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Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

International Journal of Otolaryngology and Head & Neck Surgery 2024年第4期13卷 293-303页

作者： Kassim Diarra Oumou Coulibaly Yaya Dembele Nfaly Konaté Sidibe Youssouf Saydi Ag Mohamed Harouna Sanogo Abraham Diarra Ibrahim Fofana Moussa Bourama Keita Youssouf Traore Fatogoma Issa Koné Boubacary Guindo Siaka Soumaoro doum.ia kadidiatou singare Mohamed Amadou Keita ORLCCF Department Gabriel Toure University Hospital Bamako Mali ORLCCF Unit Kati Army Polyclinics Kati Mali ENT-CCF Department CHU Luxembourg Bamako Mali ORLCCF Service of the Reference Center of Commune VI Sogoniko Bamako Mali

In Mali, cholesteatoma surgery remains a challenge due to the limited number of otological practitioners, and the low socio-economic level of patients reflecting the difficulties in performing CT or MRI for post-operative follow-up. We therefore initiated this work with the objective of analyzing, through a broad bibliographic review, the clinical, paraclinical, topographical, therapeutic and progressive aspects of a series of ear cholesteatoma. Materials and Method: This was a retrospective and prospective, descriptive study that took place in the ENT and head and neck surgery department of the Gabriel Touré University Hospital over 36 months from November 2020 to October 2023. These were patients admitted to the department for chronic cholestematous otitis media. Result: In total, we collected 34 files of patients admitted for cholesteatoma. This represented 9% of cases compared to all otological surgeries carried out during the same period, i.e. 362 cases. The average age of our patients was 35.31 years, with extremes ranging from 7 years to 80 years, there were 24 men and 10 women, i.e. a M/F ratio of 2.4. The average time to diagnosis was 7 years. The main functional signs were dominated by chronic fetid purulent otorrhea associated with hypoacusis in 94.6% of cases. One case of meningeal complication and three cases of cerebral empyema were reported. Clinically, a postero-superior and marginal tympanic perforation was observed in 53%, a retraction pocket in 5.9%, the sentinel polyp in 9%, and a non-marginal tympanic perforation in 32%. Pure-tone audiometry performed preoperatively for all patients showed conductive hearing loss in 83%. In 82% of cases we created a recess with the creation of a mini box. An ossiculoplasty was performed immediately with fragments of cartilage. The postoperative course found the disappearance of otorrhea (88.23%), the persistence of otorrhea in one case, two cases of facial paralysis, and one case of tinnitus. We did not identify

关键词： Cholesteatoma CT TTO TTF

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Deafness: Epidemiological, Clinical and Therapeutic Aspects in 15 Year Olds and over at the University Hospital Center Gabriel Toure of Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 202-210页

作者： Kassim Diarra N’faly Konaté Yaya Dembele Ismael Berthé Drissa Kaloga Bagayoko Boubacary Guindo Fatogoma Issa Koné Siaka Soumaoro doum.ia kadidiatou singare Mohamed Amadou Keita ENT and Head and Neck Surgery Department university hospital Gabriel Toure Bamako Mali Armies Polyclinic of the Kati Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To study the epidemiological, clinical and therapeutic aspects of hearing loss in 15-year-olds and over at the CHU GT of Bamako. Materials and Method: This is a longitudinal prospective study carried out in the ENT department of the University hospital Gabriel Toure in Bamako over 13 months (from September 2018 to September 2019). We carried out an exhaustive sampling of all the patients who consulted in the department for hearing loss and whose deafness was confirmed at pure tone audiometry with age greater than or equal to 15 years. The exclusion criteria were all patients under the age of 15 as well as a hearing loss related to earwax or foreign bodies and refusals to participate in the study. Results: Two hundred and thirty (230) patients were collected during the study. Dominated by the male sex with a sex ratio of 1.5 or 3 men for 2 women, with an average age of 38.16 ± 19 years with extremes ranging from 15 to 86 years. Among our patients, 37.40% had unilateral deafness, progressive installation evolving more than 12 weeks with a rate of cases had headaches 41% and had a history of chronic otitis media (CMO) 27%. There were a few cases of mixed type deafness, 30% had mild deafness, 22% moderate deafness and 40% severe deafness, according to the BiaP classification. Among our patients, 22.16% had conductive hearing loss, and those with sensorineural hearing loss accounted for 15.24%. Conclusion: Pure tone audiometry remains essential in the diagnosis of deafness. It not only makes it possible to confirm or invalidate the deafness, but also to define the type of deafness and especially to classify the deafness according to the degree of the average hearing loss established by the BiaP.

