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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 Doumbia 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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Ear Cholesteatoma Surgery in South Sahara: Our Experience in Bamako

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International Journal of Otolaryngology and Head & Neck Surgery（耳鼻喉） 2024年第4期 293页

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Management of Tracheal Stenosis in Sub-Saharan Medicalized Context: Real Challenge about Two Clinical Cases

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第3期12卷 151-162页

作者： Kassim Diarra Demba Coulibaly Nfaly Konaté Boubacary Guindo Adama Coulibaly Mahamadou Sidibé Adama Dao Naoma Cissé Fatogoma Issa Koné Kalifa Coulibaly Youssouf Sidibe Siaka Soumaoro moussa bourama keita Doumbia Kadidiatou Singaré Mohamed Amadou keita ENT and Head and Neck Surgery Department University Hospital Center “Gabriel Touré” Bamako Mali Department of Anesthesia Resuscitation University Hospital Center Gabriel Toure Bamako Mali Imaging Department University Hospital Center “Gabriel Touré” Bamako Mali ENT and Head and Neck Surgery Department University Hospital Center “Le Luxembourg” Bamako Mali

Introduction: Post-intubation tracheal stenosis (STPI) is a complication of ventilatory assistance by intubation and/or tracheotomy. Her frequency is estimated between 10% to 20%. The treatment of choice remains surgery. It is based on tracheal resection-anastomosis which guarantees satisfactory and reliable long-term results. Objectives: To determine the frequency of post-intubation tracheal stenosis, to specify the diagnostic and therapeutic methods, to determine the complications and the evolution. Material and methods: This was a study carried out in the ENT and head and neck surgery department of the University Hospital Center Gabriel TOURE. Our study focused on two (02) cases of post-intubation tracheal stenosis (STPI) collected during a period of 1 year (January 2021 to December 2021). Results: They are all acquired, secondary to an intubation. The two (02) cases benefited from a tracheal anastomosis resection, the indications of which were specified and the results and complications evaluated. Conclusion: Our results show that resection anastomosis remains the reference treatment for STPI.

关键词： Tracheal Stenosis Intubation Tracheostomy

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Pleomorphic Adenoma of the Salivary Glands: Two Atypical Locations

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第3期13卷 251-257页

作者： Sidibé Youssouf Diarra Abraham Samaké Djibril Sanogo Boubacar Traoré Abdoul Moumine Diarra Kassim Coulibaly bourama Diakité Youssouf keita Mohamed Amadou Department of ENT and Head and Neck Surgery Mother-Child University Hospital “ Le Luxembourg&#8221 Bamako Mali Faculty of Medicine and Odontostomatology Bamako Mali Department of ENT and Head and Neck Surgery The Mali-Gavardo Hospital Bamako Mali Ministry of Higher Education and Scientific Research Bamako Mali ENT and Head and Neck Surgery Department of the Commune V Reference Health Center (CSRef CV) Bamako Mali Department of ENT and Head and Neck Surgery at CHU Gabriel Touré Bamako Mali Department of Anatomy and Pathological Cytology Gabriel Tour&#233 University Hospital Center Bamko Mali Department of Oral Surgery Sikasso Regional Hospital Sikasso Mali

Pleomorphic adenoma is the most common tumor of the salivary glands, accounting for approximately 50% of salivary gland lesions. It develops mainly in the salivary glands: parotid (80%), submaxillary (10%), sublingual (1%) and in the accessory oral-pharyngeal glands (9%). The aim of this work was to report 2 cases of pleomorphic adenoma of atypical location and then to discuss the difficulties linked to its diagnostic and therapeutic management in the Malian context. They were a 40-year-old man and a 72-year-old woman. They were admitted to the ENT department of the “Luxembourg Mere-infant” hospital for oropharyngeal swelling for the first and swelling of the palate for the second. The clinical expression was a swelling in both cases, of a hard, mobile consistency with healthy mucosa on their surface. The remainder of the physical examination was unremarkable. The diagnosis of a tumor of the oropharynx and palate was made following clinical radiological examinations. The histopathological examination of the surgical specimen made it possible to make the diagnosis of pleomorphic adenoma of the palate and the left palatine tonsil. The follow-up surgery was straightforward, with a favorable outcome. Pleomorphic adenomas are relatively rare benign tumors of the accessory salivary glands;their clinical expression remains swelling. Therapeutic management is surgery and the diagnosis is confirmed by histopathological examination.

