[Maxillo-facial loss of substances of traumatic origin at the Yalgado Ouedraogo University Hospital]. / Pertes de substances maxillo-faciales d'origine traumatique au centre hospitalier universitaire Yalgado Ouedraogo.

OBJECTIVE: This work aims to report the modalities of management of maxillofacial substance loss following trauma in our context. METHODS: This was a descriptive cross-sectional study with retrospective data collection of 55 cases of maxillofacial substance loss of traumatic origin over a period of 7 years from 2014 to 2020 in the department of stomatology and maxillofacial surgery of Yalgado Ouedraogo University Hospital. RESULTS: The annual prevalence was 7.86 cases. The etiology was dominated by road traffic accidents (80% of cases). Loss of labial substance was the most frequent (58.18%). The lesions were severe, Lakmann type IV in 76.36% of cases. Bone loss occurred in 9.10% of the cases and was mainly located in the mandible. The repair of substance losses by locoregional flaps was the main technique for soft tissue reconstruction. Bone defects were repaired with non-vascularized bone grafts. The evolution was satisfactory in the majority of cases (80.3%). Infections were the main complications (5 cases) and the sequelae were dominated by unaesthetic scars (45.45%). CONCLUSION: The management of maxillofacial substance loss of traumatic origin must be early and adequate for a better aesthetic and functional result.

Cellulites cervico-faciales graves, morbidité et mortalité: à propos de 150 cas au CHU Yalgado Ouédraogo au Burkina Faso / Severe cervico-facial cellulitis, morbidity and mortality: concerning 150 cases at CHU Yalgado Ouedraogo in Burkina Faso

Introduction : Les cellulites cervico-faciales graves sont des infections redoutables de par leur extension locorégionale et à distance mais aussi de par le pronostic vital qu'elles peuvent engager. L'objectif de cette étude était d'étudier la morbi-mortalité des cellulites cervico-faciales graves. Méthode : Il s'est agi d'une étude transversale descriptive concernant tous les patients admis du 1er Janvier 2008 au 31 Décembre 2017 dans le service de Stomatologie/ Chirurgie Maxillo-Faciale du Centre Hospitalier Universitaire /Yalgado Ouédraogo pour cellulite cervico-faciale grave. Les variables étudiées étaient sociodémographiques, cliniques, paracliniques, thérapeutiques et évolutives. L'analysées a été faite grâce au logiciel Epi-Info 7. Résultats : La fréquence hospitalière annuelle était de 15 cas avec une moyenne d'âge de 36,9 ans et une prédominance masculine. Les facteurs favorisants étaient surtout la prise d'anti-inflammatoire non stéroïdien en monothérapie (65,3%). La tuméfaction concernait la région sous mentale dans 85,3% des cas. Des signes de compressions des voies aérodigestives supérieures étaient notés dans 22% des cas. La tomodensitométrie avait noté une diffusion cranioencéphalique chez 5,3% des patients. Le traitement a été médico-chirurgical avec une évolution clinique favorable. Il existait une corrélation entre le décès et le siège de la lésion, le sexe et le recours au traitement traditionnel. Conclusion : Les cellulites graves sont une urgence médico-chirurgicale et leur prise en charge est complexe et pluridisciplinaire. La prévention et le diagnostic précoce peuvent contribuer à réduire la morbi-mortalité.

Success rate of first attempt 4% articaine para-apical anesthesia for the extraction of mandibular wisdom teeth.

Dental extraction is one of the acts that cannot be undertaken or carried out without total analgesia. Unfortunately, the success of anesthesia is not always systematic. Failures are noted during the extraction of mandibular wisdom teeth and pain management therefore remains a challenge for their extraction. The anesthesia technique and nature of the adapted anesthetic solution are controversial. However, the most commonly used technique is the Lower Alveolar Nerve Block (IANB). This technique has disadvantages (trismus, risk of intra-arterial injection and hematoma) and a failure rate of up to 88%. In some survey, 90% of 93 practitioners had difficulty obtaining proper anesthesia. Other clinical studies have also shown overall failure rates of 37%-47%, and 15%-35% on healthy lower molars. Recent studies have evaluated the success rate of articaine at between 54% and 94%, while others have shown that for mandibular teeth, articaine is more effective in para-apical anesthesia than lidocaine. Sixty subjects were selected for the study. The aim was to evaluate the overall success rate of first intention 4% articaine para-apical anesthesia during extraction of third mandibular molars. The overall success rate of para-apical anesthesia was 87%.

