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Giant Epulis of the Gum and Palate Area: A Case Report in Stomatology Department at LoméUniversity Teaching Hospital

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Open Journal of Stomatology 2019年第9期9卷 193-198页

作者： Saliou Adam Haréfétéguéna Bissa Palokina Agoda Hamza Dolès Sama Winga Foma Essobozou Plaoudézina Pegbessou eyawèlohn kpemissi Department of Stomatology and Maxillofacialsurgery Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of ENT Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Stomatology Campus University Teaching Hospital of Lomé Lomé Togo Department of Anesthesia and Intensive Care Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of ENT Campus University Teaching Hospital of Lomé Lomé Togo

Introduction: Epulis is a pseudotumor very common in women. If neglected, it can reach a considerable volume. The marginal gingiva is very involved in the tumor either in isolation or with periodontal and alveolar bone. The epulis sits classically on the vestibular gum, rarely on the palatal side. We report a case of palatal giant epulis which posed a diagnostic problem. Case report: This was a 50-year-old patient with a large tumor occupying the entire oral cavity and pushing all nearby organs. This lesion had been evolving for ten years, with a tendency to gradually increase of its volume. The orthopantomogram revealed the destruction of the underlying alveolar bone without signs of tumor invasion. Surgical excision was performed, removing all the tumor in the vicinity of the nasopalatine vascular pedicle. The pathological examination concludes with an inflammatory epulis. Conclusion: The epulis is a benign tumor of the gum, circumscribed, localized preferentially at the neck of one or two contiguous teeth. It occurs more in women, with a predilection for the vestibular side, rarely the palatal side. In the absence of appropriate treatment it can lead to a large tumor, posing a diagnostic problem and causing functional or aesthetic discomfort. Complete surgical excision with histological examination remains the solution. Healing without sequelae is the rule.

关键词： Giant Epulis Surgical Excision Stomatology Lome

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Mandibular Sequela Noma: Metal Plate Repair Associated with a Submental Flap, about One Case

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Open Journal of Stomatology 2019年第7期9卷 175-180页

作者： Saliou Adam Hamza Dolès Sama Haréfétéguéna Bissa Palokina Agoda Winga Foma Essobozou Plaoudézina Pegbessou Bathokédéou Amana Essoham Boko eyawèlohn kpemissi Department of Stomatology and Maxillofacial Surgery at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of ENT at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Anesthesia and Intensive Care at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Stomatology at Campus Universityteaching Hospital of Lomé Lomé Togo Department of ENT at Campus University Teaching Hospital of Lomé Lomé Togo Department of ENT at Regional Hospital of Lomé Lomé Togo

Introduction: Noma is a severe and mutilating gangrenous stomatitis of the orofacial sphere, starting on periodontal side. It is rare and occurs mainly in children that land is weakened by malnutrition. We report a case of mandibular sequela noma requiring plastic surgery. Clinical case: This was a 7-year-old patient with moderate acute malnutrition. She was referred from a peripheral care facility for gangrene of the left cheek, communicating the oral cavity with the outside, through an orostoma. This lesion had been evolving for two months, with a tendency towards progressive destruction of the soft tissues of the cheek and the mandibular bone. The neck and facial CT-Scan demonstrated destruction of the mandibular bone exposed on the left side, without signs of tumor invasion. After correction of nutritional status and local infection, the patient was treated with a metal plate recovered by sub-mental flap. Conclusion: Noma is a severe gangrenous stomatitis that transforms patients’ faces into ghosts by destroying soft tissues and underlying bone planes. The management of his sequelae is surgical, sometimes using complex techniques of plastic surgery.

关键词： Noma Sequelae Plastic Surgery Metal Plate Sub-Mental Flap

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Orbital Floor Fractures: Epidemiological, Clinical and Therapeutical Study at Sylvanus Olympio University Teaching Hospital in Loméabout 51 Cases

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Open Journal of Stomatology 2021年第9期11卷 373-386页

作者： Saliou Adam Hamza Dolès Sama Yao Messanvi Akpoto Haréfétéguéna Bissa Palakina Agoda Winga Foma Essobozou Plaoudézina Pegbessou Bathokédéou Amana Essohanam Boko eyawèlohn kpemissi Department of Stomatology and Maxillofacial Surgery Sylvanus Olympio University Teaching Hospital of Lomé Togo Department of ENT Sylvanus Olympio University Teaching Hospital of Lomé Togo Department of Anesthesia and Intensive Care Sylvanus Olympio University Togo Military Medical Department Sylvanus Olympio University Teaching Hospital of Lomé Togo Department of Stomatology Campus University Teaching Hospital of Lomé Togo Department of ENT Campus University Teaching Hospital of Lomé Togo

