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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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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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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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Surgical Management of Larges Goiters in the ENT Department of CHU Mother and Child“Luxembourg”

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第4期8卷 139-149页

作者： youssouf sidibe Abdoul Wahab Haidara Djibril Samake Abdoulaye Kante Siaka Soumaoro Boubacary Guindo Nagnouma Camara Mamadou Karim Toure Mahmoud Cisse Amadou Djibo youssouf Djigui Diakite Boubacar Sanogo Mohamed Amadou Keita ENT and Head and Neck Surgery Department CHU Mother-Child“Luxembourg”BamakoMali ENT and Head and Neck Surgery Department Reference Health Center District VBamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU Gabriel ToureBamakoMali Department of Anesthesia Resuscitation CHU Mother-Child“Luxembourg” BamakoMali Department of Endocrinology Mother-Child University Hospital“Luxembourg”BamakoMali

Objectives: To study the clinical and therapeutic profiles of voluminous goiter. Patients and Methods: We carried out a descriptive and prospective study, relating to a series of 30 cases of voluminous goitre, collected in the Department of Otorhinolaryngology and cervicofacial surgery (ENT and CCF) of the CHU Luxembourg Mother Child of Bamako. It has been spread over a period of 4 years from January 2015 to December 2018. Patients of all ages operated for large goitre at the ENT Department of CHU Luxembourg Mother Enfant were included. Results: In 4 years we collected 30 cases of voluminous goitre;during this period we realized 180 thyroidectomies, i.e. frequency of 16.67%. The average age was 51.37 years with an extreme ranging from 38 to 65 years. Females were common in 66.7% with a sex ratio of 0.50. The long duration of evolution has been 40 years. The sign of compression was found in 85.7%. The physical examination found a mobile swelling, hard and painless in all patients with normal endolaryngeal examination;there was no cervical lymphadenopathy. The lower dipping pole was found in 5 cases on CT. All our patients were euthyroid. The classification of TIRADS 2 was found in 80.0% of cases. Total thyroidectomy was frequent with 50.0% of cases. The average weight of the operative specimen was 586.67 g with extremes ranging from 500 g to 800 g. The size of the operative piece of 14 cm was the longest. Injury of internal jugular vein was found in 26.7% of cases. Colloid adenoma of the thyroid was found in 100% of cases, postoperative complications of the type of hematoma of the lodge in 3.3% of cases, the release of the operative wound in 10% of cases local superinfection in 7.1%. Signs of hypothyroidism were common with 50.0%. Postoperative nasofibroscopy found good vocal fold mobility in all patients. Conclusion: The large goiters have become rare because of the early management of thyroid nodule. Its management must allow the prevention of recurrent and parathy

关键词： Thyroid Large Goiter Thyroidectomy

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Anatomical Dissection of the External Branch of the Superior Laryngeal Nerve to the Laboratory of Anatomy of the Faculty of Medicine of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2018年第4期6卷 47-54页

作者： Abdoulaye Kante youssouf sidibe Babou Ba Brehima Bengaly Brehima Coulibaly Drissa Traore Drissa Ouattara Mariam Daou Tata Toure Siaka Diakite Moumouna Kone Siaka Diallo Cheickh Tidiane Diallo Ousmane Ibrahim Toure Birama Togola Nouhoum Ongoiba Service of Surgery B CHU Point GBamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU Mother-Child“Luxembourg”BamakoMali Service of Neurology CHU Gabriel ToureBamakMali

Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.

关键词： External Laryngeal Nerve Superior Thyroid Artery Anatomy Thyroid Gland Surgery

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Unusual Head Trauma: About Three Observations at the Chu Pr Bocar Sidy Sall (BSS) of Kati

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Open Journal of Medical Imaging 2023年第3期13卷 57-62页

作者： Coulibaly Salia Ilias Guindo Traore Ousmane Diarra Issa Traore youssouf Sanogo Souleymane Diarra Ouncoumba Diarra Hawa sidibe Siaka Medical Imaging Department Pr BSS University Hospital of Kati Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Traumatology Neurosurgery Unit Pr BSS University Hospital of Kati Mali

Introduction: Penetrating head injuries are often due to human-to-human violence, mainly by firearms, those by stab are rare. CT is the exam of choice in the assessment of emergency lesions. We report three observations, all victims of knife assault during the brawl in order to clarify the contribution of DTM in the care. Observations: 1) Mr. I S, 21-year-old, student, was admitted with the hillside implanted in the skull. There were traces of blood on his face and clothes. There was no neurological deficit on examination. The CT scan performed showed the knife penetrating the vault of the skull at the left parietal level, up to 5 cm in the cerebral parenchyma with a minimal subdural and intracerebral hematoma;2) Mr. S C, 43-year-old, farmer, admitted with a large left fronto-temporo-parietal wound, bleeding and right hemiplegia. The CT scan performed showed a frontal linear fracture (with fronto-ethmoid hemosinus) and left temporoparietal with a parietal intraparenchymal hematoma and homolateral frontoparietal subdural hematoma;3) Mr. S B: 40 years old, driver, admitted with a parietal wound. The CT scan performed objectified a left parietal cortical hematoma in relation to a metallic foreign body (3000 HU) corresponding to the distal end of the knife penetrating the vault of the skull. They all underwent emergency surgery and received antibiotics and preventive serotherapy. The postoperative follow-up was simple, the follow-ups are without neurological sequelae. Conclusion: Head trauma by knife is rare, it results from inter-human violence. The lesion diagnosis is computed tomography. The prognosis depends on the severity.

