Management of Mandibular Fractures in Children in Ivory Coast: Experience of the Stomatology and Maxillofacial Surgery Department at the University Hospital of Cocody from 2000 to 2019

Introduction: Mandibular fractures in children are becoming increasingly common. Treatment of these fractures is difficult due to their anatomical and physiological complexity. Therefore, there is a need for well-codified management. Our main aim was to develop a decision algorithm for the management of mandibular fractures in children based on our experience. Materials and Methods: This was a retrospective descriptive study carried out in the Department of Stomatology and Maxillofacial Surgery at the University Hospital of Cocody over a period of 20 years (2000-2019). Results: We enrolled 58 patients. The mean age of the patients was 9.35 ± 2.3 years with a sex ratio of 2.22. Traffic accidents were the main cause of mandibular fractures (60.35%). Condylar fractures were the most common (46.87%). Treatment was orthopedic in 45.76% of cases, mixed (orthopedic and surgical) in 24.14% and surgical in 5.17%. Patients were followed up weekly for 1 month, then monthly for 6 months and annually for 3 years, with panoramic radiographs of the maxilla starting at 21 days. We observed 2 cases of complications: temporomandibular ankylosis and gingival stomatitis. Conclusion: Mandibular fractures are common in children. Management is difficult due to anatomical and physiological peculiarities. The choice of treatment depends on several criteria.

Post-Traumatic Palatine Odontogenic Abscess: About 2 Cases

Introduction: Palatal abscess or cellulitis of dental origin is a rare clinical form of circumscribed cellulitis that can sometimes pose a diagnostic problem. It is the consequence of poor or non-treatment of dental caries or trauma. The aim of this study is to describe the clinical and therapeutic aspects of these two cases of palatal cellulitis of post-traumatic dental origin. Observation: The patients consulted for painful palatal swelling secondary to untreated dental trauma of the 21s. The diagnosis of palatal cellulitis was based on the inflammatory and fluctuating nature of the swelling. A probabilistic bi-antibiotic treatment and an incision and drainage associated with treatment of the portal of entry were carried out. Progression was favourable in both cases. Conclusion: Palatal cellulitis is a rare condition and can be prevented by systematic stomatological consultation after dental trauma. Diagnosis is clinical. However, CT scans are sometimes useful. The course is generally favorable with appropriate treatment.

Primary Cutaneous Leiomyosarcoma of the Face: A Rare Tumor that Is Difficult to Diagnose

Leiomyosarcoma is a rare malignant tumour of the lower limbs. Its differential histological diagnosis is difficult and is made in the presence of young scar tissue, leimyoma, dermatofibroma, melanoma, rabdomyosarcoma, sarcomatoid carcinoma, fibroxantoma, Darrier Ferrand dermatofibrosarcoma and myofibroblastic tumours. Treatment is essentially surgical, with margins of 3 to 5 centimetres. We report two observations of tumours localised to the face, including one case of a known leiomyosarcoma and another case initially diagnosed as a leiomyosarcoma which turned out to be a cellular myofibroma with no sign of malignancy after several readings. The aim of this work is to review the literature on this pathology while highlighting the diagnostic and therapeutic difficulties. Conclusion: A rare smooth muscle tumour with a high risk of local recurrence in the event of incomplete treatment, leiomyosarcoma in its dermal component is preferentially located in the head and neck. Its treatment is exclusively surgical and highly mutilating.

Study of Mortality and Causes of Death in the Service of Stomatology, Maxillofacial and Plastic Surgery of the Face at Cocody Teaching Hospital (RCI)

Introduction: The study of mortality is an indicator that allows a control and a review of the therapeutic measures in the hospital environment. The purpose of this work was to determine the epidemiological profile of the patients who died and analyse the circumstances of the death in a hospital service. Material and Methods: It is a retrospective descriptive study conducted in the service of Stomatology, maxillofacial and plastic surgery of the face over a period of 10 years (from January 1999 to December 2008). Seventy-two cases have been taken into account. Results: The crude death rate was 4.29%. Higher level of male has been noted with a sex ratio of 1.77. The most affected age groups were the 3rd and 2nd decades, respectively with 20.8% and 19.4% with an average age of 39 years. Cellulitis of the face and their complications were responsible for deaths in 58.33% of cases. The majority of deaths occurred between 6 p.m. and 6 a.m. (65.28%). These deaths were preventable in 5.6% of cases. Conclusion: Facing the lack of description of the ultimate circumstances of death in the medical records, the conclusion of this study has been the establishment of a regular medical audit in the service, which would track mortality in order to reduce its rate.