Review of 6 Years of Middle Ear Surgery in the ENT-Laryngology Department of the Donka National Hospital and a Literature Review

Introduction: Middle ear surgery is increasingly performed in our department. Our goal was to take stock of this activity in the ENT department of the Donka National Hospital. Equipment and Methods: It was a descriptive and retrospective study;it involved 71 patients’ records operated from January 1, 2018 to December 31, 2023. We included the files of patients who had a middle ear surgery including the post-operative report and follow-up. Incomplete or illegible records were excluded. The parameters studied were epidemiological, otoscopic, tomodensitometric, surgical indications, surgical techniques and results. Results: We recorded 71 middle ear surgeries out of 548 ENT surgeries, the prevalence was 12.96%. The average age was 23 years (type-deviation = 17, 29 years) with extremes of 3 to 75 years. According to the preoperative audiometry, the deafness was medium (48.8%), mild (36.9%) and severe (14.3%). The operative indications were among others: perforation of the tympanic sequellar (52.5%), chronic otomastoiditis (23.8%), cholesteatoma (15%) and seromuqueous otitis (8.7%). We performed 70 tympanoplasties (90.9%), 50 mastoidectomies (64.9%) and 7 trans-tympanic aerators (9.1%). One month after surgery, the neotympanum was constituted in 86%, and the hearing gain was between 11 and 15 dB in 18.3% of cases. Conclusion: Middle ear surgery was infrequent. Young subjects are the most concerned. Tympanoplasty and mastoidectomy are the main surgical techniques. The anatomical and functional results are appreciable.

Thyroid Disease at the University Hospital of Conakry, Guinea

Objectives: To describe the epidemiological, clinical and therapeutic characteristics of thyroid disease at the University Hospital of Conakry, Guinea. Methods: This was a descriptive study with prospective data collection, carried out over the period of December 2016 to April 2019 at the endocrinology outpatient consultation at the University Hospital of Conakry. All the epidemiological, clinical and therapeutic data of the patients followed-up for thyroid disease were collected, analyzed and classified according to the epidemiological, clinical and therapeutic profile. The functional, morphological and autoimmune aspects of the thyroid gland were studied. Results: Out of a total of 3.517 endocrinology consultations during the study period, 204 patients were diagnosed with thyroid disease (180 women and 24 men, F/H ratio: 7.5). The average age was 47 ± 16 years. A total of 90 patients (44.33%) had hyperthyroidism, including 52 cases of Graves-Basedow disease (57.6%) and 24 cases of toxic multi-nodular goiter (32.6%). Hypothyroidism was confirmed in 25 patients (11%);about half (48%) of them had a complete thyroid surgery. The treatment of hyperthyroidism was exclusively done by synthetic antithyroid drugs, except 5 cases of Hashimoto disease with transient initial hyperthyroidism phase. Hypothyroidism was treated by hormone replacement therapy. Thyroidectomy, partial (n = 5) or total (n = 12), was performed for aesthetic discomfort (n = 6), cervical compression (n = 8) and suspicion of thyroid cancer (n = 3). Follow-up was considered regular in 40 cases (44%). Conclusion: Thyroid disease was frequent in this study conducted in Conakry and its clinical features were very diverse, dominated by hyperthyroidism mainly due to Grave disease. However, diagnostic and therapeutic strategies were hindered by the limitation in availability of biological and morphological explorations.