关键词： Pure Tone Audiometry Deafness BiaP

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Chronic Purulent Otorrhea in the South of the Sahara: Epidemiological, Clinical and Therapeutic Profiles about 135 Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 219-226页

作者： Kassim Diarra N’faly Konaté Youssou Sidibé Famagan Bah Boubacary Guindo Siaka Soumaoro Drissa Kaloga Bagayoko Fatogoma Issa Koné doum.ia kadidiatou singare Mohamed Amadou Keita Surgery Department University Hospital Gabriel Toure Bamako Mali Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.

关键词： Chronic Otorrhea Cholesteatoma Myringoplasty Bamako

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Complications of Sinusitis: About 9 Cases in the Ear Nose &Throat (ENT) Department of the University Hospital Gabriel Touréin Bamako

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Surgical Science 2016年第1期7卷 27-33页

作者： kadidiatou doum.ia-singare Abdoul Aziz Diakite Sidiki N’Dao Samba Karim Timbo Youssouf Sogoba Drissa Kanikomo Boubacary Guindo Siaka Soumaoro Lamine Traore Fatogoma Kone Fatou Sylla Mohamed Keita Alhousseini Ag Mohamed ENT Department and Neck Surgery of the University Hospital Gabriel Toure Bamako Mali Neurosurgery Department of the University Hospital Gabriel Toure Bamako Mali Pediatric Department of the University Hospital Gabriel Toure Bamako Mali African Institute of Tropical Ophthalmology Bamako Mali

Objective: This study aims to analyze clinical, paraclinical and therapeutic aspects of sinusitis complications in the Otorhinolaryngology department at the teaching hospital of Gabriel Toure in Bamako. Materials and methods: This descriptive and longitudinal study was conducted on 12 months from March 2012 to February 2013 in 9 cases of sinusitis complications in the department of Otorhinolaryngology at the University Hospital Gabriel Toure in Bamako. Results: The average age of patients was 22.7 years;a median of 19 years within 6 men and 3 women with almost 12.9 days of care seeking duration. The factors of risky were the use of nonsteroid anti-inflammatory drugs NSAID (4 cases), maxillofacial trauma (1 case) and HIV (1 case). Facial pain was the major symptom, such as frontal oedema, rhinorrhea with pus shedding and nasal obstruction. Computer tomography was used for complications specification. Frontal sinusitis was the most encountered with subperiosteal abscess (44.4%). Streptococcus pneumoniae was identified in 3 cases. Medical treatment associated to surgery was conducted on 7 patients. Two cases of death have been registered. Conclusion: The complicated sinusitis is an emergency and dangerous disease requiring specific care by a multidisciplinary staff. Much of complications are commonly encountered despite the antibiotic era.

关键词： Sinusitis Complications Diagnosis Treatment Surgery

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Audiometric Profile of Deafness at the University Hospital Center Gabriel Toure of Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第1期9卷 38-45页

作者： Kassim Diarra Boubacary Guindo Youssouf Sidibé N’faly Konaté Ibrahim Fofana Drissa Kaloga Bagayoko Fatogoma Issa Koné Siaka Soumaoro doum.ia kadidiatou singare Samba Karim Timbo Mohamed Amadou Keita ENT and Head and Neck Surgery Department CHU Gabriel Toure Bamako Mali ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali

