agissait d'une étude transversale descriptive menée en consultation sur une période de six mois allant de janvier 2018 à juin 2018 dans l'unité d'ORL-CCF du Centre de Santé de Référence de la Commune V de Bamako. Ont été inclus tout patient venu pour la première fois en consultation dans ladite unité pour pathologie naso-sinusienne. Résultats : Les pathologies naso-sinusiennes ont représenté 12,62% des consultations qui s'élevaient à 1656 patients. Nous avons recensé 60,3% de femmes et 39,7% d'hommes. La tranche d'âge 21-30 ans a constitué 25,8% des cas. L'âge moyen a été de 29 ans, avec des extrêmes de 11 jours et 80 ans. Les motifs de consultation ont été l'obstruction nasale (41,6%), l'épistaxis (19,2%), et les rhinorrhées 12,4%. Les rhinites ont représenté 59,8%, les sinusites 20,1%, les corps étrangers et les épistaxis chacun 7,6% des diagnostics. Un cas de tuberculose nasale a été observé. Conclusion : Les pathologies naso-sinusiennes sont dominées par la pathologie inflammatoire et infectieuse
Subject(s)
Epidemiologic Methods , Mali , Nose Diseases , Paranasal Sinuses , Patients , Sinusitis/diagnosisABSTRACT
Background: Rhinosinusitis (RSS) is a common form of upper airway disease encountered by Otolaryngologists. Objectives: To describe the trends in the clinical presentation, diagnosis and management of RSS in a tertiary hospital.Methods:Retrospective analysis of clinical information retrieved from the hospital records of patients with RSS managed in the ENT department of OOUTH Sagamu over an 18-month period was done.Results: Out of 1814 patients, 143 had RRS with the prevalence rate of 7.9%. The male-to-female ratio was 1.1:1, the age ranged from 7 to 79 (median = 32.4) years. The presenting symptoms included mucoid nasal discharge (68.7%), nasal congestion (61.5%) and excessive sneezing (46.8%). Most (71.3%) of the patients presented after 3weeks of the onset of symptoms and the median duration was 3.2 months. The leading physical findings included engorged nasal turbinates (78.3%), ooedematous nasal mucosa (72.0%), mucopurulent anterior rhinorrhoea (28.6%) and pale nasal mucosa (25.9%). The investigations done included plain X-Rays of the sinuses (86.0%), full blood count (67.1%) and computerized tomographic (CT) scan of the sinuses (8.4%). Plain X-Ray abnormalities were most common in the maxillary sinuses (45.5%) while 30.1% had multi-sinusitis. The trend of diagnosis ranged from infective RSS in 51.7% to allergic RSS in 38.5%. About a quarter had different forms of non-endoscopic surgical intervention. Recorded complications included nasal polyps in 11.9%. Conclusion: The trend of RSS observed relative affectation of adults and mostly chronic infective types, and sometimes allergic types.Radiological assessment was by plain X-Rays in most cases, management was either medical or non-endoscopic surgical methods, frequently complicated by polyps
Subject(s)
Nigeria , Retrospective Studies , Sinusitis/diagnosis , Tertiary Care Centers , X-RaysABSTRACT
Background/Objectives: Rhinosinusitis is the commonest viral infection in man and the commonest inflammatory disorder encountered by general practitioners; chest physicians; and otorhinolaryngologists all over the world. The clinical pattern and outcome of conventional management measures were assessed. Method: All new patients with the diagnosis of rhinosinusitis over a 2-year period from July 1999 to July 2001 were analyzed for clinical features; conventional radiological findings; and treatment modalities over a period of 3 years follow up. Results: There were 195 (11.7) new cases of rhinosinusitis out of a total number of 1661 patients seen over the period under review. Only 146 case notes were accessible for the study. Eighty-four (57.5) were males and 62 (42.5) were females. Their ages ranged from 7 months to 70 years. The main clinical symptoms and signs were nasal discharge or rhinorrhea (84.9); nasal obstruction (24.7); epistaxis (22.0); and sneezing (20.6). The duration of symptoms ranged from few days to about 10 years with 24 (16.4) being acute cases while 122 (83.6) were chronic cases giving a prevalence of 1.4and 7.3; respectively. Maxillary sinus (58.9) was the commonest sinus involved. More than one sinus involvement accounted for 37.7of the cases. Infective causes accounted for 67.1of cases followed by allergy (28.8). There were complications in 21 (14.4) cases with orbital involvement (33.3) being the commonest complication. Mode of treatment were medical (86.3); and conventional surgery was carried out in 13.7of the cases for either failed medical treatment or associated complications. Facial paraesthesia along the sites of surgery was the commonest complications; otherwise the outcome of treatment was excellent. Conclusion: Rhinosinusitis in this region was more of chronic (83.6) variety than acute (16.4) variety. Infective causes (67.1) and allergy (28.8) were the commonest etiological factors. About (86.3) were amendable to medical treatment while surgical treatment was carried out in 13.7of the cases. Rhinosinusitis should be managed medically first before recourse to surgical measures in carefully selected cases. Endoscopic sinonasal surgery is most desirable in keeping with current global trends of treatment of rhinosinusitis but where facilities do not exist; conventional surgical measures may be used
