[Hearing aids at the International Center of Auditory rehabilitation in Abidjan: Prosthetics gains and satisfaction in patients].

Subject: To evaluate patients wearing hearing aid at the International Center of Auditory Correction in Abidjan. Method and material: It is a descriptif and transversal study from 07/01/99 to 06/30/10. We have included the files of patients completely filled. We have stu­died the indications, prosthetics gains and the satisfaction after hearing aid. Results: We have achieved 536 files. The ave­rage was 36 years. The indications have been in 76.1% cases of sensorineural hearing loss. The hearing loss has been associa­ted in 13.2% cases to language disorder. For all patient we have noticed bilateral hearing loss in 496 cases (92.5%). The behind the ear aids have been chosen in 69% cases. The type was analogical or digital respectively in 65% and 35% des cas. The prosthetic pure tonal gain was more than 30 dB in 66.8% cases and the prosthetic speech reception threshold gain more than 30 dB in 55.3% cases. The patients have been respectively satisfied less satisfacted, no satisfacted in 68.47%, 22.76% and 8.7% cases. Conclusion: The hearing aids have improved the audition in most of the indications. The proportion of patients satisfied was proportionally equivalent to the audiometric results.

[Management of cancers of nasal cavities and paranasal sinuses in the ENT Unit at CHU de Treichville (Abidjan)]. / Prise en Charge des Cancers Naso-Sinusiens dans le Service D'Orl du CHU de Treichville (Abidjan).

INTRODUCTION: Cancers of nasal cavities and paranasal sinuses are not very frequent; they attract attention by their histological varieties. The aims of this study were to describe the epidemiologic and diagnostic characteristics of cancers of the cavities naso-sinusiennes in the service of ORL of the CHU of Treichville; and to evaluate their treatment. PATIENTS AND METHODS: Were concerned 8 patients (6 men and 2 women) operated for cancer of the cavities naso-sinusiennes during the period from January 1996 to May 2007. RESULTS: They mean aged 51 years; extremes from 28 to 75 years old. No significant factor supporting was raised. The diagnosis was late in the majority of the cases (T > 2: n=5). The way of rhinotomy paralateronasale was used for the tumoral excision associated a ganglionic clearing out in a case. The operational continuations were marked by neurological and ocular disorders. Three patients repeated. The operational follow-up post not having exceeded three months, the long-term evolution and mortality could not be evaluated. CONCLUSION: In our unit the epidemiologic and histological characteristics of cancers of nasal cavities and paranasal sinuses are common with those of the literature. Surgery was the main treatment witch was late and disappointing.

Prise en charge des cancers naso-sinusiens dans le service d'ORL du CHU de Treicheville (Abidjan)

Introduction : Les cancers des cavites naso-sinusiennes sont peu frequents et se singularisent par leurs varietes histologiques. Les objectifs de ce travail etaient de decrire les caracteristiques epidemiologiques et diagnostiques des cancers des cavites naso-sinusiennes; et d'evaluer leur traitement. Patients et methodes : Cette etude a concerne 8 patients (6 hommes et 2 femmes) operes pour un cancer des cavites naso-sinusiennes durant la periode allant du Ier janvier 1996 a 31 mai 2007. Resultats : Ils avaient un age moyen de 51 ans avec des extremes allant de 28 a 75 ans. Aucun facteur favorisant significatif n'a ete releve. Le diagnostic a ete tardif pour la plupart des cas (T2 : n=5). La voie de rhinotomie paralateronasale a ete utilisee pour l'exerese tumorale associee a un curage ganglionnaire dans un cas. Les suites operatoires ont ete marquees par des troubles neurologiques et oculaires. Trois cas de recidive ont ete observes. Le suivi post operatoire n'ayant pas excede trois mois; l'evolution a long terme et la mortalite n'ont pu etre evaluees. Conclusion : Dans notre service; les caracteristiques epidemiologiques et histologiques des cancers naso-sinusiens ont ete superposables a celles de la litterature. Le traitement essentiellement chirurgical a ete tardif et decevant

[Nasal cutaneous cryptococcosis localization]. / Localisation nasale de la cryptococcose cutanée.

Cryptococcosis is a polymorphous disease occurring especially in the course of the Acquired Immuno Deficiency Syndrome (AIDS). It puts so diagnostic that therapeutical problems in African countries. The objective of this observation is to report a case of nasal localization with a cutaneous cryptococcosis. It has been confirmed by the histopathologic study of the cutaneous biopsy. The patient was 42 year-old female, HIV positive, bachelor and hospitalised for epistaxis with cutaneous tumefaction and lesions of the nose. The rate of CD4 was 98/mm3. The treatment was based on amphotericine B. Patient died from neuro meningitis extension of the disease.