Objective: To determine the audiometric profile of deafness in our practice. Materials and Methods: Longitudinal prospective study was conducted out in the ENT department and cervicofacial surgery of Gabriel Toure University Hospital in Bamako, we made an exhaustive sampling of all the patients who consulted for hearing loss, tinnitus, vertigo, hiring report, medical expertise and whose deafness was confirmed to tonal audiometry with an age greater than or equal to 15 years. It was spread over 10 months (June 2016 to March 2017). A total of 200 patients were collected. Exclusion criteria were all patients under 15 years of age as well as deafness related to earwax or foreign bodies, and refusal to participate in the study Results: During our study period, 6055 outpatients were admitted out of which 734 patients underwent audiometric testing and 200 patients (3.30%) met our criteria. The male sex was the most represented with a rate of 60%. The sex ratio was 1.5 or 3 men for 2 women. The 15 to 25 age group was the most represented at 37.5%. The average age was 37.18 years old with extremes ranging from 15 to 83 years old. Pupils/students were the most represented with a rate of 29.5%, followed by housewives in 23%, farmers in 10.5% and military in 10%. As antecedent 26% of our patients had a chronic otitis media (OMC), against 23% who had no antecedent otological and 17% had a traumatic antecedent. Bilateral deafness was the most common with a rate of 64.5%. The mode of progressive appearance was the most frequent in 74.5%. As functional signs 46.22% of our patients had a hearing loss associated with tinnitus. Otoscopic examination was pathological in 34.5% of our patients. Mixed deafness was the most common in 43.35%, followed by perception deafness in 32.19% and transmission deafness 24.46%. Mean deafness was the most common with a rate of 48.91%, was severe in 20.22%, mild in 18.31%, deep in 11.47% and cophotic in 01.09%. Asymmetrical curves were the most found in

关键词： Deafness Tonal Audiometry Bamako

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Surgery of the Goiter in the ENT Department of Chu Gabriel Toure: Problematic and Perspective

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第6期8卷 283-291页

作者： Kassim Diarra N’faly Konaté Youssouf Sidibé Tiguida Sissoko Fatogoma Issa Koné Boubacary Guindo Harouna Sanogo Bagayoko Drissa Kaloga Siaka Soumaoro doum.ia kadidiatou singare Samba Karim Timbo Mohamed Amadou Keita ENT and Head and Neck Surgery Department Gabriel Toure University Hospital Bamako Mali ENT and Head and Neck Surgery Department Mother-Child “Luxembourg” Hospital Bamako Mali ENT and Head and Neck Surgery Department Reference Health Kalanbancoro Bamako Mali Anesthesia Resuscitation Department Mother-Child “Luxembourg” Hospital Bamako Mali

Aims: To describe the diagnostic aspects, surgical indications and post-operative complications of thyroidectomies performed in our department. Materials and method: A descriptive retrospective study that took place in the ENT Department and Cervicofacial Surgery of Gabriel TOURE University Hospital of Bamako. We did a comprehensive sampling of all goiter cases from January 2013 to December 2018. Were included in the study, the records of patients of all ages and genders, admitted into the ward and scheduled for thyroidectomy (partial or total). The exclusion criteria were incomplete hospitalization records. There were a total of 139 files were retained. Results: In 60 months, 139 cases were collected out of 1720 patients hospitalized for surgery, representing a hospital prevalence of 8.08%. The average age was 46.89 years. (123 women and 16 men). The socio-professional categories were dominated by housewives (68.34%). The reported functional signs were tachycardia, asthenia and other signs of dysthyroidism in 59% as well as signs of compression in 24.46%. In 72 cases or 51.80%, the patients consulted between 2 and 10 years of disease progression. Twenty patients or 14.39% had a history of familial goiter and 2 patients had a history of thyroid surgery. On physical examination the swelling was antero-cervical in 56.83% of cases. In 96 cases or 69.06% the glandular diameter was between 5 and 9 cm. In 2 cases or 1.43% we noted cervical adenopathy in the jugulo-carotid chain. Ultrasound, TSHus and fT4 were performed first-line and systematically in all our patients. Ultrasound objectified an appearance of multinodular goiter in 106 cases or 76.26%. In 60.43% of cases the patients were TI classes RADS 3, they were TI RADS 4A in 16 cases or 11.51%. CT scans were performed in 3 patients or 2.15% to specify the loco-regional extension, to look for possible lymph node invasion, and to compress or dipping the goiter. Surgical indication was placed in front of a multinodular

关键词： Goiter Thyroidectomy Recurrent Surgery

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