关键词： Head Trauma Stabbing CT CHU Kati

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Left Pyelic Bifidity and Ectopic Ureteral Superolateral Intravesical Homolateral Ectopic Junction Revealed by a Urinary Calculus Apropos of a Case at the Pasteur Clinic

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Open Journal of Medical Imaging 2022年第3期12卷 123-130页

作者： Abdoulaye Kone Oucoumba Diarra Mamoudou Camara youssouf Kone Abba Ata Omar Moussa Traore Ibrahima Coulibaly Moussa Konate Kassim sidibe Toumin Camara youssouf Diawara Cheick Oumar Toure Abdoulaye Mody Camara Salia Coulibaly Mahamadou Diallo Adama Diaman Keita Aboubacar S. Ndiaye Siaka sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Mother Child Hospital Luxembourg Bamako Mali FSTS Gamal Abdel NasserConakry Guinea Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France France Medical Imaging Department of the Pasteur Polyclinic Bamko Mali DCSSA Bamako Mali General Medicine Department of the Siguiri Prefectural Hospital Siguiri Guinea Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of KATI Hospital Bamako Mali Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali

Introduction: Malformations of the excretory tract are abnormalities due to a disorder of embryogenesis. According to some authors, their frequency varies from 0.30 to 5.25 per 1000. The aim of this study was to highlight the CT uroscan aspect of pyelic bifidity with intravesical ureteral ectopic junction revealed by a urinary calculus and to explain the interest of CT uroscan in the management of urinary pathologies. Result: We report the observation of a 37-year-old overweight patient with a body mass index equal to 28, a history of surgery and extracorporeal litho-thipsis dating back 10 years. He was referred to the Imaging Department in the context of renal colic. The uroscanner made it possible to highlight a left pyelic bifidity associated with an ectopic abutment of the left ureter on the superolateral wall of the bladder, a calculation in the left ectopic ureteral meatus measured at 4 mm in axial diameter. He noted upstream of these lesions, a uretero-pyelo-calicielle dilation on double homolateral pyelon. On late cuts, a slight delay in left renal excretion was noted. The right kidney was also the site of a hyperdense calculation of 1257 HU density and measured 4 mm in transverse diameter with a non-obstructive appearance. Due to a lack of means, our patient was subjected to oral medication, hygiene and dietary rules and rigorous monitoring. Conclusion: At the end of this study, the uroscanner is presented as the reference examination to better explore urinary pathologies. At the same time, it makes it possible to carry out a study of the organs surrounding the urinary tract. Always think about the association of several urinary pathologies each time you see a patient for renal colic.

关键词： Bifidity Pyelic Uroscanner Ectopia Lithiasis

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Epidemiological, Clinical and Radiological Study of Patients Operated on for Spondylolisthesis in the Neurosurgery Department of CH “the Luxembourg” in Bamako

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Open Journal of Medical Imaging 2022年第3期12卷 109-122页

作者： Abdoulaye Kone Moussa Traore Mamoudou Camara youssouf Kone Moussavou-Imounga Jacqueline Ouncoumba Diarra Mamadou Diarra youssouf Diawara Oumar Abba Ata Ibrahima Coulibaly Moussa Konate Kassim sidibe Toumin Camara Cheick Oumar Touré Abdoulaye Mody Camara Salia Coulibaly Mahamadou Diallo Adama Diaman Keita Siaka Sidibé Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Medical Imaging Department of the Pasteur Polyclinic Bamako Mali Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Medical Imaging Service Mother Child Hospital Luxembourg Bamako Mali Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinee Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Neurosurgery Department of the Mère-enfant le Luxembourg Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali DCSSA Bamako Mali Internal Medicine Department of the Prefectural Hospital of Siguiri Siguiri Guinea Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of KATI Hospital Kati Mali

Introduction: Spondylolisthesis is defined as a permanent anterior sliding of the vertebral body accompanied by the pedicles, the transverse processes and the posterior joints in relation to the underlying vertebra. The prevalence of spondylolisthesis varies between 4% and 9%, according to different authors in France, China and Japan. In Africa, some African authors find a spondylolisthesis rate of 9.93%. The objective of this study was to study the clinical and radiological aspects of spondylolisthesis at the Mother-Child Hospital of Bamako. Methods: Prospective and retrospective descriptive study carried out in the neurosurgery department of CH Mother-Child Luxembourg in Bamako from 2010 to 2018. Result: We collected 42 patients operated on for spondylolisthesis out of 145 patients, i.e., 29% of the department’s activities. The average age of our patients was 51 years old, with extremes of 20 and 75 years old. The sex ratio was 0.81 in favor of women. 61.9% of our patients performed work requiring physical strength. Neurogenic claudication was the predominant clinical sign with 88.1% of cases. CT was the most common way of exploration in 57.1% of cases and CT myelo in 47.6% of cases. Disc herniation was associated with spondylolisthesis in 23% of cases. Spondylolisthesis was grade 1 in 59.6% of cases and was responsible for mixed stenosis in 73.82% of cases. All our patients underwent laminectomy. The evolution at 6 months postoperative was favorable in 64.3% of cases. Conclusion: The diagnosis of spondylolisthesis is radiological and makes it possible to define the type of lesion according to its etiology and its severity, but also to highlight the conflicts with the nervous system which will have to be cured. Field and household work, pregnancy, carrying loads or children on the back could be incriminated.