Subject(s)
Practice Patterns, Physicians' , Retrospective Studies , Sinusitis/diagnosisABSTRACT
Background: Nasal polyposis is the benign protrusion of soft tissue into the nasal cavity; with multifactorial origin. This study is designed to examine the suggested role of IgE and CD and CD lymphocytes in the pathogenesis of 4 8 nasal polyposis. Method: Blood samples were taken from 32 patients with chronic polypoid sinusitis and 32 controls. CD and CD 4 8 total lymphocyte count were determined by flow cytometry and the level of serum IgE was measured by ELISA. Nasal discharge samples were also collected for determining IgE level in both patients and controls during surgery. Results: In 68.8of patients a history of allergy was present. The level of nasal discharge IgE was significantly higher (p0.001) in patients compared to controls; but the difference between serum IgE levels was not significant (p 0.05). CD concentration and blood lymphocytes were 8 significantly higher (p0.001) in the patients group; while CD concentration was significantly lower (p0.001) in 4 them. Finally; CD /CD ratio was significantly lower 4 8 (p0.001) in the patients group. Conclusion: This study suggests that a change in the amount of CD and CD lymphocytes and an increased 4 8 level of local IgE contribute to nasal polyposis; but the results should be confirmed in more extensive studies including cytokine analyses. Such increasing insights in the patho physiology of nasal polyposis open perspectives for new pharmacological treatment options; with immunologic factors as potential targets.of patients a history of allergy was present. The level of nasal discharge IgE was significantly higher (p0.001) in patients compared to controls; but the difference between serum IgE levels was not significant (p 0.05). CD concentration and blood lymphocytes were 8 significantly higher (p0.001) in the patients group; while CD concentration was significantly lower (p0.001) in 4 them. Finally; CD /CD ratio was significantly lower 4 8 (p0.001) in the patients group. Conclusion: This study suggests that a change in the amount of CD and CD lymphocytes and an increased 4 8 level of local IgE contribute to nasal polyposis; but the results should be confirmed in more extensive studies including cytokine analyses. Such increasing insights in the patho physiology of nasal polyposis open perspectives for new pharmacological treatment options; with immunologic factors as potential targets
Subject(s)
Nasal Cavity , Sinusitis/immunologyABSTRACT
Les auteurs rapportent deux cas de cellulites periorbitaires colligees sur une annee dans le service ORL. Ces deux cas ont la particularite d'etre survenue chez des enfants dans un contexte de pyorrhee alveolodentaire et de poly sinusites faciales associees. Le parcours therapeutique avant l'hopital a ete emaille de traitement traditionnel dans un cas et d'automedication dans l'autre. Dans les deux cas le medecin referent a ete un ophtalmologiste. Les deux patients ont ete admis en hospitalisation ORL au stade de phlegmon periorbitaire collecte ayant necessite un drainage chirurgical sous anesthesie generale. Les suites operatoires ont ete simples; cependant un des enfants admis au stade d'une acuite visuelle reduite a la simple perception lumineuse n'a pas recupere de sa perte de vision
Subject(s)
Blindness , Case Reports , Dental Caries , Orbital Cellulitis , Sinusitis/complicationsABSTRACT
Background: Complications of acute inflammatory sinusitis into orbital and intracranial sepsis is a common problem in paediatrics. A delay in making a diagnosis and early appropriate treatment has a high morbidity and mortality rate.The commonest presenting symptoms are throbbing headache and facial or periorbital swelling usually fallowing a two week history of upper respiratory tract infection. A high resolution Computed Tomography(CT) scan is very helpful in making a proper and accurate diagnosis. Appropiate early medical and surgical treatment has a good outcome.We are reporting our epidemiological study of complicated sinusitis of 59 cases treated at Dr George Mukhari Hospital; ENT Department a Tertiary referral centre; Medunsa Campus;University of Limpopo; RSA.Methods: A prospective case series of all patients admitted with complicate inflammatory confirmed on CT scan betweenApril 2004 to August 2005(Winter months).An interview data collection sheet was used to collect all clinical information.ResultsFifty-nine (59) inpatients (50 males and 9 females) admitted and treated at DGMH for complicated pan-sinusitis.The mean age of the patients was 13 years; with a male:female ratio of 7:1. All patients presented with a sporadic first episode of sinusitis; occurring within two weeks of upper airway infection. The affected age group was mainly paediatric of peripubertal age. In almost all the patients; headache and facial (peri-orbital) swelling were the main presenting symptoms. Most patients (85) were initially referred to other departments 59.3(35) to Ophthalmology; 18.6(11) to Neurosurgery; 6.7(4) to Paediatrics and only 15.2(9) directly to ENT (Otorhinolaryngology). Of these patients; 36 (61) had