[Necrotizing external otitis: a case report from Abidjan]. / Otite nécrosante externe: à propos d'un cas à Abidjan.

Necrotizing external otitis is a serious infection of the external ear canal. It often occurs in older people with diabetes. We report here the case of an immunocompetent 2-year-old girl, infected by Pseudomonas aeruginosa. The examination showed deep ulceration and necrosis of the left antihelix. The patient received systemic and local medical treatment. Stricture of the left external ear canal was treated surgically.

[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.

[Cysts and congenital fistulas of the face and the neck. About 78 cases]. / Kystes et fistules congénitaux de la face et du cou. A propos de 78 cas.

The cysts and congenital fistulas of the face and neck induce frequent malformations in Oto-Rhino-Laryngology. A retrospective study on these malformations has been carried out from January 1986 to December 2001 in the Oto-Rhino-Laryngology unit of the Brazzaville Teaching Hospital. This study considered the epidemio-clinical aspects, the modes of therapeutic treatment and the evolution of these congenital pathologies. The cysts and congenital fistulas represented 2% of the consultations in the service. Patients were aged of 10 months to 50 years (average age: 21 +/- 5 years) among them 49 men (63%) and 29 women (37%). The pathology appeared in childhood in 41% of the cases and during adult age in 59% of the cases. The main circumstances of discovery were: cystic swelling (72%), infectious complication (18%) and productive fistula (10%). The clinical forms have been dominated by the cysts of the thyreoglossal tractus (72%), followed by the pre-auricular fistulas (10%), the amygdaloid (9%), dermoid (6%) and nasopalatine (3%) cysts. The treatment was in any case surgical. A good embryo-pathogenic knowleldge should contribute to a complete surgical exeresis, a necessary condition to avoid recurrence.

[Prevalence and risk factors for otomycosis treated in the hospital setting in Abidjan (Ivory Coast)]. / Prévalence et facteurs favorisants des otomycoses traitées en milieu hospitalier à Abidjan (Côte d'Ivoire).

Otomycosis is frequently encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence, predisposing factors, and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan, Ivory Coast. Mycological examinations were performed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95% Confidence Interval (CI), 34.4-52.2). Univariate analysis showed that the predisposing factors for otomycosis were frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1), daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95% = 4.3-20.1). The most common etiologic agents were Aspergillus flavus (20.4%), Candida albicans (16.3%), Candida parapsilosis (14.3%), and Aspergillus niger (12.2%). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivory Coast. Management of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection.

Prevalence et facteurs favorisants des otomycoses traitees en milieu hospitalier a Abidjan (Cote d'Ivoire)

Otomycosis is fre q u e n t ly encountered in tropical and subtropical zones. In Ivory Coast diagnosis of this disease is often based solely on the clinical symptoms. The objectives of this study were to determine the prevalence; predisposing factors; and etiologic agents associated with otomycosis at the Treichville University Hospital Center in Abidjan; Ivory Coast. M y c o l ogical examinations we re perfo rmed on specimens obtained from 115 patients presenting with external otitis at the d'Oto-Rhino-Laryngology Department. Fungi-positive cultures were obtained in 49 patients for an overall otomycosis prevalence of 42.6 (95Confidence Interval (CI); 34.4-52.2). Univa ri ate analysis showed that the predisposing fa c t o rs for otomycosis we re frequent swimming in natural or artificial pools (Relative Risk (RR) 3.7; CI 1.7-8.1); daily ear cleaning (RR 3.5; CI 1.8-6.8) and excessive use of eardrops containing antibiotics and corticoids (RR = 9.3; IC95= 4.3-20.1). The most common etiologic agents were Aspergillus fl avus (20.4); Candida albicans (16.3); Candida parapsilosis (14.3); and A s p e rgillus niger (12.2). A combination of two agents was found in five cases. These data show that otomycosis is endemic in Ivo ry Coast. Manage m e n t of otomycosis must include mycological examination for diagnosis as well as changing behavior patterns leading to infection

[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.

[Laryngeal papillomatosis: value of early diagnosis, apropos of 7 cases diagnosed at the University Hospital Center in Brazzaville, Congo]. / La papillomatose laryngee: interet d'un diagnostic precoce, a propos de 7 cas diagnostiques au CHU de Brazzaville, Congo.

Laryngeal papillomatosis is a benign tumor process that occurs most commonly in children but can also affect adults. The purpose of this report is to describe a series of 7 cases treated at the Otorhinolaryngology Department of the University Hospital Center in Brazzaville, Congo. Special focus is placed on particularities and pitfalls of management. There were 4 girls and 3 boys with a mean age of 8.4 years (range, 7 to 10 years). The mean duration between the onset of symptoms and diagnosis was 3.4 years (range, 1 to 5 years). The initial symptom was choking in 3 cases, hoarseness in 2, and combined choking and hoarseness in 2. Tracheotomy was required in 3 cases. Instrumental debulking was performed in all cases. Two patients died due to obstruction of the cannula. Outcome was favorable in the remaining 5 cases. Our experience highlights the need for early diagnosis for optimal therapeutic outcome. In this regard information campaigns are necessary to educate doctors and parents.

[Sudden deafness in sickle cell anemia: a case report]. / La surdité brutale chez le drépanocytaire: à propos d'un cas.

The non-expected deafness is quite obvious or easily diagnosed cause. The sickle cell disease is one of the aetiologies of this one. We present one case observed on a 30 years old patient. There is a close connection between the vascular factor of the non-expect deafness and the erythrocytic falciformation of sickle cell anaemia causing the obliteration of the terminal auditory internal artery and generating the ischaemia of the cochlea anoxia. The high sensitivity of the cochlea to anoxia and its great fragility require an early therapy in order to recover auditory capacity. Patients suffering from sickle cell disease should be encouraged to have a regular assessment of audition.

[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.

[A case of mixed otomyiasis in Ivory Coast]. / Un cas d'otomyiase mixte en Côte-D'Ivoire.

Authors relate the first case of otomyiasis in Ivory Coast due to Chrysomyia bezziana and Sarcophaga sp. They insist on scarcity of such a localisation. Egg-laying and development of larvae in tympanum case was favoured by a preexisting cholesteatoma. Precise entomological diagnosis needs incubation of the larvae in Petri dishes.