Caractéristiques de l'automédication en ORL à l'Hôpital d'Instruction des Armées-Cotonou au Bénin / Characteristics of self-medication in ENT at Military Teaching Hospital Cotonou in Benin

Etudier l'ampleur et les caractéristiques de l'automédication en consultation ORL. Méthode: Etude descriptive du 1er juin 2020 au 1er février 2021 dans le service d'ORL-CCF/ Hôpital d'Instruction des Armées. Ont été inclus tous les patients reçus en consultation ORL ayant déclaré avoir utilisé des substances actives sans prescription médicale pour soulager leur plainte actuelle. 6 Résultats: L'automédication a été retrouvée chez 373 patients soit une prévalence de 47,88%. La moyenne d'âge était 32,26 ans (02 mois et 80 ans). Les sujets âgés 0 à 20 étaient plus représenté (68,4%). La sex-ratio était de 0,86. Les professions libérales étaient plus représentées (30%). La quasi-totalité des patients (98%) a pu énumérer au moins deux effets nocifs de l'automédication. Les médicaments en cause étaient les médicament en vente libre OTC (80%). Les principales raisons ayant motivé l'automédication ont été le coût élevé des prestations médicales (41,3%) et le manque de temps (33,2%). Conclusion: L'automédication a été retrouvée chez des patients volontiers jeunes, de sexe féminin, porteurs d'affections rhinologiques. Les OTC étaient en cause dans huit cas sur dix. Les principales motivations à l'automédication ont été le coût élevé des prestations médicales et le manque de temps.

Apport de la tomodensitométrie dans la pathologie ORL non traumatique au centre hospitalier universitaire de Brazzaville / NA

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.

The dynamics of bacteria population on the skin, throat, and gastrointestinal tract of HIV-seropositive patients

Background: The study determined bacteria population on the skin; throat; and gastrointestinal tract of human immunodeficiency virus (HIV)-seropositive patients and HIV seronegative controls at the baseline; 3 months; and 6 months; respectively; at Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC); Ile-Ife; Osun State; Nigeria and State Specialist Hospital; Akure; Ondo State; Nigeria between May and November; 2012. Materials and Methods: Seventy HIV-seropositive subjects and 51 HIV seronegative controls who attended the HIV clinics were recruited. Skin; throat; and rectal swabs were obtained from the participants using sterile cotton-tipped applicators introduced into thioglycollate broth and incubated at 37oC overnight. When growth was noticed; the broth culture was streaked on different bacteriologic media and the isolates were characterized by the standard methods and disc diffusion for antibiotic sensitivity. Results: The number of isolates cultured from the HIV-seropositive subjects was 934; with the distribution being 397; 326; and 211 at the baseline; 3 months; and 6 months; respectively. The distribution of 1;138 isolates cultured from 51 HIV-seronegative controls was 433; 354; and 351 at the baseline; 3 months; and 6 months; respectively. At the baseline among HIV-seropositive patients; the predominant isolates were Arcanobacterium haemolyticum; Pseudomonas aeruginosa (P. aeruginosa); and Bacillus cereus (B. cereus). However; Corynebacterium haemolyticum; Enterococcus faecalis; and Escherichia coli (E. coli) were predominant at 3 months while at 6 months; Corynebacterium haemolyticum and Corynebacterium diphtheriae had the highest frequency followed by Pseudomonas fluorescens (P. fluorescens). In the controls; Corynebacterium diphtheriae; Listeria monocytogenes; and Staphylococcus xylosus (S. xylosus) predominated at the baseline and at 3 months while at 6 months; B. cereus; S. xylosus; and Staphylococcus aureus (S. aureus) were prevalent. Multiple resistances were widespread among the isolates. Conclusion: A preponderance of opportunists was observed in the HIV-seronegatives but higher multiresistant strains in the HIV-seropositives; suggesting both groups live in an antibiotic pressurized environment

Ear; Nose; and Throat Foreign Bodies in a Tertiary Health Institution in Sokoto; Nigeria

Background: Otorhinolaryngeal foreign bodies are common in ear; nose; and throat (ENT) practice. The objective of this study is to determine the pattern of otorhinolaryngeal foreign bodies in a Tertiary Health Institution in Sokoto; North-Western Nigeria. Materials and Methods: This is a 2 year retrospective study using the records of all cases of ENT foreign bodies at Usmanu Danfodiyo University Teaching Hospital; Sokoto; from January 2009 to December 2010. Data analysis was carried out using the SPSS for windows version 13.0. Results: A total of 90 cases were analysed. Ear foreign bodies 48 (53.3) were commonest; followed by nasal foreign bodies 16 (17.8); bronchial foreign bodies 15 (16.7); and esophageal foreign bodies 11 (12.2). Age range was 9 months to 64 years. High frequency of the foreign bodies was noted in the younger age group. The foreign bodies varied according to the site with plant seed being more common in the ear and the nose while meat bolus is more common in the esophagus. Bronchial foreign bodies were seen exclusively in children less than 14 years old with beads and valve of plastic toys being the most common. Conclusion: Otorhinolaryngeal foreign bodies remain frequent occurrence particularly in the younger age group 9 years old or less and high index of suspicion suggested and early intervention to prevent the morbidity and mortality from complications

