Tuberculosis of the temporomandibular joint.

INTRODUCTION: Extrapulmonary and extra-spinal tuberculosis (TB) is rare, even in countries where the disease is endemic. Ten percent of these localizations are cervico-facial. Involvement of the temporomandibular joint (TMJ) is very unusual. We present the features of such a case. REVIEW: We looked for patients managed for TMJ TB in 2 Maxillofacial Surgery departments and in 1 Pneumology & Phthisiology Department since 1992. The second part of the study was a literature review. One case was found in our departments and 15 other cases were found in published data. Most patients were women with mean age of 39.9 years (5 to 68). Pre-auricular swelling was the predominant functional sign, often without fever or change in the health status. The biological and radiological abnormalities were non-specific (osteolysis, joint pinching, etc.). No lung involvement was observed. The joint recovered its normal function after appropriate management. DISCUSSION: Tuberculosis of the TMJ is difficult to diagnose given its rarity and the non-specific nature of clinical and paraclinical signs. It must be considered in the differential diagnosis for common diseases of the TMJ whether TB is endemic or not.

[Diagnostic and therapeutic aspects of parotid tumors in the Maxillofacial Surgery Department of the University Hospital Center in Treichville, Abidjan]. / Les aspects diagnostiques et thérapeutiques des tumeurs parotidiennes en chirurgie maxillo-faciale au CHU de Treichville Abidjan.

INTRODUCTION: Taking charge of parotid tumors in an African setting is difficult because of the weakness of the technical, delayed consultation, treatment of traditional healers, tumor volume, secondary infection and ulceration of some of them. OBJECTIVE: Identify the epidemiological, clinical, evolutive and therapeutic in order to propose an adapted scheme to the management of these tumors in our African conditions. MATERIALS AND METHODS: This is a retrospective study of 38 patients with parotid tumors operated and hospitalized in the department of stomatology and maxillofacial surgery university hospital of Treichville (Abidjan), during the period from January 2005 to December 2009 included, so a period of 5 years. RESULTS: The study involved 21 (55.3%) men for 17 (44.7%) women aged between 8 and 75 years came to 76.31% for parotid tumor. In 55.26% patients consulted between 1 and 5 years. Clinically: general condition was preserved in 91.1%, tumor size ranged between 5 and 10 cm in 60.53%, they were in the form of nodules in 78.9%, were covered with healthy skin in 78.95%, appeared as isolated tumor in 72.06%. Ultrasound examination was the most paraclinical exam used (65.79%). The tumors were benign in 76.3% dominated by pleomorphic adenoma (63.2%). The most common malignant tumor was muco epidermoid carcinoma (7.9%). Exo-facial parotidectomy was the most common technique used (60.52%). The rate of patient follow-up at 2 years was 5.26%. CONCLUSION: Social and cultural conditions of the management of tumors and lack of technical platform lead us to propose the total parotidectomy for a better cure rate of patients.

[Diagnostic and surgical approach to an hourglass-shaped nasopalatine glioma in an infant]. / Approche diagnostique et chirurgicale d'un gliome naso-palatin "en sablier" chez un nourrisson.

The authors report a case of glioma nasopalatine Multifoil in wallet, location-intra nasal and palatal left. The nasal glioma is a rare congenital malformation presenting as a nasal mass composed of neuroglial tissue heteropias resulting from an abnormality in embryonic development. It is a benign tumor that fits into the nosology of the masses of the midline. This abnormality arises primarily a diagnostic problem because often mistaken for a meningo-encephalocele or a nasal dermoid cyst. Localization nose and palate, an hourglass, is extremely rare if not exceptional; The computed tomography (CT) has enabled the accurate assessment of injury and has guided the choice of surgical technique. The resection was done successfully without recurrence. Histology examination of the surgical specimen confirmed the nature of astrocytic neuroglial tumor. The location of the tumor pedide palate to that of the left nostril is special and especially histological diagnosis of this congenital malformation.