intracranial complications confirmed on CT scan and were managed in consultation with the neurosurgeons and ophthalmologists. No major surgical complications were reported. Staphylococcus species were the most common organisms isolated; however; 50of the pus swabs had a negative culture. Medical treatment based on culture and sensitivity; together with surgical drainage; achieved good results. Three females with severe complications died during the period of the study; but there were no male deaths reported in this study; even though more males than females were affected.ConclusionComplications of septic sinusitis are a common problem in the paediatrics; with males more commonly affected than females. Females; however; had a poorer prognosis than males in this study. Complicated sinusitis should be suspected in any adolescent with orbital; facial or frontal swelling associated with headache always during the winter (cold) months. To prevent morbidity and mortality; a high resolution contrasted CT scan is mandatory for the exclusion of complicated sinusitis; medical and surgical treatments are effective management of complicated sinusitis
Subject(s)
Child , Pediatrics , Sinusitis/complicationsABSTRACT
Background: Complications of acute inflammatory sinusitis into orbital and intracranial sepsis is a common problem in paediatrics. A delay in making a diagnosis and early appropriate treatment has a high morbidity and mortality rate. The commonest presenting symptoms are throbbing headache and facial or periorbital swelling usually fallowing a two week history of upper respiratory tract infection. A high resolution Computed Tomography(CT) scan is very helpful in making a proper and accurate diagnosis. Appropiate early medical and surgical treatment has a good outcome. We are reporting our epidemiological study of complicated sinusitis of 59 cases treated at Dr George Mukhari Hospital; ENT Department a Tertiary referral centre; Medunsa Campus; University of Limpopo; RSA.Methods: A prospective case series of all patients admitted with complicate inflammatory confirmed on CT scan between April 2004 to August 2005 (Winter months). An interview data collection sheet was used to collect all clinical informationResults: Fifty-nine (59) inpatients (50 males and 9 females) admitted and treated at DGMH for complicated pan-sinusitis. The mean age of the patients was 13 years; with a male:female ratio of 7:1. All patients presented with a sporadic first episode of sinusitis; occurring within two weeks of upper airway infection. The affected age group was mainly paediatric of peripubertal age. In almost all the patients; headache and facial (peri-orbital) swelling were the main presenting symptoms. Most patients (85) were initially referred to other departments 59.3 (35) to Ophthalmology; 18.6 (11) to Neurosurgery; 6.7 (4) to Paediatrics and only 15.2 (9) directly to ENT (Otorhinolaryngology). Of these patients; 36 (61) had intracranial complications confirmed on CT scan and were managed in consultation with the neurosurgeons and ophthalmologists. No major surgical complications were reported. Staphylococcus species were the most common organisms isolated; however; 50 of the pus swabs had a negative culture. Medical treatment based on culture and sensitivity; together with surgical drainage; achieved good results. Three females with severe complications died during the period of the study; but there were no male deaths reported in this study; even though more males than females were affected.Conclusions: Complications of septic sinusitis are a common problem in the paediatrics; with males more commonly affected than females. Females; however; had a poorer prognosis than males in this study. Complicated sinusitis should be suspected in any adolescent with orbital; facial or frontal swelling associated with headache always during the winter (cold) months. To prevent morbidity and mortality; a high resolution contrasted CT scan is mandatory for the exclusion of complicated sinusitis;medical and surgical treatments are effective management of complicated sinusitis
Subject(s)
Child , Sinusitis/complications , Sinusitis/diagnosis , Sinusitis/surgery , Sinusitis/therapyABSTRACT
Le phlegmon ou abces orbitaire se presente comme une exophtalmie inflammatoire aigue febrile. En vue d'en etudier les origines et les complications; les auteurs rapportent 20 cas colliges en 4 ans (1989-1993). 65 pour cent (13/20 sujets atteints) ont 20 ans ou moins; les sinusites en sont la premiere cause avec 11/20 cas soit 55 pour cent; les traumatismes suivent avec 25 pour cent (5/20 cas). Les phlegmons orbitaires (surtout d'origine ou traumatismes) se compliquent tres souvent; certaines complications peuvent rapidement engager le pronostic vital ou fonctionnel. tel a ete le cas de 2 deces suite a une thrombophlebite du sinus caverneux et 4 cecites dont 3 par atrophie optique. Pour ces raisons le traitement doit etre institue en urgence; utilisant une antibiotherapie puissante et adaptee associee aux anti-inflammatoires de preference cortisonnes. Le drainage de la collection sinusienne avec lavage a l'aide d'une solution antibiocortisonnee en cas de sinusite est tres efficace et permet d'eviter de nombreuses complications