Sprays and Lozenges for Sore Throats

A sore throat is a common complaint; and often an early indication of another medical condition; such as a cold. In the absence of life-threatening conditions or bacterial infection; local symptomatic treatment will ease the pain. This article reviews the common causes and symptoms of sore throats; and provides an overview of some of the sprays and lozenges that are available to treat this problem

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

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

Emergency Ear; Nose throat Administrations at the Korle-Bu Teaching Hospital

Background: Ear Nose and Throat (ENT) emer-gencies are common in all communities. Early diagnosis and prompt management will result in reduction in morbidity and mortality.Objectives: To assess the size and distribution of ENT emergencies; obtain base line data and out-line preventive measures.Design: Clinical records of patients admitted for ENT emergency care at the Korle Bu Teaching Hospital from 1st January 2000 to 31st December 2002 were studied with respect to sex; age; diag-nosis on admission and outcome of emergency care. Exclusion criteria were admissions for termi-nal cancer care.Results: A total of 750 patients made up of 476 males and 274 females were admitted for emer-gency care. The age range was 1 month to 100 years; mean age was 25.5 years and median age was 18.23 years. The commonest causes of emer-gency admissions were foreign bodies in the oe-sophagus in 310 (41.3

Postoperative Throat Complications after Tracheal Intubation

Background:A prospective study was carried out to determine the incidence of sore throat after endotracheal intubation and the associated causative factors.Methods: Two hundred patients aged 18-77 years who had surgery over sixteen months were studied. Sizes 7mm - 8.0mm internal diameter (I.D) portex endotracheal tubes with cuff were used for females while sizes 8.5mm - 9.0mm I.D were used for males. A standardized form was used to collect patients' details; types of surgery; technique of airway maintenance and number of attempts at intubation. The use of nasogastric tubes; throat pack; duration of intubation and status of the anaesthetists were also noted. The presence of sore throat and other throat complications were determined within 24 - 36 hours after surgery.Results: One hundred twenty six (63) patients experienced throat complications. The incidence of sore throat was similar in both males and females. There was no statistically significant difference P=1.0000; odd ratio = 1.035; 95CI: 0.5064 - 2.115. There was no statistical difference between the group whose tubes were lubricated and the one without tube lubrication. P = 0.5296; odds ratio - 1.255; 95CI: 0.6702 - 2.351. There was statistically significant difference between the incidence of throat complications in throat related surgery and non- throat related surgery. P=0.0001.; odds ratio-9.771; 95CI: 3.065-31.148. Multiple attempts at intubation did not contribute to the development of sore throat. Duration of intubation greater than 60 minutes contributed to a higher incidence of throat complications and it was considered statistically significant.Conclusion:Routine endotracheal intubation can result in trauma and pathological changes; which could lead to postoperative throat symptoms. There is need to further evaluate if the use of smaller sized endotracheal tubes could reduce the incidence of throat complications

Tableau pharyngoscopique chez l'enfant presentant une amygdalite chronique (a propos de 128 observations)

L'analyse des tableaux pharyngoscopiques chez 128 enfants ages de 2 a 15 ans presentant une amydalite chroniquee a ete realisee. Les resultats de l'etude nous permettent de considerer comme signes pharyngoscopiques frequents de l'amygdalite chronique chez l'enfant : - les adherences et brides reliant les piliers palatins avec les amygdales et le repli de His; - l'hypertrophie des amygdales - le remaniement sclero-cicatriciel des amygdales

Pattern of dysphagia in Calabar

A retrospective study of dysphagia in 55 children; aged between six months and 12 years (mean age 4.3 years) in Calabar; has revealed foreign body impaction in the throat to be the commonest cause; occurring in 40.0 percent of the cases. Children; aged between five and 10 years; were commonly involved in foreign body impaction which was caused by coins and food (meat and fish bones) in 31.8 and 27.3 percent respectively; of the 22 cases. Oesophageal stricture due to accidental ingestion of caustic soda was found in 14.5 percent of the cases and involved children in the age group; six to eight years. The cause of dysphagia was however; unknown in 25.5 percent of the patients. Malnutrition (56.4 percent) and aspiration pneumonia (27.3 percent) were the major complications in the series. It is concluded that most of the causes of dysphagia in the series are preventable