Traumatismes maxillo-faciaux par accidents de la circulation routière impliquant les engins à deux roues au Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO). Aspects épidémiologiques et anatomo-cliniques

Introduction : Les traumatismes maxillo-faciaux par Accident de la Circulation Routière (ACR) impliquant les engins à deux roues sont fréquents et peuvent occasionner des lésions graves.Matériels et méthodes : Il s'agit d'une étude prospective allant du 1er janvier 2017 au 31 avril 2017 dans le service de stomatologie et de chirurgie maxillo-faciale du CHUYO. Les dossiers médicaux des patients, les registres de consultation et les comptes-rendus opératoires ont été les sources de collecte des données.Résulats : Au total 230 cas ont été colligés dans le service de stomatologie et de chirurgie maxillo-faciale du CHUYO. Ces cas étaient relativement fréquents soit 84.24% des motifs de consultation de traumatologie. Les travailleurs du secteur informel (43,48%) et l'homme jeune de sexe masculin (84,35%) ont été les plus touchés. Les motocyclistes (80,70%) constituaient les principaux usagers. La consommation d'alcool (49,13%) et la méconnaissance du code de la route (77,29%) étaient les principaux facteurs favorisants. Les lésions des parties molles étaient les plus fréquentes (90,43%). Le zygoma était l'os le plus atteint (49,46%). Les fractures des membres (44,73%) ont constitué les principales lésions osseuses extra-faciales associées.Conclusion : La sensibilisation de nos populations sur la sécurité routière et la collaboration interdisciplinaire permettraient de renforcer l'efficacité de nos structures de soins

[Ecthyma gangrenosum of the eyelid after chickenpox]. / Ecthyma gangreneux de la paupière compliquant une varicelle.

BACKGROUND: Ecthyma gangrenosum is an acute ulcer necrotic skin infection frequently caused by Pseudomonas aeruginosa. It is characterised by necrotic ulcerations circumscribed by an inflammatory halo. Lesions are normally found in the anal, genital and axillary regions. Ecthyma gangrenosum is most commonly seen in immunodepressed patients (cytotoxic chemotherapy, HIV infection, neutropenia or functional neutrophil deficiency, agammaglobulinemia). It is a rarely described complication in chicken pox. PATIENTS AND METHODS: Herein we report the case of a girl aged 2 ½ years presenting in our dermatology department with ecthyma gangrenosum on the right upper eyelid secondary to varicella. The disease course was marked by fibrous scarring of the inner canthus with ptosis of the right upper eyelid. The retractile scarring caused disability. DISCUSSION: There have been previous reports of the contribution of non-steroidal anti- inflammatory drugs (NSAIDs) to the appearance of necrotic cutaneous super infections during the course of chickenpox. The occurrence of such complications on an eyelid may be harmful not only for the function of the eye but it can also cause extensive aesthetic impairment. Subsequent aesthetic and functional impairment may be improved by corrective surgery.

[Epidemiology of maxillo-facial traumatism s sequels at stomatology and maxillo-facial surgery service of Yalgado Ouedraogo University Hospital Center]. / Epidémiologie des séquelles de traumatismes maxillo-faciaux au service de stomatologie et chirurgie maxillo-faciale du Centre Hospitalier Universitaire Yalgado Ouedraogo (Burkina Faso).

Introduction: Our study brings back the epidemiological and anatomo-clinical characteristics of the maxillo-facial traumatisms sequels at Yalgado Ouedraogo University Hospital Center of Ouagadougou. Methodology: It was a transversal descriptive study going from May 2013 to April 2015. Results and Discussion: In all, 152 cases of post traumatisms sequels were collected. The masculine sex was more affected with a sex-ratio of 2,53. The mean age was 30,80 years. The public road accidents (73,68%) were the main etiology of initial lesions. The isolated functional and morphological sequels respectively represented 1/3 and 1/6 of cases. Half of patients had mixed sequels. The odontological sequels (41,45%), the disgracious scars (93,68%), the neurological sequels (15,79%), the ocular sequels (11,18%), and the temporo-mandibular ankylosis were the main sequels found in our study. These sequels could be explained by the nature of initial lesions and the lateness of consultations. Conclusion: Development of population's awareness and close interdisciplinary collaboration helped to reduce the frequency of these sequels.

[Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health]. / La carie dentaire: aspects épidémiologiques et thérapeutiques aux services de chirurgie dentaire du Centre Hospitalier Universitaire Yalgado Ouedraogo et du Centre Municipal de santé bucco-dentaire.

INTRODUCTION: In order to improve the prevention and treatment of dental caries in Burkina Faso, we conducted a study on the epidemiological and therapeutic aspects of dental caries in the dental services of University Teaching Hospital Yalgado Ouedraogo and in the Municipal Centre of Oral Health of Ouagadougou. MATERIAL AND METHODS: A prospective and descriptive study from October, 15th 2012 to January, 15th 2013 was conducted on a sample of 191 patients. The variables recorded were: patient's identity, age, sex, area of residence, food mode, socioeconomic level, reason for consultation, oral hygiene, DMFT index, degree of tissue damage, the topography of the carious lesions and the applied therapy. RESULTS: Caries prevalence was 93.19% more female consultations, with sex ratio at 0.77. The average age was 31 years for a sample often engaged in trade and the informal sector. Carious lesions were usually limited to less than 4 teeth. The main motivation for the consultation was pain at 82.20%. CONCLUSION: The use of preventive care is quite low in our population. Extractions still occupy an important part of treatment. We need to improve oral hygiene and show to patients the necessity of routine visits to the dentist every year for early treatment.

[Two cases of sinus histiocytosis with massive cervical lymphadenopathy (Destombes-Rosai-Dorfman disease)]. / Deux cas d'histiocytose sinusale ganglionnaire cervicale de Destombes-Rosai-Dorfman.

INTRODUCTION: Sinus histiocytosis with massive lymphadenopathy is a rare disease. Its location is ubiquitous, but the most frequent is cervical lymph nodes. OBSERVATION: We report 2 cases of sinus histiocytosis with massive lymphadenopathy. The patients were respectively 9 and 30 years of age. They both presented with bilateral cervical polylymphadenopathy with a cervical compression syndrome in the first patient. The diagnosis was made histologically by demonstrating histiocyte emperipolesis, in the first case, and by immuno-histochemistry in the second. The treatment was corticosteroids, resulting in an almost total involution. DISCUSSION: Sinus histiocytosis with massive lymphadenopathy is a clinical and a specific pathology, but its etiopathogenesis remains to be elucidated. The cervical localization is common. The definitive diagnosis is histological. There is currently no codified treatment. The outcome is usually favorable, apart from mechanical and systemic complications that are important prognostic factors.

[Noma and Burkitt disease; a particular association about three observations seen in the Teaching Hospital Center Yalgado Ouedraogo (Burkina Faso)]. / Noma et maladie de Burkitt, une association exceptionnelle à propos de trois observations vues au centre hospitalier universitaire Yalgado Ouedraogo (Burkina Faso).

Cancrum oris is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, Gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles [3]. Burkitt lymphoma is a highly aggressive non-Hodgkin lymphoma first described by Burkitt in 1958 in African children from areas holoendemic for malaria. It is the first cancer of African child [6]. The association between Burkitt lymphoma and cancrum oris is non common. We report in the present study three cases of this association at the Academic Hospital Yalgado Ouedraogo of Ouagadougou. This association poses a problem of late diagnosis with difficulties in therapeutic management.

[Evoluting form of cancrum oris, about 55 cases collected at the Academic Hospital Yalgado Ouedraogo of Ouagadougou]. / Le noma évolutif, à propos de 55 observations vues au centre hospitalier universitaire Yalgado Ouedraogo de Ouagadougou.

