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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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Congenital Cervical Teratoma

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Surgical Science 2019年第1期10卷 44-48页

作者： fatogoma issa koné Amal Hajjij Naouma Cissé Siaka Soumaoro Abdoul Wahabhaidara Samba Karim Timbo Mohamed Amadou Keita Department of Head and Neck Surgery Gabriel Touré University Hospital Bamako Mali Department of Head and Neck Surgery University of Health Sciences (UM6SS) International University Hospital Mohamed VI Casablanca Morocco

Introduction: The word “Teratoma” derives from the Greek word “teratos” including the meaning show. Teratoid tumors derived from the transformation of multipotent germ cells. They are composed of ectodermal, endodermic and mesodermal tissues in variable proportions;hence the term “embryonic tumor”. Objectives: We are reporting the case of a mature teratoma discovered in a young child whose delivery was vaginally performed. Through this case we put in diagnostic and therapeutic highlight and we made a literature review. Case report: Patient 17 months admitted for the anterior compartment mass associated with inspiratory dyspnea. No anomaly/abnormality was detected during the follow-up of the pregnancy. The Patient with dyspnea grade 2 was admitted according to Chevaleir-Jackson classification. No abnormalities of stature ponderal developments were noted. Surgery of excision was our therapeutic alternative. Through the pathological examination a mature teratoma was found. Conclusion: Teratoma is a rare condition. Proper management of mature teratoma helps to prevent recurrence.

关键词： Mature Teratoma Congenital Neck Surgery

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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 Doumbia 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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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 Doumbia 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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Necrotizing Fasciitis in the Sub-Saharan Zone: Analysis of an Exceptional Case and Review of the Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 211-218页

作者： Kassim Diarra Nfaly konaté Yaya Dembélé Youssouf Sidibe Kalifa Coulibaly Drissa Kaloga Bagayoko fatogoma issa koné Siaka Soumaoro Boubacary Guindo Doumbia Kadidiatou Singaré Mohamed Amadou Keita Gabriel Toure University Hospital Bamako Mali Army Polyclinic Bamako Mali Luxembourg Mother and Child Hospital Bamako Mali

Necrotizing fasciitis (FN) are severe, fulminant infection with necrosis of the skin and superficial fascia. The variability of the clinical picture and the severity of the condition make it a formidable condition. B.A, 16 years old, breeder, was admitted to ENT hospitalization for a large necrotic cervico-thoracic and dorsal ulceration of sudden onset following febrile odynophagia. ENT examination: large necrotic wound extending from the antero-posterior cervical region to the thoraco-abdominal and dorsal region, letting pus weld with trismus at 1.5 cm and a fistula of the anterior pillar of the right tonsil. Cytobacteriological examination of the pus isolated Staphylococcus aureus. We instituted a probabilistic antibiotic therapy readjusted afterward to the association amoxicillin clavulanic acid with the result of the antibiogram. Incision, drainage and surgical debridement of all necrotic tissues were performed, leading to extensive loss of skin substance. A daily local dressing was applied for 11 days, then replaced by honey for 51 days. On the 64th day, he was entrusted to the dermatology department for a skin graft where he stayed for 3 months. Conclusion: current name, necrotizing bacterial dermohypodermatitis. Surgery has a key role in treatment. Antibiotic therapy should be broad-spectrum.

关键词： Necrotizing Fasciitis Surgery Sequelae

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Anatomical Variations of Recurrent Laryngeal Nerve: The Danger in Thyroid Surgery

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Surgical Science 2019年第1期10卷 11-15页

作者： fatogoma issa koné Siaka Soumaoro Naouma Cissé N’faly konaté Kassim Diarra Djibril Samaké Kadidiatou Singaré Kadidiatou Singaré Boubacary Guindo Samba Karim Timbo Mohamed Amadou Keita Department of ENT—Head and Neck Surgery Gabriel Toure University Hospital Bamako Mali

Objectives: We report two types of anatomical variations of the recurrent laryngeal nerve in two patients. Through these two patients we wanted to highlight our surgical approach of the recurrent nerve in an unusual position and to describe the surgical implication of these almost rare variations. Case report: patient aged 28 and 58 admitted for goiter. They underwent a right lobisthmectomy. Both recurrences were approached retrograde. The anatomical variations of the nerve concerned the non-recurrent laryngeal nerve in the first patient. In the second patient there were three anatomical variations, namely an extra laryngeal bifurcation of the nerve, a pre-vascular position of the nerve and a branch connecting the vagus nerve and the recurrent nerve. No recurrence nerve injury was noted. Conclusion: The anatomical variations of the nerve are numerous. A careful dissection is a guarantee of a good prognosis.

关键词： Anatomical Variation Recurrent Laryngeal Nerve Surgery Mali

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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 Doumbia 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 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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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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Overview of Child Otological Care at the Reference Health Center of Commune V, Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第4期12卷 203-213页

作者： Djibril Samaké Kadidia Bagayoko Neuilly Ghislaine Tafo Ngniée Siaka Soumaoro Boubacary Guindo fatogoma issa koné Sinaly Thiocary Yatemelou Dara Fatoumata konaté Ibrahim Diébakaté Kadidiatou Singaré Samba Karim Timbo Mohamed Amadou Kéïta ENT and Head and Neck Surgery Department Commune V Reference Health Center Bamako Mali

Aim: To profile the diagnostic and the care provided for otological conditions in children. Method: This was a prospective cross-sectional study carried out from March 1, 2022 to May 30, 2022 at the ENT Unit of the Reference Health Center of Commune V (Bamako). This study concerned the records of children with an otological condition. They were at their first consultation within the unit. The month of March was devoted to recruitment. The follow-up was done until the end of May. The parameters studied included epidemiological, clinical and therapeutic aspects. Results: We identified 184 children suffering from otological conditions out of a total of 559 patients that consulted during March 2022, i.e. an hospital prevalence of 32.9%. This study found ear infections in 60.3%. Earwax and epidermal plugs accounted for 32.60%. Traumatic injuries were 4.3%. Pre-lingual deafness was found in 1.1% of cases. Antibiotics were used for treatment in 66.3% of children without any complications detected. Conclusion: The otological affections of the child were frequent with a predominance of otitis.

关键词： Otological Disorders Otitis Child Care

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