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Post Blast Tympanic Perforations, Clinical and Paraclinical Study at Six Yaounde Hospitals

International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 126-134页

作者： Andjock Nkouo Yves Christian Lekassa Pierrette Meva’a Biouele Roger Christian Moboung Prudence Mindja Eko David Djomou Francois Njock Richard ndjolo alexis Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Omar Bongo Ondimba Military Teaching Hospital Libreville Gabon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon

Introduction: Post-blast tympanic perforations represent an entity of traumatic perforations;various mechanisms are at the origin of the latter, and the increase in conflicts and acts of violence are increasing the studies on this subject, but few data are available in our context. Objective: This paper aims to study post-blast tympanic perforations in Yaounde, specifically the epidemiological, clinical, and paraclinical aspects. Methodology: We conducted a descriptive cross-sectional study with retrospective and prospective data collection in six Yaounde hospitals over 63 months from January 1, 2018, to March 31, 2023. All patients with at least one post-blast tympanic perforation were included. Socio-demographic, clinical and paraclinical data were collected on a questionnaire and analysed using SPSS 28 software. Results: We included 124 patients. The prevalence of post-blast tympanic perforations was 0.1% of the consultations in the departments. 71 The average age was 28.6 ± 9.1 years, with extremes ranging from 7 to 49 years. The median consultation time was five days. The most frequent injury circumstances were physical aggression (81.45%) and armed conflict (10.5%). The injury mechanisms were slaps (75%), punches (21.74%) and grenades (4.8%). The main symptoms on admission were hearing loss (63.7%), tinnitus (58.1%) and otalgia (57.3%). The tympanic perforations were unilateral in all cases, the anterior-inferior location was more characteristic, and the deafness was conductive in 58.3% of cases, followed by mixed deafness in 23.3% of cases. Conclusion: Post-blast tympanic perforations are rare in consultation. The population is primarily male and from the second decade of life. The main circumstance is aggression.

关键词： Tympanic Perforation Blast Yaounde

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Massive Epistaxis Revealing a Post-Traumatic Aneurysm of the Internal Carotid Artery: A Clinical Case and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 120-125页

作者： Yannick Mossus Maguy Mbede Roger Meva’a Biouélé Leonel Atanga Adèle-Rose Ngo Nyeki Pierre Ongolo Zogo François Djomou alexis ndjolo Department of Ophthalmology ENT and Stomatology Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon Department of Medical Imaging Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon

Internal carotid artery (ICA) aneurysms are an unusual but serious cause of epistaxis. This epistaxis is massive and sometimes uncontrollable threatening the vital prognosis of patients. We report the case of a 16-year-old adolescent received in emergency with severe bilateral epistaxis, asthenia and grade-3 left exophthalmos. In his history, the subject had been the victim of an assault six months before consultation. He had received blows on the cephalic extremity with light but repeated epistaxis. The treatment consisted to blood products transfusion and local compression by sterile gazes. An ICA aneurysm in sphenoid sinus has been confirmed in a craniofacial CT scan coupled to vascular opacification. Although the ICA has a variable course in contact with the sphenoid sinus, massive epistaxis would be the consequence of a pronounced dehiscence of the ICA in the sphenoid sinus, particularly in a traumatic context. In front of this type of epistaxis in our context, general practitioners must be able to suspect a ruptured ICA aneurysm in the presence of exophthalmos and a notion of old or recent cranio-encephalic injury. Additionally, due to the high morbidity and mortality of this condition, a monitoring algorithm is necessary for patients with head trauma to facilitate early detection.

关键词： Aneurysm Internal Carotid Artery Head Trauma Epistaxis

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Preliminary Results of Cochlear Implantation in Underdeveloped Countries: The Experience of Cameroon

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第4期12卷 232-249页

作者： Andjock Nkouo Yves Christian Lekassa Pierrette Meva’a Biouele Roger Christian Kuifo Cedric Nanci Eliane Ngono Ateba Gladys Abdelaziz Raji Njock Richard Djomou Francois ndjolo alexis Ophthalmology-Ear-Nose-Throat (ENT)-Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon ENT-Cervico-Facial-Surgery (CFS) Service Yaounde General Hospital Yaounde Cameroon ENT-CFS Service Miltary Teaching Hospital Libreville Gabon ENT-CFS Service Yaounde Central Hospital Yaounde Cameroon ENT-CFS Service Douala General Hospital Douala Cameroon Anesthesiology and Reanimation Service Douala General Hospital Douala Cameroon ENT-CFS Mohammed VI Marrakech Teaching Hospital Marrakecch Morroco ENT-CFS Service Yaounde Teaching Hospital Yaounde Cameroon