The cancrum oris is still an up to date disease in our environment. The death rate and the after effects of this disease make all together the main interest of this survey. In a retrospective survey carried out from January 2003 to December 2012, we colligated 55 cases of progressive cancrum oris followed at the stomatological and maxillofacial surgery at the Academic Hospital Yalgado OUEDRAOGO. On the epidemiological level, we noticed an impact of 5.5 cases per year. The average age of our patients was about 7.64 with a sex ratio of 1.03. Most of the patients were from an underprivileged family (96.4%). On the clinical level, we noticed that most of the patients consulted only after the gangrene had fallen (89.1%) and were seriously affected (67.3%) with a bad oral and dental hygiene (38.1%). The attacks were mainly jugal (25%) and labial (24.1%). The cancrum oris was in most of the cases associated to broncho pneumonitis, malaria and to HIV infection (31.37%). For the medical treatment, we focused on resuscitation, re nutrition, hydro electrolytic rebalancing and antibiotherapy. The surgical treatment was essentially made on the affected areas, controlled skinning and most often followed by sequestrectomy. 81.8% of the patients recovered completely from the infection, 60% had after effect injuries. We recorded a death rate of 14.5%. In order to overcome this disease we need both national and international support.

[Epidemiology and clinic of dental extractions in University Teaching Hospital Yalgado Ouedraogo, (Burkina Faso)]. / Aspects épiémiologiques et cliniques des extractions dentaires au Centre Hospitalier Universitaire Yalgado Ouedraogo (Burkina Faso).

INTRODUCTION: The consequences of tooth loss are often severe for the patient: aesthetic deficit, decreased masticatory coefficient, malnutrition... The objective of this study was to describe the epidemiological and clinical aspects of dental extractions of patients attending the University Teaching Hospital Yalgado Ouedraogo (UTHYO). PATIENTS AND METHODS: It was a descriptive cross-sectional retrospective study on a sample of 65 patients who received a dental extraction at least in dental surgery of the UTHYO. RESULTS: The sample consisted of 33 (50.8%) patients female to 32 (49.2%) cases of male, or a sex ratio of 0.96. The average age was 36,55 year-old with extremes of 5 and 84 years. Employees and pupils were the most affected by extractions (33 cases; 47,8% and 22 cases; 33,8%). Dental extractions were more frequent in patients aged between 25 and 60 years. A total of 84 tooth extraction was performed in 65 patients, an average of 1.3 tooth extracted per patient. The most often extracted tooth was the third lower molar (17 cases, 22,95%). The canine was the less often extracted tooth (1 case, 1,35%). Dental decay and its complications (57 cases, 67,87%) and periodontal diseases (10 cases, 11,90%) were the commonest reasons for dental extractions. CONCLUSION: Dental decay and periodontal diseases are the most important causes of dental extractions. Particular emphasis should be placed on prevention and early care of teeth.

[HIV and noma in Burkina Faso]. / VIH et noma au Burkina Faso.

INTRODUCTION: Noma is a "gangrenous" disease beginning in gums and spreading to other parts of the face. It usually occurs in undernourished children with bad orodental hygiene. Its incidence in adults is increasing. HIV infection is very common in African countries. We had for objective to compare noma characteristics in patients with, or without, HIV. MATERIAL AND METHODS: This retrospective and descriptive study included patients managed for noma in our unit from January 1988 to December 2007. The clinical, epidemiological, and outcome data of patients treated for noma were compared according to HIV infection status. RESULTS: Two hundred and twelve patients were included and 14 (6.6%) among them were HIV positive. In the HIV positive group, there were a male predominance and patients were older (mean age 15.3 vs. 4.7 years in the other group). HIV positive patients were less frequently operated (35.7% vs. 76.3%) and their death rate was higher (37.5% vs. 5.6%). DISCUSSION: HIV infection during the course of noma impacts the clinical and epidemiological features of this condition. It worsens the prognosis. Noma could be considered as an opportunistic infection in the WHO disease staging system.

Experience with head and neck missile injuries at the yalgado university teaching hospital, ouagadougou, burkina faso.

