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

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 Doumbia 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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Thrombosis of the Transverse Sinus: About a Clinical Observation and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第3期12卷 180-186页

作者： Harouna sanogo Kassim Diarra Nfaly Konate Mohamed Saydi Ag Med Elmehdi Elansari Drissa Kaloga Bagayogo Kalifa Coulibaly Dembele Yaya Kone Fatogoma Issa Boubacary Guindo siaka Soumaoro Doumbia Kadidiatou Mohamed Amadou Keita Reference Health Center Kalaban Koro Bamako Mali ENT Head and Neck Surgery Department University Hospital Gabriel Toure Bamako Mali Reference Health Center Common VI Bamako Mali Department of Anesthetist Resuscitation University Hospital Mother-Child Luxembourg Bamako Mali

Cerebral venous thrombosis has an unfavorable prognosis. It is a rather rare pathology concerning 3 to 5 cases per million inhabitants. The clinical symptomatology also varies according to the topography of the venous thrombosis and, in some cases, the CVT can have an unusual presentation. Progress and accessibility of non-invasive imaging currently allow early diagnosis of CVT. Brain MRI is the reference method for the diagnosis of CVT. We report a case of transverse sinus thrombosis in a 32-year-old male patient who consulted for headaches through which we want to study the etiological, clinical, paraclinical, therapeutic aspects as well as the evolutionary profile. The clinical history dates back to 2 weeks ago with frontal headaches radiating to the occipital region, throbbing of severe intensity, progressive onset and permanent evolution associated with right unilateral anterior purulent rhinorrhea. He had no nasal obstruction, epistaxis, hearing loss or other otological symptoms;no neurological deficit or notion of head trauma. Cerebral and maxillofacial computed tomography showed right maxillary sinusitis and right transverse sinus thrombosis. We carried out medical treatment based on antibiotics and analgesics without the use of anticoagulants. The evolution was favorable after four weeks of treatment. Conclusion: Transverse sinus thrombosis has a non-specific and heterogeneous clinical presentation. Headaches are the first sign. MRI and CT can help establish the diagnosis. The treatment is both etiological and symptomatic.

关键词： Transverse Sinus Thrombosis Headache Non-Surgical Treatment

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Surgical Reports of the Inferior Laryngeal Nerve and the Inferior Thyroid Artery in General Surgery and in ENT

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Forensic Medicine and Anatomy Research 2019年第1期7卷 24-30页

作者： Youssouf Sidibé Abdoulaye Kanté Bréhima Bengaly siaka Diallo Mariam Daou Drissa Ouattara Babou Ba Bréhima Coulibaly Birama Togola Drissa Traoré Abdoul Wahab Haidara Boubacar sanogo Nouhoum Ongoï ba ENT and Head and Neck Surgery Department CHU “Mother-Child” The Luxembourg Bamako Mali Service of Surgery B. CHU Point G Bamako Mali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology Bamako Mali Service of Neurology CHU Gabriel Touré Bamako Mali

Aim: The purpose of this study was to determine the frequency of the hurts of the inferior laryngeal nerve, according to its anatomical reports with the inferior thyroid artery during the thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery “B” to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the Teaching Hospital “Mother-Child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were retained. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the inferior laryngeal nerve realized during the surgical operations on the thyroid, the frequency of lesion of the inferior laryngeal nerve was 1.09% (20 cases) when it passed dorsally with regard to the inferior thyroid artery (1837 cases) and when 4.04%, it was transvascular or prevascular (272 cases). Conclusion: The prevascular route or transvascular of the inferior laryngeal nerve favors its lesion per operating.