Introduction: Deafness, is the most common neurosensory deficit in humans. The origins can be diverse: congenital or acquired and sometimes of an etiology that is difficult to specify. The main risk is social exclusion. The advent of cochlear implants is a solution of choice for severe to profound sensorineural hearing loss. This innovative therapeutic modality is new to Cameroon, so we proposed to evaluate the preliminary results of cochlear implantation at the General Hospitals of Yaoundé and Douala, by addressing the epidemiological, clinical and paraclinical, surgical, and prosthetic aspects. Methodology: We conducted a descriptive and prospective cross-sectional study over a period of two years and eight months, from January 2019 to 31 August 2021. The study sites were: the general hospitals of Yaounde and Douala, as well as the private practices of speech therapists in the said cities. We collected socio-demographic, clinical, paraclinical variables and data on surgical, prosthetic and speech therapy management which were processed. Results: We recruited 15 cochlear implant patients, one adult and 14 children. The sex ratio was 1.14 in favour of girls, the average age of the child population was 4.9 years and one subject was 57 years old. These children were mostly in school (85.7%) and mostly (86.7%) living in urban areas. The average period of sound deprivation was 3.9 years. The deafness of the children was 100% prelingual and the acquired cause was evoked in front of the risk factors (prematurity, low birth weight, neonatal asphyxia, jaundice, meningitis, neuromalaria) for 57.7% of them. The adult deafness was postlingual and post-traumatic. The associated clinical conditions found in 4 (26.8%) of the patients were an ocular refraction disorder, a chronic otitis media sequelae, cerebral palsy and minor head trauma injuries. There was no syndromic or malformative picture. The deafness was bilateral in all cases, asymmetric in 22.2% of cases and severe to profound sensorineural. The threshold of the deafn

关键词： Cochlear Implants Deafness Cameroon

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Multiple Cranial Nerve Palsies in Otolaryngology Consultation: An Atypical Clinical Presentation Revealing Myasthenia Gravis

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第6期11卷 306-316页

作者： Adèle-Rose Ngo Nyeki Paul Cedric Mbonda Léonel Atanga Yannick Mossus Roger Meva’a Victor Sini Mambo Olive Ngaba David Mindja Francois Djomou Callixte Kuate Richard Njock alexis ndjolo Department of Ophthalmology-ENT-Stomatology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon Department of Neurology General Hospital of Yaoundé Yaoundé Cameroon Department of Neurology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Introduction: Myasthenia gravis is a chronic autoimmune neuromuscular disease, presents with weakness and fatigability of striated skeletal muscles. It is a rare disease in Cameroon. We report an uncommon case of myasthenia gravis in a patient with feeding difficulties, notion of oronasal reflux and swallowing disorders as first complaints. Observation: We report the case of a 29-year-old woman consulted at our department of Otolaryngology and Cervico-Facial Surgery for dysphagia and swallowing disorders. She also presented with facial diplegia, oculomotor paralysis, nasal voice, and dysarthria which has been evolving for several years now. The clinical examination revealed multiple cranial nerve palsies. The complementary workup showed a decrement of more than 50% in the electroneuromyography and the presence of anti-acetylcholine receptor autoantibodies in the blood workup. A diagnosis of myasthenia confirms clinical presumption. We initially observed a worsening of neuromuscular disorders despite the pyridostigmine treatment and subsequently a clear improvement of the clinical features concerning swallowing and speech disorders, oculomotricity and facial diplegia under a treatment combining prednisone and azathioprine. Conclusion: Myasthenia gravis is a rare and potentially fatal autoimmune neuromuscular disease. We thus highlight the atypical clinical presentation and therapeutic itinerary of our patient and the importance to think about this clinical diagnosis in front of any multiple cranial nerve paralysis in otolaryngology consultation.

