Epidemiological, Clinical and Therapeutic Profiles of Ophthalmological Complications of Rhino-Sinusitis in a Tertiary Facility in Black Africa

Introduction: Rhinosinusitis is one of the most common ENT diseases. Its main complications are of three types: cranial, endo-cranial and ophthalmological. The aim of this study was to contribute to the study of ophthalmological complications of rhino-sinusitis in our context. Material and Methods: This was a prospective study, of descriptive type, of six (6) months (July-December 2017), concerning the patients received and treated for ophthalmological complications of rhino-sinusitis at the National IgnaceDeen Hospital. Results: During our study period, we collected 32 ophthalmological complications of rhinosinusitis, i.e. 65.31% of cases. The average age of our patients was 34.25 ± 15.15 years with extremes of 8 and 76 years and a sex ratio of 0.45. A history of rhinitis and/or rhino-sinusitis was reported in all our patients. Housewives were the most affected socio-professional group, accounting for 34.37% of cases. The average consultation time was 20 ± 52 days. Tearing, palpebral oedema and purulent rhinorrhea were present in all our patients. Preseptal cellulitis and abscess were the most common complications, accounting for 56.25% and 28.12% of cases respectively. The treatment was medical-surgical. Drainage of a subperiosteal abscess of the ethmoid involved 53.12% of cases. Surgical treatment of the maxillary sinus and/or ethmoid by endoscopy was sometimes associated. The evolution was favourable in all cases. Conclusion: Ophthalmological complications of rhino-sinusitis are still frequent in our developing countries. Their management must be multidisciplinary.

Assessment of the Management of Post-Tonsillectomy Pain at the ENT-CFS Department of Ignace Deen National Hospital

Introduction: Tonsillectomy is described as one of the oldest surgical procedures according to the authors of the surgical treatise (Aulus Amida and Paul of Aegina in the 6th and 7th centuries) found in the Vatican library. The contraindication of codeine in children has changed the management of post tonsillectomy pain. The aim of this study was to assess the management of post tonsillectomy pain in our developing country context. Methods: This was a prospective, analytical study lasting 6 months (September 2019-February 2020), carried out in the ENT/CFS department of the Ignace Deen National Hospital. We included in this study all patients who underwent a tonsillectomy in the department during the study period and who agreed to participate in the survey. Results: 34 patients were included in our study, i.e. a frequency of 25% of surgical interventions. The mean age of our patients was 18.06 ± 12 years with extremes of 03 years and 45 years. Recurrent hypertrophic tonsillitis with sleep disturbances was the most frequent indication for surgery in our study, at 47.06% (n = 16). We performed an isolated tonsillectomy in 52.9% (n = 18) of cases. Analgesia was multimodal using the WHO Step I and II analgesics in 44.1% (n = 15) and 55.9% (n = 19), respectively. Pain control was satisfactory in all patients. Conclusion: The evaluation of post tonsillectomy pain is essential for optimal management. In this indication, multimodal analgesia, involving several levels I and II analgesics, provided satisfactory pain control.