关键词： Pleomorphic Adenoma Palate Tonsil Mali

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The Management of Neonatal Peritonitis in the Paediatric Surgery Department of the Donka National Hospital

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Open Journal of Pediatrics 2024年第5期14卷 823-833页

作者： Mohamed Lamine Sadou Sacko Thierno Saidou Barry Balla keita Mory Sangare Jacques Faya Millimono moussa Conde Seydou keita Daniel Agbo-Panzo Pediatric Surgery Department at Conakry University Hospital Conakry Guinea Universit Gamal Abdel Nasser de Conakry Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea

Introduction: Neonatal peritonitis is a rare but serious condition requiring early diagnosis and management. The lack of antenatal diagnosis, the precariousness of neonatal intensive care, and the delay in diagnosis and treatment are the factors of poor prognosis. The objective of this study was to study the epidemiological, diagnostic and therapeutic aspects of neonatal peritonitis in order to improve its management in the pediatric surgery department of the CHU-Donka. Materials and Methods: This is a retrospective descriptive study of the records of patients treated for neonatal peritonitis from January 1, 2017 to December 31, 2022. Results: Results: We compiled 17 records of patients operated on for neonatal peritonitis, representing a frequency of 3.85% and an incidence of 2.83 cases/year. The mean age of our patients was 8.29 days, with extremes of D0 and D25. Males were more dominant, with a frequency of 71% and a sex ratio of 2.4. The average consultation time was 72 h, with extremes of 12 h and 144 h. Abdominal bloating was the main reason for consultation (100%). Fever and vomiting were frequent, at 70.59% and 82.35% respectively. PSA revealed pneumoperitoneum in 12 patients (70.59%). The colon was the most frequent site of perforation at 29.41%. ECUN was the main etiology with 35.29%. Ostomy was the main surgical procedure in 58.82% of cases, followed by suture excision in 29.41%. Postoperative follow-up was simple in 3 patients (17.65%) and complicated in 14 (82.35%). Sepsis was the main cause of death (47.59%). The mortality rate was 76.47%. Conclusion: Mortality from neonatal peritonitis remains high in developing countries. Early diagnosis, early surgical management, and the presence of well-equipped neonatal intensive care units with qualified staff are essential for an improvement in the prognosis of neonatal peritonitis.

关键词： Etiology Newborns Gastrointestinal Perforation

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Management of Acute Idiopthic Intestinal Invaginal in Infants at Conakry University Hospital

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Open Journal of Pediatrics 2024年第5期14卷 937-950页

作者： Thierno Saidou Barry Mohamed Lamine Sadou Sacko Balla keita Mory Sangare Fanta Kourouma moussa Conde Baldé Aissatou Bailo Seydou keita Daniel Agbo-Panzo Pediatric Surgery Department of the Conakry University Hospital Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Pediatrics Department Albert Royer Childrens Hospital Cheikh Anta Diop University of Dakar (UCAD) Dakar Senegal General Surgery Department of the Ignace Deen University Hospital Conakry Guinea

Introduction: Acute intestinal intussusception (AII) has been known for a long time but its diagnosis sometimes remains difficult and its etiologies, particularly the idiopathic forms, poorly elucidated. The objective of this study was to describe the clinical and therapeutic aspects of acute intestinal intussusception in order to contribute to the improvement of the management of this condition in the pediatric surgery department of the Donka National Hospital. Materials and Methods: This is a retrospective descriptive study of patients taken in charge of acute idiopathic intestinal intussusception over a period of 7 years (January 2017 to December 31, 2023). Results: We collected 72 patients operated on for IIA, i.e. a hospital frequency of 1.1% and an incidence of 10.3 cases per year. The mean age was 16.58 months with extremes of 3 months and 28 months. The sex ratio was 12.5 in favor of the boy. The triad of ombredanne dominated the clinical picture and paroxysmal abdominal pain with period of calm represented the main reason for consultation (72 cases) i.e. 100%, followed by vomiting (62 cases) and rectal bleeding (50 cases). Ultrasound was performed in 56 patients visualizing the intussusception sausage in 54 patients or 75%. The most common anatomoclinical variety of intussusception was the ileo-caeco-colic form with 35 cases (or 38%) followed by the ileocolic form 24 cases (33%). The surgical procedure performed was a manual reduction in 54 patients or 75% and an anastomosis resection in 18 patients;the appendectomy of principle was done in 62.25%. The postoperative course was simple in 64 patients or 88.88%. The mortality rate was 6.94 %. Conclusion: AII is a common abdominal surgical emergency in infants. Recognition of the Ombredanne triad especially abdominal pain with a period of calm in children and infants in particular is an important element for vital prognosis. Early diagnosis and close interdisciplinary cooperation between pediatric, radiology an