关键词： Clinical Case Dysphagia Swallowing Disorders Facial Diplegia Nasal Voice Myasthenia Autoimmune Paralysis Cranial Nerves

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A Fatal Arterio-Tracheal Fistula Post-Tracheostomy: A Case Report in a Sub-Saharan Setting

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第5期11卷 277-282页

作者： Yannick Mossus Douglas Banga Nkomo Serge Rowling’s Ngouatna Lutresse Thome Roger Christian Meva’a Biouélé Leonel Christophe Atanga Adèle-Rose Ngo Nyeki David Mindja Eko François Djomou alexis ndjolo ENT Surgeon Department of Ophthalmology ENT and Stomatology Faculty of Medicine and Biomedical Sciences of University of Yaoundé Yaoundé Cameroon Thoracic Surgeon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences of University of Dschang Dschang Cameroon Anesthesiologist Resuscitator Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences of University of Yaoundé Yaoundé Cameroon

Fatal bleeding in patients with tracheostomy is an uncommon incident, in the order of 0.1% to 1% of cases. It is secondary in 70% of cases to the innominate artery fistula in the tracheal lumen. The fistula is generally created after the necrosis of tracheal rings. The incriminated factors are the type of cannula used, the site of tracheal opening below the 3rd tracheal ring, tracheal infections and the proximity of the innominate artery to the tracheal axis. The outcome of this incident is fatal in most cases. We report the case of a 59-year-old patient with a tracheostomy on the 11th day of his admission to intensive care for severe head trauma secondary to a road accident. On the 22nd day of his admission, the occurrence of a cataclysmic and fatal haemorrhage through the tracheostomy tube evoked an arterio-tracheal fistula of the innominate artery.

关键词： Arterio-Tracheal Fistula Innominate Artery Tracheostomy Sub-Saharan Setting Case Report

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Evaluation of SON’OR^(█),a Medical Device for Provoked Otoacoustic Emissions and Brainstem Evoked Response Audiometry Made in Cameroon

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Journal of Biomedical Science and Engineering 2017年第8期10卷 376-389页

作者： Jean Espoir E.Vokwely Jean Valentin F.Fokouo Guy Merlin Ngounou Dalil Asmaou Esthelle G.Minka Ngom Martin Kom Richard L.Njock G.Bengono alexis ndjolo Otorhinolaryngology Service Centre Hospitalier d’EssosYaoundeCameroon Regional Hospital Bertoua BertouaCameroon National Advanced School of Engineering YaoundeCameroon BENDO Company YaoundeCameroon General Hospital YaoundeCameroon General Hospital DoualaCameroon Laquintinie Hospital DoualaCameroon Cameroon Society of Otolaryngology and Head and Neck Surgery YaoundeCameroon Chantal Biya International Research Center YaoundeCameroon

Background: There is a huge gap in the audiological care in Africa by comparison with Western countries. Its main reason is the prohibitive cost of the medical devices used to screen or diagnose patients. A Cameroonian team tackled this problem by developing a medical device (SON’OR©) which integrates a new instrumentation amplifier structure dedicated to perform otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA). The major technical challenges to perform OAE and BERA are the synchronization and the amplification of signals of very low amplitude. In this work, we emphasize on the general criteria necessary and indispensable to achieve an optimal amplification. The application of a novel instrumentation amplifier structure characterized by its optimized noise factor in the case of BERA and OEA emissions provides simulations and experimental results fully in line with forecasts. The design of SON’OR©is based on general techniques of electronic instrumentation to which we associated the new instrumentation amplifier structure. Objective: To report the clinical evaluation of SON’OR©as a screening and diagnostic tool. Methods: We conducted a cross sectional comparative study in Centre Hospitalier d’Essos in Yaoundé. We tested SON’OR©on two sets of subjects, one for OAE with OTODYNAMICS Echoport ILO 292-II as gold standard and the other for BERA with NEUROSOFT NEURO AUDIO©as gold standard. Each patient was tested with both devices and then we studied the inter device differences and calculated the sensitivity, specificity, positive predictive value and negative predictive value for each test. Results: We got 52 subjects for OEA and 51 for BERA testing. Sex ratio was 1 woman for 2 men in both groups. Mean age was 24.86(SD = 10.53) and 26.33 (10.55) for OAE and BERA groups respectively. SON’OR©had good performances, showing sensitivity of 92.85%/95%, specificity of 96.77%/90.47%, positive predictive value of 95.21%/93.44% and negative predictive value of 95.23%/92.68

关键词： SON’OR^(█) Brainstem Evoked Response Audiometry Otoacoustic Emissions Cameroon Neonatal Hearing Screening