[Rhinophyma in a black African]. / Rhinophyma chez un noir africain.

Many cases of rhinophyma have been reported in the European and American literature. To date, African cases have not been described. We report a case of rhinophyma observed in the ENT unit at CHU of Treichville. The diagnosis is made clinically and histologically. This patient refused surgical treatment and has not been seen in our unit since. This is the first case of rhinophyma seen in our service. Treatment difficulties arise due to the technical challenges of a good cosmesis and rejection of surgical intervention as in this case.

[Oto-rhino-laryngology and geriatrics in the Ivory Coast]. / L'oto-rhino-laryngologie et la gériatrie en milieu ivoirien.

Geriatrics medicine develops more and more as a specialized branch of medicine. We report a prospective study of 69 cases of geriatric patients hospitalized in the ENT department of Treichville's teaching hospital from 1996 till 2001. The frequency of hospitalization was estimated at 6.5%. The cohort consisted of 48 males (69.5%) and 21 females (30.5%) with an overall average age of 66.5 years. The majority of the patients lived in the city of Abidjan (61%) with a low socio-economic level (54%). 50.7% were married and 75.4% lived in a house-bold of several persons. The main lesions were at the level of the larynx (36.2%) and nose and sinuses (21.7%) cancers (52%) were more frequent. The patients were little dependent (84%), however 11.6% presented with psychological troubles. Associated pathologies were identified in 18.8% of case. The age, dependence and pathology determined the average duration of stay and the mode of exit. Mortality, of tumoral cause (cancer of the larynx), was estimated at 11.6%. An improved service requires a mutli-disciplinary approach an ORL-based presentative programme and prospective multicentre studies.

[Tracheocele: a rare cause of pharyngeal disorders]. / Trachéocèle: une cause rare de gêne pharyngée.

A 40-year-old woman with an uneventful history consulted for an episode of cervical swelling and pharyngeal disorders with sensation of a foreign body. Cervical and ENT examination was normal. The barium swallow showed a normal esophagus and the CT scan showed an air image in the right side of the trachea. The diagnosis of tracheocele was made at surgery and was confirmed by histology. Clinical, endoscopic, and radiologic outcome was favorable three months after surgical resection of the diverticulum. Tracheocele is rarely reported in the literature. It results from a congenital or acquired weakness of the tracheal wall. The right side is involved more frequently. No specific signs or symptoms have been identified. Diagnosis is often based on CT findings. Surgery confirms the diagnosis and allows resection.

[Hemangiopericytoma of the infratemporalis fossa: a multi-operated patient]. / Hémangiopéricytome de la fosse infra-temporale.

Hemangiopericytoma (HPC) was diagnosed in a 65-year-old man in 1991. Initially the tumor was located in the maxillary sinus. Resection was followed by multiple recurrences involving the infratemporalis fossa (ITF), the nasopharyngeal region, and the right tonsillar region. Over a 10-year-old period, the histology pattern remained unchanged. Multiple approaches, as described in the literature, were used for resection depending on the site of the recurrence. To data, no malignant structure has been identified. Pain and cranial nerve deficits (V2, V3) have been the main squeleae. This case points out the limitations of radical resection because of the difficulty of the approach to this anatomic region. CT scan must be performed to choose the best access route depending on the primary site of the tumor and its extension.

[Necrotizing external otitis in children in Abidjan (Ivory Coast)]. / L'otite nécrosante chez l'enfant à Abidjan (Côte d'Ivoire).

Necrotizing external otitis (NEO) is a fulminant Pseudomonas infection of the external auditory canal affecting mainly elderly diabetic patients. Since the early descriptions, many authors have related cases of NEO in non diabetic patients. We report eight cases of NEO in young children. They are less than two years old, they are undernourished and non diabetics. We get a good evolution in spite of our modest therapeutic ways. Emphasis is placed on efficiency of local remedy with colistine.

[ORL manifestations in malignant hemopathies]. / Manifestations ORL observées au cours des hémopathies malignes.

The purpose of this study was to collect ENT signs observed during lymphomas. The study was conducted in the unit of ENT at the CHU of Treichville, during 15 month from december 1995 to march 1997. Ten cas of lymphomas was enrolled with 6 Hodgkin's lymphomas, 3 acute leukemia and 1 Hodgkin's lymphoma. The diagnosis was based on biopsy and myelogram. There is a wide spectrum and non specific clinical pictures. Pharynx is the common site particularly on the Waldeyer's ring. The disease is common among young people, low socio-economical status. Female are predominant. Most patients died before specific treatment because of the late diagnosis.