关键词： Acute Idiopathic Intussusception Infant Intussusception Sausage Pediatric Surgery

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Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

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Open Journal of Pediatrics 2024年第4期14卷 719-726页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko Balla keita Sory Sidimé moussa Condé Daniel Agbo-Panzo Pediatric Surgery Department Donka National Hospital (HND) of the University Hospital of Conakry Gamal Abdel Nasser University of Conakry (UGANC) of Guinea Conakry Guinea Orthopedic and Trauma Surgery Department Donka National Hospital (HND) of the Conakry University Hospital Conakry Guinea

Introduction: Solitary exostoses are the most common benign tumors of the fertile metaphyses of the long bones of children. Their radiological diagnosis of metaphyseal bone growth must be confirmed on pathological examination. These tumors can remain asymptomatic for a long time and reveal themselves during a particularly vascular complication. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of these tumors. Patient and Observation: We report the case of a 15-year-old adolescent girl, with no particular pathological history, received in the pediatric surgery department of the Donka National Hospital (HND) of the Conakry University Hospital for recurrent acute painful swelling of the lower third of the left thigh in an afebrile context accompanied by lameness and stopping school for a few days (2 - 3 days). The symptoms appear to have evolved over the past 3 years and after physical activities. It regresses with rest, analgesics and non-steroidal anti-inflammatory drugs. The notion of trauma and sickle cell disease was not reported in the patient's clinical history. It is the persistence of the symptomatology which motivates the said consultation. On palpation, a small hard mass is noted at the expense of the internal metaphysis of the left distal femur. Deep palpation of this area causes a tingling sensation and during rapid mobilization of the knee. The remainder of the orthopedic examination was unremarkable. Standard x-ray of the femur shows a bony growth with a pointed tip from the distal metaphysis of the left femur. On surgical exploration, we noted a wedge-shaped exostosis oriented towards the vastus medialis muscle. Histological examination of the surgical specimen confirms osteogenic exostosis. There is no recurrence after 2 years. Conclusion: The distal femoral metaphysis is the most common location of solitary osteochondromas in children. Their definitive diagnosis requires the histology of

关键词： Osteogenic Exostosis Osteochondromas Fertile Long Bone Metaphyses Child

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Ultrasound Biometry of the Liver at the Point “G” University Hospital Center in Bamako

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Open Journal of Medical Imaging 2024年第3期14卷 86-95页

作者： Ousmane Traore Siaka Diakite Drissa Mansa Sidibe moussa Konate Mamadou N’Diaye Salia Coulibaly Nouhoum Ongoiba Adama Diaman keita Department of Radiology and Medical Imaging University Hospital Center of Point G Bamako Mali Department of Family Medicine/Community Medicine Faculty of Medicine and Odontostomatology (FMOS) Bamako Mali Department of Radiology Bamako-Mali Military Health Center Bamako Mali Department of Radiology and Medical Imaging University Hospital Center Kati Mali Department of Anatomy Faculty of Medicine and Odonto-Stomatology Bamako Mali