关键词： Spondylolisthesis Radiology Operated

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Reliability of Medical Imaging in the Pre-Therapeutic Assessment of Acute Intestinal Obstruction at the Centre Hospitalier Universitaire Du Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 147-156页

作者： Abdoulaye Koné Mahamadou Daou youssouf Koné Moussa Traoré Moussa Konaté Ouncoumba Diarra Ibrahima Coulibaly youssouf Diawara Amadou Doumbia Cheick Oumar Touré Kassim Sidibé Mody A. Camara Oumar Aba Ata Mahamadou Diallo Adama Diaman Keita Salia Coulibaly Zimogo Zié Sanogo Siaka sidibe Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali DCSSA Kati Mali Medical Imaging Department of Mali Hospital Bamako Mali Medical Imaging Department of Kati Hospital Bamako Mali Department of General Surgery of Point G University Hospital Bamako Mali

Introduction: Acute intestinal obstruction is a serious pathology, a surgical emergency for which medical imaging plays an important role in the management. We initiated this work in order to study the contribution of imaging in the diagnosis of acute intestinal obstruction at the Point-G University Hospital. Patients and Methods: This was a prospective, descriptive and analytical study of 96 patients collected at the radiology and medical imaging department of CHU Point-G from January 2018 to January 2019. Results: The age of our patients varied from 11 to 86 years, with an average of 36 years old. There was a male predominance of 64.6% against 35.4% for women, i.e., a sex ratio of 1.82. Previous surgery was found in 61.5% of our patients. The pain was present in all patients. An unprepared abdominal X-ray was performed in 89.6% of patients. Hydroaerobic levels were found in 96.5% of patients. Abdominopelvic CT scans were performed on 12 patients, all of whom were diagnosed with occlusion. These positive diagnostic findings were consistent with intraoperative findings in 92% of cases. The causes were dominated by bridges in 46 patients and tumors in 9 patients. Signs of severity on CT were dominated by signs of distress of the upstream bile ducts in 8.3%. Exactly 8% of our patients spontaneously resumed transit, 91% received surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients (83.3%) and poor with death in 16 patients (16.7%). Conclusion: Acute intestinal obstruction remains a serious pathology for which the X-ray of the PSA is often the only radiological examination performed in an emergency. However, abdominopelvic CT seems to us to be widely indicated thanks to its contribution both to the positive diagnosis and to the diagnosis of severity and etiology. However, this imaging technique is widely underused in our practice because of its high cost and lack of availability.

关键词： Medical Imaging Acute Intestinal Obstruction Abdominal CT Reliability

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Valorisation of Auriferous Indices: Case of the Siribaya Deposit, Western Mali

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Open Journal of Geology 2021年第10期11卷 457-470页

作者： Fodé Tounkara Jianguo Chen Mory sidibe Oumar Soumare Adama youssouf Koné Université de Ségou Ségou Mali State Key Laboratory of Geological Processes and Mineral Resources China University of Geosciences Wuhan China Ecole Nationale d’Ingènieurs Abderhamane Baba Touré Bamako Mali Laboratoire de Cartographie Département de Géologie Faculté des Sciences et Techniques (FST) Université des Sciences des Techniques et des Technologiques de Bamako (USTTB) Bamako Mali

The purpose of this paper is to understand the valorization of gold showings in the Seribaya deposit, western Mali. Samples taken from Air Core (AC) boreholes were subjected respectively to the magnetic susceptibility test and the X-ray fluorescence analysis. These results lead to the development of a simple methodology, based on signatures/indicators geochemical to identify lithology or to locate mineralization. We note that, compared to other chemical elements, Arsenic remains the most correlated with gold in the study area. Since this correlation remains weak (r = 0.16), it shows that Arsenic does not always accompany gold. There would be a generation of Arsenic related to mineralization, and other generations that would not be. The observation of the strip logs led to the identification of the lithologies (focusing on the immobile elements, Ti, V, Cr, Y, Zr) and the establishment of the alteration profile. Highly altered levels (Saprolite ± Saprock) are characterized by the disappearance of most mobile elements. A medium to strong correlation between gold mineralization and magnetic susceptibility measurements has been observed, in some places, and at depths. These mineralized intervals typically consist of quartz veins, suggesting that they have structural control over the mineralization. Gold mineralization is believed to be related to quartz veins. In addition, gold would be in paragenesis with a generation of Arsenic hosted in coarse sediments.

关键词： Valorization Gold Index Strip Logs Magnetic Susceptibility

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