Introduction: Orbital floor fractures are a significant pathology among maxillofacial injuries. They can cause oculomotor, sensory, and sometimes esthetic disorders. The goal of this study was to determine the epidemiological profile of orbital floor fractures and show their clinical and therapeutic approach in Lomé. Patients and method: This was a descriptive retrospective study of orbital floor fractures collected in the ENT and maxillofacial surgery department of Sylvanus Olympio University Hospital in Lomé over 8 years (January 1, 2011 to December 31, 2018). Results: We reviewed 63 cases of orbital floor fractures out of 552 cases of facial trauma. According to the inclusion and non-inclusion criteria, we retained 51 cases. The hospital frequency of orbital floor fractures was 9.24% of facial fractures. The average age of the patients was 35 ± 10.34 years. Males were predominant (ratio = 7.5). The main etiology was road accidents (92.16%). Ophthalmological signs were dominated by vertical diplopia (31.37%), limited eye movement (25.49%), and enophthalmia (29.41%). The sensory sign was dominated by suborbital hypoesthesia (13.73%). Surgical treatment was performed in 86.27% of patients. The average intervention time was 17.84 ± 12.69 days after the trauma. The main approach was the subciliary route (65.91%). The surgical procedures consisted of muscle and fat removal (20.45%) and orbital floor repair by mesh plate (50%). The average length of hospitalization was 9.63 ± 5.23 days. Surgical site infection was the main postoperative complication observed in 3.92% of patients. The main sequelae were diplopia (4.55%), suborbital hypoesthesia (4.55%), and enophthalmos (4.55%). Conclusion: Orbital floor fractures are mainly due to road accidents. Management must be multidisciplinary and adequate in order to avoid irreversible functional and/or morphological sequelae. Their prevention consists of effecti

关键词： Orbital Floor Fracture Diplopia Facial Bone Road Accidents Lomé (Togo)

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Labio-Jugal Squamous Cell Carcinoma on HIV Site: Surgical Excision and Reconstruction with a Musculocutaneous Flap of the Pectoralis Major: A Case Report

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Open Journal of Stomatology 2021年第11期11卷 460-466页

作者： Salio Adam Hamza Dolès Sama Essobozou Plaoudézina Pegbessou Yao Messanvi Akpoto Palakina Agoda Winga Foma Haréfétéguéna Bissa Bathokédéou Amana Mohaman Awalou Djibril Essohanam Boko eyawèlohn kpemissi Department of Stomatology and Maxillofacial Surgery Sylvanus Olympio University Teaching Hospital of Lomé Togo Lomé Department of ENT Sylvanus Olympio University Teaching Hospital of Lomé Togo Lomé Department of Anesthesia and Intensive Care Sylvanus Olympio University Teaching Hospital of Lomé Togo Lomé Department of ENT Campus University Teaching Hospital of Lomé Togo Lomé Department of Military Medical Sylvanus Olympio University Teaching Hospital of Lomé Togo Lomé Department of Stomatology Campus University Teaching Hospital of Lomé Togo Lomé

Introduction: Malignant skin tumors are very frequent lesions, induced by sustained sun exposure. Cutaneous squamous cell carcinoma is a dangerous cancer of the skin. It’s more frequent in white people than black people. Squamous cell carcinomas sometimes pose a real problem of local reconstruction after their removal. Reconstructions may involve the production of regional pedunculated flaps to repair the loss of substance. We report the case of a labio-jugal squamous cell carcinoma in an HIV-positive patient. The excision of the tumor required repair by a musculocutaneous flap of the pectoralis major. The aim of this paper is to show the dangerousness of that cancer, the particularity of its location around the mouth. We also want to call for a reflection about the recurrence of that disease on HIV infection ground, despite correct resection. Clinical Case: This was a 47-year-old HIV-positive patient on antiretroviral therapy (ARVs), treated 23 years ago for pulmonary tuberculosis. He presented with an ulcerated lower lip wound extending to the right labial commissure, right cheek, and the right lateral third of the upper lip. This lesion had progressed for about 6 months without a tendency to spontaneous healing. There was no palpable lymphadenopathy, especially in the cervicofacial region. The biopsy of the lower labial lesion concluded that it was a differentiated, mature, infiltrating squamous cell carcinoma. The craniofacial CT scan did not note any regional tumor invasion. We indicated tumor excision, functional lymph node dissection, and reconstruction by a flap of the pectoralis major muscle. The operative procedure was performed under general anesthesia. The edge cuts after carcinoma removal were healthy. Three months later, the patient is seen again with a local right submandibular recurrence. Radiotherapy was offered to him. Discussion: Squamous cell carcinomas are frequent in sub-Saharan Africa with pre