关键词： Anatomy Inferior Laryngeal Nerve Recurring Nerve Thyroid Surgery Goiter

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Omphalocele Diagnosis Problem in Rural Environment

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Surgical Science 2024年第8期15卷 501-506页

作者： Kanté Sékou Diallo siaka Touré Cheick Amed Sékou Ousmane I. Touré Coulibaly Ibrahim Traoré Drissa Bengaly Brehima sanogo Soulemane Togola Birama Ouattara Drissa Saye Jack Ongoïba Nouhoum Koumaré Abdel Karim Service de Chirurgie B CHU Point G Bamako Mali Facult de Mdecine de lUSTTB Bamako Mali

Introduction: An omphalocele is a congenital malformation due to a failure of closure of the umbilical ring with exteriorization of the abdominal viscera covered by the translucent and avascular amniotic membrane. We report a case of giant omphalocele unrecognized at birth followed by a review of the literature. Observation: This was a 4-year-old girl admitted to the department for umbilical swelling that had been present since birth. Clinical and paraclinical examinations made it possible to objectivize a post-omphalocele hernia with hepatic content plus ectopic accession of the left ureter, the surgical procedure consisted of reintroducing the liver associated with a cure of the hernia + ureterovesical reimplantation. Conclusion: Omphalocele is a congenital malformation, antenatal diagnosis is possible during morphological ultrasound from the 12th week.

关键词： Omphalocele Ectopic Left Ureter

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Tonsillitis and Their Complications: Epidemiological, Clinical and Therapeutic Profiles

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第3期8卷 98-105页

作者： Abdoul Wahab Haidara Youssouf Sidibé Djibril Samaké Amady Coulibaly Mamadou Karim Touré Bréhima Bolonpé Coulibaly siaka Soumaoro Boubacary Guindo Kassim Diarra Kalifa Coulibaly Boubacar sanogo Mohamed Kéï ta Alhousseini Ag Mohamed ENT and Head and Neck Surgery Department CHU Mother-Child “Luxembourg” Bamako Mali ENT and Head and Neck Surgery Department Reference Health Center Bamako Mali Department of Stomatology and Maxillofacial Surgery CHU-CNOS Bamako Mali Department of Anesthesia Resuscitation CHU Mother-Child “Luxembourg” Bamako Mali ENT and Head and Neck Surgery Department CHU Gabriel Toure Bamako Mali

Tonsillitis or angina, is considered as an inflammation of the palatine tonsils most often of infectious origin. It can be acute or chronic. The germs in question are mostly viruses and bacteria. Objectives: The objective of this work was to study the epidemiological and therapeutic profile of tonsillitis and their complications in the ENT Department and Head and Neck Surgery of the Mother-Child University Hospital in Luxembourg. Patients and Methods: This is a prospective study over a 12-month period from January 2018 to December 2018, including all patients who presented with tonsillitis and/or their complications. Results: Three hundred and fifteen (315) patients were collected during this period. The average age in our study was 14.25 years with extremes ranging from 2 years to 61 years. The sex ratio was 0.65 in favor of the female sex. During this period we recorded 80.95% of cases of uncomplicated tonsillitis including 60.50% for acute tonsillitis, 24.5% for chronic tonsillitis 5% for adenoid tonsillitis and 19.05% for complications. Complications included peritonsillar phlegmon 42.22%, heart disease 33.33%, cervical cellulitis 8.89%, adeno-phlegmon 6.67%, para-pharyngeal abscess 4.44%, and sepsis 4.44%. The exclusive medical treatment was performed in 44.31%. Surgical treatment (drainage incision and tonsillectomy) was performed in 55.69%. Conclusion: Tonsillitis and its complications represent an important pathology in ENT. Feynophagy febrile is the pair-origin symptom that can lead to the diagnosis. The prevention of complications is the guarantor of the reduction of its morbidity. We recommend that in the absence of RDT (Rapid Diagnostic Test), it is necessary to systematize antibiotic therapy to prevent serious complications.

