Rhinological observations during a humanitarian mission in a rural sub-Saharan African setting.

AIMS: Patients with rhinological symptoms and pathologies represent an important population. Their prevalence in developing areas without ENT care is not well documented. Due to various factors like migration, they may have an influence out of these territories. Our objective was to determine the prevalence and epidemiology of the main rhinological symptoms and pathologies during a humanitarian mission. MATERIAL AND METHODS: Six hundred and seventy nine patients presenting to our general medical consultations were examined. All of them had careful interrogation and a basic ENT check-up. Patient data and correlating photos were registered to be analyzed retrospectively. RESULTS: The ethnic origins of the patients were different. Most of them were younger than 50 years old. The rhinological problems were amongst the most frequent reasons to consult, the prevalence was higher when secondary findings and complaints were also considered, representing altogether 44 (6.48%) cases. CONCLUSION: A high prevalence of rhinological pathologies showing the importance of public health issues, screening and an important need of adapted treatments was found. Due to migration, climatic changes and humanitarian missions, their presentation and incidence may vary. Health care providers and rhinologists need a thorough knowledge of community acquired and tropical pathologies.

A new method for reconstruction of the larynx after vertical partial resections.

The indications and problems of organ-preserving vertical partial laryngectomy (VPL) in cases of T1b glottic or T2 glottic and subglottic cancers are well known. The first and imperative requirement for the surgeon is adequate resection of tumor while the second prerequisite is the safe and successful correction of the excised portion of the anterolateral wall of the larynx. Since reconstruction of the defect can cause significant challenges for surgeons, the main requirements are an adequate lumen for breathing, a smooth surface for epithelialization, voice restoration and good deglution. Krajina's method for reconstruction of the larynx utilizes pedicled sternohyoid fascia, which is thin, elastic, well adaptable to defects, and resistent to infection or saliva. By providing a large surface for covering defects, granulations and synechiae can be prevented. We now use the superficial fascia colli as a new method for reconstruction of laryngeal defects after frontolateral partial resections. The technique was first refined experimentally in dogs. A Leroux-Robert partial laryngectomy was carried aut on five animals and laterally pedicled fascia was sutured to the edge of the defect created. At 2-week intervals through 8 weeks after the operation fixation, vascularization and epithelialization were examined histologically. To date, clinical reconstruction with the fascial flap has been used in 29 cases. Because the flap has a very low metabolism, no necrosis was seen. Functional results of respiration, phonation and swallowing have been good. These findings show that laterally pedicled fascia with the bipedicled sternohyoid muscles can play an important role in laryngeal reconstruction.