关键词： Squamous Cell Carcinoma Labio-Jugal Pectoralis Major Flap HIV Site

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Naso-Labio-Palatine Clefts: Humanitarian Care in Togo

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Open Journal of Stomatology 2021年第10期11卷 411-421页

作者： Saliou Adam Hamza Dolès Sama Winga Foma Haréfétéguéna Bissa Palakina Agoda Bina Béténora Essobozou Plaoudézina Pegbessou Bathokédéou Amana Essohanam Boko Mohaman Awalou Djibril eyawèlohn kpemissi Department of Stomatology and Maxillofacial Surgery at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of ENT at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo Department of Anesthesia and Intensive Care at Sylvanus Olympio University Lomé Togo Department of Stomatology at Campus University Teaching Hospital of Lomé Teaching Hospital of Lomé Lomé Togo Department of ENT at Campus University Teaching Hospital of Lomé Lomé Togo Military Medical Department at Sylvanus Olympio University Teaching Hospital of Lomé Lomé Togo

Introduction: The management of nasolabial-palatal clefts in precarious environments is one of the topics most addressed by many humanitarian missions, especially in Africa and Asia. The aim of our study was to propose a humanitarian and not expensive care to the patients presenting with facial clefts during the fairgrounds in disadvantaged areas. Patients and Method: We carried out a prospective study on 32 patients who were operated with very limited means during the mobile clinics inside Togo during the year 2013. These patients were followed over a period of one year after their surgery. Included in our series were native patients with facial clefts, who had no means of managing their condition, and who therefore needed humanitarian support. We have reported the clinical history of some patients to illustrate our results. Results: Our study included 32 children, including 15 boys and 17 girls, with a sex ratio of around 1. The average age of patients was 5 years, with extremes of 6 months and 13 years. We performed 13 clefts (including 12 unilateral clefts and 1 bilateral cleft), 17 clefts palate (including 12 unilateral clefts and 5 bilateral clefts), and 2 velar clefts. We described the clinical history of a few patients in this humanitarian setting and showed the surgical results obtained.

关键词： Nasolabial-Palatal Clefts Humanitarian Care Togo

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Epidemiological, Clinical and Therapeutic Issues of Epulis at Campus University Teaching Hospital of Lomé: About 33 Cases

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Open Journal of Stomatology 2019年第7期9卷 168-174页

作者： Saliou Adam Hamza Dolè s Sama Palokina Agoda Haré fé té gué na Bissa Winga Foma Essobozou Plaoudé zina Pegbessou Bathoké dé ou Amana Essoham Boko eyawè lohn kpemissi Department of Stomatology and Maxillofacial Surgery at Sylvanus Olympio University Teaching Hospital of Lomé Lom&#233 Togo Department of ENT at Sylvanus Olympio University Teaching Hospital of Lomé Lom&#233 Togo Department of Anesthesia and Intensive Care at Sylvanus Olympio University Teaching Hospital of Lomé Lom&#233 Togo Department of Stomatology at Campus University Teaching Hospital of Lomé Lom&#233 Togo Department of ENT at Campus University Teaching Hospital of Lomé Lom&#233 Togo Department of ENT at Regional Hospital of Lomé Lom&#233 Togo

Introduction: The epulis is a hyperplastic tumor-like of the gingival or cheek mucosa that would be due to inflammatory reactions. Its pathogenesis remains incompletely understood. It appears to be common in Africa, but no study has been conducted in Togo. Our purpose was to describe epidemiological, clinical and therapeutic aspects of the epulis at the Campus University Teaching Hospital in Lomé. Patients and methods: This was a retrospective descriptive study on 33 cases at the Odontostomatology Department, from January 1st, 2014 to December 31st, 2016. Results: The prevalence of epulis was 0.88%. The average age of the patients was 36.92 years old. The most affected age group was 20 - 29 years old (30.30%). The sex ratio was 0.57. Low education and poor socio-economic conditions were found to be predisposing factors. Mucous swelling was the main reason for consultation. A local irritative factor was found in more than half of the cases. The preferred seat was gum (63.63%). Inflammatory epulis was found in 36.36% of cases. Biopsy-excision was performed in 96.96% of patients, with a cure without sequelae in 100%. Conclusion: The epulis is a rare benign affection of the gum. Its favoring factors are mechanical or infectious local irritation, or hormonal factors. His diagnosis is essentially clinical, but requires histological confirmation to distinguish it from other serious tumors. Biopsy-excision is the main treatment. No sequelae are observed in all patients of our series.