关键词： Tonsillitis Complication Mali

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Ultrasound Causes of Female Infertility at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 107-113页

作者： Mamadou Dembele Alassane Kouma Ilias Guindo Zoumana Cheick Berete Souleymane sanogo Mamadou N'diaye Brahima Doumbia Oncoumba Diarra Ousmane Traore Issa Cisse Aboubacar Sidiki N’ Diaye Badiougou Doucoure Youssouf Yalcouye Adama Diaman Keita siaka Sidibe Radiology Department Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Radiology Unit Fertilia Medical Clinic Bamako Mali Department of Education and Research in Public Health (DERSP) FMOS Bamako Mali

Aims: Infertility is a major problem in our current societies and the Fertilia medical clinic in Bamako is a center for medical assistance in procreation (MAP) where there is an increasingly growing demand for ultrasound. The objective of our study was to investigate the ultrasound causes likely to prevent the occurrence of pregnancy in a group of infertile and subfertile women. Subjects and Methods: This was a 5-year cross-sectional and prospective study, between January 2017 and January 2022, which involved 250 women wishing to become pregnant (infertile or subfertile), who came for pelvic ultrasound or follicular monitoring and who agreed to participate in our study. The parameters used were ultrasound reports including uterine, ovarian and tubal pathologies. It should be noted that in some cases no ultrasound cause of infertility was found. Data were entered and analyzed in SPSS. Results: 250 women were recruited into our. The average age was 32 years with extremes ranging from 17 to 51 years. 179 patients or 71.6% were between 17 and 35 years old. 139 patients or 55.6% had secondary infertility against 44.4% primary infertility. 202 patients or 80.8% had at least one ultrasound lesion and 48 patients or 19.2% had no significant ultrasound abnormality. The most represented ultrasound lesions were of uterine origin with 72.20%, 23.7% ovarian lesions and 04% tubal lesions. Uterine lesions were dominated by myomas, adenomyosis, endometrial polyps, uterine malformations and synechiae. As for ovarian lesions we noted cysts, polycystic ovary syndrome (PCOS), ovarian endometriosis, non-follicular ovaries and tubal ultrasound lesions showed unilateral or bilateral hydrosalpinx. Conclusion: In our study, ultrasound was an invaluable contribution to the diagnosis of the causes likely to explain subfertility and infertility in our respondents. She highlighted uterine, ovarian and tubal lesions, some of which could be corrected and pregnancies ensued.

关键词： Ultrasound Female Infertility Myomas Polycystic Ovaries Hydrosalpinx

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Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

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Open Journal of Medical Imaging 2023年第3期13卷 84-91页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman Keita siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of th

关键词： Ultrasound Male Infertility Varicocele Oligoasthenoteratozoospermia

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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 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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Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

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Open Journal of Medical Imaging 2023年第3期13卷 92-100页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’Diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré Youssouf Yalcouyé Adama Diaman Keita siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 12

关键词： Endometrial Status Embryonic Implantation Medically Assisted Procreation

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The Pericarditis in CHU of Point G and Luxembourg: Clinical Aspects and Etiologies

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Open Journal of Thoracic Surgery 2018年第4期8卷 68-73页

作者： Abdoulaye Kante Brehima Coulibaly Mamadou Diakite Mamadou Almamy Keita Drissa Traore Brehima Bengaly siaka Diallo Mariam Daou Babou Bah MoustaphIssa Magane Tata Toure Bakary Keita Birama Togola Drissa Ouattara Souleymane sanogo Timbely Guidere Nouhoum Ongoiba General Surgery Department CHU Point GBamakoMali Department of Cardiology CHU Point GBamakoMali Department of Neurology Gabriel Toure Teaching HospitalBamakoMali Anesthesia Service and Resuscitation Department CHU Gabriel ToureBamakoMali

The authors bring back 70 cases of pericarditis brought together between 2012 and 2017 in the service of surgery B of the CHU Point G and to the Hospital Mother-Child, the Luxembourg in Mali. The average age of the patients is 31.5 years with extremes of 2 years and 84 years. The tubercular etiology widely comes to mind with 49 cases. The diagnostic contributions of the echocardiography are analyzed. The accent is put on good tolerance hemodynamic of the tubercular pericarditis. The forecast depends essentially on the etiology and on the diagnostic delay;indeed the tamponade pericardium can be inaugural or complicated;the evolution of the pericarditis is burdened of a heavy mortality (4.2% in our series). On the other hand the passage in the chronicity complicates essentially pericarditis seen late (8.6% in our series).

关键词： Etiology of the Pericarditis Aspect Private Hospital CHU G-Spot and Luxembourg

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