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Viral Hepatitis B and C Detection among Ebola Survivors and Health Care Workers in Makeni, Sierra Leone

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Journal of Biosciences and Medicines 2020年第10期8卷 18-32页

作者： Nadege Goumkwa Mafopa Marta Giovanetti Raoul Emeric Guetiya Wadoum Antonella Minutolo Claude Kwe Yinda Gianluca Russo Béatrice Dambaya Georges Teto Georgia Ambada Patrick Turay Judith Torimiro alexis ndjolo Vittorio Colizzi Carla Montesano Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management Yaoundé Cameroon University of Roma “Tor Vergata” Rome Italy National Institute of Health-ISS Rome Italy University of Makeni Sierra Leone National Institute of Health (NIH) Intramural Research Program (IRP) Hamilton Montana USA University di Roma “Sapienza” Rome Italy Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management University of Yaoundé I Yaoundé Cameroon Holy Spirit Hospital Makeni Sierra Leone Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.

关键词： Viral Hepatitis B and C Ebola Survivors Health Care Workers

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Immunoglobulin G Specific Antibody Level against Ebola Viral Glycoprotein and Nucleoprotein in Ebola Virus Disease Survivors and Their Relatives

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Journal of Biosciences and Medicines 2021年第4期9卷 179-196页

作者： Nadège Goumkwa Mafopa Raoul Emeric Guetiya Wadoum Marta Giovanetti Antonella Minutolo Béatrice Dambaya Claude Kwe Yinda Gianluca Russo Georges Teto Georgia Ambada Patrick Turay Judith Torimiro alexis ndjolo Jules Roger Kuate Vittorio Colizzi Carla Montesano Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management Yaoundé Cameroon University of Roma “Tor Vergata” Rome Italy Department of Biochemistry University of Dschang Dschang Cameroon Departement of Public Health University of Makeni Makeni Sierra Leone National Institute of Health—ISS Rome Italy Faculty of Science University of Yaoundé I Yaoundé Cameroon Intramural Research Program National Institute of Health Bethesda Maryland USA University di Roma “Sapienza” Rome Italy Holy Spirit Hospital Makeni Makeni Sierra Leone Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Ebola virus disease is a complex zoonosis that is highly virulent in humans. Despite its sorely pathogenic and lethal nature, survivors of this infection and even asymptomatic cases are able to develop both humoral and cellular immunity against several Ebola virus (EBOV) proteins. We aimed at determining immunoglobulin G (IgG) antibodies level against two Ebola viral antigens, the glycoprotein and the nucleoprotein in Ebola survivors and their relatives. Anti-EBOV glycoprotein (GP) and nucleoprotein (NP) IgG antibodies were quantified using ELISA. We enrolled 199 participants in two different sites as follow: 91 survivors at the Loreto clinic and 70 survivors with 38 relatives of Sierra Leone Association of Ebola Survivors Bombali Branch (SLAESB) tested for anti-EBOV NP and anti-EBOV GP IgG antibodies. Our findings revealed that the median anti-EBOV IgG level among survivors was 5.7128 U/ml [IQR: 2.793 - 7.783] for anti-EBOV GP IgG and 4.431 U/ml [IQR: 2.083 - 7.696] for anti-EBOV NP IgG. Survivors relatives had a median anti-EBOV GP IgG level of ?0.7128 U/ml [IQR: -0.903 to -0.04327] and -2.711 U/ml [IQR: -4.01 to -1.918] for anti-EBOV NP IgG. We observed that IgG levels in survivors were higher than in relatives with a significant difference of about 0.0001. The median value of anti-EBOV IgG level among seropositive relatives was 0.7043 U/ml [IQR: 0.5686 to 3.716] for anti-EBOV GP IgG and 4.05 U/ml [IQR: 0.2765 to 7.759] for anti-EBOV NP IgG respectively. Interestingly, we observed that 3.30% of Loreto clinic survivors did not developed anti-EBOV NP IgG antibodies;also about 10% survivors of the SLAESB were not reactive to anti-EBOV NP IgG and 1.43% of these survivors did not express antibodies against the Ebola viral glycoprotein. Our work is consistent with previous published studies showing heterogeneity in both survivors and asymptomatic cases of Ebola infection developing adaptive immunity against EBOV proteins.

关键词： Immunoglobulin IgG Level Ebola Survivors and Relatives Glycoprotein and Nucleoprotein

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