Introduction: Biometrics therefore corresponds to the measurement of the morphological elements of humans. One of the most common ultrasound requests by clinicians is the assessment of liver size. The aim of our study was to study liver biometry using ultrasound in healthy adult subjects. Material and Methods: This was a prospective, descriptive and analytical study, carried out at CHU Point-G over a period of 7 months. A liver ultrasound was performed on 100 individuals without lesions, by a doctor in his final year of specialization in radiology and medical imaging. For each subject, we determined the height and anteroposterior diameter of the right liver and the left liver. Results: The mean age was 39.05 ± 16.86 years. The body mass index (BMI) 18.5 - 24.9 group was the most represented with 58%. The mean height of the right liver was 138.40 ± 14.85 mm. It was 136.81 ± 14.70 mm in men and 139.92 ± 14.99 mm in women (P = 0.306). That of the left liver was 95.55 ± 14.34 mm, in men, it was 91.79 ± 13.51 mm and 99.16 ± 14.31 mm in women (P = 0.019). We found a significant correlation between right liver height and BMI (P = 0.013). Conclusion: The mean values of liver biometry were established in our series. There was a significant correlation between right liver height and BMI. Liver ultrasound remains a reliable technique for liver biometry.

关键词： Liver Biometry Ultrasound Point-G University Hospital Bamako

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Maternal Fetal Prognosis: Pregnancy and Delivery in Women of 40 Years Old and Over in a Second Reference Hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 509-519页

作者： Samaké Alou Diarra Lasseny keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté moussa Maiga Mariam Mohamed Saydi Ag Med Elmehdi Elansari Kassogue Djibril Seydou Zana Dao Samake Hawa Konate Karim Dembele Bertin Coulibaly moussa Mariko Seydou Collarete Dohino Reference Health Center of Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (BDH) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako District Bamako Mali Reference Health Center in Commune V of the Bamako District Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Late pregnancies are considered a public health problem linked to maternal mortality due to their complications. These risks, which worsen with maternal age, should be better known and taken into account in monitoring these pregnancies. Objective: To evaluate the impact of age on the prevalence of obstetric and neonatal complications among parturients of 40 years old and over. Methodology: This was an 11-year retrospective analytical case control study from January 1, 2007 to December 31, 2017. The study population was female patients of 40 years old or older for cases and female patients younger than 40 years of control case. Results: In total, we collected 640 cases of parturients of 40 years old and over out of a total of 84,234 deliveries during the study period;i.e. a frequency of 0.76%. Spontaneous abortion increased in patients of 40 and over with 8.28%. Hypertension and diabetes were higher of women of 40 and over, 52.65%. Concerning the method of admission: 55% of parturients of 40 and over were referrals. Incidents occurring among women of 40 and over were more pronounced than in control cases. Complications during vaginal delivery, cervical tear, perineal tear, uterine dehiscence and uterine rupture are high in our cases, i.e. 11.88%;3.59%;2.19%;2.66. During our study, depending on the type of delivery, the cesarean rate was much higher among women of 40 and over than among control cases, i.e. 54.22% versus 12.24%. Hemorrhages in the 3rd trimester were the main indications for cesarean section. Hemorrhages in the 3rd trimester were more frequent with women of 40 and over, i.e. 10.47%;5.94% versus 1.74% and 0.42%. As for the different types of malformations in parturients, women under 40 years old fetal malformations were absent in 92.29%, on the other hand they were more frequent in patients with 40 years and over, i.e. a normal frequency of 36.72%. Conclusion: Pregnancy at a late age exposes the elderly patient and the newborn to several ri

关键词： Advanced Maternal Age Childbirth Risk Mali

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Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

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Open Journal of Obstetrics and Gynecology 2024年第5期14卷 855-867页

作者： Samaké Alou Diarra Lasseny keita Mamadou Haidara Dramane Haidara Mamadou Diallo Mamadou Konaté moussa Maiga Mariam MS Ag Med Elméhdi Elansari Kassogue Djibril Dao Seydou Zana Samake Hawa Konate Karim Dembele Bertin Coulibaly moussa Mariko Seydou Colette Dohinnon Reference Health Center in Commune VI of the Bamako District Bamako Mali Bamako Dermatology Hospital (HDB) Bamako Mali Kalaban Coro Reference Health Center Bamako Mali Timbuktu Hospital Timbuktu Mali Reference Health Center of Commune II of the Bamako district Bamako Mali Reference Health Center in Commune V of the Bamako district Bamako Mali National Institute for Training in Health Sciences Bamako Mali Mali Hospital Bamako Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

关键词： Pregnancy High Blood Pressure Prognosis

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