关键词： Epulis Epidemiology Clinic Treatment Togo

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Mandibular Fractures at Sylvanus Olympio Teaching Hospital: About 153 Cases

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Open Journal of Stomatology 2017年第12期7卷 501-510页

作者： Haréfétéguéna Bissa Saliou Adam Winga Foma Palokina Agoda Essobozou Plaodèzina Pegbessou Essolam Tagba Bathokédéou Amana eyawèlhon kpemissi Department of Stomatology Otorhinolaryngology Maxillofacial and Head and Neck Surgery Health Sciences Faculty University of Lomé Lomé Togo

Introduction: Mandibular fractures have epidemiological and therapeutic characteristics that vary from one region to another. The aim of our work was to report the particularities of this pathology in Lomé. Material and Methods: We analyzed retrospectively the records of 153 patients admitted for mandibular fractures in the ENT and Head and Neck and Maxillofacial Surgery Department of the Sylvanus Olympio Teaching Hospital in Lomé, between 2010 and 2015. Age, sex, etiology, topography and the therapeutic modalities were the parameters of study. Results: The prevalence of mandibular fractures was 15% with a sex ratio of 9.2. The average age was 33.5 +/- 11.4 years with extremes of 7 years and 67 years. The etiology was marked by the predominance of road accidents (RA) in 63.3% followed by accidents at work in 14.4% and 80.4% motorcyclists involved. Unifocal fractures were found in 68.6% and the parasymphyseal region was the most affected (47%) followed by the corpus (17.7%). The osteosyntheses were performed in 71.9% and intermaxillary fixation in 13.7%. The sequelae were noted in 12 patients (tooth loss, paresthesia in the lower dental nerve area). Discussion: Our results are superimposable with publications in developing countries. Mandibular fractures remain as the prerogative of young men of the 2nd and 3rd decades. However, treatment using modern methods (screw plate osteosynthesis) is still dependent on socioeconomic status.

关键词： Mandible Fracture Epidemiology Treatment Togo

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Maxillofacial Trauma at LOMÉ(TOGO): About 501 Cases

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Open Journal of Stomatology 2017年第12期7卷 511-518页

作者： Haréfétéguéna Bissa Essobozou Plaodèzina Pegbessou Saliou Adam Winga Foma Tagba Essolam Essobizou Amana Bathokédéou Amana eyawèlhon kpemissi ENT and Cervicofacial and Maxillofacial Surgery Unit Sylvanus Olympio Teaching Hospital of Lomé Lomé Togo

Objective: We conducted a retrospective study to determine the epidemiological profile and describe the diagnostic aspects of maxillofacial trauma. Methods: It was a retrospective descriptive study over 20 years (January 1995-December 2014) in Oral and Maxillofacial Surgery Department of the Sylvanus Olympio Teaching Hospital in Lomé. All the hospitalized patients for facial trauma were included. Results: 501 cases of facial trauma were retained with an annual incidence of 25 cases. The average age was 33 years and the most represented age groups are those of 20 to 29 years (35.53%) and 30 to 39 years (30.14%);and the sex ratio was 9. Traffic roads accidents represented the main circumstance (89.81%) and the motorcycle was the most involved (80.34%). Patients were admitted in the first week (75.65%) with 35.93% on the first day. The maxillofacial CT-Scan was the most requested radiological examination (33.75%). Bone lesions were: mandible (31%), zygomatic (23.26%) and maxillary (18.99%). Dental lesions were found in 68 cases. Extra-facial lesions were found in 44 cases. The patients were treated in the first week (62.48%) and in the first day after admission (20.76%). Conclusions: Maxillofacial trauma is increasing, mainly in young adults due to road traffic accidents.

关键词： Maxillofacial Trauma Fractures Clinical Study Lomé

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