BACKGROUND: To report the diagnostic and therapeutic options of missile head and neck injuries. AIM AND OBJECTIVES: To present our experience in the management of head and neck missile injuries as seen in our centre. METHODOLOGY: All the patients with head and neck missile injuries who were managed in the ENT and Dental services of Yalgado University Teaching Hospital, in Ouagadougou, the capital of Burkina Faso between January 2003 and December 2012 were reviewed. The data obtained from medical records included demographic data, history, physical findings, and site of injury, diagnosis, type of treatment/surgery, complications and outcome. RESULTS: Out of a total of 32 patients in this study, there were 26 males and 6 females with a sex ratio of 4.3:1. Their ages ranged from 18 to 63 years with a mean of 32 years ± 5.2. The age range of 20-40 accounted for 68.7% of the patients. The injury was accidental in 37.5%, assault in 56.3 and self inflicted/suicide in 6.3%. Most (59.4%) of the patients had multiple injuries while in 50 % of the cases, the injuries affected the face. Surgical intervention was done in 59.4% of the patients and conservative treatment in 40.6 % of the patients. Complications were noted in 52% of the patients. Seven patients died given a mortality rate of 21.9%. CONCLUSION: The head and neck missile injuries are not uncommon in our environment with a high mortality and morbidity rates.

[Conidiobolomycosis, a rare fungal tumor: a case report in Ouagadougou, Burkina Faso]. / Conidiobolomycose, une tumeur fongique rare: un cas a Ouagadougou, Burkina Faso.

Conidiobolomycosis is a deep, rare mycosis, due to Conidiobolus coronatus which is a saprophyte of vegetation in decomposition. We report one case in Burkina Faso. A 17 years old man, shepherd, consulted for tumefactions on the face. It could date back insidiously to a traumatism, one year before. A month later some painless tumefactions appeared on the cheekbone, the right eyelid, the nose with epistaxis. The upper lip then the lower one had swollen. Dermatological exam revealed multiple, painless, hard, sub-cutaneous swellings, affecting the cheekbone, the eyelids, the root and the ala of the nose. This tumefaction sometimes adhered to underlying tissues and to the overlying skin, sometimes mobile; painless and hard swelling of the two lips was also noted. ENT exam showed an inflammation of the nasal mucous without ulceration and the permeability of the nasal tracts was subnormal. The cephalic tomodensitometry showed a thickness of the soft tissues of the lips and the nose with an infectious feature associated to a pansinusitis without bone lesion. Histology was in favour of conidiobolomycosis. The patient was treated with fluconazole and the swelling progressively disappeared. Conidiobolomycosis is a disease generally reported in some humid tropical countries. It begins in the nasal cavities leading then to a nasal obstruction. This case was singular by the fact it happened in a dry Sudano-Sahelian climate and by its clinical features.

[Mandibular fractures in children. Apropos of 20 cases]. / Les fractures mandibulaires de l'enfant. A propos de 20 cas.

Authors report their experiences about the caring for child mandible fractures at Yalgado Ouedraogo University Hospital Centre, CHUYO. These fractures constitute day-to-day relative immediate emergencies. The techniques of retention used after bone setting are various. Ligatures with steel thread are frequently used. The retention is shortened because of the quick strengthening noticed in child. The satisfying results reveal the necessity of classical retention and ligatures with steel thread in jawbone fractures.

[Oro-facial manifestations during AIDS/HIV infection. Apropos of 60 cases seen at the Ambulatory Treatment Center in Ouagadougou and at the Yalgado University Hospital Center]. / Les manifestations bucco-faciales au cours de l'infection VIH/SIDA. A propos de 60 cas vus au Centre de Traitement Ambulatoire de Ouagadougou et au Centre Hospitalier Universitaire Yalgado (CHU-YO).

The opportinistics complaints of the AIDS occur all along the episode of the infection and depend on the individual's body immunity and on the existence or no of an anti-retroviral treatment. The buccal appearences on the face are relatively frequent. They are dominated by the buccal mycosis, the lymphatic ganglion's complaints, the inflammation of gums and buccal mucous, and the tooth decay in our context. Some authors suggest a classification that can make easy their study and treatment. Complaints like the herpes simplex infection, the herpes zoster infection, are usually found during the symptomatic stage non AIDS, whereas others like KAPOSI's disease are typical to AIDS disease. The availlability of an anti-retroviral treatment and a specialized one strenghten the efficiency of the reimbursement and improve the prognosis.